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H.R. 5810 — what changed

Medicaid Health Homes for Opioid-Use-Disorder Medicaid Enrollees Encouraged Act

From Introduced in House to Reported in House. 1 added between Introduced in House and Reported in House.

Sec. 3 Requirement for State Medicaid plans to provide coverage for medication-assisted treatment

added
(a)
added Requirement for State Medicaid plans to provide coverage for medication-assisted treatment— Section 1902(a)(10)(A) of the Social Security Act (42 U.S.C. 1396a(a)(10)(A)) is amended, in the matter preceding clause (i), by striking “and (28)” and inserting “(28), and (29)”.
(b)
added Inclusion of medication-assisted treatment as medical assistance— Section 1905(a) of the Social Security Act (42 U.S.C. 1396d(a)) is amended—
(1)
added in paragraph (28), by striking “and” at the end;
(2)
added by redesignating paragraph (29) as paragraph (30); and
(3)
added by inserting after paragraph (28) the following new paragraph:

added “(29) subject to paragraph (2) of subsection (ee), for the period beginning October 1, 2020, and ending September 30, 2025, medication-assisted treatment (as defined in paragraph (1) of such subsection); and”

(c)
added Medication-assisted treatment defined; Waivers— Section 1905 of the Social Security Act (42 U.S.C. 1396d) is amended by adding at the end the following new subsection:

added “(ee) Medication-assisted treatment

added “(1) Definition—For purposes of subsection (a)(29), the term “medication-assisted treatment”—

added “(A) means all drugs approved under section 505 of the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 355), including methadone, and all biological products licensed under section 351 of the Public Health Service Act (42 U.S.C. 262) to treat opioid use disorders; and

added “(B) includes, with respect to the provision of such drugs and biological products, counseling services and behavioral therapy.

added “(2) Exception—The provisions of paragraph (29) of subsection (a) shall not apply with respect to a State for the period specified in such paragraph, if before the beginning of such period the State certifies to the satisfaction of the Secretary that implementing such provisions statewide for all individuals eligible to enroll in the State plan (or waiver of the State plan) would not be feasible by reason of a shortage of qualified providers of medication-assisted treatment, or facilities providing such treatment, that will contract with the State or a managed care entity with which the State has a contract under section 1903(m) or under section 1905(t)(3).”

(d)
added Effective date—
(1)
added In general— Subject to paragraph (2), the amendments made by this section shall apply with respect to medical assistance provided on or after October 1, 2020, and before October 1, 2025.
(2)
added Exception for State legislation— In the case of a State plan under title XIX of the Social Security Act (42 U.S.C. 1396 et seq.) that the Secretary of Health and Human Services determines requires State legislation in order for the respective plan to meet any requirement imposed by the amendments made by this section, the respective plan shall not be regarded as failing to comply with the requirements of such title solely on the basis of its failure to meet such an additional requirement before the first day of the first calendar quarter beginning after the close of the first regular session of the State legislature that begins after the date of the enactment of this Act. For purposes of the previous sentence, in the case of a State that has a 2-year legislative session, each year of the session shall be considered to be a separate regular session of the State legislature.