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To amend title XIX of the Social Security Act to expand the application of Medicaid State programs to monitor antipsychotic medications to all Medicaid beneficiaries.

H.R. 4096 · 118th Congress · Jun 14, 2023 · Lineage

A BILL

Section 1 Expanding application of Medicaid State programs to monitor antipsychotic medications to all Medicaid beneficiaries

Section 1902(oo) of the Social Security Act (42 U.S.C. 1396a(oo)) is amended—
(1)
in paragraph (1)(B)—
(A)
in the subparagraph header, by striking “by children”;
(B)
by inserting “, and, beginning January 1, 2024, by individuals (regardless of age) enrolled,” after “children enrolled”; and
(C)
by striking “for individuals not more than the age of 18 years generally and children in foster care specifically” and inserting “, including for individuals not more than the age of 18 years generally, children in foster care specifically, and, beginning January 1, 2024, individuals over the age of 65, individuals receiving home and community-based services (as defined in section 9817(a)(2) of Public Law 117–2), and individuals residing in institutional care settings, including nursing facilities and intermediate care facilities for individuals with intellectual disabilities”; and
(2)
in paragraph (3)—
(A)
in subparagraph (A)(ii), by striking “is a resident” and inserting “subject to subparagraph (C), is a resident”; and
(B)
by adding at the end the following new subparagraph:

“(C) Application in case of program to monitor antipsychotic medications—Subparagraph (A)(ii) shall not apply to the drug review and utilization requirement described in subparagraph (1)(B) with respect to an individual 18 years of age or older.”