Section 1 Short title
This Act may be cited as the “Securing Advances and a Variety of Evidence-Based IMD Options Act”.
Securing Advances and a Variety of Evidence-Based IMD Options Act
A BILL
To amend title XIX of the Social Security Act to make permanent the Medicaid option to remove the IMD exclusion to provide medical assistance for certain individuals who are patients in an institution for mental diseases.
Sec. 2 Making permanent State Plan Amendment Option To Provide Medical Assistance for Certain Individuals Who Are Patients in Certain Institutions for Mental Diseases
In general— Section 1915(l)(1) of the Social Security Act (42 U.S.C. 1396n(l)(1)) is amended by striking “With respect to calendar quarters beginning during the period beginning October 1, 2019, and ending September 30, 2023,” and inserting “With respect to calendar quarters beginning on or after October 1, 2019,”.
Maintenance of effort revision— Section 1915(l)(3)(A) of the Social Security Act (42 U.S.C. 1396n(l)(3)(A)) is amended—
in the matter preceding clause (i), by striking “other than under this title”; and
in clause (i), by striking “or, if higher,” and all that follows through “in accordance with this subsection”.
Additional requirements—
In general—
General requirements— Section 1915(l)(4) of the Social Security Act (42 U.S.C. 1396n(l)(4)) is amended—
in subparagraph (A), by striking “through (D)” and inserting “through (F)”;
in subparagraph (C), by adding at the end the following new clause:
“(iii) Medication-assisted treatment—The State shall, when appropriate, facilitate access to, and provide medical assistance for, medication-assisted treatment for substance use disorder treatment, irrespective of the setting in which such treatment is provided.”
in subparagraph (D), in the matter preceding clause (i), by inserting “have in place evidence-based, substance use disorder-specific individual placement criteria and utilization management approach to ensure placement of such individual in an appropriate level of care and shall” after “State shall”; and
by adding at the end the following new subparagraph:
“(E) Review process—The State shall have in place a process to review the compliance of eligible institutions for mental diseases with evidence-based, substance use disorder-specific program standards of care for eligible individuals specified by the State.”
Effective date— The amendments made by subparagraph (A) shall apply with respect to medical assistance furnished in calendar quarters beginning on or after October 1, 2025.
One-time assessment— Section 1915(l)(4) of the Social Security Act (42 U.S.C. 1396n(l)(4)), as amended by paragraph (1), is further amended by adding at the end the following new subparagraph:
“(F) Assessment—The State shall, not later than 12 months after the approval of a State plan amendment described in this subsection (or, in the case such State has such an amendment approved as of the date of the enactment of this subparagraph, not later than 12 months after such date), commence an assessment of—
“(i) the availability of treatment for individuals enrolled under a State plan under this title (or waiver of such plan) in each level of care described in subparagraph (C); and
“(ii) the availability of medication-assisted treatment and medically supervised withdrawal management services for such individuals.”
Clarification of levels of care— Section 1915(l)(7)(A) of the Social Security Act (42 U.S.C. 1396n(l)(7)(A)) is amended by inserting “(or any successor publication)” before the period.