I 

116TH CONGRESS 

1ST SESSION H. R. 5232 

To amend titles XIX and XXI of the Social Security Act to remove barriers 

to access to residential substance use disorder treatment services under 

Medicaid and the Children’s Health Insurance Program (CHIP). 

IN THE HOUSE OF REPRESENTATIVES 

NOVEMBER 21, 2019 

Mr. FITZPATRICK (for himself, Ms. KUSTER of New Hampshire, and Mrs. 

MURPHY of Florida) introduced the following bill; which was referred to 

the Committee on Energy and Commerce 

A BILL 

To amend titles XIX and XXI of the Social Security Act 

to remove barriers to access to residential substance use 

disorder treatment services under Medicaid and the Children’s Health Insurance Program (CHIP). 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Road to Recovery 

5 Act’’. 


kjohnson on DSK79L0C42 with BILLS
2 

•HR 5232 IH

1 SEC. 2. REMOVING BARRIERS TO ACCESS TO RESIDENTIAL 

2 SUBSTANCE USE DISORDER TREATMENT 

3 SERVICES UNDER MEDICAID AND CHIP. 

4 (a) MEDICAID.—Section 1905 of the Social Security 

5 Act (42 U.S.C. 1396d) is amended— 

6 (1) in subsection (a)— 

7 (A) by striking ‘‘and’’ at the end of para8 graph (28); 

9 (B) by redesignating paragraph (29) as 

10 paragraph (30); and 

11 (C) by inserting after paragraph (28) the 

12 following new paragraph: 

13 ‘‘(29) residential substance use disorder treat14 ment services (as defined in subsection (h)(3)(A));’’; 

15 (2) in the subparagraph (B) following para16 graph (30), as so redesignated, by inserting after 

17 ‘‘an institution for mental diseases’’ the following: 

18 ‘‘(other than with respect to residential substance 

19 use disorder treatment services, as defined in sub20 section (h)(3)(A))’’; and 

21 (3) in subsection (h), by adding at the end the 

22 following new paragraph: 

23 ‘‘(3)(A) For purposes of subsection (a) and section 

24 2110(b)(2)(A), the term ‘residential substance use dis25 order treatment services’ means, with respect to an indi26 vidual, inpatient services in a residential substance use 


kjohnson on DSK79L0C42 with BILLS
3 

•HR 5232 IH

1 disorder treatment facility (as defined in subparagraph 

2 (B)) if— 

3 ‘‘(i) the individual is under 65 years of age; and 

4 ‘‘(ii) the individual’s continued need for such 

5 services is reviewed and reaffirmed periodically (on 

6 a frequency, specified by the State that is not less 

7 often than every 60 days) based on criteria approved 

8 by the Secretary or established or endorsed by the 

9 State’s single State agency identified in section 

10 1932(b)(1)(A)(ii) of the Public Health Service Act. 

11 ‘‘(B) In this paragraph, the term ‘residential sub12 stance use disorder treatment facility’ means a facility 

13 that— 

14 ‘‘(i) is primarily engaged in furnishing inpatient 

15 services in the treatment of substance use disorders; 

16 and 

17 ‘‘(ii) is accredited as an inpatient nonhospital 

18 facility, inpatient nonhospital detoxification facility, 

19 or residential facility, by a national accrediting orga20 nization recognized by the Secretary for this purpose 

21 and is accredited or licensed by a State accrediting 

22 or licensing agency for substance use disorder treat23 ment.’’. 

24 (b) CHIP.—Section 2110(b)(2)(A) of the Social Se25 curity Act (42 U.S.C. 1397jj(b)(2)(A)) is amended by inVerDate Sep 11 2014 03:09 Dec 04, 2019 Jkt 099200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\H5232.IH H5232

kjohnson on DSK79L0C42 with BILLS
4 

•HR 5232 IH

1 serting after ‘‘an institution for mental diseases’’ the fol2 lowing: ‘‘(other than with respect to residential substance 

3 use disorder treatment services, as defined in section 

4 1905(h)(3)(A))’’. 

5 (c) EFFECTIVE DATE; CONSTRUCTION.— 

6 (1) EFFECTIVE DATE.—The amendments made 

7 by this section shall apply to items and services fur8 nished on or after July 1, 2020. 

9 (2) CONSTRUCTION.—Nothing in this section 

10 shall be construed as affecting the availability of 

11 Federal financial participation for medical assistance 

12 under title XIX of the Social Security Act (or for 

13 child health assistance under title XXI of such Act) 

14 for inpatient services furnished, before the amend15 ments made by this section are implemented, in an 

16 inpatient nonhospital facility, inpatient nonhospital 

17 detoxification facility, or residential facility, that is 

18 primarily engaged in furnishing inpatient services in 

19 the treatment of substance use disorder services. 

Æ 


kjohnson on DSK79L0C42 with BILLS