II 

118TH CONGRESS 

1ST SESSION S. 3098 

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. 

IN THE SENATE OF THE UNITED STATES 

OCTOBER 19, 2023 

Mr. THUNE (for himself, Ms. HASSAN, and Mrs. BLACKBURN) introduced the 

following bill; which was read twice and referred to the Committee on Finance 

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. 

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 ‘‘Securing Advances and 

5 a Variety of Evidence-Based IMD Options Act’’. 


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1 SEC. 2. MAKING PERMANENT STATE PLAN AMENDMENT 

2 OPTION TO PROVIDE MEDICAL ASSISTANCE 

3 FOR CERTAIN INDIVIDUALS WHO ARE PA4 TIENTS IN CERTAIN INSTITUTIONS FOR MEN5 TAL DISEASES. 

6 (a) IN GENERAL.—Section 1915(l)(1) of the Social 

7 Security Act (42 U.S.C. 1396n(l)(1)) is amended by strik8 ing ‘‘With respect to calendar quarters beginning during 

9 the period beginning October 1, 2019, and ending Sep10 tember 30, 2023,’’ and inserting ‘‘With respect to calendar 

11 quarters beginning on or after October 1, 2019,’’. 

12 (b) MAINTENANCE OF EFFORT REVISION.—Section 

13 1915(l)(3)(A) of the Social Security Act (42 U.S.C. 

14 1396n(l)(3)(A)) is amended— 

15 (1) in the matter preceding clause (i), by strik16 ing ‘‘other than under this title’’; and 

17 (2) in clause (i), by striking ‘‘or, if higher,’’ and 

18 all that follows through ‘‘in accordance with this 

19 subsection’’. 

20 (c) ADDITIONAL REQUIREMENTS.— 

21 (1) IN GENERAL.— 

22 (A) GENERAL REQUIREMENTS.—Section 

23 1915(l)(4) of the Social Security Act (42 

24 U.S.C. 1396n(l)(4)) is amended— 


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1 (i) in subparagraph (A), by striking 

2 ‘‘through (D)’’ and inserting ‘‘through 

3 (F)’’; 

4 (ii) in subparagraph (C), by adding at 

5 the end the following new clause: 

6 ‘‘(iii) MEDICATION-ASSISTED TREAT7 MENT.—The State shall, when appropriate, 

8 facilitate access to, and provide medical as9 sistance for, medication-assisted treatment 

10 for substance use disorder treatment, irre11 spective of the setting in which such treat12 ment is provided.’’; 

13 (iii) in subparagraph (D), in the mat14 ter preceding clause (i), by inserting ‘‘have 

15 in place evidence-based, substance use dis16 order-specific individual placement criteria 

17 and utilization management approach to 

18 ensure placement of such individual in an 

19 appropriate level of care and shall’’ after 

20 ‘‘State shall’’; and 

21 (iv) by adding at the end the following 

22 new subparagraph: 

23 ‘‘(E) REVIEW PROCESS.—The State shall 

24 have in place a process to review the compliance 

25 of eligible institutions for mental diseases with 


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1 evidence-based, substance use disorder-specific 

2 program standards of care for eligible individ3 uals specified by the State.’’. 

4 (B) EFFECTIVE DATE.—The amendments 

5 made by subparagraph (A) shall apply with re6 spect to medical assistance furnished in cal7 endar quarters beginning on or after October 1, 

8 2025. 

9 (2) ONE-TIME ASSESSMENT.—Section 

10 1915(l)(4) of the Social Security Act (42 U.S.C. 

11 1396n(l)(4)), as amended by paragraph (1), is fur12 ther amended by adding at the end the following 

13 new subparagraph: 

14 ‘‘(F) ASSESSMENT.—The State shall, not 

15 later than 12 months after the approval of a 

16 State plan amendment described in this sub17 section (or, in the case such State has such an 

18 amendment approved as of the date of the en19 actment of this subparagraph, not later than 12 

20 months after such date), commence an assess21 ment of— 

22 ‘‘(i) the availability of treatment for 

23 individuals enrolled under a State plan 

24 under this title (or waiver of such plan) in 


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1 each level of care described in subpara2 graph (C); and 

3 ‘‘(ii) the availability of medication-as4 sisted treatment and medically supervised 

5 withdrawal management services for such 

6 individuals.’’. 

7 (3) CLARIFICATION OF LEVELS OF CARE.—Sec8 tion 1915(l)(7)(A) of the Social Security Act (42 

9 U.S.C. 1396n(l)(7)(A)) is amended by inserting ‘‘(or 

10 any successor publication)’’ before the period. 

Æ 


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