I 

114TH CONGRESS 

1ST SESSION H. R. 1988 

To provide for the waiver of the Medicaid IMD limitation in order to permit 

Medicaid coverage for substance use disorder treatment services furnished 

to certain individuals in a community-based institution for mental diseases. 

IN THE HOUSE OF REPRESENTATIVES 

APRIL 23, 2015 

Ms. FUDGE (for herself, Mr. RYAN of Ohio, and Ms. KAPTUR) introduced the 

following bill; which was referred to the Committee on Energy and Commerce 

A BILL 

To provide for the waiver of the Medicaid IMD limitation 

in order to permit Medicaid coverage for substance use 

disorder treatment services furnished to certain individuals in a community-based 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 ‘‘Breaking Addiction 

5 Act of 2015’’. 


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1 SEC. 2. MEDICAID WAIVER FOR COMMUNITY-BASED INPA2 TIENT SUBSTANCE USE DISORDER TREAT3 MENT. 

4 (a) IN GENERAL.—The Secretary of Health and 

5 Human Services shall provide, under the authority of sec6 tion 1115(a) of the Social Security Act (42 U.S.C. 

7 1315(a)) and in accordance with the procedures for waiv8 ers sunder such section and upon application of a State, 

9 for the waiver of the IMD limitation (as defined in sub10 section (c)(2)) in order to permit the provision of medical 

11 assistance under title XIX of such Act for treatment of 

12 a substance use condition for a qualified individual in a 

13 community-based institution for mental diseases. To the 

14 maximum extent practicable, such a waiver shall be grant15 ed to each State that applies and qualifies for such a waiv16 er. 

17 (b) REPORT TO CONGRESS.—Not later than 4 years 

18 after the date waivers are first implemented under sub19 section (a) and taking into account the evaluations con20 ducted in connection with such waivers, the Secretary shall 

21 submit to Congress and make available to the public a re22 port on such waivers. The report shall include— 

23 (1) the findings of such evaluations; and 

24 (2) recommendations regarding expanding and 

25 making permanent the waiver of the IMD limitation 

26 to permit all States to provide the medical assistance 


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1 described in subsection (a) to all qualified individ2 uals. 

3 (c) DEFINITIONS.—In this section: 

4 (1) COMMUNITY-BASED INSTITUTION FOR MEN5 TAL DISEASES.—The term ‘‘community-based insti6 tution for mental diseases’’ means an institution for 

7 mental diseases (as defined in section 1905(i) of the 

8 Social Security Act (42 U.S.C. 1396d(i)) that has 

9 not more than 60 beds. 

10 (2) IMD LIMITATION.—The term ‘‘IMD limita11 tion’’ means the limitation under the subdivision (B) 

12 following paragraph (29) of section 1905(a) of the 

13 Social Security Act (42 U.S.C. 1396d(a)) on medical 

14 assistance furnished to certain patients in an institu15 tion for mental diseases. 

16 (3) QUALIFIED INDIVIDUAL.—The term ‘‘quali17 fied individual’’ means an individual who, because of 

18 the individual’s substance use condition, requires 

19 substance use disorder treatment and who, but for 

20 the IMD limitation, would be eligible for medical as21 sistance under title XIX of the Social Security Act 

22 (42 U.S.C. 1396 et seq.) for substance use disorder 

23 treatment services furnished in a community-based 

24 institution for mental diseases. 


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1 (4) STATE.—The term ‘‘State’’ has the mean2 ing given such term for purposes of title XIX of the 

3 Social Security Act. 

Æ 


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