I 

115TH CONGRESS 

2D SESSION H. R. 5725 

To direct the Secretary of Health and Human Services to submit to Congress 

a report on the extent to which Medicare Advantage plans offered under 

part C of the Medicare program include supplemental health care benefits 

designed to treat or prevent substance use disorders. 

IN THE HOUSE OF REPRESENTATIVES 

MAY 9, 2018 

Mr. ROSKAM (for himself, Ms. SA ́NCHEZ, Mr. SHIMKUS, and Mr. RUIZ) introduced the following bill; which was referred to the Committee on Ways 

and Means, and in addition to the Committee on Energy and Commerce, 

for a period to be subsequently determined by the Speaker, in each case 

for consideration of such provisions as fall within the jurisdiction of the 

committee concerned 

A BILL 

To direct the Secretary of Health and Human Services to 

submit to Congress a report on the extent to which 

Medicare Advantage plans offered under part C of the 

Medicare program include supplemental health care benefits designed to treat or prevent substance use disorders. 

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


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1 SECTION 1. SHORT TITLE. 

2 This Act may be cited as the ‘‘Benefit Evaluation of 

3 Safe Treatment Act of 2018’’ or the ‘‘BEST Act of 

4 2018’’. 

5 SEC. 2. STUDYING THE AVAILABILITY OF SUPPLEMENTAL 

6 BENEFITS DESIGNED TO TREAT OR PREVENT 

7 SUBSTANCE USE DISORDERS UNDER MEDI8 CARE ADVANTAGE PLANS. 

9 (a) IN GENERAL.—Not later than 2 years after the 

10 date of the enactment of this Act, the Secretary of Health 

11 and Human Services (in this section referred to as the 

12 ‘‘Secretary’’) shall submit to Congress a report on the 

13 availability of supplemental health care benefits (as de14 scribed in section 1852(a)(3)(A) of the Social Security Act 

15 (42 U.S.C. 1395w–22(a)(3)(A))) designed to treat or pre16 vent substance use disorders under Medicare Advantage 

17 plans offered under part C of title XVIII of such Act. Such 

18 report shall include the analysis described in subsection 

19 (c) and any differences in the availability of such benefits 

20 under specialized MA plans for special needs individuals 

21 (as defined in section 1859(b)(6) of such Act (42 U.S.C. 

22 1395w–28(b)(6))) offered to individuals entitled to med23 ical assistance under title XIX of such Act and other such 

24 Medicare Advantage plans. 


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1 (b) CONSULTATION.—The Secretary shall develop the 

2 report described in subsection (a) in consultation with rel3 evant stakeholders, including— 

4 (1) individuals entitled to benefits under part A 

5 or enrolled under part B of title XVIII of the Social 

6 Security Act; 

7 (2) entities who advocate on behalf of such indi8 viduals; 

9 (3) Medicare Advantage organizations; 

10 (4) pharmacy benefit managers; and 

11 (5) providers of services and suppliers (as such 

12 terms are defined in section 1861 of such Act (42 

13 U.S.C. 1395x)). 

14 (c) CONTENTS.—The report described in subsection 

15 (a) shall include an analysis on the following: 

16 (1) The extent to which plans described in such 

17 subsection offer supplemental health care benefits 

18 relating to coverage of— 

19 (A) medication-assisted treatments for 

20 opioid use, substance use disorder counseling, 

21 peer recovery support services, or other forms 

22 of substance use disorder treatments (whether 

23 furnished in an inpatient or outpatient setting); 

24 and 


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•HR 5725 IH

1 (B) non-opioid alternatives for the treat2 ment of pain. 

3 (2) Challenges associated with such plans offer4 ing supplemental health care benefits relating to cov5 erage of items and services described in subpara6 graph (A) or (B) of paragraph (1). 

7 (3) The impact, if any, increasing the applicable 

8 rebate percentage determined under section 

9 1854(b)(1)(C) of the Social Security Act (42 U.S.C. 

10 1395w–24(b)(1)(C)) for plans offering such benefits 

11 relating to such coverage would have on the avail12 ability of such benefits relating to such coverage of13 fered under Medicare Advantage plans. 

14 (4) Potential ways to improve upon such cov15 erage or to incentivize such plans to offer additional 

16 supplemental health care benefits relating to such 

17 coverage. 

Æ 


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