IB 

Union Calendar No. 552 

115TH CONGRESS 

2D SESSION H. R. 5800 

[Report No. 115–717] 

To require the Medicaid and CHIP Payment and Access Commission to 

conduct an exploratory study and report on requirements applicable to 

and practices of institutions for mental diseases under the Medicaid 

program. 

IN THE HOUSE OF REPRESENTATIVES 

MAY 15, 2018 

Mr. UPTON (for himself and Mrs. MIMI WALTERS of California) introduced 

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

Commerce 

JUNE 8, 2018 

Additional sponsors: Mrs. BLACKBURN and Mr. WALDEN

JUNE 8, 2018 

Committed to the Committee of the Whole House on the State of the Union 

and ordered to be printed 


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•HR 5800 RH

A BILL 

To require the Medicaid and CHIP Payment and Access 

Commission to conduct an exploratory study and report 

on requirements applicable to and practices of institutions for mental diseases under the Medicaid program. 


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•HR 5800 RH

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 ‘‘Medicaid Institutes 

5 for Mental Disease Are Decisive in Delivering Inpatient 

6 Treatment for Individuals but Opportunities for Needed 

7 Access are Limited without Information Needed about Fa8 cility Obligations Act’’ or the ‘‘Medicaid IMD ADDI9 TIONAL INFO Act’’. 

10 SEC. 2. MACPAC EXPLORATORY STUDY AND REPORT ON IN11 STITUTIONS FOR MENTAL DISEASES RE12 QUIREMENTS AND PRACTICES UNDER MED13 ICAID. 

14 (a) IN GENERAL.—Not later than January 1, 2020, 

15 the Medicaid and CHIP Payment and Access Commission 

16 established under section 1900 of the Social Security Act 

17 (42 U.S.C. 1396) shall conduct an exploratory study, 

18 using data from a representative sample of States, and 

19 submit to Congress a report on at least the following infor20 mation, with respect to services furnished to individuals 

21 enrolled under State plans under the Medicaid program 

22 under title XIX of such Act (42 U.S.C. 1396 et seq.) (or 

23 waivers of such plans) who are patients in institutions for 

24 mental diseases and for which payment is made through 


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1 fee-for-service or managed care arrangements under such 

2 State plans (or waivers): 

3 (1) A description of such institutions for mental 

4 diseases in each such State, including at a min5 imum— 

6 (A) the number of such institutions in the 

7 State; 

8 (B) the facility type of such institutions in 

9 the State; and 

10 (C) any coverage limitations under each 

11 such State plan (or waiver) on scope, duration, 

12 or frequency of such services. 

13 (2) With respect to each such institution for 

14 mental diseases in each such State, a description 

15 of— 

16 (A) such services provided at such institu17 tion; 

18 (B) the process, including any timeframe, 

19 used by such institution to clinically assess and 

20 reassess such individuals; and 

21 (C) the discharge process used by such in22 stitution, including any care continuum of rel23 evant services or facilities provided or used in 

24 such process. 

25 (3) A description of— 


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1 (A) any Federal waiver that each such 

2 State has for such institutions and the Federal 

3 statutory authority for such waiver; and 

4 (B) any other Medicaid funding sources 

5 used by each such State for funding such insti6 tutions, such as supplemental payments. 

7 (4) A summary of State requirements (such as 

8 certification, licensure, and accreditation) applied by 

9 each such State to such institutions in order for 

10 such institutions to receive payment under the State 

11 plan (or waiver) and how each such State deter12 mines if such requirements have been met. 

13 (5) A summary of State standards (such as 

14 quality standards, clinical standards, and facility 

15 standards) that such institutions must meet to re16 ceive payment under such State plans (or waivers) 

17 and how each such State determines if such stand18 ards have been met. 

19 (6) Recommendations for actions by Congress 

20 and the Centers for Medicare & Medicaid Services. 

21 such as how State Medicaid programs may improve 

22 care and improve standards and including a rec23 ommendation for how the Centers for Medicare & 

24 Medicaid Services can improve data collection from 

25 such programs to address any gaps in information. 


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1 (b) STAKEHOLDER INPUT.—In carrying out sub2 section (a), the Medicaid and CHIP Payment and Access 

3 Commission shall seek input from State Medicaid direc4 tors and stakeholders, including at a minimum the Sub5 stance Abuse and Mental Health Services Administration, 

6 Centers for Medicare & Medicaid Services, State Medicaid 

7 officials, State mental health authorities, Medicaid bene8 ficiary advocates, health care providers, and Medicaid 

9 managed care organizations. 

10 (c) DEFINITIONS.—In this section: 

11 (1) REPRESENTATIVE SAMPLE OF STATES.— 

12 The term ‘‘representative sample of States’’ means 

13 a non-probability sample in which at least two 

14 States are selected based on the knowledge and pro15 fessional judgment of the selector. 

16 (2) STATE.—The term ‘‘State’’ means each of 

17 the 50 States, the District of Columbia, and any 

18 commonwealth or territory of the United States. 

19 (3) INSTITUTION FOR MENTAL DISEASES.—The 

20 term ‘‘institution for mental diseases’’ has the mean21 ing given such term in section 435.1009 of title 42, 

22 Code of Federal Regulations, or any successor regu23 lation. 


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Union Calendar No. 552 

115TH CONGRESS 

2D SESSION H. R. 5800 

[Report No. 115–717] 

A BILL 

To require the Medicaid and CHIP Payment and 

under the Medicaid program. and practices of institutions for mental diseases study and report on requirements applicable to Access Commission to conduct an exploratory 

JUNE 8, 2018 

Committed to the Committee of the Whole House on the 

State of the Union and ordered to be printed 


lotter on DSKBCFDHB2PROD with BILLS