I 

115TH CONGRESS 

2D SESSION H. R. 5802 

To amend title XIX of the Social Security Act to require States to include 

under their State Medicaid plans coverage for medication-assisted treatment, and for other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

MAY 15, 2018 

Mr. GENE GREEN of Texas introduced the following bill; which was referred 

to the Committee on Energy and Commerce 

A BILL 

To amend title XIX of the Social Security Act to require 

States to include under their State Medicaid plans coverage for medication-assisted treatment, and for other 

purposes. 

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 ‘‘Ensuring Complete 

5 Coverage of Medication-Assisted Treatment Act’’. 


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1 SEC. 2. REQUIREMENT FOR STATE MEDICAID PLANS TO 

2 PROVIDE COVERAGE FOR MEDICATION-AS3 SISTED TREATMENT. 

4 (a) REQUIREMENT FOR STATE MEDICAID PLANS TO

5 PROVIDE COVERAGE FOR MEDICATION-ASSISTED TREAT6 MENT.—Section 1902(a)(10)(A) of the Social Security Act 

7 (42 U.S.C. 1396a(a)(10)(A)) is amended, in the matter 

8 preceding clause (i), by striking ‘‘and (28)’’ and inserting 

9 ‘‘(28), and (29)’’. 

10 (b) INCLUSION OF MEDICATION-ASSISTED TREAT11 MENT AS MEDICAL ASSISTANCE.—Section 1905(a) of the 

12 Social Security Act (42 U.S.C. 1396d(a)) is amended— 

13 (1) in paragraph (28), by striking ‘‘and’’ at the 

14 end; 

15 (2) by redesignating paragraph (29) as para16 graph (30); and 

17 (3) by inserting after paragraph (28) the fol18 lowing new paragraph: 

19 ‘‘(29) beginning, subject to paragraph (2) of 

20 subsection (ee), January 1, 2020, medication-as21 sisted treatment (as defined in paragraph (1) of 

22 such subsection); and’’. 

23 (c) MEDICATION-ASSISTED TREATMENT DEFINED; 

24 WAIVERS.—Section 1905 of the Social Security Act (42 

25 U.S.C. 1396d) is amended by adding at the end the fol26 lowing new subsection: 


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1 ‘‘(ee) MEDICATION-ASSISTED TREATMENT DEFINED; 

2 WAIVERS.— 

3 ‘‘(1) MEDICATION-ASSISTED TREATMENT DE4 FINED.—For purposes of subsection (a)(29), the 

5 term ‘medication-assisted treatment’— 

6 ‘‘(A) means all drugs approved under sec7 tion 505 of the Federal Food, Drug, and Cos8 metic Act (21 U.S.C. 355), including metha9 done, and all biological products licensed under 

10 section 351 of the Public Health Service Act 

11 (42 U.S.C. 262) to treat substance use dis12 orders; and 

13 ‘‘(B) includes, with respect to the provision 

14 of such drugs and biological products, coun15 seling services and behavioral therapy. 

16 ‘‘(2) WAIVERS.—For purposes of subsection 

17 (a)(29), the Secretary may grant a waiver, with re18 spect to a State, to delay the application of such 

19 subsection if the State submits a waiver request that 

20 includes the following: 

21 ‘‘(A) The reasoning for such waiver. 

22 ‘‘(B) A timeline for the State to implement 

23 the requirement of such subsection. 

24 ‘‘(C) A review of any prior authorization 

25 program and any drug utilization management 


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1 program established by the State under the 

2 State plan (or a waiver of such plan) to assess 

3 the types of barriers that individuals encounter 

4 in accessing medication-assisted treatment (as 

5 defined in paragraph (1)) under such plan (or 

6 waiver). 

7 ‘‘(D) Any other information that the Sec8 retary may require.’’. 

9 (d) EFFECTIVE DATE.— 

10 (1) IN GENERAL.—Subject to paragraph (2), 

11 the amendments made by this section shall take ef12 fect with respect to medical assistance provided on 

13 or after January 1, 2020. 

14 (2) EXCEPTION FOR STATE LEGISLATION.—In 

15 the case of a State plan under title XIX of the So16 cial Security Act (42 U.S.C. 1396 et seq.) that the 

17 Secretary of Health and Human Services determines 

18 requires State legislation in order for the respective 

19 plan to meet any requirement imposed by the 

20 amendments made by this section, the respective 

21 plan shall not be regarded as failing to comply with 

22 the requirements of such title solely on the basis of 

23 its failure to meet such an additional requirement 

24 before the first day of the first calendar quarter be25 ginning after the close of the first regular session of 


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1 the State legislature that begins after the date of the 

2 enactment of this Act. For purposes of the previous 

3 sentence, in the case of a State that has a 2-year 

4 legislative session, each year of the session shall be 

5 considered to be a separate regular session of the 

6 State legislature. 

Æ 


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