I 
115TH CONGRESS 
1ST SESSION H. R. 2239 
To amend title XIX of the Social Security Act to provide for a State Medicaid 
option to provide coverage of community-based inpatient substance use 
disorder treatment for nonelderly adults, to remove such services from 
the Medicaid exclusion from medical assistance of items and services 
for patients in an institution for mental diseases, and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
APRIL 28, 2017 
Ms. FUDGE (for herself, Mr. RYAN of Ohio, Ms. KAPTUR, and Mrs. BEATTY) 
introduced the following bill; which was referred to the Committee on En-
ergy and Commerce 
A BILL 
To amend title XIX of the Social Security Act to provide 
for a State Medicaid option to provide coverage of com-
munity-based inpatient substance use disorder treatment 
for nonelderly adults, to remove such services from the 
Medicaid exclusion from medical assistance of items and 
services for patients in an institution for mental diseases, 
and for other purposes. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
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SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Breaking Addiction 
Act of 2017’’. 
SEC. 2. STATE OPTION TO PROVIDE MEDICAL ASSISTANCE 
FOR 
COMMUNITY-BASED 
INPATIENT 
SUB-
STANCE USE DISORDER TREATMENT SERV-
ICES TO NONELDERLY ADULTS. 
(a) IN GENERAL.—Section 1905 of the Social Secu-
rity Act (42 U.S.C. 1396d) is amended— 
(1) in subsection (a)(16)— 
(A) by striking ‘‘, and, (B)’’ and inserting 
‘‘, (B)’’; and 
(B) by inserting before the semicolon at 
the end the following: ‘‘, and (C) community- 
based inpatient substance use disorder treat-
ment services for individuals over 21 years of 
age and under 65 years of age’’; and 
(2) in subsection (h)— 
(A) in paragraph (1)(B), by inserting ‘‘(in-
cluding a substance use disorder)’’ after ‘‘men-
tal health conditions’’; and 
(B) by adding at the end the following new 
paragraph: 
‘‘(3) For purposes of subsection (a)(16)(C), the term 
‘community-based inpatient substance use disorder treat-
ment services’ means services described in subparagraphs 
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(A) and (B) of paragraph (1) that are furnished in an 
institution for mental diseases (as defined in section 
1905(i) of the Social Security Act (42 U.S.C. 1396d(i)) 
that has not more than 60 beds.’’. 
(b) REPORT TO CONGRESS.—Not later than 4 years 
after the date of the enactment of this Act, the Secretary 
of Health and Human Services shall submit to Congress, 
and make available to the public, a report on the avail-
ability of, and access to, community-based inpatient sub-
stance use disorder treatment services provided under 
State Medicaid plans under title XIX of the Social Secu-
rity Act (or waivers of such plans) (42 U.S.C. 1396 et 
seq.) pursuant to the amendments made by subsection (a). 
The report shall include recommendations regarding a 
permanent and expanded waiver of the limitation on pay-
ment under the subdivision (B) following section 
1905(a)(29) of the Social Security Act (42 U.S.C. 
1396d(a)(29)) to permit all States to provide such services 
to all individuals eligible to receive medical assistance 
under such State Medicaid plans. 
(c) EFFECTIVE DATE.—The amendments made by 
subsection (a) shall apply to calendar quarters beginning 
on or after the date that is 30 days after the date of the 
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enactment of this Act, but in no case shall such amend-
ments apply earlier than October 1, 2017. 
Æ 
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