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 treat-
ment, 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 cov-
erage for medication-assisted treatment, and for other 
purposes. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Ensuring Complete 
Coverage of Medication-Assisted Treatment Act’’. 
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SEC. 2. REQUIREMENT FOR STATE MEDICAID PLANS TO 
PROVIDE COVERAGE FOR MEDICATION-AS-
SISTED TREATMENT. 
(a) REQUIREMENT FOR STATE MEDICAID PLANS TO 
PROVIDE COVERAGE FOR MEDICATION-ASSISTED TREAT-
MENT.—Section 1902(a)(10)(A) of the Social Security Act 
(42 U.S.C. 1396a(a)(10)(A)) is amended, in the matter 
preceding clause (i), by striking ‘‘and (28)’’ and inserting 
‘‘(28), and (29)’’. 
(b) INCLUSION OF MEDICATION-ASSISTED TREAT-
MENT AS MEDICAL ASSISTANCE.—Section 1905(a) of the 
Social Security Act (42 U.S.C. 1396d(a)) is amended— 
(1) in paragraph (28), by striking ‘‘and’’ at the 
end; 
(2) by redesignating paragraph (29) as para-
graph (30); and 
(3) by inserting after paragraph (28) the fol-
lowing new paragraph: 
‘‘(29) beginning, subject to paragraph (2) of 
subsection (ee), January 1, 2020, medication-as-
sisted treatment (as defined in paragraph (1) of 
such subsection); and’’. 
(c) MEDICATION-ASSISTED TREATMENT DEFINED; 
WAIVERS.—Section 1905 of the Social Security Act (42 
U.S.C. 1396d) is amended by adding at the end the fol-
lowing new subsection: 
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‘‘(ee) MEDICATION-ASSISTED TREATMENT DEFINED; 
WAIVERS.— 
‘‘(1) MEDICATION-ASSISTED
TREATMENT
DE-
FINED.—For purposes of subsection (a)(29), the 
term ‘medication-assisted treatment’— 
‘‘(A) means all drugs approved under sec-
tion 505 of the Federal Food, Drug, and Cos-
metic Act (21 U.S.C. 355), including metha-
done, and all biological products licensed under 
section 351 of the Public Health Service Act 
(42 U.S.C. 262) to treat substance use dis-
orders; and 
‘‘(B) includes, with respect to the provision 
of such drugs and biological products, coun-
seling services and behavioral therapy. 
‘‘(2) WAIVERS.—For purposes of subsection 
(a)(29), the Secretary may grant a waiver, with re-
spect to a State, to delay the application of such 
subsection if the State submits a waiver request that 
includes the following: 
‘‘(A) The reasoning for such waiver. 
‘‘(B) A timeline for the State to implement 
the requirement of such subsection. 
‘‘(C) A review of any prior authorization 
program and any drug utilization management 
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program established by the State under the 
State plan (or a waiver of such plan) to assess 
the types of barriers that individuals encounter 
in accessing medication-assisted treatment (as 
defined in paragraph (1)) under such plan (or 
waiver). 
‘‘(D) Any other information that the Sec-
retary may require.’’. 
(d) EFFECTIVE DATE.— 
(1) IN GENERAL.—Subject to paragraph (2), 
the amendments made by this section shall take ef-
fect with respect to medical assistance provided on 
or after January 1, 2020. 
(2) EXCEPTION FOR STATE LEGISLATION.—In 
the case of a State plan under title XIX of the So-
cial Security Act (42 U.S.C. 1396 et seq.) that the 
Secretary of Health and Human Services determines 
requires State legislation in order for the respective 
plan to meet any requirement imposed by the 
amendments made by this section, the respective 
plan shall not be regarded as failing to comply with 
the requirements of such title solely on the basis of 
its failure to meet such an additional requirement 
before the first day of the first calendar quarter be-
ginning after the close of the first regular session of 
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the State legislature that begins after the date of the 
enactment of this Act. For purposes of the previous 
sentence, in the case of a State that has a 2-year 
legislative session, each year of the session shall be 
considered to be a separate regular session of the 
State legislature. 
Æ 
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