I 
114TH CONGRESS 
1ST SESSION H. R. 1988 
To provide for the waiver of the Medicaid IMD limitation in order to permit 
Medicaid coverage for substance use disorder treatment services furnished 
to certain individuals in a community-based institution for mental dis-
eases. 
IN THE HOUSE OF REPRESENTATIVES 
APRIL 23, 2015 
Ms. FUDGE (for herself, Mr. RYAN of Ohio, and Ms. KAPTUR) introduced the 
following bill; which was referred to the Committee on Energy and Commerce 
A BILL 
To provide for the waiver of the Medicaid IMD limitation 
in order to permit Medicaid coverage for substance use 
disorder treatment services furnished to certain individ-
uals in a community-based institution for mental dis-
eases. 
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 ‘‘Breaking Addiction 
Act of 2015’’. 
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SEC. 2. MEDICAID WAIVER FOR COMMUNITY-BASED INPA-
TIENT SUBSTANCE USE DISORDER TREAT-
MENT. 
(a) IN GENERAL.—The Secretary of Health and 
Human Services shall provide, under the authority of sec-
tion 1115(a) of the Social Security Act (42 U.S.C. 
1315(a)) and in accordance with the procedures for waiv-
ers sunder such section and upon application of a State, 
for the waiver of the IMD limitation (as defined in sub-
section (c)(2)) in order to permit the provision of medical 
assistance under title XIX of such Act for treatment of 
a substance use condition for a qualified individual in a 
community-based institution for mental diseases. To the 
maximum extent practicable, such a waiver shall be grant-
ed to each State that applies and qualifies for such a waiv-
er. 
(b) REPORT TO CONGRESS.—Not later than 4 years 
after the date waivers are first implemented under sub-
section (a) and taking into account the evaluations con-
ducted in connection with such waivers, the Secretary shall 
submit to Congress and make available to the public a re-
port on such waivers. The report shall include— 
(1) the findings of such evaluations; and 
(2) recommendations regarding expanding and 
making permanent the waiver of the IMD limitation 
to permit all States to provide the medical assistance 
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described in subsection (a) to all qualified individ-
uals. 
(c) DEFINITIONS.—In this section: 
(1) COMMUNITY-BASED INSTITUTION FOR MEN-
TAL DISEASES.—The term ‘‘community-based insti-
tution for mental diseases’’ means 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. 
(2) IMD LIMITATION.—The term ‘‘IMD limita-
tion’’ means the limitation under the subdivision (B) 
following paragraph (29) of section 1905(a) of the 
Social Security Act (42 U.S.C. 1396d(a)) on medical 
assistance furnished to certain patients in an institu-
tion for mental diseases. 
(3) QUALIFIED INDIVIDUAL.—The term ‘‘quali-
fied individual’’ means an individual who, because of 
the individual’s substance use condition, requires 
substance use disorder treatment and who, but for 
the IMD limitation, would be eligible for medical as-
sistance under title XIX of the Social Security Act 
(42 U.S.C. 1396 et seq.) for substance use disorder 
treatment services furnished in a community-based 
institution for mental diseases. 
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(4) STATE.—The term ‘‘State’’ has the mean-
ing given such term for purposes of title XIX of the 
Social Security Act. 
Æ 
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