I 
115TH CONGRESS 
1ST SESSION H. R. 4097 
To amend title XVIII of the Social Security Act to provide for coverage 
of methadone under Medicare part B. 
IN THE HOUSE OF REPRESENTATIVES 
OCTOBER 23, 2017 
Mr. NEAL introduced the following bill; which was referred to the Committee 
on Energy and Commerce, and in addition to the Committee on Ways 
and Means, for a period to be subsequently determined by the Speaker, 
in each case for consideration of such provisions as fall within the juris-
diction of the committee concerned 
A BILL 
To amend title XVIII of the Social Security Act to provide 
for coverage of methadone under Medicare part B. 
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 ‘‘Medicare Beneficiary 
Opioid Addiction Treatment Act’’. 
SEC. 2. COVERAGE OF METHADONE UNDER MEDICARE 
PART B. 
(a) COVERAGE.—Section 1861(s)(2) of the Social Se-
curity Act (42 U.S.C. 1395x(s)(2)) is amended— 
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(1) by striking ‘‘and’’ at the end of subpara-
graph (FF); 
(2) by adding ‘‘and’’ at the end of subpara-
graph (GG); and 
(3) by inserting after subparagraph (GG) the 
following new subparagraph: 
‘‘(HH) methadone, if furnished or dis-
pensed (including by prescription) on or after 
January 1, 2018, to an individual for the pur-
pose of maintenance or detoxification treatment 
by a physician or other practitioner who has in 
effect a registration or waiver under section 
303(g) of such Act (21 U.S.C. 823(g)) to dis-
pense methadone for such purpose;’’. 
(b) PAYMENT.— 
(1) IN CONNECTION WITH PHYSICIAN AND SUP-
PLIER SERVICE.—Section 1842(o)(1) of the Social 
Security Act (42 U.S.C. 1395u(o)(1)) is amended by 
adding at the end the following new subparagraph: 
‘‘(H) In the case of methadone (as de-
scribed in section 1861(s)(2)(HH)), the amount 
provided under section 1847A for such drug.’’. 
(2) 
COVERED
OPD
SERVICE.—Section 
1833(t)(1)(B)(iii) of the Social Security Act (42 
U.S.C. 1395l(t)(1)(B)(iii)) is amended by inserting 
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‘‘and methadone described in paragraph (2)(HH) of 
such section’’ after ‘‘section 1861(s)’’. 
(c) BUDGET NEUTRALITY.—The Secretary of Health 
and Human Services shall implement the amendments 
made by this section in a manner such that— 
(1) estimated expenditures under the physician 
fee schedule under section 1848 of the Social Secu-
rity Act (42 U.S.C. 1395w–4) with application of 
such amendments are equal to estimated expendi-
tures under such schedule without application of 
such amendments; and 
(2) estimated expenditures under the prospec-
tive payment system under section 1833(t) of the 
Social Security Act (42 U.S.C. 1395l(t)) with appli-
cation of such amendments made by this section are 
equal to estimated expenditures under such system 
without application of such amendments. 
Æ 
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