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SEC. 118. REFERENCES TO OPIOID OVERDOSE REVERSAL 
AGENTS IN HHS GRANT PROGRAMS. 
(a) IN GENERAL.—The Secretary of Health and 
Human Services shall ensure that, as appropriate, when-
ever the Department of Health and Human Services 
issues a regulation or guidance for any grant program ad-
dressing opioid misuse and use disorders, any reference 
to an opioid overdose reversal drug (such as a reference 
to naloxone) is inclusive of any opioid overdose reversal 
drug that has been approved under section 505 of the Fed-
eral Food, Drug, and Cosmetic Act (21 U.S.C. 355) for 
emergency treatment of a known or suspected opioid over-
dose. 
(b) EXISTING REFERENCES.— 
(1) UPDATE.—Not later than one year after the 
date of enactment of this Act, the Secretary of 
Health and Human Services shall update all ref-
erences described in paragraph (2) to be inclusive of 
any opioid overdose reversal drug that has been ap-
proved or otherwise authorized for use by the Food 
and Drug Administration. 
(2) REFERENCES.—A reference described in 
this paragraph is any reference to an opioid overdose 
reversal drug (such as naloxone) in any regulation or 
guidance of the Department of Health and Human 
Services that— 
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(A) was issued before the date of enact-
ment of this Act; and 
(B) is included in— 
(i) the grant program for State and 
Tribal response to opioid use disorders 
under section 1003 of the 21st Century 
Cures Act (42 U.S.C. 290ee–3 note) (com-
monly referred to as ‘‘State Opioid Re-
sponse Grants’’ and ‘‘Tribal Opioid Re-
sponse Grants’’); or 
(ii) the grant program for priority 
substance use disorder prevention needs of 
regional and national significance under 
section 516 of the Public Health Service 
Act (42 U.S.C. 290bb–22). 
SEC. 119. ADDRESSING OTHER CONCURRENT SUBSTANCE 
USE DISORDERS THROUGH GRANT PROGRAM 
FOR 
STATE 
AND 
TRIBAL 
RESPONSE 
TO 
OPIOID USE DISORDERS. 
(a) ADDITIONAL USE OF FUNDS.—Section 1003(b) 
of the 21st Century Cures Act (42 U.S.C. 290ee–3 note) 
is amended by adding at the end the following: 
‘‘(5) OTHER
CONCURRENT
SUBSTANCE
USE 
DISORDERS.—The Secretary may authorize the re-
cipient of a grant under this subsection, in addition 
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to using the grant for activities described in para-
graph (4) with respect to opioid misuse and use dis-
orders and stimulant misuse and use disorders, to 
use the grant for similar activities with respect to 
other concurrent substance use disorders.’’. 
(b) ANNUAL
REPORT
TO
CONGRESS.—Section 
1003(f) of the 21st Century Cures Act (42 U.S.C. 290ee– 
3 note) is amended— 
(1) in paragraph (2), strike ‘‘and’’ at the end; 
(2) in paragraph (3), strike the period at the 
end and insert a semicolon; and 
(3) by adding at the end the following: 
‘‘(4) the amount of funds each State that re-
ceived a grant under subsection (b) received for the 
12-month grant cycle covered by the report; 
‘‘(5) the amount of grant funds each such State 
spent for such grant cycle, disaggregated by the uses 
for which such funds were spent, including each al-
lowable use under paragraphs (4) and (5) of sub-
section (b); 
‘‘(6) how many such States for such grant cycle 
did not spend all of the grant funds before such 
grant cycle expired; 
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‘‘(7) how many such States for such grant cycle 
requested no-cost extensions to extend the grant 
cycle; and 
‘‘(8) challenges for such States to spend all of 
the funds allocated and the reason for such chal-
lenges, including to what extent reporting require-
ments or other requirements placed an increased 
burden on the ability of such States to spend all of 
the funds.’’. 
(c) OTHER CONCURRENT SUBSTANCE USE DIS-
ORDERS DEFINED.—Section 1003(h) of the 21st Century 
Cures Act (42 U.S.C. 290ee–3 note) is amended— 
(1) by redesignating paragraphs (2) through 
(4) as paragraphs (3) through (5); and 
(2) by inserting before paragraph (3), as redes-
ignated, the following: 
‘‘(2) OTHER
CONCURRENT
SUBSTANCE
USE 
DISORDERS.—The term ‘other concurrent substance 
use disorders’ means— 
‘‘(A) alcohol use disorders co-occurring 
with opioid misuse and use disorders as a pri-
mary disorder; or 
‘‘(B) alcohol use disorders co-occurring 
with stimulant misuse and use disorders as a 
primary disorder.’’. 
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(d) RULE OF CONSTRUCTION.—Nothing in this Act 
or the amendments made by this Act shall be construed 
to change the allocation of funds among grantees pursuant 
to the minimum allocations and formula methodology 
under section 1003 of the 21st Century Cures Act (42 
U.S.C. 290ee–3 note). 
SEC. 120. PROVIDING FOR A STUDY ON THE EFFECTS OF 
REMOTE MONITORING ON INDIVIDUALS WHO 
ARE PRESCRIBED OPIOIDS. 
(a) IN GENERAL.—Not later than 18 months after 
the date of enactment of this Act, the Comptroller General 
of the United States shall conduct a study and submit to 
the Committee on Energy and Commerce of the House 
of Representatives and the Committee on Health, Edu-
cation, Labor, and Pensions and the Committee on Fi-
nance of the Senate a report on the use of remote moni-
toring with respect to individuals who are prescribed 
opioids. 
(b) REPORT.—The report described in subsection (a) 
shall include to the extent information is available and re-
liable— 
(1) an assessment of scientific evidence related 
to the efficacy, individual outcomes, and potential 
cost savings associated with remote monitoring for 
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individuals who are prescribed opioids compared to 
such individuals who are not so monitored; 
(2) an assessment of the current prevalence of 
remote monitoring for individuals who are prescribed 
opioids, including the use of such monitoring for 
such individuals in other countries; and 
(3) information, including recommendations as 
appropriate, to improve availability, access, and cov-
erage for remote monitoring for individuals who are 
prescribed opioids, including through changes to 
Federal health care programs (as defined in section 
1128B of the Social Security Act (42 U.S.C. 1320a– 
7b)). 
TITLE II—CONTROLLED 
SUBSTANCES 
SEC. 201. DELIVERY OF CERTAIN SUBSTANCES BY A PHAR-
MACY 
TO 
AN 
ADMINISTERING 
PRACTI-
TIONER. 
Paragraph (2) of section 309A(a) of the Controlled 
Substances Act (21 U.S.C. 829a(a)) is amended to read 
as follows: 
‘‘(2) the controlled substance is a drug in 
schedule III, IV, or V that is, pursuant to the ap-
proval or licensure of such drug under the Federal 
Food, Drug, and Cosmetic Act or section 351 of the 
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Public Health Service Act, to be administered by, or 
under the supervision of, the prescribing practi-
tioner;’’. 
SEC. 202. REVIEWING THE SCHEDULING OF APPROVED 
PRODUCTS CONTAINING A COMBINATION OF 
BUPRENORPHINE AND NALOXONE. 
(a) SECRETARY OF HHS.—The Secretary of Health 
and Human Services shall, consistent with the require-
ments and procedures set forth in sections 201 and 202 
of the Controlled Substances Act (21 U.S.C. 811; 812)— 
(1) review the relevant data pertaining to the 
scheduling of products containing a combination of 
buprenorphine and naloxone that have been ap-
proved under section 505 of the Federal Food, 
Drug, and Cosmetic Act (21 U.S.C. 355); and 
(2) if appropriate, request that the Attorney 
General initiate rulemaking proceedings to revise the 
schedules accordingly with respect to such products. 
(b) ATTORNEY GENERAL.—The Attorney General 
shall review any request made by the Secretary of Health 
and Human Services under subsection (a)(2) and deter-
mine whether to initiate proceedings to revise the sched-
ules in accordance with the criteria set forth in sections 
201 and 202 of the Controlled Substances Act (21 U.S.C. 
811; 812). 
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SEC. 203. COMBATING ILLICIT XYLAZINE. 
(a) DEFINITIONS.— 
(1) IN
GENERAL.—In this section, the term 
‘‘xylazine’’ has the meaning given the term in para-
graph (60) of section 102 of the Controlled Sub-
stances Act, as added by paragraph (2). 
(2) CONTROLLED
SUBSTANCES
ACT.—Section 
102 of the Controlled Substances Act (21 U.S.C. 
802) is amended— 
(A) by redesignating the second paragraph 
(57) (relating to serious drug felony) and para-
graph (58) as paragraphs (58) and (59), re-
spectively; 
(B) by moving the margin of paragraph 
(57) 2 ems to the left; 
(C) by moving the margins of paragraphs 
(58) and (59), as redesignated, 2 ems to the 
left; and 
(D) by adding at the end the following: 
‘‘(60)(A) The term ‘xylazine’ means the substance 
xylazine as well as its salts, isomers, and salts of isomers 
whenever the existence of such salts, isomers, and salts 
of isomers is possible. 
‘‘(B) Except as provided in subparagraph (E), such 
term does not include a substance described in subpara-
graph (A) to the extent— 
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‘‘(i) such substance is an animal drug that has 
been approved by the Secretary of Health and 
Human Services under section 512 of the Federal 
Food, Drug, and Cosmetic Act and such substance’s 
use or intended use conforms to the approved appli-
cation, including the manufacturing, importation, 
holding, or distribution for such use; or 
‘‘(ii) such substance is used or intended for use 
in animals other than humans as permitted under 
section 512(a)(4) of the Federal Food, Drug, and 
Cosmetic Act. 
‘‘(C) If any person prescribes, dispenses, distributes, 
manufactures, or imports xylazine for human use, such 
person shall be considered to have prescribed, dispensed, 
distributed, manufactured, or imported xylazine not sub-
ject to an exclusion under subparagraph (B).’’. 
(b) PLACEMENT OF XYLAZINE ON SCHEDULE III.— 
Schedule III in section 202(c) of the Controlled Sub-
stances Act (21 U.S.C. 812(c)) is amended by adding at 
the end the following: 
‘‘(f) Xylazine.’’. 
(c) ARCOS TRACKING.—Section 307(i) of the Con-
trolled Substances Act (21 U.S.C. 827(i)) is amended— 
(1) in the matter preceding paragraph (1)— 
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(A) by inserting ‘‘or xylazine’’ after 
‘‘gamma hydroxybutyric acid’’; 
(B) by inserting ‘‘or 512’’ after ‘‘section 
505’’; and 
(C) by inserting ‘‘respectively,’’ after ‘‘the 
Federal Food, Drug, and Cosmetic Act,’’; and 
(2) in paragraph (6), by inserting ‘‘or xylazine’’ 
after ‘‘gamma hydroxybutyric acid’’. 
(d) REPORT TO CONGRESS ON XYLAZINE.— 
(1) INITIAL REPORT.—Not later than 1 year 
after the date of enactment of this Act, the Attorney 
General, acting through the Administrator of the 
Drug Enforcement Administration and in coordina-
tion with the Commissioner of Food and Drugs, 
shall submit to Congress a report on the prevalence 
of illicit use of xylazine in the United States and the 
impacts of such use, including— 
(A) where the drug is being diverted; 
(B) where the drug is originating; 
(C) whether any analogues to such drug 
present a substantial risk of abuse; 
(D) whether and to what extent the illicit 
supply of xylazine derives from the licit supply 
chain; and 
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(E) recommendations for Congress with re-
spect to whether xylazine should be transferred 
to another schedule under section 202 of the 
Controlled Substances Act (21 U.S.C. 812). 
(2) ADDITIONAL
REPORT.—Not later than 3 
years after the date of enactment of this Act, the 
Attorney General, acting through the Administrator 
of the Drug Enforcement Administration and in co-
ordination with the Commissioner of Food and 
Drugs, shall submit to Congress a report updating 
Congress on the prevalence of xylazine trafficking, 
misuse, and proliferation in the United States, in-
cluding— 
(A) the status and results of research on 
the impact xylazine has on human health; and 
(B) the effects of the classification of 
xylazine under the Controlled Substances Act 
(21 U.S.C. 801 et seq.) on the prevalence of 
xylazine trafficking, misuse, and proliferation in 
the United States. 
(3) OBTAINING OFFICIAL DATA.—The Attorney 
General, acting through the Administrator of the 
Drug Enforcement Administration and in coordina-
tion with the Commissioner of Food and Drugs, may 
secure directly from any department or agency of 
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the United States documents, statistical data, and 
other information necessary to carry out paragraphs 
(1) and (2). Upon receipt of a request from the At-
torney General for such documents, data, and infor-
mation, the head of the department or agency shall, 
in accordance with applicable procedures for the ap-
propriate handling of classified information, prompt-
ly provide reasonable access to such documents, 
data, and information. 
(4) VIEWS OF EXPERTS FROM NON-FEDERAL 
ENTITIES.—In developing the reports under para-
graphs (1) and (2), the Attorney General, acting 
through the Administrator of the Drug Enforcement 
Administration and in coordination with the Com-
missioner of Food and Drugs, shall consult with, 
and take into consideration the views of, experts 
from appropriate non-Federal entities, including 
such experts from— 
(A) the scientific and medical research 
community; 
(B) the State and local law enforcement 
community; and 
(C) community-based organizations. 
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SEC. 204. TECHNICAL CORRECTIONS. 
Effective as if included in the enactment of Public 
Law 117–328— 
(1) section 1252(a) of division FF of Public 
Law 117–328 is amended, in the matter being in-
serted into section 302(e) of the Controlled Sub-
stances Act, by striking ‘‘303(g)’’ and inserting 
‘‘303(h)’’; 
(2) section 1262 of division FF of Public Law 
117–328 is amended— 
(A) in subsection (a)— 
(i) in the matter preceding paragraph 
(1), by striking ‘‘303(g)’’ and inserting 
‘‘303(h)’’; 
(ii) in the matter being stricken by 
subsection (a)(2), by striking ‘‘(g)(1)’’ and 
inserting ‘‘(h)(1)’’; and 
(iii) in the matter being inserted by 
subsection (a)(2), by striking ‘‘(g) Practi-
tioners’’ and inserting ‘‘(h) Practitioners’’; 
and 
(B) in subsection (b)— 
(i) in the matter being stricken by 
paragraph (1), by striking ‘‘303(g)(1)’’ 
and inserting ‘‘303(h)(1)’’; 
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(ii) in the matter being inserted by 
paragraph (1), by striking ‘‘303(g)’’ and 
inserting ‘‘303(h)’’; 
(iii) in the matter being stricken by 
paragraph (2)(A), by striking ‘‘303(g)(2)’’ 
and inserting ‘‘303(h)(2)’’; 
(iv) in the matter being stricken by 
paragraph (3), by striking ‘‘303(g)(2)(B)’’ 
and inserting ‘‘303(h)(2)(B)’’; 
(v) in the matter being stricken by 
paragraph (5), by striking ‘‘303(g)’’ and 
inserting ‘‘303(h)’’; and 
(vi) in the matter being stricken by 
paragraph (6), by striking ‘‘303(g)’’ and 
inserting ‘‘303(h)’’; and 
(3) section 1263(b) of division FF of Public 
Law 117–328 is amended— 
(A) by striking ‘‘303(g)(2)’’ and inserting 
‘‘303(h)(2)’’; and 
(B) by striking ‘‘(21 U.S.C. 823(g)(2))’’ 
and inserting ‘‘(21 U.S.C. 823(h)(2))’’. 
SEC. 205. REQUIRED TRAINING FOR PRESCRIBERS OF CON-
TROLLED SUBSTANCES. 
Section 303 of the Controlled Substances Act (21 
U.S.C. 823) is amended— 
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(1) by redesignating the second subsection (l) 
(added by section 1263 of division FF of Public Law 
117–328) as subsection (m); and 
(2) in subsection (m), as redesignated— 
(A) in paragraph (1)(A)(iv)— 
(i) in subclause (I), by striking ‘‘or 
the Commission for Continuing Education 
Provider Recognition (CCEPR)’’ and in-
serting ‘‘the Commission for Continuing 
Education Provider Recognition (CCEPR), 
the American Podiatric Medical Associa-
tion, the Council on Podiatric Medical 
Education (CPME), or the Academy of 
General Dentistry’’; 
(ii) by redesignating subclauses (II), 
(III), and (IV) as subclauses (III), (IV), 
and (V), respectively; and 
(iii) by inserting after subclause (I) 
the following: 
‘‘(II) the American Academy of 
Family Physicians or any organization 
whose continuing medical education 
activity has been approved or accred-
ited by the American Academy of 
Family Physicians;’’; and 
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(iv) in subclause (V), as redesignated, 
by striking ‘‘any organization approved by 
the Assistant Secretary for Mental Health 
and Substance Use, the ACCME, or the 
CCEPR’’ and inserting ‘‘any organization 
approved by the ACCME or the CCEPR’’; 
(B) in paragraph (1)(A)(v)— 
(i) by inserting ‘‘podiatric medicine,’’ 
after ‘‘allopathic medicine, osteopathic 
medicine,’’; and 
(ii) by striking ‘‘allopathic or osteo-
pathic medicine curriculum’’ and inserting 
‘‘allopathic, osteopathic, or podiatric medi-
cine curriculum’’; 
(C) in paragraph (1)(B)(i), by striking ‘‘or 
any other organization approved or accredited 
by the Assistant Secretary for Mental Health 
and Substance Use or the Accreditation Council 
for Continuing Medical Education’’ and insert-
ing ‘‘the American Podiatric Medical Associa-
tion, the Council on Podiatric Medical Edu-
cation (CPME), the American Pharmacists As-
sociation, the Accreditation Council for Phar-
macy Education, the American Optometric As-
sociation, the Academy of General Dentistry, 
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the American Psychiatric Nurses Association, 
the American Academy of Nursing, the Amer-
ican Academy of Family Physicians, or any 
other organization approved or accredited by 
the American Academy of Family Physicians or 
the Accreditation Council for Continuing Med-
ical Education’’; and 
(D) in paragraph (1)(B)(ii), by striking 
‘‘from an accredited physician assistant school 
or accredited school of advanced practice nurs-
ing’’ and inserting ‘‘from an accredited physi-
cian assistant school, an accredited school of 
advanced practice nursing, or an accredited 
school of pharmacy’’. 
TITLE III—MEDICAID 
SEC. 301. EXTENDING REQUIREMENT FOR STATE MEDICAID 
PLANS TO PROVIDE COVERAGE FOR MEDICA-
TION-ASSISTED TREATMENT. 
(a) IN GENERAL.—Section 1905 of the Social Secu-
rity Act (42 U.S.C. 1396d) is amended— 
(1) in subsection (a)(29), by striking ‘‘for the 
period beginning October 1, 2020, and ending Sep-
tember 30, 2025,’’ and inserting ‘‘beginning on Oc-
tober 1, 2020,’’; and 
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(2) in subsection (ee)(2), by striking ‘‘for the 
period specified in such paragraph, if before the be-
ginning of such period the State certifies to the sat-
isfaction of the Secretary’’ and inserting ‘‘if such 
State certifies, not less than every 5 years and to the 
satisfaction of the Secretary,’’. 
(b) 
CONFORMING
AMENDMENT.—Section 
1006(b)(4)(A) of the Substance Use-Disorder Prevention 
that Promotes Opioid Recovery and Treatment for Pa-
tients and Communities Act (42 U.S.C. 1396a note) is 
amended by striking ‘‘, and before October 1, 2025’’. 
SEC. 302. EXPANDING REQUIRED REPORTS ON T-MSIS SUB-
STANCE USE DISORDER DATA TO INCLUDE 
MENTAL HEALTH CONDITION DATA. 
(a) IN GENERAL.—Section 1015(a) of the SUP-
PORT for Patients and Communities Act (42 U.S.C. 
1320d–2 note) is amended— 
(1) in the heading, by striking ‘‘SUBSTANCE 
USE DISORDER DATA BOOK’’ and inserting ‘‘BE-
HAVIORAL HEALTH DATA BOOK’’; 
(2) in paragraph (2)— 
(A) in the matter preceding subparagraph 
(A), by inserting ‘‘, including as updated in ac-
cordance with paragraph (3),’’ after ‘‘paragraph 
(1)’’; 
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(B) in subparagraph (A), by inserting ‘‘, 
mental health condition, or a mental health con-
dition co-occurring with substance use disorder’’ 
after ‘‘substance use disorder’’; 
(C) in subparagraph (B), by inserting 
‘‘and mental health treatment services’’ after 
‘‘substance use disorder treatment services’’; 
(D) in subparagraph (C)— 
(i) by inserting ‘‘, mental health con-
dition, or a mental health condition co-oc-
curring with a substance use disorder diag-
nosis’’ after ‘‘substance use disorder diag-
nosis’’; and 
(ii) by inserting ‘‘or mental health 
treatment services, respectively,’’ after 
‘‘substance use disorder treatment serv-
ices’’; 
(E) in subparagraph (D), by inserting ‘‘, 
mental health condition, or a mental health con-
dition co-occurring with substance use disorder’’ 
after ‘‘substance use disorder diagnosis’’; 
(F) in subparagraph (E), by inserting ‘‘or 
mental health treatment’’ after ‘‘substance use 
disorder treatment’’; and 
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(G) in subparagraph (F), by inserting ‘‘, 
individuals with a mental health condition who 
receive mental health treatment services, and 
individuals with a co-occurring mental health 
condition and substance use disorder who re-
ceive substance use disorder treatment services 
and mental health treatment services,’’ after 
‘‘substance use disorder treatment services’’; 
and 
(3) in paragraph (3), by striking ‘‘through 
2024’’. 
(b) APPLICATION.—The amendments made by sub-
section (a)(1) shall apply beginning with respect to the 
first update made pursuant to section 1015(a)(3) of the 
SUPPORT for Patients and Communities Act (42 U.S.C. 
1320d–2 note) after the date that is 12 months after the 
date of enactment of this Act. 
SEC. 303. MONITORING PRESCRIBING OF ANTIPSYCHOTIC 
MEDICATIONS. 
Section 1902(oo)(1)(B) of the Social Security Act (42 
U.S.C. 1396a(oo)(1)(B)) is amended— 
(1) in the subparagraph heading, by striking 
‘‘BY CHILDREN’’; 
(2) by inserting ‘‘, and beginning on the date 
that is 24 months after the date of enactment of 
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Support for Patients and Communities Reauthoriza-
tion Act, individuals over the age of 18, individuals 
receiving home and community-based services (as de-
fined in section 9817(a)(2)(B) of Public Law 117– 
2), and individuals residing in institutional care set-
tings (including nursing facilities, intermediate care 
facilities for individuals with intellectual disabilities, 
and other such institutional care settings) enrolled,’’ 
after ‘‘children enrolled’’; and 
(3) by striking ‘‘not more than the age of 18 
years’’ and inserting ‘‘subject to the program’’. 
SEC. 304. LIFTING THE IMD EXCLUSION FOR SUBSTANCE 
USE DISORDER. 
(a) MAKING PERMANENT STATE PLAN AMENDMENT 
OPTION TO PROVIDE MEDICAL ASSISTANCE FOR CER-
TAIN INDIVIDUALS WHO ARE PATIENTS IN CERTAIN IN-
STITUTIONS FOR MENTAL DISEASES.—Section 1915(l)(1) 
of the Social Security Act (42 U.S.C. 1396n(l)(1)) is 
amended by striking ‘‘With respect to calendar quarters 
beginning during the period beginning October 1, 2019, 
and ending September 30, 2023,’’ and inserting ‘‘With re-
spect to calendar quarters beginning on or after October 
1, 2019,’’. 
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(b) MAINTENANCE OF EFFORT REVISION.—Section 
1915(l)(3) of the Social Security Act (42 U.S.C. 
1396n(l)(3)) is amended— 
(1) in subparagraph (A)-— 
(A) in the matter preceding clause (i), by 
striking ‘‘other than under this title’’; and 
(B) in clause (i), by striking ‘‘or, if high-
er,’’ and all that follows through ‘‘in accordance 
with this subsection’’; and 
(2) by adding at the end the following new sub-
paragraph: 
‘‘(D) APPLICATION OF MAINTENANCE OF 
EFFORT
REQUIREMENTS
TO
CERTAIN 
STATES.—In the case of a State with a State 
plan amendment in effect on the date of the en-
actment of this subparagraph, for the 1-year 
period beginning on such date, the provisions of 
subparagraph (A) shall be applied as if the 
amendments to such subparagraph made by the 
Support for Patients and Communities Reau-
thorization Act had never been made.’’. 
(c) ADDITIONAL REQUIREMENTS.— 
(1) IN GENERAL.— 
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(A) GENERAL
REQUIREMENTS.—Section 
1915(l)(4) of the Social Security Act (42 
U.S.C. 1396n(l)(4)) is amended— 
(i) in subparagraph (A), by striking 
‘‘through (D)’’ and inserting ‘‘through 
(F)’’; 
(ii) in subparagraph (D), in the mat-
ter preceding clause (i), by inserting ‘‘have 
in place evidence-based, substance use dis-
order-specific individual placement criteria 
and utilization management approach to 
ensure placement of such individual in an 
appropriate level of care and shall’’ after 
‘‘State shall’’; and 
(iii) by adding at the end the fol-
lowing new subparagraph: 
‘‘(E) REVIEW PROCESS.—The State shall 
have in place a process to review the compliance 
of eligible institutions for mental diseases with 
evidence-based, substance use disorder-specific 
program standards for eligible individuals speci-
fied by the State.’’. 
(B) EFFECTIVE DATE.—The amendments 
made by subparagraph (A) shall apply with re-
spect to medical assistance furnished in cal-
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endar quarters beginning on or after October 1, 
2025. 
(2) 
ONE-TIME
ASSESSMENT.—Section 
1915(l)(4) of the Social Security Act (42 U.S.C. 
1396n(l)(4)), as amended by paragraph (1), is fur-
ther amended by adding at the end the following 
new subparagraph: 
‘‘(F) ASSESSMENT.— 
‘‘(i) IN GENERAL.—The State shall, 
not later than 12 months after the ap-
proval of a State plan amendment de-
scribed in this subsection (or, in the case 
such State has such an amendment ap-
proved as of the date of the enactment of 
this subparagraph, not later than 12 
months after such date), commence an as-
sessment of— 
‘‘(I) the availability of treatment 
for individuals enrolled under a State 
plan under this title (or waiver of 
such plan) in each level of care de-
scribed in subparagraph (C); and 
‘‘(II) the availability of medica-
tion-assisted treatment and medically 
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supervised withdrawal management 
services for such individuals. 
‘‘(ii) REQUIRED
COMPLETION.—The 
State compete an assessment described in 
clause (i) not later than 12 months after 
the date the State commences such assess-
ment.’’. 
(3) CLARIFICATION OF LEVELS OF CARE.—Sec-
tion 1915(l)(7)(A) of the Social Security Act (42 
U.S.C. 1396n(l)(7)(A)) is amended by inserting ‘‘(or 
any successor publication)’’ before the period. 
SEC. 305. PROHIBITION ON TERMINATION OF ENROLLMENT 
DUE TO INCARCERATION. 
(a) MEDICAID.— 
(1) IN GENERAL.—Section 1902(a)(84)(A) of 
the 
Social 
Security 
Act 
(42 
U.S.C. 
1396a(a)(86)(A)), as amended by section 5122(a)(2) 
of the Consolidated Appropriations Act, 2023 (Pub-
lic Law 117–328), is further amended— 
(A) by striking ‘‘under the State plan’’ and 
inserting ‘‘under the State plan (or waiver of 
such plan)’’; 
(B) by striking ‘‘who is an eligible juvenile 
(as defined in subsection (nn)(2))’’; 
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(C) by striking ‘‘because the juvenile’’ and 
inserting ‘‘because the individual’’; 
(D) by striking ‘‘during the period the ju-
venile’’ and inserting ‘‘during the period the in-
dividual’’; and 
(E) by inserting ‘‘such an individual who is 
an eligible juvenile (as defined in subsection 
(nn)(2)) or a woman during pregnancy (and 
during the 60-day beginning on the last day of 
pregnancy) and’’ after ‘‘or in the case of’’. 
(2) EFFECTIVE DATE.—The amendments made 
by— 
(A) subparagraph (A) of paragraph (1) 
shall take effect on the date of the enactment 
of this Act; and 
(B) subparagraphs (B) through (E) of 
paragraph (1) shall take effect on January 1, 
2025. 
(b) CHIP.— 
(1) IN GENERAL.—Section 2102(d)(1)(A) of the 
Social Security Act (42 U.S.C. 1397bb(d)(1)(A)) is 
amended— 
(A) by inserting ‘‘or pregnancy-related’’ 
after ‘‘child health’’; 
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(B) by inserting ‘‘or targeted low-income 
pregnant woman’’ after ‘‘targeted low-income 
child’’; 
(C) by inserting ‘‘or pregnant woman’’ 
after ‘‘because the child’’; and 
(D) by inserting ‘‘or pregnant woman’’ 
after ‘‘during the period the child’’. 
(2) EFFECTIVE DATE.—The amendments made 
by paragraph (1) shall apply beginning January 1, 
2025. 
(c) 
TECHNICAL
CORRECTION.—Section 
1902(nn)(2)(A) of the Social Security Act (42 U.S.C. 
1395a(a)(nn)(2)(A)) is amended by striking ‘‘State plan’’ 
and inserting ‘‘State plan (or waiver of such plan)’’. 
SEC. 306. STATE OPTION RELATING TO INMATES WHO ARE 
PREGNANT WOMEN PENDING DISPOSITION 
OF CHARGES. 
(a) STATE OPTION.— 
(1) MEDICAID.—The subdivision (A) of section 
1905(a) of the Social Security Act (42 U.S.C. 
1396d(a)) following paragraph (31) of such section, 
as amended by section 5122 of the Consolidated Ap-
propriations Act, 2023 (Public Law 117–328), is 
further amended by inserting ‘‘or a woman during 
pregnancy (and during the 60-day beginning on the 
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last day of pregnancy)’’ after ‘‘(as defined in section 
1902(nn)(2))’’. 
(2) CHIP.—Section 2110(b)(7) of the Social 
Security Act (42 U.S.C. 1397jj(b)(10)), as amended 
by section 5122 of the Consolidated Appropriations 
Act, 2023 (Public Law 117–328), is further amend-
ed— 
(A) by inserting ‘‘a woman during preg-
nancy (and during the 60-day beginning on the 
last day of pregnancy) or’’ after ‘‘At the option 
of the State,’’; and 
(B) by striking ‘‘during the period that the 
child’’ and inserting ‘‘during the period that the 
woman or child’’. 
(3) EFFECTIVE DATE.—The amendments made 
by this subsection shall take effect on January 1, 
2025. 
(b) TECHNICAL CORRECTION.—Section 5122(a)(1) 
of the Consolidated Appropriations Act, 2023 (Public Law 
117–328) is amended by striking ‘‘after’’ and all that fol-
lows through the period at the end and inserting ‘‘after 
‘or in the case of an eligible juvenile described in section 
1902(a)(84)(D) with respect to the screenings, diagnostic 
services, referrals, and targeted case management services 
required under such section’.’’. 
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SEC. 307. PERMITTING ACCESS TO MEDICAL ASSISTANCE 
UNDER THE MEDICAID PROGRAM FOR FOS-
TER YOUTH. 
(a) IN GENERAL.—Section 1905(a) of the Social Se-
curity Act (42 U.S.C. 1396d(a)) is amended by adding 
at the end the following new sentence: ‘‘In the case of an 
individual who is under the age of 21 and who is a patient 
in an institution for mental diseases that is a qualified 
residential treatment program (as defined in section 
472(k)(4)), the exclusion from the definition of medical 
assistance set forth in the subdivision (B) following the 
last numbered paragraph of this subsection shall not apply 
with respect to items and services furnished to such an 
individual when received outside of such program.’’. 
(b) EFFECTIVE DATE.—The amendment made by 
paragraph (1) shall apply with respect to medical assist-
ance furnished in calendar quarters beginning on or after 
January 1, 2025. 
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TITLE IV—OFFSETS 
SEC. 401. PROMOTING VALUE IN MEDICAID MANAGED 
CARE. 
Section 1903(m)(9)(A) of the Social Security Act (42 
U.S.C. 1396b(m)(9)(A)) is amended by striking ‘‘(and be-
fore fiscal year 2024)’’. 
Passed the House of Representatives December 12, 
2023. 
Attest: 
KEVIN F. MCCUMBER, 
Clerk. 
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