I 
115TH CONGRESS 
2D SESSION 
H. R. 5800 
To require the Medicaid and CHIP Payment and Access Commission to 
conduct an exploratory study and report on requirements applicable to 
and practices of institutions for mental diseases under the Medicaid 
program. 
IN THE HOUSE OF REPRESENTATIVES 
MAY 15, 2018 
Mr. UPTON (for himself and Mrs. MIMI WALTERS of California) introduced 
the following bill; which was referred to the Committee on Energy and 
Commerce 
A BILL 
To require the Medicaid and CHIP Payment and Access 
Commission to conduct an exploratory study and report 
on requirements applicable to and practices of institu-
tions for mental diseases under the Medicaid program. 
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 ‘‘Medicaid Institutes 
for Mental Disease Are Decisive in Delivering Inpatient 
Treatment for Individuals but Opportunities for Needed 
Access are Limited without Information Needed about Fa-
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cility Obligations Act’’ or the ‘‘Medicaid IMD ADDI-
TIONAL INFO Act’’. 
SEC. 2. MACPAC EXPLORATORY STUDY AND REPORT ON IN-
STITUTIONS 
FOR 
MENTAL 
DISEASES 
RE-
QUIREMENTS AND PRACTICES UNDER MED-
ICAID. 
(a) IN GENERAL.—Not later than January 1, 2020, 
the Medicaid and CHIP Payment and Access Commission 
established under section 1900 of the Social Security Act 
(42 U.S.C. 1396) shall conduct an exploratory study, 
using data from a representative sample of States, and 
submit to Congress a report on at least the following infor-
mation, with respect to services furnished to individuals 
enrolled under State plans under the Medicaid program 
under title XIX of such Act (42 U.S.C. 1396 et seq.) (or 
waivers of such plans) who are patients in institutions for 
mental diseases and for which payment is made through 
fee-for-service or managed care arrangements under such 
State plans (or waivers): 
(1) A description of such institutions for mental 
diseases in each such State, including at a min-
imum— 
(A) the number of such institutions in the 
State; 
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(B) the facility type of such institutions in 
the State; and 
(C) any coverage limitations under each 
such State plan (or waiver) on scope, duration, 
or frequency of such services. 
(2) With respect to each such institution for 
mental diseases in each such State, a description 
of— 
(A) such services provided at such institu-
tion; 
(B) the process, including any timeframe, 
used by such institution to clinically assess and 
reassess such individuals; and 
(C) the discharge process used by such in-
stitution, including any care continuum of rel-
evant services or facilities provided or used in 
such process. 
(3) A description of— 
(A) any Federal waiver that each such 
State has for such institutions and the Federal 
statutory authority for such waiver; and 
(B) any other Medicaid funding sources 
used by each such State for funding such insti-
tutions, such as supplemental payments. 
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(4) A summary of State requirements (such as 
certification, licensure, and accreditation) applied by 
each such State to such institutions in order for 
such institutions to receive payment under the State 
plan (or waiver) and how each such State deter-
mines if such requirements have been met. 
(5) A summary of State standards (such as 
quality standards, clinical standards, and facility 
standards) that such institutions must meet to re-
ceive payment under such State plans (or waivers) 
and how each such State determines if such stand-
ards have been met. 
(6) Recommendations for actions by Congress 
and the Centers for Medicare & Medicaid Services. 
such as how State Medicaid programs may improve 
care and improve standards and including a rec-
ommendation for how the Centers for Medicare & 
Medicaid Services can improve data collection from 
such programs to address any gaps in information. 
(b) STAKEHOLDER INPUT.—In carrying out sub-
section (a), the Medicaid and CHIP Payment and Access 
Commission shall seek input from State Medicaid direc-
tors and stakeholders, including at a minimum the Sub-
stance Abuse and Mental Health Services Administration, 
Centers for Medicare & Medicaid Services, State Medicaid 
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officials, State mental health authorities, Medicaid bene-
ficiary advocates, health care providers, and Medicaid 
managed care organizations. 
(c) DEFINITIONS.—In this section: 
(1) REPRESENTATIVE
SAMPLE
OF
STATES.— 
The term ‘‘representative sample of States’’ means 
a non-probability sample in which at least two 
States are selected based on the knowledge and pro-
fessional judgment of the selector. 
(2) STATE.—The term ‘‘State’’ means each of 
the 50 States, the District of Columbia, and any 
commonwealth or territory of the United States. 
(3) INSTITUTION FOR MENTAL DISEASES.—The 
term ‘‘institution for mental diseases’’ has the mean-
ing given such term in section 435.1009 of title 42, 
Code of Federal Regulations, or any successor regu-
lation. 
Æ 
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