I 
115TH CONGRESS 
2D SESSION 
H. R. 5810 
To amend title XIX of the Social Security Act to provide for an extension 
of the enhanced FMAP for certain Medicaid health homes for individuals 
with substance use disorders. 
IN THE HOUSE OF REPRESENTATIVES 
MAY 15, 2018 
Mr. LANCE (for himself, Mr. WELCH, and Mr. ROTHFUS) 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 provide 
for an extension of the enhanced FMAP for certain 
Medicaid health homes for individuals with substance 
use disorders. 
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 Health 
Homes for Opioid-Use-Disorder Medicaid Enrollees En-
couraged Act’’ or the ‘‘Medicaid Health HOME Act’’. 
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SEC. 2. EXTENSION OF ENHANCED FMAP FOR CERTAIN 
HEALTH HOMES FOR INDIVIDUALS WITH 
SUBSTANCE USE DISORDERS. 
Section 1945 of the Social Security Act (42 U.S.C. 
1396w–4) is amended— 
(1) in subsection (c)— 
(A) in paragraph (1), by inserting ‘‘subject 
to paragraph (4),’’ after ‘‘except that,’’; and 
(B) by adding at the end the following new 
paragraph: 
‘‘(4) SPECIAL RULE RELATING TO SUBSTANCE 
USE DISORDER HEALTH HOMES.— 
‘‘(A) IN GENERAL.—In the case of a State 
with an SUD-focused State plan amendment 
approved by the Secretary on or after October 
1, 2018, the Secretary may, at the request of 
the State, extend the application of the Federal 
medical assistance percentage described in 
paragraph (1) to payments for the provision of 
health home services to SUD-eligible individuals 
under such State plan amendment, in addition 
to the first 8 fiscal year quarters the State plan 
amendment is in effect, for the subsequent 2 
fiscal year quarters that the State plan amend-
ment is in effect. Nothing in this section shall 
be construed as prohibiting a State with a State 
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plan amendment that is approved under this 
section and that is not an SUD-focused State 
plan amendment from additionally having ap-
proved on or after such date an SUD-focused 
State plan amendment under this section, in-
cluding for purposes of application of this para-
graph. 
‘‘(B) REPORT
REQUIREMENTS.—In the 
case of a State with an SUD-focused State plan 
amendment for which the application of the 
Federal medical assistance percentage has been 
extended under subparagraph (A), such State 
shall, at the end of the period of such State 
plan amendment, submit to the Secretary a re-
port on the following, with respect to SUD-eli-
gible individuals provided health home services 
under such State plan amendment: 
‘‘(i) The quality of health care pro-
vided to such individuals, with a focus on 
outcomes relevant to the recovery of each 
such individual. 
‘‘(ii) The access of such individuals to 
health care. 
‘‘(iii) The total expenditures of such 
individuals for health care. 
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For purposes of this subparagraph, the 
Secretary shall specify all applicable meas-
ures for determining quality, access, and 
expenditures. 
‘‘(C) BEST
PRACTICES.—Not later than 
October 1, 2020, the Secretary shall make pub-
licly available on the Internet website of the 
Centers for Medicare & Medicaid Services best 
practices for designing and implementing an 
SUD-focused State plan amendment, based on 
the experiences of States that have State plan 
amendments approved under this section that 
include SUD-eligible individuals. 
‘‘(D) DEFINITIONS.—For purposes of this 
paragraph: 
‘‘(i) SUD-ELIGIBLE
INDIVIDUALS.— 
The term ‘SUD-eligible individual’ means, 
with respect to a State, an individual who 
satisfies all of the following: 
‘‘(I) The individual is an eligible 
individual with chronic conditions. 
‘‘(II) The individual is an indi-
vidual with a substance use disorder. 
‘‘(III) The individual has not pre-
viously received health home services 
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under any other State plan amend-
ment approved for the State under 
this section by the Secretary. 
‘‘(ii) 
SUD-FOCUSED
STATE
PLAN 
AMENDMENT.—The 
term 
‘SUD-focused 
State plan amendment’ means a State plan 
amendment under this section that is de-
signed to provide health home services pri-
marily to SUD-eligible individuals.’’. 
Æ 
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