to such States or to the Federal Government under 
this title. 
‘‘(3) REPORT
ON
PLAN
FOR
COORDINATED 
CARE.—Not later than January 1, 2021, each State 
operating a qualified drug management program 
shall submit to the Administrator of the Centers for 
Medicare & Medicaid Services a report on how such 
State plans to provide coordinated care for individ-
uals enrolled under the State plan (or waiver of the 
State plan) and— 
‘‘(A) who are enrolled under the program; 
or 
‘‘(B) who are enrolled with a managed care 
entity and enrolled under such a qualified drug 
management program operated by such entity. 
‘‘(f) APPLICABILITY
TO
MANAGED
CARE
ENTI-
TIES.— 
‘‘(1) IN GENERAL.—With respect to any con-
tract that a State enters into on or after January 
1, 2020, with a managed care entity (as defined in 
section 1932(a)(1)(B)) pursuant to section 1903(m), 
the State shall, as a condition of the contract, re-
quire the managed care entity— 
‘‘(A) to operate a qualified drug manage-
ment program (as defined in subsection (b)) for 
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pbinns on DSK79D2C42PROD with BILLS
at-risk beneficiaries who are enrolled with such 
entity and identified by the managed care entity 
by means of application of paragraph (2); 
‘‘(B) to submit to the State an annual re-
port on the matters described in subparagraphs 
(A) through (E) of subsection (e)(1); and 
‘‘(C) to submit to the State a list (and as 
necessary update such list) of individuals en-
rolled with such entity under the qualified drug 
management program operated by such entity 
under subparagraph (A) for purposes of allow-
ing State plans for which medical assistance is 
paid on a fee-for-service basis to have access to 
such information. 
‘‘(2) APPLICATION.—For purposes of applying, 
with respect to a managed care entity— 
‘‘(A) under paragraph (1)(A)— 
‘‘(i) the definition of the term ‘quali-
fied drug management program’ under 
subsection (b), other than paragraph 
(2)(D) of such subsection; and 
‘‘(ii) the provisions of paragraphs (1) 
and (2) of subsection (c); and 
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pbinns on DSK79D2C42PROD with BILLS
‘‘(B) under paragraph (1)(B), the report 
requirements described in subparagraphs (A) 
through (E) of subsection (e)(1); 
each reference in such subsection (b) and para-
graphs of subsection (c) to ‘a State’ or ‘the State’ 
(other than to ‘a State plan’ or ‘the State plan’) 
shall be deemed a reference to the managed care en-
tity, each reference under such subsection, para-
graphs, or subparagraphs to individuals enrolled 
under the State plan (or waiver of the State plan) 
shall be deemed a reference to individuals enrolled 
with such entity, and each reference under such sub-
section, paragraphs, or subparagraphs to individuals 
enrolled under the qualified drug management pro-
gram operated by the State shall be deemed a ref-
erence to individuals enrolled under the qualified 
drug management program operated by the man-
aged care entity. 
‘‘(g) CONTROLLED SUBSTANCE DEFINED.—For pur-
poses of this section, the term ‘controlled substance’ 
means a drug that is included in schedule II, III, or IV 
of section 202(c) of the Controlled Substances Act, or any 
combination thereof, as specified by the State.’’. 
(b) 
GUIDANCE
ON
AT-RISK
POPULATION 
TRANSITIONING BETWEEN MEDICAID FFS AND MAN-
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pbinns on DSK79D2C42PROD with BILLS
AGED CARE.—Not later than October 1, 2019, the Sec-
retary of Health and Human Services shall issue guidance 
for State Medicaid programs, with respect to individuals 
who are enrolled under a State plan (or waiver of such 
plan) under title XIX of the Social Security Act and under 
a drug management program, for purposes of providing 
best practices— 
(1) for transitioning, as applicable, such indi-
viduals from fee-for-service Medicaid (and such a 
program operated by the State) to receiving medical 
assistance under such title through a managed care 
entity (as defined in section 1932(a)(1)(B) of the 
Social Security Act) with a contract that with the 
State pursuant to section 1903(m) of such Act (and 
such a program operated by such entity); and 
(2) for transitioning, as applicable, such indi-
viduals from receiving medical assistance under such 
title through a managed care entity (as defined in 
section 1932(a)(1)(B) of the Social Security Act) 
with a contract that with the State pursuant to sec-
tion 1903(m) of such Act (and such a program oper-
ated by such entity) to fee-for-service Medicaid (and 
such a program operated by the State). 
(c) 
GUIDANCE
ON
AT-RISK
POPULATION 
TRANSITIONING TO MEDICARE.— 
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pbinns on DSK79D2C42PROD with BILLS
(1) IN GENERAL.—Not later than January 1, 
2020, the Secretary of Health and Human Services, 
after consultation with the Federal Coordinated 
Health Care Office established under section 2602 
of the Patient Protection and Affordable Care Act 
(42 U.S.C. 1315b), shall issue guidance for State 
Medicaid programs, with respect to transitioning in-
dividuals, providing for— 
(A) notification to be submitted by the 
State to the Centers for Medicare & Medicaid 
Services and such individuals of the status of 
such individuals as transitioning individuals; 
(B) notification to such individuals about 
enrollment under a prescription drug plan 
under part D of such title or under a MA–PD 
plan under part C of such title; 
(C) best practices for transitioning such in-
dividuals to such a plan; and 
(D) best practices for coordination between 
the qualified drug management program (as de-
scribed in section 1927A(b) of the Social Secu-
rity Act, as added by subsection (a)) carried out 
by the State and a drug management program 
carried out under such a plan pursuant to sec-
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