Title: Ensuring Complete Coverage of Medication-Assisted Treatment Act
Policy area: Health

Summary:
Ensuring Complete Coverage of Medication-Assisted Treatment Act
This bill requires coverage of medication-assisted treatment, which is used to treat substance-use disorders, under Medicaid.

[Congressional Bills 115th Congress]
[From the U.S. Government Publishing Office]
[H.R. 5802 Introduced in House (IH)]

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115th CONGRESS
  2d Session
                                H. R. 5802

  To amend title XIX of the Social Security Act to require States to 
   include under their State Medicaid plans coverage for medication-
              assisted treatment, and for other purposes.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                              May 15, 2018

   Mr. Gene Green of Texas 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 require States to 
   include under their State Medicaid plans coverage for medication-
              assisted treatment, and for other purposes.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Ensuring Complete Coverage of 
Medication-Assisted Treatment Act''.

SEC. 2. REQUIREMENT FOR STATE MEDICAID PLANS TO PROVIDE COVERAGE FOR 
              MEDICATION-ASSISTED TREATMENT.

    (a) Requirement for State Medicaid Plans To Provide Coverage for 
Medication-Assisted Treatment.--Section 1902(a)(10)(A) of the Social 
Security Act (42 U.S.C. 1396a(a)(10)(A)) is amended, in the matter 
preceding clause (i), by striking ``and (28)'' and inserting ``(28), 
and (29)''.
    (b) Inclusion of Medication-Assisted Treatment as Medical 
Assistance.--Section 1905(a) of the Social Security Act (42 U.S.C. 
1396d(a)) is amended--
            (1) in paragraph (28), by striking ``and'' at the end;
            (2) by redesignating paragraph (29) as paragraph (30); and
            (3) by inserting after paragraph (28) the following new 
        paragraph:
            ``(29) beginning, subject to paragraph (2) of subsection 
        (ee), January 1, 2020, medication-assisted treatment (as 
        defined in paragraph (1) of such subsection); and''.
    (c) Medication-Assisted Treatment Defined; Waivers.--Section 1905 
of the Social Security Act (42 U.S.C. 1396d) is amended by adding at 
the end the following new subsection:
    ``(ee) Medication-Assisted Treatment Defined; Waivers.--
            ``(1) Medication-assisted treatment defined.--For purposes 
        of subsection (a)(29), the term `medication-assisted 
        treatment'--
                    ``(A) means all drugs approved under section 505 of 
                the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 
                355), including methadone, and all biological products 
                licensed under section 351 of the Public Health Service 
                Act (42 U.S.C. 262) to treat substance use disorders; 
                and
                    ``(B) includes, with respect to the provision of 
                such drugs and biological products, counseling services 
                and behavioral therapy.
            ``(2) Waivers.--For purposes of subsection (a)(29), the 
        Secretary may grant a waiver, with respect to a State, to delay 
        the application of such subsection if the State submits a 
        waiver request that includes the following:
                    ``(A) The reasoning for such waiver.
                    ``(B) A timeline for the State to implement the 
                requirement of such subsection.
                    ``(C) A review of any prior authorization program 
                and any drug utilization management program established 
                by the State under the State plan (or a waiver of such 
                plan) to assess the types of barriers that individuals 
                encounter in accessing medication-assisted treatment 
                (as defined in paragraph (1)) under such plan (or 
                waiver).
                    ``(D) Any other information that the Secretary may 
                require.''.
    (d) Effective Date.--
            (1) In general.--Subject to paragraph (2), the amendments 
        made by this section shall take effect with respect to medical 
        assistance provided on or after January 1, 2020.
            (2) Exception for state legislation.--In the case of a 
        State plan under title XIX of the Social Security Act (42 
        U.S.C. 1396 et seq.) that the Secretary of Health and Human 
        Services determines requires State legislation in order for the 
        respective plan to meet any requirement imposed by the 
        amendments made by this section, the respective plan shall not 
        be regarded as failing to comply with the requirements of such 
        title solely on the basis of its failure to meet such an 
        additional requirement before the first day of the first 
        calendar quarter beginning after the close of the first regular 
        session of the State legislature that begins after the date of 
        the enactment of this Act. For purposes of the previous 
        sentence, in the case of a State that has a 2-year legislative 
        session, each year of the session shall be considered to be a 
        separate regular session of the State legislature.
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