Title: Medicaid IMD ADDITIONAL INFO Act
Policy area: Health

Summary:
Medicaid Institutes for Mental Disease Are Decisive in Delivering Inpatient Treatment for Individuals but Opportunities for Needed Access are Limited without Information Needed about Facility Obligations Act or the Medicaid IMD ADDITIONAL INFO Act
This bill requires the Medicaid and Children's Health Insurance Program (CHIP) Payment and Access Commission to report on information relating to services for Medicaid enrollees who are patients in institutions for mental diseases (IMDs), including: (1) the number and type of IMDs in each sampled state and associated coverage limitations, (2) services and processes provided at such IMDs, (3) applicable federal waivers and other Medicaid funding sources for such IMDs, (4) state requirements for such IMDs to receive funding, and (5) recommendations to improve standards and data collection for IMDs.

[Congressional Bills 115th Congress]
[From the U.S. Government Publishing Office]
[H.R. 5800 Introduced in House (IH)]

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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 institutions for mental diseases under the Medicaid 
                                program.

    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 ``Medicaid Institutes for Mental 
Disease Are Decisive in Delivering Inpatient Treatment for Individuals 
but Opportunities for Needed Access are Limited without Information 
Needed about Facility Obligations Act'' or the ``Medicaid IMD 
ADDITIONAL INFO Act''.

SEC. 2. MACPAC EXPLORATORY STUDY AND REPORT ON INSTITUTIONS FOR MENTAL 
              DISEASES REQUIREMENTS AND PRACTICES UNDER MEDICAID.

    (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 information, 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 minimum--
                    (A) the number of such institutions in the State;
                    (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 institution;
                    (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 institution, 
                including any care continuum of relevant 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 institutions, such as 
                supplemental payments.
            (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 determines 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 receive payment under such State 
        plans (or waivers) and how each such State determines if such 
        standards 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 
        recommendation 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 subsection (a), the 
Medicaid and CHIP Payment and Access Commission shall seek input from 
State Medicaid directors and stakeholders, including at a minimum the 
Substance Abuse and Mental Health Services Administration, Centers for 
Medicare & Medicaid Services, State Medicaid officials, State mental 
health authorities, Medicaid beneficiary 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 professional 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 meaning given such 
        term in section 435.1009 of title 42, Code of Federal 
        Regulations, or any successor regulation.
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