Title: Michelle Alyssa Go Act
Policy area: Health

Summary:
Michelle Alyssa Go Act
This bill removes certain limitations relating to Medicaid coverage of services provided in institutions for mental diseases (IMDs).
Current law generally prohibits federal payment under Medicaid for services provided in IMDs with more than 16 beds for individuals under the age of 65 (although states may receive payment through certain mechanisms, such as through a Medicaid demonstration waiver).
The bill removes the age limitation and allows any institution to qualify as an IMD, regardless of the number of beds, if it primarily treats individuals with mental diseases and meets nationally recognized standards for mental health or substance use disorder programs, as approved by the Centers for Medicare & Medicaid Services.

[Congressional Bills 117th Congress]
[From the U.S. Government Publishing Office]
[H.R. 7803 Introduced in House (IH)]

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117th CONGRESS
  2d Session
                                H. R. 7803

 To amend title XIX of the Social Security Act to remove the exclusion 
    from medical assistance under the Medicaid program of items and 
 services for patients in an institution for mental diseases, and for 
                            other purposes.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                              May 17, 2022

  Mrs. Carolyn B. Maloney of New York 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 remove the exclusion 
    from medical assistance under the Medicaid program of items and 
 services for patients in an institution for mental diseases, 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 ``Michelle Alyssa Go Act''.

SEC. 2. REMOVAL OF AGE EXCLUSION FROM MEDICAL ASSISTANCE OF ITEMS AND 
              SERVICES FOR PATIENTS IN AN INSTITUTION FOR MENTAL 
              DISEASES.

    (a) In General.--Section 1905(a) of the Social Security Act (42 
U.S.C. 1396d(a)) is amended, in the first sentence, in the matter 
following paragraph (31)--
            (1) by striking ``such term does not include--'' and all 
        that follows through ``(a) any'' and inserting ``such term does 
        not include any'';
            (2) by striking ``; or'' and inserting a period; and
            (3) by striking subparagraph (B).
    (b) Conforming Amendments To Permit Medical Assistance for IMD 
Patients Under 65 Years of Age.--Title XIX of the Social Security Act 
(42 U.S.C. 1396a et seq.) is amended--
            (1) in section 1902(a)--
                    (A) in paragraph (20)--
                            (i) in the matter preceding subparagraph 
                        (A), by striking ``65 years of age or older''; 
                        and
                            (ii) in subparagraph (C), by striking ``65 
                        years of age or older''; and
                    (B) in paragraph (21) by striking ``65 years of age 
                or older'';
            (2) in section 1905(a)(14), by striking ``65 years of age 
        or over''; and
            (3) in section 1919(e)(7)(B)(i)(I), by striking ``65 years 
        of age or older''.

SEC. 3. REQUIRED STANDARDS FOR IMDS.

    Section 1905(i) of the Social Security Act (42 U.S.C. 1396d(i)) is 
amended to read as follows:
    ``(i) Institution for Mental Diseases.--The term `institution for 
mental diseases' means a hospital, nursing facility, or other 
institution that--
            ``(1) is primarily engaged in providing diagnosis, 
        treatment, or care of persons with mental diseases, including 
        medical attention, nursing care, and related services; and
            ``(2) meets nationally recognized, evidence-based standards 
        for mental health programs (and, in the case of an institution 
        for mental diseases that provides treatment for substance use 
        disorders, meets nationally recognized, evidence-based 
        standards for substance use disorder programs, such as the 
        latest standards set forth by the American Society of Addiction 
        Medicine), approved by the Secretary, including standards that 
        establish the types of services offered, hours of clinical 
        care, and staffing credentials for such an institution, and any 
        other standards as the Secretary may require.''.

SEC. 4. EFFECTIVE DATE.

    The amendments made by this Act shall take effect 180 days after 
the date of enactment of this Act and shall apply to State plans 
beginning on such date.
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