I 118th CONGRESS 1st Session H. R. 3892 IN THE HOUSE OF REPRESENTATIVES June 7, 2023 Mr. Burgess (for himself and Mr. Torres 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 make permanent the State plan amendment option to provide medical assistance for certain individuals who are patients in certain institutions for mental diseases, and for other purposes.

1. Short title This Act may be cited as the Improving Mental Health and Drug Treatment Act of 2023 . 2. Lifting the IMD exclusion for substance use disorder and serious mental illness (a) Making permanent State Plan Amendment Option To Provide Medical Assistance for Certain Individuals Who Are Patients in Certain Institutions for Mental Diseases Section 1915(l)(1) of the Social Security Act ( 42 U.S.C. 1396n(l)(1) ) is amended by striking With respect to calendar quarters beginning during the period beginning October 1, 2019, and ending September 30, 2023, and inserting With respect to calendar quarters beginning on or after October 1, 2019, . (b) Lengths of stay Section 1915(l)(2) of the Social Security Act ( 42 U.S.C. 1396n(l)(2) ) is amended— (1) by striking 30 days and inserting 45 days ; and (2) by adding at the end the following new sentence: Nothing in this paragraph shall be construed as precluding a State from using other authorities, including section 1115, that apply with respect to medical assistance under the State plan under this title, or waiver of such plan, for delivering care in certain institutions for mental diseases with more than 16 beds concurrently with this paragraph and allowing for stays in such institutions for mental diseases equal to the combined total lengths of stays permitted under the respective authorities so long as all requirements for such authorities are met. . (c) Maintenance of effort revision Clauses (i) and (ii) of section 1915(l)(3)(A) of the Social Security Act ( 42 U.S.C. 1396n(l)(3)(A) ) are each amended by striking or, if higher, and all that follows through in accordance with this subsection . (d) Additional requirements (1) In general (A) General requirements Section 1915(l)(4) of the Social Security Act ( 42 U.S.C. 1396n(l)(4) ) is amended— (i) in subparagraph (A), by striking through (D) and inserting through (E) ; (ii) in subparagraph (D), in the matter preceding clause (i), by inserting have in place a substance use disorder-specific individual placement criteria and utilization management approach to ensure placement of such individual in an appropriate level of care and shall after State shall ; and (iii) by adding at the end the following new subparagraph: (E) Review process The State shall have in place a process to review the compliance of eligible institutions for mental diseases with standards of care for eligible individuals specified by the State. . (B) Effective date The amendments made by subparagraph (A) shall apply with respect to medical assistance furnished in calendar quarters beginning on or after October 1, 2025. (2) One-time assessment Section 1915(l)(4) of the Social Security Act ( 42 U.S.C. 1396n(l)(4) ), as amended by paragraph (1), is further amended by adding at the end the following new subparagraph: (F) Assessment The State shall, not later than 12 months after the approval of a State plan amendment described in this subsection (or, in the case such State has such an amendment approved as of the date of the enactment of this subparagraph, not later than 12 months after such date), conduct an assessment of— (i) the availability of treatment for individuals enrolled under a State plan under this title (or waiver of such plan) in each level of care described in subparagraph (C); and (ii) the availability of medication-assisted treatment and medically supervised withdrawal management services for such individuals. .