,i #aacth ,,congress #b;d ,session ,h4 ,r4 #eacf ,,in ,,the ,,house ,,of ,,representatives ,july #ag1 #bjad ,ms4 ,fudge 7for herself1 ,mr4 ,ryan of ,ohio1 ,mr4 ,cummings1 ,ms4 ,lee of ,california1 ,ms4 ,norton1 ,mr4 ,richmond1 ,mr4 ,hastings of ,florida1 and ,ms4 ,clarke of ,new ,york7 introduced the following bill2 which was referred to the ,committee on ,energy and ,commerce ,a ,,bill ,to direct the ,secretary of ,health and ,human ,services to establish a demonstration project under the ,medicaid program under title ,,xix of the ,social ,security ,act under which payment may be made to ,states for expenditures for medical assistance with respect to substance use disorder treatment services1 and for other purposes4 #a4 ,short title ,this ,act may be cited as the ,breaking ,addiction ,act of #bjad4 #b4 ,medicaid community-based inpatient substance use disorder treatment demonstration project 7a7 ,authority ,the ,secretary of ,health and ,human ,services shall establish a #e-year demonstration project 7in this section referred to as the demonstration project7 under which payment may be made to each participating ,state 7as described in subsection 7b771 for any medical assistance provided with respect to a qualified individual in a community-based institution for mental diseases who is being treated in such institution for a substance use condition4 7b7 ,participating ,states 7#a7 ,eligibility ,a ,state is eligible to participate in the demonstration project under this section if the ,state plan of the ,state provides for payment under the plan for community-based inpatient substance use disorder treatment services furnished to qualified individuals4 7#b7 ,application ,a ,state seeking to participate in the demonstration project under this section shall submit to the ,secretary an application1 at such time1 in such form1 and that contains such information1 provisions1 and assurances1 as the ,secretary may require4 7#c7 ,selection ,the ,secretary shall select1 on a competitive basis1 from among the ,states that submit an application under paragraph 7#a7 to the satisfaction of the ,secretary1 the ,states that will be participating in the demonstration project4 ,in selecting such participating ,states1 the ,secretary shall seek to achieve an equitable geographic distribution4 7c7 ,waiver authority 7#a7 ,in general ,the ,secretary shall waive the limitation on payment for care and services imposed by the subdivision 7,b7 that follows paragraph 7#bi7 of section #aije7;a7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acif;d7a77 7relating to a limitation on payments for care or services for any individual who is under #fe years of age and who is a patient in an institution for mental diseases7 with respect to payment for the medical assistance described in subsection 7a74 7#b7 ,limited other waiver authority ,the ,secretary may waive other requirements of titles ,,xi and ,,xix of the ,social ,security ,act 7including the requirements of sections #aijb7;a77#a7 7relating to statewideness7 7#db ,u4,s4,c4 #acif;a7a77#a77 and #aijb7;a77#aj77;,b7 7relating to comparability7 7#db ,u4,s4,c4 #acif;a7a77#aj77;,b77 of such ,act7 only to the extent necessary to carry out the demonstration project under this section4 7d7 ,evaluation and report to congress 7#a7 ,evaluation ,the ,secretary shall conduct an evaluation of the impact the demonstration project carried out under this section has on the functioning of the health and substance use disorder system and individuals enrolled in ,state plans under the ,medicaid program under title ,,xix of the ,social ,security ,act4 ,the evaluation shall include each of the following3 7,a7 ,an assessment of the access such individuals have to substance use disorder treatment services under the demonstration project carried out under this section1 and with respect to such services1 the average lengths of inpatient stays and emergency room visits4 7,b7 ,an assessment of the discharge planning by the health care providers furnishing such services4 7,c7 ,an assessment of the impact of the demonstration project on the costs of the full range of health care items and services1 including inpatient1 emergency and ambulatory care1 diversions from inpatient and emergency care1 and readmissions to institutions for mental diseases4 7,d7 ,an analysis of the percentage of individuals enrolled in such plans who are admitted to community-based institutions for mental diseases as a result of the demonstration project as compared to those admitted to such institutions through other means4 7#b7 ,report ,not later than ,december #ca1 #bjbj1 the ,secretary shall submit to ,congress and make available to the public a report that contains-- 7,a7 the findings of the evaluation under paragraph 7#a72 and 7,b7 the recommendations of the ,secretary regarding whether-- 7i7 the limitation referred to in subsection 7c77#a7 is a barrier to care that needs to be reviewed by ,congress2 and 7ii7 the demonstration project carried out under this section should be continued after ,december #ca1 #bjbj1 and expanded on a national basis4 7e7 ,funding 7#a7 ,appropriation ,out of any funds in the ,treasury not otherwise appropriated1 there is appropriated to carry out this section1 #cjj1jjj1jjj for fiscal year #bjae4 7#b7 #aj-year availability ,funds appropriated under paragraph 7#a7 shall remain available for obligation through ,december #ca1 #bjbd4 7#c7 ,funds allocated to ,states ,funds shall be allocated to participating ,states on the basis of criteria1 including a ,state's application and the availability of funds1 as determined by the ,secretary4 7#d7 ,payment to ,states ,for each calendar quarter beginning on or after ,october #a1 #bjad1 the ,secretary shall pay to each participating ,state1 from the allocation made to the ,state under paragraph 7#c71 an amount equal to the ,federal medical assistance percentage of the amount expended during such quarter for the medical assistance described in subsection 7a74 7#e7 ,limitation on payments ,in no case may-- 7,a7 the aggregate amount of payments made by the ,secretary to participating ,states under this section exceed #cjj1jjj1jjj2 or 7,b7 payments be made by the ,secretary to participating ,states under this section after ,december #ca1 #bjbd4 7f7 ,definitions ,in this section3 7#a7 ,federal medical assistance percentage ,the term ,federal medical assistance percentage has the meaning given such term in section #aije7;b7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acif;d7b774 7#b7 ,institution for mental diseases ,the term institution for mental diseases has the meaning given such term in section #aije7;i7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acif;d7i774 7#c7 ,medical assistance ,the term medical assistance has the meaning given such term in section #aije7;a7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acif;d7a774 7#d7 ,qualified individual ,the term qualified individual means an individual who1 because of the individual's substance use condition1 requires substance use disorder treatment and who-- 7,a7 is over #ba years of age and under #fe years of age2 and 7,b7 is eligible for medical assistance under the ,state plan under the ,medicaid program under title ,,xix of the ,social ,security ,act 7#db ,u4,s4,c4 #acif et seq474 7#e7 ,state ,the term ,state has the meaning given such term for purposes of title ,,xix of the ,social ,security ,act 7#db ,u4,s4,c4 #acif et seq474