,i #aaeth ,,congress #b;d ,session ,h4 ,r4 #edgg ,,in ,,the ,,house ,,of ,,representatives ,april #aa1 #bjah,mr4 ,o',halleran introduced the following bill2 which was referred to the ,committee on ,energy and ,commerce ,a ,,bill ,to amend title ,,xix of the ,social ,security ,act to provide for a demonstration project to increase substance use provider capacity under the ,medicaid program4 #a4 ,short title ,this ,act may be cited as the ,rural ,development of ,opioid ,capacity ,services ,act or the ,rural ,,docs ,act4 #b4 ,demonstration project to increase substance use provider capacity under the ,medicaid program ,section #aijc of the ,social ,security ,act 7#db ,u4,s4,c4 #acif;b7 is amended by adding at the end the following new subsection3 7aa7 ,demonstration project ,to increase substance use provider capacity 7#a7 ,in general ,beginning ,january #a1 #bjai1 the ,secretary shall conduct a #e-year demonstration project under which the ,secretary shall provide to an eligible ,state 7as defined in paragraph 7#b77;,a77 payments1 in accordance with paragraph 7#c71 with respect to expenditures by such eligible ,state for incentives1 training1 and technical assistance for providers under the ,state plan 7or a waiver of such plan7 to expand substance use treatment and recovery services for individuals enrolled under such ,state plan 7or waiver71 including each of the following activities3 7,a7 ,activities that support the development of an assessment of the behavioral health treatment needs of the ,state to determine the extent to which providers are needed 7including the types of such providers and geographic area of need7 to improve the network of providers that treat substance use disorders under the ,state plan 7or waiver71 including3 7i7 ,an estimate of the number of individuals enrolled under the ,state plan 7or a waiver of such plan7 who have a substance use disorder4 7ii7 ,information on the capacity of providers to provide substance use disorder services to individuals enrolled under the ,state plan 7or waiver71 including information on providers who provide such services4 7iii7 ,information on the gap in substance use disorder treatment under the ,state plan 7or waiver7 based on the information described in clauses 7i7 and 7ii74 7iv7 ,projections regarding the extent to which participating under the demonstration project would increase the number of providers offering substance use disorder services under the ,state plan 7or waiver7 during the period of the demonstration project4 7,b7 ,activities that1 taking into account the results of the assessment described in subparagraph 7,a71 support the recruitment1 training1 and provision of technical assistance for current1 new1 and prospective participating providers under the ,state plan 7or a waiver of such plan7 that specialize in substance use disorder treatment and recovery4 7,c7 ,activities that specifically expand1 including through the provision of incentives1 the number of providers participating under the ,state plan 7or waiver7 that-- 7i7 are authorized to dispense drugs approved by the ,food and ,drug ,administration for individuals with a substance use disorder who need withdrawal management or maintenance treatment for such disorder2 7ii7 have in effect a registration or waiver under section #cjc7;g7 of the ,controlled ,substances ,act for purposes of dispensing narcotic drugs to individuals for maintenance treatment or detoxification treatment and are in compliance with any regulation promulgated by the ,assistant ,secretary for ,mental ,health and ,substance ,use for purposes of carrying out the requirements of such section #cjc7;g72 and 7iii7 are licensed or certified under applicable ,state law to provide substance use disorder treatment and recovery services4 7,d7 ,activities that specifically expand1 including through the provision of incentives1 the number of providers participating under the ,state plan 7or waiver7 that have the qualifications to address the treatment and recovery needs of-- 7i7 individuals enrolled under the ,state plan 7or a waiver of such plan7 who have neonatal abstinence syndrome1 in accordance with guidelines issued by the ,american ,academy of ,pediatrics and ,american ,college of ,obstetricians and ,gynecologists relating to maternal care and infant care with respect to neonatal abstinence syndrome2 7ii7 postpartum women and infants1 particularly the concurrent treatment and comprehensive case management of postpartum women and infants1 enrolled under the ,state plan 7or a waiver of such plan72 7iii7 adolescents and young adults between the ages of #ab and #ba enrolled under the ,state plan 7or a waiver of such plan72 or 7iv7 ,american ,indian and ,alaska ,native individuals enrolled under the ,state plan 7or a waiver of such plan74 7#b7 ,eligible ,states 7,a7 ,definition ,for purposes of this subsection1 the term eligible ,state means a ,state selected by the ,secretary under subparagraph 7,b74 7,b7 ,selection ,for purposes of this subsection1 the ,secretary shall select #aj ,states that meet the criteria for eligibility under subparagraph 7,c74 ,in selecting such ,states1 the ,secretary shall-- 7i7 select ,states in a manner that ensures geographic diversity2 7ii7 give preference to ,states with a prevalence of substance use disorders 7in particular opioid use disorders7 that is comparable to or higher than the national average prevalence1 as measured by aggregate drug overdoses1 or any other measure that the ,secretary deems appropriate2 and 7iii7 take into consideration the quality of applications submitted under subparagraph 7,d74 7,c7 ,criteria for eligibility ,to be eligible for selection under subparagraph 7,b71 a ,state shall-- 7i7 have a ,state plan 7or waiver of the ,state plan7 approved under this title2 and 7ii7 submit to the ,secretary an application in accordance with the requirements in subparagraph 7,d74 7,d7 ,applications ,for purposes of this paragraph1 a ,state shall submit to the ,secretary1 at such time and in such form and manner as the ,secretary requires1 an application that includes such information1 provisions1 and assurances1 as the ,secretary may require1 in addition to the following3 7i7 ,a proposed process for undertaking the assessment described in paragraph 7#a77;,a74 7ii7 ,a proposed process for reviewing reimbursement methodologies and other policies related to substance use disorder services under the ,state plan 7or waiver7 that may create barriers to increasing the number of providers delivering substance use disorder services4 7iii7 ,a proposed process for developing a plan that will result in long-term and sustainable provider networks under the ,state plan 7or waiver7 that will offer a continuum of care for substance use disorders4 ,such plan shall include the following3 7,i7 ,specific activities to increase access to providers 7including providers that specialize in providing substance use disorder services1 hospitals1 health care systems1 and ,federally qualified health centers7 that offer substance use disorder treatment1 recovery1 and support services1 including short-term detoxification services1 outpatient substance use disorder services1 and evidence-based peer recovery services4 7,,ii7 ,strategies that will incentivize providers described in paragraph 7#a77;,c7 to obtain the necessary training1 education1 and support to deliver substance use disorder services in the ,state4 7,,iii7 ,milestones and timeliness for implementing activities set forth in the plan4 7,,iv7 ,specific measurable targets for increasing the substance use disorder provider network under the ,state plan 7or a waiver of such plan74 7iv7 ,a proposed process for reporting the information required under paragraph 7#d77;,a71 including information demonstrating the progress of the efforts of the ,state to expand the capacity of providers to deliver substance use disorder services during the period of the demonstration project under this subsection4 7v7 ,a projected five-year budget for the ,state to carry out under the demonstration project under this subsection the activities set forth in the plan4 7#c7 ,payment 7,a7 ,in general ,for each quarter occurring during the period for which the demonstration project is conducted1 the ,secretary shall pay under this subsection1 subject to subparagraph 7,b71 to each eligible ,state an amount equal to #ij percent of so much of the sums expended during such quarter as are attributable to activities described in paragraph 7#a74 7,b7 ,non-duplication of payment ,in the case that payment is made under subparagraph 7,a7 with respect to expenditures for activities carried out by an eligible ,state under the demonstration project under this subsection1 payment may not also be made under subsection 7a7 with respect to expenditures for the same activities carried out by the eligible ,state4 7#d7 ,reports 7,a7 ,state reports ,a ,state receiving payments under this subsection shall1 for the period of the demonstration project under this subsection1 submit to the ,secretary a quarterly report1 with respect to expenditures for activities for which payment is made to the ,state under this subsection1 on the following3 7i7 ,the specific activities with respect to which payment under this subsection was provided4 7ii7 ,the number of providers that delivered substance use disorder services in the ,state under the demonstration project compared to the estimated number of providers that would have otherwise delivered such services in the absence of such demonstration project4 7iii7 ,the number of individuals enrolled under the ,state plan 7or a waiver of such plan7 who received substance use disorder services under the demonstration project compared to the estimated number of such individuals who would have otherwise received such services in the absence of such demonstration project4 7iv7 ,other matters as determined by the ,secretary4 7,b7 ,,cms reports 7i7 ,interim report ,not later than ,october #a1 #bjbb1 the ,administrator of the ,centers for ,medicare ,medicaid ,services shall submit to ,congress an interim report on activities carried out under the demonstration project under this subsection4 7ii7 ,final report ,not later than ,october #a1 #bjbd1 the ,administrator of the ,centers for ,medicare ,medicaid ,services shall submit to ,congress a final report on activities carried out under the demonstration project under this subsection4 4