,i  #aae? ,,congress  #b;d ,session  ,h4
 ,r4 #edgg  ,,9 ,,! ,,h\se ,,(          
,,repres5tatives  ,april #aa1 #bjah,mr4 
,o',hall]an introduc$ ! foll[+ bill2 :i*
 0 ref]r$ to ! ,committee on ,en]gy &   
,comm]ce  ,a ,,bill  ,to am5d title     
,,xix ( ! ,social ,security ,act to     
provide = a demon/ration project to     
increase sub/ance use provid] capacity  
"u ! ,m$icaid program4  #a4 ,%ort title 
,?is ,act may be cit$ z ! ,rural        
,developm5t ( ,opioid ,capacity ,s]vices
 ,act or ! ,rural ,,docs ,act4  #b4     
,demon/ration project to increase       
sub/ance use provid] capacity "u !      
,m$icaid program ,section #aijc ( !     
,social ,security ,act 7#db ,u4,s4,c4   
#acif;b7 is am5d$ by add+ at ! end !    
foll[+ new subsection3  7aa7            
,demon/ration project ,to increase      
sub/ance use provid] capacity  7#a7 ,9  
g5]al ,beg9n+ ,janu>y #a1 #bjai1 !      
,secret>y %all conduct a #e-ye>         
demon/ration project "u :i* ! ,secret>y 
%all provide to an eligible ,/ate 7z    

def9$ 9 p>agraph 7#b77;,a77 paym5ts1 9  
accordance ) p>agraph 7#c71 ) respect to
 exp5ditures by su* eligible ,/ate =    
inc5tives1 tra9+1 & te*nical assi/ance =
 provid]s "u ! ,/ate plan 7or a waiv] ( 
su* plan7 to exp& sub/ance use treatm5t 
& recov]y s]vices = individuals enroll$ 
"u su* ,/ate plan 7or waiv]71 includ+   
ea* ( ! foll[+ activities3  7,a7        
,activities t support ! developm5t ( an 
assessm5t ( ! behavioral heal? treatm5t 
ne$s ( ! ,/ate to det]m9e ! ext5t to :i*
 provid]s are ne$$ 7includ+ ! types (   
su* provid]s & geographic area ( ne$7 to
 improve ! network ( provid]s t treat   
sub/ance use disord]s "u ! ,/ate plan   
7or waiv]71 includ+3  7i7 ,an e/imate ( 
! numb] ( individuals enroll$ "u ! ,/ate
 plan 7or a waiv] ( su* plan7 :o h a    
sub/ance use disord]4  7ii7 ,in=mation  
on ! capacity ( provid]s to provide     
sub/ance use disord] s]vices to         
individuals enroll$ "u ! ,/ate plan 7or 
waiv]71 includ+ in=mation on provid]s :o
 provide su* s]vices4  7iii7 ,in=mation 

on ! gap 9 sub/ance use disord] treatm5t
 "u ! ,/ate plan 7or waiv]7 bas$ on !   
in=mation describ$ 9 clauses 7i7 & 7ii74
  7iv7 ,projections reg>d+ ! ext5t to   
:i* p>ticipat+ "u ! demon/ration project
 w\ld increase ! numb] ( provid]s (f]+  
sub/ance use disord] s]vices "u ! ,/ate 
plan 7or waiv]7 dur+ ! p]iod ( !        
demon/ration project4  7,b7 ,activities 
t1 tak+ into acc\nt ! results ( !       
assessm5t describ$ 9 subp>agraph 7,a71  
support ! recruitm5t1 tra9+1 & provision
 ( te*nical assi/ance = curr5t1 new1 &  
prospective p>ticipat+ provid]s "u !    
,/ate plan 7or a waiv] ( su* plan7 t    
specialize 9 sub/ance use disord]       
treatm5t & recov]y4  7,c7 ,activities t 
specifically exp&1 includ+ ?r\gh !      
provision ( inc5tives1 ! numb] (        
provid]s p>ticipat+ "u ! ,/ate plan 7or 
waiv]7 t--  7i7 are au?oriz$ to disp5se 
drugs approv$ by ! ,food & ,drug        
,adm9i/ration = individuals ) a sub/ance
 use disord] :o ne$ )drawal managem5t or
 ma9t5ance treatm5t = su* disord]2  7ii7

 h 9 effect a regi/ration or waiv] "u   
section #cjc7;g7 ( ! ,controll$         
,sub/ances ,act = purposes ( disp5s+    
n>cotic drugs to individuals = ma9t5ance
 treatm5t or detoxification treatm5t &  
are 9 compliance ) any regulation       
promulgat$ by ! ,assi/ant ,secret>y =   
,m5tal ,heal? & ,sub/ance ,use =        
purposes ( c>ry+ out ! requirem5ts ( su*
 section #cjc7;g72 &  7iii7 are lic5s$  
or c]tifi$ "u applicable ,/ate law to   
provide sub/ance use disord] treatm5t & 
recov]y s]vices4  7,d7 ,activities t    
specifically exp&1 includ+ ?r\gh !      
provision ( inc5tives1 ! numb] (        
provid]s p>ticipat+ "u ! ,/ate plan 7or 
waiv]7 t h ! qualifications to address !
 treatm5t & recov]y ne$s (--  7i7       
individuals enroll$ "u ! ,/ate plan 7or 
a waiv] ( su* plan7 :o h neonatal       
ab/95ce syndrome1 9 accordance )        
guidel9es issu$ by ! ,am]ican ,academy (
 ,p$iatrics & ,am]ican ,college (       
,ob/etricians & ,gynecologi/s relat+ to 
mat]nal c>e & infant c>e ) respect to   

neonatal ab/95ce syndrome2  7ii7        
po/p>tum wom5 & infants1 p>ticul>ly !   
concurr5t treatm5t & compreh5sive case  
managem5t ( po/p>tum wom5 & infants1    
enroll$ "u ! ,/ate plan 7or a waiv] (   
su* plan72  7iii7 adolesc5ts & "y adults
 betwe5 ! ages ( #ab & #ba enroll$ "u ! 
,/ate plan 7or a waiv] ( su* plan72 or  
7iv7 ,am]ican ,indian & ,alaska ,native 
individuals enroll$ "u ! ,/ate plan 7or 
a waiv] ( su* plan74  7#b7 ,eligible    
,/ates  7,a7 ,def9ition ,= purposes (   
?is subsection1 ! t]m eligible ,/ate    
means a ,/ate select$ by ! ,secret>y "u 
subp>agraph 7,b74  7,b7 ,selection ,=   
purposes ( ?is subsection1 ! ,secret>y  
%all select #aj ,/ates t meet ! crit]ia 
= eligibility "u subp>agraph 7,c74 ,9   
select+ su* ,/ates1 ! ,secret>y %all--  
7i7 select ,/ates 9 a mann] t ensures   
geographic div]sity2  7ii7 give pref]5ce
 to ,/ates ) a preval5ce ( sub/ance use 
disord]s 79 p>ticul> opioid use         
disord]s7 t is comp>able to or high] ?an
 ! national av]age preval5ce1 z measur$ 

by aggregate drug ov]doses1 or any o!r  
measure t ! ,secret>y deems appropriate2
 &  7iii7 take into consid]ation !      
quality ( applications submitt$ "u      
subp>agraph 7,d74  7,c7 ,crit]ia =      
eligibility ,to be eligible = selection 
"u subp>agraph 7,b71 a ,/ate %all--  7i7
 h a ,/ate plan 7or waiv] ( ! ,/ate     
plan7 approv$ "u ?is title2 &  7ii7     
submit to ! ,secret>y an application 9  
accordance ) ! requirem5ts 9 subp>agraph
 7,d74  7,d7 ,applications ,= purposes (
 ?is p>agraph1 a ,/ate %all submit to ! 
,secret>y1 at su* "t & 9 su* =m & mann] 
z ! ,secret>y requires1 an application t
 includes su* in=mation1 provisions1 &  
assurances1 z ! ,secret>y may require1 9
 addition to ! foll[+3  7i7 ,a propos$  
process = und]tak+ ! assessm5t describ$ 
9 p>agraph 7#a77;,a74  7ii7 ,a propos$  
process = review+ reimbursem5t          
me?odologies & o!r policies relat$ to   
sub/ance use disord] s]vices "u ! ,/ate 
plan 7or waiv]7 t may create b>ri]s to  
increas+ ! numb] ( provid]s deliv]+     

sub/ance use disord] s]vices4  7iii7 ,a 
propos$ process = develop+ a plan t w   
result 9 long-t]m & su/a9able provid]   
networks "u ! ,/ate plan 7or waiv]7 t w 
(f] a cont9uum ( c>e = sub/ance use     
disord]s4 ,su* plan %all include !      
foll[+3  7,i7 ,specific activities to   
increase access to provid]s 7includ+    
provid]s t specialize 9 provid+ sub/ance
 use disord] s]vices1 hospitals1 heal?  
c>e sy/ems1 & ,f$]ally qualifi$ heal?   
c5t]s7 t (f] sub/ance use disord]       
treatm5t1 recov]y1 & support s]vices1   
includ+ %ort-t]m detoxification s]vices1
 outpati5t sub/ance use disord] s]vices1
 & evid5ce-bas$ pe] recov]y s]vices4    
7,,ii7 ,/rategies t w inc5tivize        
provid]s describ$ 9 p>agraph 7#a77;,c7  
to obta9 ! necess>y tra9+1 education1 & 
support to deliv] sub/ance use disord]  
s]vices 9 ! ,/ate4  7,,iii7 ,mile/ones &
 timel9ess = implem5t+ activities set =?
 9 ! plan4  7,,iv7 ,specific measurable 
t>gets = increas+ ! sub/ance use disord]
 provid] network "u ! ,/ate plan 7or a  

waiv] ( su* plan74  7iv7 ,a propos$     
process = report+ ! in=mation requir$ "u
 p>agraph 7#d77;,a71 includ+ in=mation  
demon/rat+ ! progress ( ! ef=ts ( !     
,/ate to exp& ! capacity ( provid]s to  
deliv] sub/ance use disord] s]vices dur+
 ! p]iod ( ! demon/ration project "u ?is
 subsection4  7v7 ,a project$ five-ye>  
budget = ! ,/ate to c>ry out "u !       
demon/ration project "u ?is subsection !
 activities set =? 9 ! plan4  7#c7      
,paym5t  7,a7 ,9 g5]al ,= ea* qu>t]     
occurr+ dur+ ! p]iod = :i* !            
demon/ration project is conduct$1 !     
,secret>y %all pay "u ?is subsection1   
subject to subp>agraph 7,b71 to ea*     
eligible ,/ate an am\nt equal to #ij    
p]c5t ( s mu* ( ! sums exp5d$ dur+ su*  
qu>t] z are attributable to activities  
describ$ 9 p>agraph 7#a74  7,b7         
,non-duplication ( paym5t ,9 ! case t   
paym5t is made "u subp>agraph 7,a7 )    
respect to exp5ditures = activities     
c>ri$ out by an eligible ,/ate "u !     
demon/ration project "u ?is subsection1 

paym5t may n also be made "u subsection 
7a7 ) respect to exp5ditures = ! same   
activities c>ri$ out by ! eligible      
,/ate4  7#d7 ,reports  7,a7 ,/ate       
reports ,a ,/ate receiv+ paym5ts "u ?is 
subsection %all1 = ! p]iod ( !          
demon/ration project "u ?is subsection1 
submit to ! ,secret>y a qu>t]ly report1 
) respect to exp5ditures = activities = 
:i* paym5t is made to ! ,/ate "u ?is    
subsection1 on ! foll[+3  7i7 ,!        
specific activities ) respect to :i*    
paym5t "u ?is subsection 0 provid$4     
7ii7 ,! numb] ( provid]s t deliv]$      
sub/ance use disord] s]vices 9 ! ,/ate  
"u ! demon/ration project comp>$ to !   
e/imat$ numb] ( provid]s t w\ld h       
o!rwise deliv]$ su* s]vices 9 ! abs5ce (
 su* demon/ration project4  7iii7 ,!    
numb] ( individuals enroll$ "u ! ,/ate  
plan 7or a waiv] ( su* plan7 :o receiv$ 
sub/ance use disord] s]vices "u !       
demon/ration project comp>$ to ! e/imat$
 numb] ( su* individuals :o w\ld h      
o!rwise receiv$ su* s]vices 9 ! abs5ce (

 su* demon/ration project4  7iv7 ,o!r   
matt]s z det]m9$ by ! ,secret>y4  7,b7  
,,cms reports  7i7 ,int]im report ,n    
lat] ?an ,octob] #a1 #bjbb1 !           
,adm9i/rator ( ! ,c5t]s = ,m$ic>e       
,m$icaid ,s]vices %all submit to        
,congress an int]im report on activities
 c>ri$ out "u ! demon/ration project "u 
?is subsection4  7ii7 ,f9al report ,n   
lat] ?an ,octob] #a1 #bjbd1 !           
,adm9i/rator ( ! ,c5t]s = ,m$ic>e       
,m$icaid ,s]vices %all submit to        
,congress a f9al report on activities   
c>ri$ out "u ! demon/ration project "u  
?is subsection4  4