Sec. 401. Medicaid coverage for eating disorder treatment services
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Section 1905 of the Social Security Act ( 42 U.S.C. 1396d(a) ), as amended by section 2301(a)(1) of the Patient Protection and Affordable Care Act ( Public Law 111–148 ) and section 1202(b) of the Health Care and Education Reconciliation Act of 2010 ( Public Law 111–152 ), is amended— in subsection (a)— in paragraph (28), by striking and at the end; by redesignating paragraph
(29)as paragraph (30); and by inserting after paragraph
(28)the following new paragraph: eating disorder treatment services (as defined in subsection (ee)(1)); and ; and by adding at the end the following new subsection: The term eating disorder treatment services means services relating to diagnosis and treatment of an eating disorder (as defined in section 399OO of the Public Health Service Act), including screening, counseling, pharmacotherapy (including coverage of drugs described in paragraph (2)), and other necessary health care services. For purposes of paragraph (1), eating disorder treatment services shall include drugs provided as part of care in an inpatient setting, covered outpatient drugs (as defined in section 1927(k)(2)), and non-prescription drugs described in section 1927(d)(2)(A) that are prescribed, in accordance with generally accepted medical guidelines, for treatment of an eating disorder. . Section 1905(b) of the Social Security Act ( 42 U.S.C. 1396d(b) ), as amended by section 4106(b) of the Patient Protection and Affordable Care Act, is amended— by striking and before
(5); and by inserting before the period at the end the following: , and
(6)the Federal medical assistance percentage shall be equal to the enhanced FMAP described in section 2105(b) with respect to medical assistance for eating disorder treatment services (as defined in subsection (ee)(1)) provided to an individual who is eligible for such assistance and has an eating disorder (as defined in section 399OO of the Public Health Service Act) . Section 1905(r)(1)(B) of such Act ( 42 U.S.C. 1396d(r)(1)(B) ) is amended— in clause (iv), by striking and at the end; in clause (v), by striking the period at the end and inserting , and ; and by inserting after clause
(v)the following new clause: appropriate diagnostic services relating to eating disorders (as defined in section 399OO of the Public Health Service Act). . Section 1927(d)(2)(A) of such Act ( 42 U.S.C. 1396r–8(d)(2)(A) ) is amended by inserting before the period at the end the following: , except for drugs that are prescribed, in accordance with generally accepted medical guidelines, for the purpose of treatment of an individual who is eligible for medical assistance under the State plan and has an eating disorder (as defined in section 399OO of the Public Health Service Act) . The amendments made by this section shall apply to drugs and services furnished on or after the date of the enactment of this Act.
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- Pub. L. 111-148
- Pub. L. 111-152
- 42 USC 1396r–8(d)(2)(A)
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Sec. 401
Medicaid coverage for eating disorder treatment services
Pub. L.Pub. L. 111-148
Pub. L.Pub. L. 111-152
Cite42 USC 1396r–8(d)(2)(A)
Cites 4Cited by 0 across 0 sources