Sec. 1009. Medicaid substance use disorder treatment via telehealth
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In this section: The term Comptroller General means the Comptroller General of the United States. The term school-based health center has the meaning given that term in section 2110(c)(9) of the Social Security Act ( 42 U.S.C. 1397jj(c)(9) ). The term Secretary means the Secretary of Health and Human Services. The term underserved area means a health professional shortage area (as defined in section 332(a)(1)(A) of the Public Health Service Act ( 42 U.S.C. 254e(a)(1)(A) )) and a medically underserved area (according to a designation under section 330(b)(3)(A) of the Public Health Service Act ( 42 U.S.C. 254b(b)(3)(A) )).
Not later than 1 year after the date of enactment of this Act, the Secretary, acting through the Administrator of the Centers for Medicare & Medicaid Services, shall issue guidance to States on the following: State options for Federal reimbursement of expenditures under Medicaid for furnishing services and treatment for substance use disorders, including assessment, medication-assisted treatment, counseling, medication management, and medication adherence with prescribed medication regimes, using services delivered via telehealth.
Such guidance shall also include guidance on furnishing services and treatments that address the needs of high-risk individuals, including at least the following groups: American Indians and Alaska Natives. Adults under the age of 40. Individuals with a history of non-fatal overdose. Individuals with a co-occurring serious mental illness and substance use disorder. State options for Federal reimbursement of expenditures under Medicaid for education directed to providers serving Medicaid beneficiaries with substance use disorders using the hub and spoke model, through contracts with managed care entities, through administrative claiming for disease management activities, and under Delivery System Reform Incentive Payment ( DSRIP ) programs.
State options for Federal reimbursement of expenditures under Medicaid for furnishing services and treatment for substance use disorders for individuals enrolled in Medicaid in a school-based health center using services delivered via telehealth. The Comptroller General shall evaluate children’s access to services and treatment for substance use disorders under Medicaid. The evaluation shall include an analysis of State options for improving children's access to such services and treatment and for improving outcomes, including by increasing the number of Medicaid providers who offer services or treatment for substance use disorders in a school-based health center using services delivered via telehealth, particularly in rural and underserved areas.
The evaluation shall include an analysis of Medicaid provider reimbursement rates for services and treatment for substance use disorders. Not later than 1 year after the date of enactment of this Act, the Comptroller General shall submit to Congress a report containing the results of the evaluation conducted under paragraph (1), together with recommendations for such legislation and administrative action as the Comptroller General determines appropriate. Not later than 1 year after the date of enactment of this Act, the Secretary, acting through the Administrator of the Centers for Medicare & Medicaid Services, shall issue a report to the Committee on Finance of the Senate and the Committee on Energy and Commerce of the House of Representatives identifying best practices and potential solutions for reducing barriers to using services delivered via telehealth to furnish services and treatment for substance use disorders among pediatric populations under Medicaid.
The report shall include— analyses of the best practices, barriers, and potential solutions for using services delivered via telehealth to diagnose and provide services and treatment for children with substance use disorders, including opioid use disorder; and identification and analysis of the differences, if any, in furnishing services and treatment for children with substance use disorders using services delivered via telehealth and using services delivered in person, such as, and to the extent feasible, with respect to— utilization rates; costs; avoidable inpatient admissions and readmissions; quality of care; and patient, family, and provider satisfaction.
The Secretary shall publish the report required under paragraph
(1)on a public internet website of the Department of Health and Human Services.
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Sec. 1009
Medicaid substance use disorder treatment via telehealth
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