Sec. 1015. Opioid addiction treatment programs enhancement

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Not later than the date that is 12 months after the date of enactment of this Act, the Secretary of Health and Human Services (in this section referred to as the Secretary ) shall publish on the public website of the Centers for Medicare & Medicaid Services a report with comprehensive data on the prevalence of substance use disorders in the Medicaid beneficiary population and services provided for the treatment of substance use disorders under Medicaid. The report required under paragraph

(1)shall include, at a minimum, the following data for each State (including, to the extent available, for the District of Columbia, Puerto Rico, the United States Virgin Islands, Guam, the Northern Mariana Islands, and American Samoa): The number and percentage of individuals enrolled in the State Medicaid plan or waiver of such plan in each of the major enrollment categories (as defined in a public letter from the Medicaid and CHIP Payment and Access Commission to the Secretary) who have been diagnosed with a substance use disorder and whether such individuals are enrolled under the State Medicaid plan or a waiver of such plan, including the specific waiver authority under which they are enrolled, to the extent available. A list of the substance use disorder treatment services by each major type of service, such as counseling, medication-assisted treatment, peer support, residential treatment, and inpatient care, for which beneficiaries in each State received at least 1 service under the State Medicaid plan or a waiver of such plan. The number and percentage of individuals with a substance use disorder diagnosis enrolled in the State Medicaid plan or waiver of such plan who received substance use disorder treatment services under such plan or waiver by each major type of service under subparagraph

(B)within each major setting type, such as outpatient, inpatient, residential, and other home-based and community-based settings. The number of services provided under the State Medicaid plan or waiver of such plan per individual with a substance use disorder diagnosis enrolled in such plan or waiver for each major type of service under subparagraph (B). The number and percentage of individuals enrolled in the State Medicaid plan or waiver, by major enrollment category, who received substance use disorder treatment through— a medicaid managed care entity (as defined in section 1932(a)(1)(B) of the Social Security Act ( 42 U.S.C. 1396u–2(a)(1)(B) )), including the number of such individuals who received such assistance through a prepaid inpatient health plan or a prepaid ambulatory health plan; a fee-for-service payment model; or an alternative payment model, to the extent available. The number and percentage of individuals with a substance use disorder who receive substance use disorder treatment services in an outpatient or home-based and community-based setting after receiving treatment in an inpatient or residential setting, and the number of services received by such individuals in the outpatient or home-based and community-based setting. The Secretary shall issue an updated version of the report required under paragraph

(1)not later than January 1 of each calendar year through 2024. The report required under paragraph

(1)and updates required under paragraph

(3)shall— use data and definitions from the Transformed Medicaid Statistical Information System ( T–MSIS ) data set that is no more than 12 months old on the date that the report or update is published; and as appropriate, include a description with respect to each State of the quality and completeness of the data and caveats describing the limitations of the data reported to the Secretary by the State that is sufficient to communicate the appropriate uses for the information. The Secretary shall publish in the Federal Register a system of records notice for the data specified in paragraph

(2)for the Transformed Medicaid Statistical Information System, in accordance with section 552a(e)(4) of title 5, United States Code. The notice shall outline policies that protect the security and privacy of the data that, at a minimum, meet the security and privacy policies of SORN 09–70–0541 for the Medicaid Statistical Information System. The data covered by the systems of records notice required under paragraph

(1)shall be sufficient for researchers and States to analyze the prevalence of substance use disorders in the Medicaid beneficiary population and the treatment of substance use disorders under Medicaid across all States (including the District of Columbia, Puerto Rico, the United States Virgin Islands, Guam, the Northern Mariana Islands, and American Samoa), forms of treatment, and treatment settings. Not later than January 1, 2019, the Secretary shall initiate the data-sharing activities outlined in the notice required under paragraph (1).

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42 USC 1396u–2(a)(1)(B)

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Sec. 1015

Opioid addiction treatment programs enhancement

Cite42 USC 1396u–2(a)(1)(B)

Cites 1Cited by 0 across 0 sources