Sec. 212. State option to provide medical assistance for residential addiction treatment facility services
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Section 1905 of the Social Security Act ( 42 U.S.C. 1396d ) is amended— in subsection (a)(16)— by striking as defined in subsection (h), and,
(B)and inserting as defined in subsection (h)(1),
(B); and by inserting , and
(C)residential addiction treatment facility services (as defined in subsection (h)(3)), if offered as part of a full continuum of evidence-based treatment services provided under the State plan, including residential, outpatient, and community-based care, for individuals with substance use disorders before the semicolon; and in subsection (h)— in paragraph (1), by striking paragraph
(16)of subsection
(a)and inserting subsection (a)(16)(A) ; and by adding at the end the following: For purposes of subsection (a)(16)(C), the term residential addiction treatment facility services means, subject to subparagraph (B), inpatient services provided— to an individual for the purpose of treating a substance use disorder that are furnished to an individual in the State for not more than 60 consecutive days (on a statewide average basis), provided that upon completion of each period of 30 consecutive days of treatment, the individual is assessed and determined to have progressed through the clinical continuum of care, in accordance with criteria established by the Secretary, in consultation with the American Society of Addiction Medicine, and requires continued medically necessary treatment and social support services to promote recovery, stable transition to ongoing treatment, and discharge; and in a facility that is accredited for the treatment of substance use disorders by the Joint Commission on Accreditation of Healthcare Organizations, the Commission on Accreditation of Rehabilitation Facilities, the Council on Accreditation, or any other accrediting agency that the Secretary deems appropriate as necessary to ensure nationwide applicability, including qualified national organizations and State-level accrediting agencies. The State agency responsible for administering the State plan under this title shall establish procedures to ensure that, with respect to any facility providing residential addiction treatment facility services in a fiscal year, the number of beds used by the facility to provide such services during such year is consistent with State licensure standards. The provision of medical assistance for residential addiction treatment facility services to an individual shall not prohibit Federal financial participation for medical assistance for items or services that are provided to the individual in or away from the residential addiction treatment facility during any 30-day period in which the individual is receiving residential addiction treatment facility services. A woman who is eligible for medical assistance on the basis of being pregnant and who is furnished residential addiction treatment facility services during any 30-day period may remain eligible for, and continue to be furnished with, such services for additional 30-day periods without regard to any eligibility limit that would otherwise apply to the woman as a result of her pregnancy ending, subject to assessment by the facility and a determination based on medical necessity related to substance use disorder and the impact of substance use disorder on birth outcomes. . The amendments made by this section shall apply to items and services furnished on or after January 1, 2023.
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Sec. 212
State option to provide medical assistance for residential addiction treatment facility services
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