Sec. 12002. STUDY AND REPORT RELATED TO MEDICAID MANAGED CARE REGULATION
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## SEC. 12002 STUDY AND REPORT RELATED TO MEDICAID MANAGED CARE REGULATION ###
(a)Study The Secretary of Health and Human Services, acting through the Administrator of the Centers for Medicare & Medicaid Services, shall conduct a study on coverage under the Medicaid program under title XIX of the Social Security Act (42 U.S.C. 1396 et seq.) of services provided through a medicaid managed care organization (as defined in section 1903(m) of such Act (42 U.S.C. 1396b(m)) or a prepaid inpatient health plan (as defined in section 438.2 of title 42, Code of Federal Regulations (or any successor regulation)) with respect to individuals over the age of 21 and under the age of 65 for the treatment of a mental health disorder in institutions for mental diseases (as defined in section 1905(i) of such Act (42 U.S.C. 1396d(i))). Such study shall include information on the following: ####
(1)The extent to which States, including the District of Columbia and each territory or possession of the United States, are providing capitated payments to such organizations or plans for enrollees who are receiving services in institutions for mental diseases. ####
(2)The number of individuals receiving medical assistance under a State plan under such title XIX, or a waiver of such plan, who receive services in institutions for mental diseases through such organizations and plans. ####
(3)The range of and average number of months, and the length of stay during such months, that such individuals are receiving such services in such institutions. ####
(4)How such organizations or plans determine when to provide for the furnishing of such services through an institution for mental diseases in lieu of other benefits (including the full range of community-based services) under their contract with the State agency administering the State plan under such title XIX, or a waiver of such plan, to address psychiatric or substance use disorder treatment. ####
(5)The extent to which the provision of services within such institutions has affected the capitated payments for such organizations or plans. ###
(b)Report Not later than 3 years after the date of the enactment of this Act, the Secretary shall submit to Congress a report on the study conducted under subsection (a).
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Sec. 12002
STUDY AND REPORT RELATED TO MEDICAID MANAGED CARE REGULATION
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