Sec. 204. EXTENSION OF STATE OPTION TO PROVIDE MEDICAL ASSISTANCE FOR CERTAIN INDIVIDUALS IN INSTITUTIONS FOR MENTAL DISEASES
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## SEC. 204 EXTENSION OF STATE OPTION TO PROVIDE MEDICAL ASSISTANCE FOR CERTAIN INDIVIDUALS IN INSTITUTIONS FOR MENTAL DISEASES ###
(a)Making Permanent State Plan Amendment Option To Provide Medical Assistance for Certain Individuals Who Are Patients in Certain Institutions for Mental Diseases Section 1915(l)(1) of the Social Security Act (42 U.S.C. 1396n(l)(1)) is amended by striking “With respect to calendar quarters beginning during the period beginning October 1, 2019, and ending September 30, 2023,” and inserting “With respect to calendar quarters beginning on or after October 1, 2019,”. ###
(b)Maintenance of Effort Revision Section 1915(l)(3) of the Social Security Act (42 U.S.C. 1396n(l)(3)) is amended— ####
(1)in subparagraph (A)— #####
(A)by striking “other than under this title from non-Federal funds” and all that follows through “subparagraph (B))” and inserting “from non-Federal funds for items and services (including services described in subparagraph (B))”; and #####
(B)by striking “ such items and services ” and all that follows through the period and inserting > “such items and services for, at the option of the State— > > > ###### “(i) > > fiscal year 2018; or > > > ###### “(ii) > > the most recently ended fiscal year as of the date the State submits a State plan amendment to the Secretary to provide such medical assistance in accordance with this subsection.” > ; ####
(2)in subparagraph (B), by striking “subparagraph (A)(ii)” and inserting “subparagraph (A)”; and ####
(3)by adding at the end the following new subparagraph: > > ##### “(D) Application of maintenance of effort requirements to certain states > > In the case of a State with a State plan amendment in effect on September 30, 2023, for the 1-year period beginning on the date of enactment of this subparagraph, the provisions of subparagraph
(A)shall be applied as if the amendments to such subparagraph made by the Consolidated Appropriations Act, 2024 had never been made.” > . ###
(c)Additional Requirements ####
(1)In general #####
(A)General requirements Section 1915(l)(4) of the Social Security Act (42 U.S.C. 1396n(l)(4)) is amended— ######
(i)in subparagraph (A), by striking “through (D)” and inserting “through (F)”; ######
(ii)in subparagraph (B)— ######
(I)by striking “Prior to approval of a State plan amendment under this subsection, the State shall notify the Secretary of how the State will ensure” and inserting “The State shall have in place evidence-based, substance use disorder-specific individual placement criteria and utilization management approaches to ensure placement of eligible individuals in an appropriate level of care, including criteria and approaches to ensure”; and ######
(II)by adding at the end the following sentence: “The State shall notify the Secretary at such time and in such form and manner as the Secretary shall require of such criteria and utilization management approaches.”; and ######
(iii)by adding at the end the following new subparagraph: > > ##### “(E) Review process > > The State shall, using nationally recognized substance use disorder-specific program standards, have in place a process to review the compliance of eligible institutions for mental diseases with such program standards specified by the State.” > . #####
(B)Effective date The amendments made by subparagraph
(A)shall apply with respect to States providing medical assistance for items and services pursuant to a State plan amendment under section 1915(l) of the Social Security Act (42 U.S.C. 1396n(l)) in calendar quarters beginning on or after October 1, 2025. ####
(2)One-time assessment **[**[42 U.S.C. 1396n note](/us/usc/t42/s1396n)**]** Section 1915(l)(4) of the Social Security Act (42 U.S.C. 1396n(l)(4)), as amended by paragraph (1), is further amended by adding at the end the following new subparagraph: > > ##### “(F) Assessment > > > ###### “(i) In general > > The State shall, not later than 12 months after the approval of a State plan amendment described in this subsection (or, in the case of a State that has such an amendment approved as of September 30, 2023, not later than 12 months after the date of enactment of this subparagraph), commence an assessment of— > > > ###### “(I) > > the availability of treatment for individuals enrolled under a State plan under this title (or waiver of such plan) in each level of care described in subparagraph (C), including how such availability varies by region of the State; and > > > ###### “(II) > > the availability of medication-assisted treatment and medically supervised withdrawal management services for such individuals, including how such availability varies by region of the State. > > > ###### “(ii) Required completion > > The State shall complete an assessment described in clause
(i)not later than 12 months after the date the State commences such assessment.” > . ####
(3)Clarification of levels of care Section 1915(l) of the Social Security Act (42 U.S.C. 1396n(l)) is amended— #####
(A)in paragraph (4)(C)(ii), by striking “problems in Dimensions 1, 2, or 3” each place it appears and inserting “conditions”; and #####
(B)in paragraph (7), by striking subparagraph
(A)and redesignating subparagraphs
(B)through
(D)as subparagraphs
(A)through (C), respectively. ###
(d)Application to Certain States **[**[42 U.S.C. 1396n note](/us/usc/t42/s1396n)**]** Notwithstanding section 430.20 of title 42, Code of Federal Regulations, the Secretary of Health and Human Services may approve a request to renew a State plan amendment under section 1915(l) of the Social Security Act (42 U.S.C. 1396n(l)) with an effective date of October 1, 2023, if the State making such request— ####
(1)had approval for a State plan amendment under such section as of September 30, 2023; and ####
(2)submits the request to renew such amendment not later than 60 days after the date of enactment of this Act.
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Sec. 204
EXTENSION OF STATE OPTION TO PROVIDE MEDICAL ASSISTANCE FOR CERTAIN INDIVIDUALS IN INSTITUTIONS FOR MENTAL DISEASES
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