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[Congressional Bills 118th Congress]
[From the U.S. Government Publishing Office]
[H.R. 6675 Introduced in House (IH)]
<DOC>
118th CONGRESS
1st Session
H. R. 6675
To amend titles XIX and XXI of the Social Security Act to provide
mental health and substance use services to incarcerated individuals,
and for other purposes.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
December 7, 2023
Ms. Kuster (for herself and Mr. Bacon) introduced the following bill;
which was referred to the Committee on Energy and Commerce
_______________________________________________________________________
A BILL
To amend titles XIX and XXI of the Social Security Act to provide
mental health and substance use services to incarcerated individuals,
and for other purposes.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Rehabilitation and Recovery During
Incarceration Act''.
SEC. 2. MODIFYING MEDICAID AND CHIP EXCLUSIONS RELATING TO INCARCERATED
INDIVIDUALS TO ALLOW FOR PROVISION OF MENTAL HEALTH AND
SUBSTANCE USE SERVICES.
(a) Medicaid Option.--
(1) In general.--Section 1905(a) of the Social Security Act
(42 U.S.C. 1396d(a)) is amended, in the subdivision (A)
following paragraph (31), by inserting ``, or, at the option of
the State, in the case of an eligible inmate (as defined in
paragraph (4) of section 1902(nn)), with respect to mental
health and substance use services described in paragraph (5) of
such section'' before ``); or''.
(2) Eligible inmate and mental health and substance use
services defined.--Section 1902(nn) of the Social Security Act
(42 U.S.C. 1396a(nn)) is amended--
(A) in the subsection header, by inserting ``;
Eligible Inmate; Mental Health and Substance Use
Services'' after ``Public Institution'';
(B) in the matter preceding paragraph (1), by
striking ``and this subsection'' and inserting ``, this
subsection, and the subdivision (A) following the last
numbered paragraph of section 1905(a)''; and
(C) by adding at the end the following new
paragraphs:
``(4) Eligible inmate.--The term `eligible inmate' means an
individual of any age who is an inmate of a public institution
and who--
``(A) was determined eligible for medical
assistance under the State plan immediately before
becoming an inmate of such a public institution; or
``(B) is determined eligible for such medical
assistance while an inmate of a public institution.
``(5) Mental health and substance use services.--The term
`mental health and substance use services' means such services
for the treatment of a mental health condition or substance use
disorder as the Secretary shall specify by regulation.''.
(b) CHIP Option.--
(1) In general.--Section 2110(b)(7) of the Social Security
Act (42 U.S.C. 1397jj(b)(7)) is amended--
(A) in the paragraph header, by striking
``Exception'' and inserting ``Exceptions'';
(B) by striking ``In the case of'' and inserting
the following:
``(A) Provision of screening, diagnostic, referral,
and case management services pre-release.--In the case
of''; and
(C) by adding at the end the following new
subparagraph:
``(B) Provision of mental health and substance use
disorder services while an inmate.--
``(i) In general.--In the case of a child
who is an eligible inmate, the child shall not
be considered to be described in paragraph
(2)(A) with respect to mental health services
and substance use disorder services otherwise
covered under the State child health plan (or
waiver of such plan).
``(ii) Eligible inmate defined.--For
purposes of this subparagraph, the term
`eligible inmate' has the meaning given that
term in section 1902(nn)(4), except that such
section shall be applied by--
``(I) substituting `child health
assistance' for `medical assistance'
each place it appears; and
``(II) by substituting `State child
health plan under title XXI' for `State
plan'.''.
(2) Technical amendment.--
(A) In general.--Section 5122(b) of division FF of
the Consolidated Appropriations Act, 2023 (Public Law
117-328) is amended by striking paragraph (1).
(B) Effective date.--The amendment made by this
paragraph shall take effect as if included in the
enactment of the Consolidated Appropriations Act, 2023
(Public Law 117-328).
(c) Increased Federal Match for Mental Health and Substance Use
Disorder Services Furnished to Incarcerated Individuals.--
(1) Medicaid.--Section 1905 of the Social Security Act (42
U.S.C. 1396d) is amended--
(A) in subsection (b), by striking ``and (ii)'' and
inserting ``(ii), and (jj)''; and
(B) by adding at the end the following new
subsection:
``(jj) Increased FMAP for Mental Health and Substance Use Services
Furnished to Inmates.--
``(1) In general.--Notwithstanding any other provision of
this title except for paragraph (3), the Federal medical
assistance percentage for a State, with respect to amounts
expended by the State for medical assistance for mental health
and substance use disorder services furnished to an eligible
inmate (as such terms are defined in section 1902(nn)) shall be
equal to 100 percent.
``(2) Exclusion of expenditures from territorial caps.--Any
payment made to a territory for expenditures for medical
assistance that are subject to the Federal medical assistance
percentage specified under paragraph (1) shall not be taken
into account for purposes of applying payment limits under
subsections (f) and (g) of section 1108.
``(3) Requirement to reinvest additional funds.--As a
condition for the receipt of the increase under paragraph (1)
to the Federal medical assistance percentage of a State, the
State shall demonstrate to the satisfaction of the Secretary
that the State will use the Federal funds attributable to such
increase only for the following purposes:
``(A) To improve health information technology and
data sharing between State Medicaid programs, jails and
prisons, and community-based providers and support
organizations.
``(B) To increase the treatment capacity of
community-based providers who are particularly attuned
to, and able to serve, the specific needs of
individuals who are involved with the justice system or
at risk of becoming involved in the justice system.
``(C) To expand or enhance community-based reentry
services and supports provided by the State to
incarcerated and formerly incarcerated individuals,
including services and supports designed to meet the
health-related social needs of such individuals.''.
(2) CHIP.--
(A) In general.--Section 2105 of the Social
Security Act (42 U.S.C. 1397ee) is amended--
(i) in subsection (b), by striking ``(11)''
and inserting ``(11), (12), and (13)''; and
(ii) in subsection (c), by adding at the
end the following new paragraph:
``(13) Enhanced payment for coverage of mental health and
substance use disorder services.--
``(A) In general.--Notwithstanding subsection (b)
and subject to subparagraph (B), the enhanced FMAP for
a State with respect to payments under subsection (a)
for expenditures under the State child health plan (or
a waiver of such plan) for mental health or substance
use disorder services furnished to a targeted low-
income child or a targeted low-income pregnant woman
who is an eligible inmate (as such term is defined in
section 2110(b)(7)(B)(ii)) shall be equal to 100
percent.
``(B) Requirement to reinvest additional funds.--
The requirement described in paragraph (3) of section
1905(jj) shall apply to Federal funds attributable to
an increase in the enhanced Federal medical assistance
percentage of a State under subparagraph (A) in the
same manner as such requirement applies to Federal
funds attributable to an increase to the Federal
medical assistance percentage of a State under
paragraph (1) of such section.''.
(B) Adjusting state chip allotments to account for
increased payments for coverage of mental health and
substance use services furnished to eligible inmates.--
Section 2104(m) of the Social Security Act (42 U.S.C.
1397dd(m)) is amended--
(i) in paragraph (2)(B), in the matter
preceding clause (i), by striking ``and (12)''
and inserting ``(12), and (13)''; and
(ii) by adding at the end the following new
paragraph:
``(13) Adjusting allotments to account for increased
federal payments for coverage of mental health and substance
use services for eligible inmates.--If a State, commonwealth,
or territory receives payment for a fiscal year under
subsection (a) of section 2105 for expenditures that are
subject to the enhanced FMAP specified under subsection (c)(13)
of such section, the amount of the allotment determined for the
State, commonwealth, or territory under this subsection--
``(A) for such fiscal year shall be increased by
the projected expenditures for such year by the State,
commonwealth, or territory under the State child health
plan (or a waiver of such plan) for mental health and
substance use disorder services furnished to eligible
inmates (as defined in section 2110(b)(7)(B)(ii)); and
``(B) once actual expenditures are available in the
subsequent fiscal year, the fiscal year allotment that
was adjusted by the amount described in subparagraph
(A) shall be adjusted on the basis of the difference
between--
``(i) such projected amount of expenditures
described in subparagraph (A) for such fiscal
year described in such subparagraph by the
State, commonwealth, or territory; and
``(ii) the actual amount of expenditures
for such fiscal year described in subparagraph
(A) by the State, commonwealth, or territory
under the State child health plan (or waiver of
such plan) for mental health and substance use
disorder services furnished to eligible inmates
(as defined in section 2110(b)(7)(B)(ii)).''.
(d) Conforming Amendments.--
(1) Section 1905(a) of the Social Security Act (42 U.S.C.
1396d(a)), as amended by subsection (a), is amended, in the
matter following paragraph (31), by striking ``set forth in the
subdivision (B) following paragraph (30) of the first sentence
of this subsection'' and inserting ``set forth in the portion
of the first sentence of this subsection that follows the last
numbered paragraph of this subsection''.
(2) Section 5122(a)(1) of division FF of the Consolidated
Appropriations Act, 2023 (Public Law 117-328) is amended by
striking ``case management'' and inserting ``targeted case
management services''.
(e) Effective Date.--
(1) In general.--Except as provided in paragraph (2), the
amendments made by this section shall apply with respect to
medical assistance, child health assistance, and pregnancy-
related assistance provided on or after January 1, 2023.
(2) Effective date of conforming amendment.--The amendment
made by paragraph (2) of subsection (d) shall take effect as if
included in the enactment of the Consolidated Appropriations
Act, 2023 (Public Law 117-328).
SEC. 3. REPORT BY COMPTROLLER GENERAL.
Not later than the date that is 5 years after the date of enactment
of this Act, the Comptroller General of the United States shall submit
to Congress a report containing available information regarding
incarcerated individuals that receive medical assistance or child
health assistance under a State plan under title XIX or XXI of the
Social Security Act (42 U.S.C. 1396 et seq., 1397aa et seq.) (as
applicable) as a result of a State electing to provide coverage to
eligible inmates pursuant to the amendments to such titles made by
section 2. The information contained in the report may include
information such as the following:
(1) The number of such incarcerated individuals.
(2) The access of such incarcerated individuals to health
care services, including specialty care, and health care
providers.
(3) The quality of health care services provided to
incarcerated individuals.
(4) Any impact of coverage under such a State plan on
recidivism.
(5) The percentage of such incarcerated individuals who,
upon release, are--
(A) enrolled under such a State plan;
(B) connected to a provider in their community of
mental health, substance use disorder, or primary care
services; and
(C) receiving medication-assisted treatment for the
treatment of a substance use disorder.
(6) Any other information the Comptroller General
determines necessary regarding the health of incarcerated
individuals.
<all>
Introduced in House
Introduced in House
Referred to the House Committee on Energy and Commerce.
Referred to the Subcommittee on Health.
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