S. 3384Senate115th Congress (2017-2019)In Committee

Medicaid Health HOME Act

Introduced August 23, 2018

AI-Generated Summary

Updated April 15, 2026 at 11:27 PM UTC

The Medicaid Health HOME Act would let states keep a higher federal matching rate (enhanced FMAP) for Medicaid health‑home services that target people with substance‑use disorders. After the first eight fiscal‑year quarters of a state’s SUD‑focused health‑home plan, the Secretary could extend the higher match for an additional two quarters if the state asks. The bill also requires states to report on the quality, access, and costs of those services and directs the federal government to share best‑practice guidance.

Key Provisions

  • Allows the Secretary of Health and Human Services to apply the enhanced FMAP to health‑home payments for SUD‑eligible individuals for two extra fiscal quarters beyond the initial eight‑quarter period, if a state requests it.
  • Mandates that states submit a report at the end of the plan period covering health‑care quality, access, and total expenditures for SUD‑eligible individuals receiving health‑home services.
  • Requires the Secretary to publish best‑practice guidelines for designing and implementing SUD‑focused state plan amendments by October 1, 2020.
  • Defines “SUD‑eligible individuals” as Medicaid‑eligible people with chronic conditions who also have a substance‑use disorder, and defines a “SUD‑focused state plan amendment” as a plan primarily aimed at those individuals.

Legislative Activity

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SenateIntro Referral Latest Action

Read twice and referred to the Committee on Finance.

August 23, 2018

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SenateIntro Referral

Introduced in Senate

August 23, 2018

SenateIntro Referral

Read twice and referred to the Committee on Finance.

August 23, 2018

Bill Text

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Introduced in SenateIssued August 23, 2018

II

115th CONGRESS

2d Session

S. 3384

IN THE SENATE OF THE UNITED STATES

August 23, 2018

Mr. Cardin introduced the following bill; which was read twice and referred to the Committee on Finance

A BILL

To amend title XIX of the Social Security Act to provide for an extension of the enhanced FMAP for certain Medicaid health homes for individuals with substance use disorders.

1.

Short title

This Act may be cited as the Medicaid Health Homes for Opioid-Use-Disorder Medicaid Enrollees Encouraged Act or the Medicaid Health HOME Act.

2.

Extension of enhanced FMAP for certain health homes for individuals with substance use disorders

Section 1945 of the Social Security Act (42 U.S.C. 1396w–4) is amended—

(1)

in subsection (c)—

(A)

in paragraph (1), by inserting subject to paragraph (4), after except that,; and

(B)

by adding at the end the following new paragraph:

(4)

Special rule relating to substance use disorder health homes

(A)

In general

In the case of a State with a SUD-focused State plan amendment, the Secretary may, at the request of the State, apply the Federal medical assistance percentage described in paragraph (1) to payments for the provision of health home services to SUD-eligible individuals under such State plan amendment, in addition to the first 8 fiscal year quarters the State plan amendment is in effect, for the subsequent 2 fiscal quarters that the State plan amendment is in effect (or, in the case of a SUD-focused State plan amendment that has already been in effect for more than 8 fiscal year quarters when the State makes such request, for the next 2 fiscal year quarters that begin after the State makes such request and the State plan amendment is in effect). Nothing in this section shall be construed as prohibiting a State with a State plan amendment that is approved under this section and that is not a SUD-focused State plan amendment from additionally having approved a SUD-focused State plan amendment under this section, including for purposes of application of this paragraph.

(B)

Report requirements

In the case of a State with a SUD-focused State plan amendment which has a request approved under subparagraph (A), such State shall, at the end of the period of such State plan amendment, submit to the Secretary a report on the following, with respect to SUD-eligible individuals provided health home services under such State plan amendment:

(i)

The quality of health care provided to such individuals, with a focus on outcomes relevant to the recovery of each such individual.

(ii)

The access of such individuals to health care.

(iii)

The total expenditures of such individuals for health care.

For purposes of this subparagraph, the Secretary shall specify all applicable measures for determining quality, access, and expenditures.
(C)

Best practices

Not later than October 1, 2020, the Secretary shall make publicly available on the Internet website of the Centers for Medicare & Medicaid Services best practices for designing and implementing a SUD-focused State plan amendment, based on the experiences of States that have State plan amendments approved under this section that include SUD-eligible individuals.

(D)

Definitions

For purposes of this paragraph:

(i)

SUD-eligible individuals

The term SUD-eligible individual means, with respect to a State, an individual who satisfies all of the following:

(I)

The individual is an eligible individual with chronic conditions.

(II)

The individual is an individual with a substance use disorder.

(ii)

SUD-focused State plan amendment

The term SUD-focused State plan amendment means a State plan amendment under this section that is designed to provide health home services primarily to SUD-eligible individuals, as determined by the Secretary.

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