S. 3098Senate118th Congress (2023-2025)In Committee

Securing Advances and a Variety of Evidence-Based IMD Options Act

Sponsored by John ThuneSen. John Thune (R-SD)
Introduced October 19, 2023

AI-Generated Summary

Updated January 20, 2026 at 12:21 PM UTC

The bill makes the Medicaid option that removes the institution‑for‑mental‑diseases (IMD) exclusion permanent, allowing Medicaid to cover care for people who are patients in certain mental‑health facilities. It also adds new requirements for states to support medication‑assisted treatment for substance‑use disorders, use evidence‑based placement criteria, and set up review and assessment processes to ensure appropriate care. The changes apply to Medicaid programs under Title XIX of the Social Security Act and affect states that receive Medicaid funding.

Key Provisions

  • Permanently authorizes the Medicaid waiver that removes the IMD exclusion, effective for calendar quarters beginning on or after October 1, 2019.
  • Requires states to facilitate access to medication‑assisted treatment for substance‑use disorders, regardless of the care setting.
  • Mandates that states have evidence‑based, substance‑use‑disorder‑specific placement criteria and utilization‑management approaches for appropriate level of care.
  • Establishes a state review process to ensure institutions for mental diseases meet evidence‑based program standards for eligible individuals.
  • Requires states to conduct an assessment, within 12 months of a plan amendment, of the availability of treatment across care levels and of medication‑assisted and medically supervised withdrawal services.

Legislative Activity

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1 earlier action
SenateIntro Referral Latest Action

Read twice and referred to the Committee on Finance. (text: CR S5112)

October 19, 2023

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SenateIntro Referral

Introduced in Senate

October 19, 2023

SenateIntro Referral

Read twice and referred to the Committee on Finance. (text: CR S5112)

October 19, 2023

Floor Debate

1 member

What members said about S. 3098 on the floor

1 Republican
John Thune
Sen. John ThuneR-SD · Oct 19, 2023

Madam President, I ask unanimous consent that the text of the bill be printed in the Record.

John Thune
Sen. John ThuneR-SD · Oct 19, 2023

Madam President, I ask unanimous consent that the text of the bill be printed in the Record.

Bill Text

Latest available legislative text

Reading Mode
Latest
Introduced in SenateIssued October 19, 2023

II

118th CONGRESS

1st Session

S. 3098

IN THE SENATE OF THE UNITED STATES

October 19, 2023

Mr. Thune (for himself, Ms. Hassan, and Mrs. Blackburn) 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 make permanent the Medicaid option to remove the IMD exclusion to provide medical assistance for certain individuals who are patients in an institution for mental diseases.

1.

Short title

This Act may be cited as the Securing Advances and a Variety of Evidence-Based IMD Options Act.

2.

Making permanent State Plan Amendment Option To Provide Medical Assistance for Certain Individuals Who Are Patients in Certain Institutions for Mental Diseases

(a)

In general

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)(A) of the Social Security Act (42 U.S.C. 1396n(l)(3)(A)) is amended—

(1)

in the matter preceding clause (i), by striking other than under this title; and

(2)

in clause (i), by striking or, if higher, and all that follows through in accordance with this subsection.

(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 (C), by adding at the end the following new clause:

(iii)

Medication-assisted treatment

The State shall, when appropriate, facilitate access to, and provide medical assistance for, medication-assisted treatment for substance use disorder treatment, irrespective of the setting in which such treatment is provided.

;

(iii)

in subparagraph (D), in the matter preceding clause (i), by inserting have in place evidence-based, substance use disorder-specific individual placement criteria and utilization management approach to ensure placement of such individual in an appropriate level of care and shall after State shall; and

(iv)

by adding at the end the following new subparagraph:

(E)

Review process

The State shall have in place a process to review the compliance of eligible institutions for mental diseases with evidence-based, substance use disorder-specific program standards of care for eligible individuals specified by the State.

.

(B)

Effective date

The amendments made by subparagraph (A) shall apply with respect to medical assistance furnished in calendar quarters beginning on or after October 1, 2025.

(2)

One-time assessment

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

The State shall, not later than 12 months after the approval of a State plan amendment described in this subsection (or, in the case such State has such an amendment approved as of the date of the enactment of this subparagraph, not later than 12 months after such date), 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); and

(ii)

the availability of medication-assisted treatment and medically supervised withdrawal management services for such individuals.

.

(3)

Clarification of levels of care

Section 1915(l)(7)(A) of the Social Security Act (42 U.S.C. 1396n(l)(7)(A)) is amended by inserting (or any successor publication) before the period.