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House Bill 4097
115th Congress(2017-2018)
Medicare Beneficiary Opioid Addiction Treatment Act
Introduced
Introduced
Introduced in House on Oct 23, 2017
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Introduced in House 
Oct 23, 2017
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Introduced in House(Oct 23, 2017)
Oct 23, 2017
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H. R. 4097 (Introduced-in-House)


115th CONGRESS
1st Session
H. R. 4097


To amend title XVIII of the Social Security Act to provide for coverage of methadone under Medicare part B.

IN THE HOUSE OF REPRESENTATIVES

October 23, 2017

Mr. Neal introduced the following bill; which was referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned

A BILL

To amend title XVIII of the Social Security Act to provide for coverage of methadone under Medicare part B.

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 “Medicare Beneficiary Opioid Addiction Treatment Act”.

SEC. 2. Coverage of methadone under Medicare part B.

(a) Coverage.—Section 1861(s)(2) of the Social Security Act (42 U.S.C. 1395x(s)(2)) is amended—

(1) by striking “and” at the end of subparagraph (FF);

(2) by adding “and” at the end of subparagraph (GG); and

(3) by inserting after subparagraph (GG) the following new subparagraph:

“(HH) methadone, if furnished or dispensed (including by prescription) on or after January 1, 2018, to an individual for the purpose of maintenance or detoxification treatment by a physician or other practitioner who has in effect a registration or waiver under section 303(g) of such Act (21 U.S.C. 823(g)) to dispense methadone for such purpose;”.

(b) Payment.—

(1) IN CONNECTION WITH PHYSICIAN AND SUPPLIER SERVICE.—Section 1842(o)(1) of the Social Security Act (42 U.S.C. 1395u(o)(1)) is amended by adding at the end the following new subparagraph:

“(H) In the case of methadone (as described in section 1861(s)(2)(HH)), the amount provided under section 1847A for such drug.”.

(2) COVERED OPD SERVICE.—Section 1833(t)(1)(B)(iii) of the Social Security Act (42 U.S.C. 1395l(t)(1)(B)(iii)) is amended by inserting “and methadone described in paragraph (2)(HH) of such section” after “section 1861(s)”.

(c) Budget neutrality.—The Secretary of Health and Human Services shall implement the amendments made by this section in a manner such that—

(1) estimated expenditures under the physician fee schedule under section 1848 of the Social Security Act (42 U.S.C. 1395w–4) with application of such amendments are equal to estimated expenditures under such schedule without application of such amendments; and

(2) estimated expenditures under the prospective payment system under section 1833(t) of the Social Security Act (42 U.S.C. 1395l(t)) with application of such amendments made by this section are equal to estimated expenditures under such system without application of such amendments.