Increasing Behavioral Health Treatment Act

I 117TH CONGRESS 1ST SESSION H. R. 2611 To amend title XIX of the Social Security Act to remove the exclusion from medical assistance under the Medicaid Program of items and serv- ices for patients in an institution for mental diseases, and for other purposes. IN THE HOUSE OF REPRESENTATIVES APRIL 16, 2021 Mrs. NAPOLITANO introduced the following bill; which was referred to the Committee on Energy and Commerce A BILL To amend title XIX of the Social Security Act to remove the exclusion from medical assistance under the Medicaid Program of items and services for patients in an institu- tion for mental diseases, and for other purposes. Be it enacted by the Senate and House of Representa- 1 tives of the United States of America in Congress assembled, 2 SECTION 1. SHORT TITLE. 3 This Act may be cited as the ‘‘Increasing Behavioral 4 Health Treatment Act’’. 5 VerDate Sep 11 2014 00:12 Jun 09, 2021 Jkt 019200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\H2611.IH H2611 pbinns on DSKJLVW7X2PROD with BILLS 2 •HR 2611 IH SEC. 2. REMOVAL OF MEDICAID EXCLUSION FROM MED- 1 ICAL ASSISTANCE OF ITEMS AND SERVICES 2 FURNISHED TO PATIENTS IN AN INSTITU- 3 TION FOR MENTAL DISEASES IF STATE SUB- 4 MITS PLAN FOR PROVIDING APPROPRIATE 5 OUTPATIENT CARE TO SUCH PATIENTS. 6 (a) REMOVAL OF EXCLUSION.— 7 (1) IN GENERAL.—The first sentence of section 8 1905(a) of the Social Security Act (42 U.S.C. 9 1396d(a)) is amended, in the matter following para- 10 graph (30)— 11 (A) by striking ‘‘such term does not in- 12 clude—’’ and all that follows through ‘‘(A) any’’ 13 and inserting ‘‘such term does not include any’’; 14 (B) by striking ‘‘; or’’ and inserting a pe- 15 riod; and 16 (C) by striking subparagraph (B). 17 (2) CONFORMING AMENDMENTS TO PERMIT 18 MEDICAL ASSISTANCE FOR IMD PATIENTS UNDER 65 19 YEARS OF AGE.—The following provisions of such 20 Act are each amended by striking ‘‘65 years of age 21 or older’’ and ‘‘65 years of age or over’’ each place 22 it appears: 23 (A) Paragraphs (20) and (21) of section 24 1902(a) (42 U.S.C. 1396a(a)). 25 VerDate Sep 11 2014 00:12 Jun 09, 2021 Jkt 019200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H2611.IH H2611 pbinns on DSKJLVW7X2PROD with BILLS 3 •HR 2611 IH (B) Section 1905(a)(14) (42 U.S.C. 1 1396d(a)(14)). 2 (C) Section 1919(e)(7)(B)(i)(I) (42 U.S.C. 3 1396r(e)(7)(B)(i)(I)). 4 (b) REPORTING AND PLAN REQUIREMENT.—Section 5 1902(a)(20) of the Social Security Act (42 U.S.C. 6 1396a(a)(20)) is amended— 7 (1) in subparagraph (B), by striking at the end 8 ‘‘and’’; 9 (2) by adding at the end the following new sub- 10 paragraphs: 11 ‘‘(D) provide for a plan to achieve (and for 12 the annual submission to the Secretary of ac- 13 tions taken by the State, and progress with re- 14 spect to such actions, to achieve)— 15 ‘‘(i) increased access to outpatient and 16 community-based behavioral health care, 17 with respect to individuals furnished serv- 18 ices in an institution for mental diseases, 19 especially for individuals transitioning from 20 such an institution; 21 ‘‘(ii) increased availability of services 22 made available through crisis call centers, 23 mobile crisis units, coordinated community 24 crisis response that involves law enforce- 25 VerDate Sep 11 2014 00:12 Jun 09, 2021 Jkt 019200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\H2611.IH H2611 pbinns on DSKJLVW7X2PROD with BILLS 4 •HR 2611 IH ment and other first responders, observa- 1 tion or assessment centers, and on-going 2 community-based services (such as inten- 3 sive outpatient services, assertive commu- 4 nity treatment, and services in integrated 5 care settings such as the Certified Commu- 6 nity Behavioral Health Clinic model) (such 7 services referred to as crisis stabilization 8 services) for individuals experiencing a se- 9 rious mental illness (as such term is de- 10 fined for purposes of title V of the Public 11 Health Service Act), serious emotional dis- 12 turbance, or substance use disorder crisis; 13 ‘‘(iii) improved data sharing and co- 14 ordination between physical health, mental 15 health, and addiction treatment providers 16 (including hospitals and community-based 17 behavioral health facilities) and first re- 18 sponders to improve health outcomes for 19 individuals furnished services in an institu- 20 tion for mental diseases, who are experi- 21 encing a serious mental illness (as so de- 22 fined), serious emotional disturbance, or 23 substance use disorder crisis; 24 ‘‘(E) provide for the demonstration of— 25 VerDate Sep 11 2014 00:12 Jun 09, 2021 Jkt 019200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\H2611.IH H2611 pbinns on DSKJLVW7X2PROD with BILLS 5 •HR 2611 IH ‘‘(i) State policies to ensure individ- 1 uals receiving medical assistance under the 2 State plan who receive care in psychiatric 3 hospitals and residential treatment settings 4 are consistently screened for co-morbid 5 physical health conditions and substance 6 use disorders prior to or upon admission, 7 and that participating facilities have the 8 capacity to address co-morbid physical 9 health conditions during stays in such psy- 10 chiatric hospitals and residential treatment 11 settings either through on-site medical 12 services or external referrals and care co- 13 ordination; 14 ‘‘(ii) established strategies of the 15 State for identifying and engaging individ- 16 uals, particularly adolescents and young 17 adults, experiencing a serious mental ill- 18 ness (as such term is defined for purposes 19 of title V of the Public Health Service 20 Act), serious emotional disturbance, or 21 substance use disorder crisis; and 22 ‘‘(iii) established utilization review 23 policies of the State Medicaid agency or 24 Medicaid managed care organizations, as 25 VerDate Sep 11 2014 00:12 Jun 09, 2021 Jkt 019200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\H2611.IH H2611 pbinns on DSKJLVW7X2PROD with BILLS 6 •HR 2611 IH applicable, to ensure individuals receiving 1 medical assistance under the State plan re- 2 ceive treatment at clinically appropriate 3 levels of care and services are generally de- 4 livered in the least restrictive environment; 5 and 6 ‘‘(F) reporting to the Secretary (in a form 7 and manner specified by the Secretary) of, with 8 respect to each year beginning on or after the 9 date of the enactment of this subparagraph— 10 ‘‘(i) in the aggregate and by facility 11 type, costs and utilization for institutions 12 for mental diseases and inpatient psy- 13 chiatric hospitals that are not such institu- 14 tions; 15 ‘‘(ii) the number of individuals experi- 16 encing a serious mental illness (as such 17 term is defined for purposes of title V of 18 the Public Health Service Act), serious 19 emotional disturbance, or substance use 20 disorder crisis who received medical assist- 21 ance under the State plan during the year; 22 ‘‘(iii) the length of the stay of each 23 such individual in an institution for mental 24 disease; and 25 VerDate Sep 11 2014 00:12 Jun 09, 2021 Jkt 019200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\H2611.IH H2611 pbinns on DSKJLVW7X2PROD with BILLS 7 •HR 2611 IH ‘‘(iv) the type of outpatient treatment, 1 including medication assisted treatment, 2 each such individual received after being 3 discharged from such institution;’’. 4 (c) EFFECTIVE DATE.— 5 (1) IN GENERAL.—Subject to paragraph (2), 6 the amendments made by this section shall take ef- 7 fect on the date of the enactment of this Act and 8 shall apply to State plans beginning on such date. 9 (2) EXCEPTION IF STATE LEGISLATION RE- 10 QUIRED.—In the case of a State plan for medical as- 11 sistance under title XIX of the Social Security Act 12 which the Secretary of Health and Human Services 13 determines requires State legislation (other than leg- 14 islation appropriating funds) in order for the plan to 15 meet the additional requirement imposed by the 16 amendments made by this section, the State plan 17 shall not be regarded as failing to comply with the 18 requirements of such title solely on the basis of its 19 failure to meet this additional requirement before 20 the first day of the first calendar quarter beginning 21 after the close of the first regular session of the 22 State legislature that begins after the date of the en- 23 actment of this Act. For purposes of the previous 24 sentence, in the case of a State that has a 2-year 25 VerDate Sep 11 2014 00:12 Jun 09, 2021 Jkt 019200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\H2611.IH H2611 pbinns on DSKJLVW7X2PROD with BILLS 8 •HR 2611 IH legislative session, each year of such session shall be 1 deemed to be a separate regular session of the State 2 legislature. 3 Æ VerDate Sep 11 2014 00:12 Jun 09, 2021 Jkt 019200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6301 E:\BILLS\H2611.IH H2611 pbinns on DSKJLVW7X2PROD with BILLS