Medicaid Bump Act

I 117TH CONGRESS 1ST SESSION H. R. 3450 To amend title XIX of the Social Security Act to provide a higher Federal matching rate for increased expenditures under Medicaid for behavioral health services (including those related to mental health and substance use), and for other purposes. IN THE HOUSE OF REPRESENTATIVES MAY 20, 2021 Mr. TONKO (for himself, Mr. TRONE, and Mr. FITZPATRICK) 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 provide a higher Federal matching rate for increased expendi- tures under Medicaid for behavioral health services (in- cluding those related to mental health and substance use), 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 ‘‘Medicaid Bump Act’’. 4 VerDate Sep 11 2014 05:02 Jun 26, 2021 Jkt 019200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\H3450.IH H3450 pbinns on DSKJLVW7X2PROD with BILLS 2 •HR 3450 IH SEC. 2. HIGHER FEDERAL MATCH FOR INCREASED EX- 1 PENDITURES UNDER MEDICAID FOR BEHAV- 2 IORAL HEALTH SERVICES. 3 (a) IN GENERAL.—Section 1903 of the Social Secu- 4 rity Act (42 U.S.C. 1396b) is amended— 5 (1) in subsection (a)(5)— 6 (A) by striking ‘‘an amount equal’’ and in- 7 serting ‘‘(A) an amount equal’’; and 8 (B) by adding at the end the following: 9 ‘‘and 10 ‘‘(B) subject to subsection (b)(6), an 11 amount equal to 90 percent of the amount by 12 which— 13 ‘‘(i) the sum of the amounts expended 14 during such quarter which are attributable 15 to the offering, arranging, and furnishing 16 (directly or on a contract basis) under the 17 State plan (or under a waiver of the plan) 18 of behavioral health services (including 19 those related to mental health and sub- 20 stance use), exceeds 21 ‘‘(ii) the sum of the amounts ex- 22 pended during the corresponding quarter 23 in the 4-quarter period ending on March 24 31, 2019, which are attributable to the of- 25 fering, arranging, and furnishing (directly 26 VerDate Sep 11 2014 05:02 Jun 26, 2021 Jkt 019200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H3450.IH H3450 pbinns on DSKJLVW7X2PROD with BILLS 3 •HR 3450 IH or on a contract basis) under the State 1 plan (or under a waiver of the plan) of 2 such services, plus’’; and 3 (2) in subsection (b), by adding at the end the 4 following new paragraph: 5 ‘‘(6) ACCOUNTABILITY AND MAINTENANCE OF 6 EFFORT REQUIREMENTS FOR ADDITIONAL FEDERAL 7 FUNDING FOR INCREASED EXPENDITURES FOR BE- 8 HAVIORAL HEALTH SERVICES.—As conditions for re- 9 ceiving the funds the Secretary is otherwise obli- 10 gated to pay to a State under subsection (a)(5)(B), 11 a State shall meet the following requirements: 12 ‘‘(A) SUPPLEMENT, NOT SUPPLANT.—The 13 State shall use the funds received under such 14 subsection to supplement, not supplant, the 15 level of State funds expended for the offering, 16 arranging, and furnishing (directly or on a con- 17 tract basis) under the State plan (or under a 18 waiver of the plan) of behavioral health services 19 (including those related to mental health and 20 substance use) through programs and activities 21 in effect as of April 1, 2021. 22 ‘‘(B) USE OF FUNDS FOR ACTIVITIES 23 THAT IMPROVE DELIVERY OF BEHAVIORAL 24 HEALTH SERVICES.—The State shall use the 25 VerDate Sep 11 2014 05:02 Jun 26, 2021 Jkt 019200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\H3450.IH H3450 pbinns on DSKJLVW7X2PROD with BILLS 4 •HR 3450 IH funds received under such subsection for activi- 1 ties that increase the capacity, efficiency, and 2 quality in the provision of behavioral health 3 services (including those related to mental 4 health and substance use) delivered by pro- 5 viders, including through increases in payment 6 rates for providers of those services and the 7 adoption of other measures that ensure a reduc- 8 tion in staff turnover.’’. 9 (b) SUB-REGULATORY GUIDANCE.—Not later than 10 180 days after the date of enactment of this Act, the Sec- 11 retary of Health and Human Services shall issue sub-regu- 12 latory guidance to States specifying the services that are 13 behavioral health services for purposes of subparagraph 14 (B) of section 1903(a)(5) of the Social Security Act (42 15 U.S.C. 1396b(a)(5)), as added by subsection (a). 16 (c) EFFECTIVE DATE.—The amendments made by 17 this section shall apply with respect to calendar quarters 18 beginning on or after January 1 of the year beginning 19 after one year after the date of the enactment of this Act. 20 SEC. 3. REPORT REGARDING BEHAVIORAL HEALTH SERV- 21 ICE. 22 Not later than 1 year after the date of enactment 23 of this Act, and annually thereafter, the Secretary of 24 Health and Human Services shall submit to the Com- 25 VerDate Sep 11 2014 05:02 Jun 26, 2021 Jkt 019200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\H3450.IH H3450 pbinns on DSKJLVW7X2PROD with BILLS 5 •HR 3450 IH mittee on Energy and Commerce of the House of Rep- 1 resentatives and the Committee on Finance of the Senate 2 a report regarding behavioral health services (including 3 those related to mental health and substance use) provided 4 under title XIX of the Social Security Act (42 U.S.C. 5 1396 et seq.) in each State, specifying the payment rates 6 for such services, the rationale for deriving such payment 7 rates, and utilization of such services, as such data are 8 available. 9 Æ VerDate Sep 11 2014 05:02 Jun 26, 2021 Jkt 019200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6301 E:\BILLS\H3450.IH H3450 pbinns on DSKJLVW7X2PROD with BILLS