[Congressional Bills 117th Congress]
[From the U.S. Government Publishing Office]
[S. 4747 Introduced in Senate (IS)]
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117th CONGRESS
2d Session
S. 4747
To amend title XIX of the Social Security Act to expand the
availability of mental, emotional, and behavioral health services under
the Medicaid program, and for other purposes.
_______________________________________________________________________
IN THE SENATE OF THE UNITED STATES
August 2, 2022
Mr. Portman (for himself and Mr. Casey) 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 expand the
availability of mental, emotional, and behavioral health services under
the Medicaid program, and for other purposes.
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 ``Investing in Kids' Mental Health Now
Act of 2022''.
SEC. 2. TABLE OF CONTENTS.
The table of contents for this Act is as follows:
Sec. 1. Short title.
Sec. 2. Table of contents.
Sec. 3. Payment rate increase for pediatric behavioral health services.
Sec. 4. Guidance to States on supporting mental, emotional, and
behavioral health services, and on the
availability of telehealth under Medicaid.
Sec. 5. Ensuring children receive timely access to care.
SEC. 3. PAYMENT RATE INCREASE FOR PEDIATRIC BEHAVIORAL HEALTH SERVICES.
(a) Payment Rate Increase for Pediatric Behavioral Health
Services.--Section 1902 of the Social Security Act (42 U.S.C. 1396a) is
amended--
(1) in subsection (a)(13)--
(A) in subparagraph (B), by striking ``and'' at the
end;
(B) in subparagraph (C), by adding ``and'' at the
end; and
(C) by adding at the end the following new
subparagraph:
``(D) that, for a 1-year period that begins not
later than 6 months after the date of enactment of this
subparagraph, the State shall pay for pediatric mental,
emotional, and behavioral health services (as defined
in subsection (tt)) furnished during such period at a
rate that is at least 1 percent, and not more than 9
percent, higher than the rate that was applicable to
such services under the State plan as of the day before
the date that is 6 months before the date of enactment
of this subparagraph;''; and
(2) by adding at the end the following new subsection:
``(tt) Pediatric Mental, Emotional, and Behavioral Health Services
Defined.--For purposes of subsection (a)(13)(D), the term `pediatric
mental, emotional, and behavioral health services' means at least 10 of
the following services furnished by a health care provider, including
hospitals, physicians, and other providers determined by the Secretary,
for the purposes of screening for, identifying, diagnosing, or treating
a mental, emotional, or behavioral health condition, whether furnished
in-person or via telehealth:
``(1) Mental health and substance use disorder screenings.
``(2) Mental health development assessments.
``(3) Mental health behavior assessments and interventions.
``(4) Psychological and neuropsychological testing and
assessment.
``(5) Mental health primary prevention services.
``(6) Mental health and substance use disorder case
management services.
``(7) School-based mental health and substance use disorder
prevention, identification, and treatment services.
``(8) Child and adolescent psychiatry and psychology
services.
``(9) Partial hospitalization services.
``(10) Day program services.
``(11) Intensive outpatient services.
``(12) Eating disorder treatment services.
``(13) Outpatient services.
``(14) Crisis residential services.
``(15) Crisis intervention and stabilization.
``(16) Inpatient psychiatric and psychological services.
``(17) Individual therapy.
``(18) Family therapy.
``(19) Group therapy services.
``(20) Intensive in-home services.
``(21) Peer support services.
``(22) Provider-to-provider consultation services involving
primary care practitioners and mental health care specialists,
including child and adolescent specialists.
``(23) Substance use disorder screening, including SBIRT,
and treatment.
``(24) Medication management.
``(25) Any other pediatric mental, emotional, or behavioral
health service determined appropriate by the Secretary.''.
(b) Under Medicaid Managed Care Plans.--Section 1932(f) of such Act
(42 U.S.C. 1396u-2(f)) is amended--
(1) in the header, by inserting ``and Pediatric Mental,
Emotional, and Behavioral Health'' before ``Services'';
(2) by inserting ``and pediatric mental, emotional, and
behavioral health services described in section
1902(a)(13)(D)'' after ``section 1902(a)(13)(C)''; and
(3) by striking ``such section'' and inserting ``section
1902(a)(13)''.
(c) Increase in Payment Using Increased FMAP.--Section 1905 of the
Social Security Act (42 U.S.C. 1396d) is amended by adding at the end
the following new subsection:
``(jj) Increased FMAP for Additional Expenditures for Pediatric
Mental, Emotional, and Behavioral Health Services.--Notwithstanding
subsection (b), with respect to the portion of the amounts expended for
medical assistance for services described in section 1902(a)(13)(D)
that is furnished during the 1-year period described in such section
and that is attributable to the increase to the payment rate applicable
to such services required under such section (or, by application,
section 1932(f)), the Federal medical assistance percentage for a State
that is one of the 50 States or the District of Columbia shall be equal
to 100 percent. The preceding sentence does not prohibit the payment of
Federal financial participation based on the Federal medical assistance
percentage for amounts in excess of those specified in such
sentence.''.
SEC. 4. GUIDANCE TO STATES ON SUPPORTING MENTAL, EMOTIONAL, AND
BEHAVIORAL HEALTH SERVICES, AND ON THE AVAILABILITY OF
TELEHEALTH UNDER MEDICAID.
(a) Mental, Emotional, and Behavioral Health Services.--Not later
than 180 days after date of enactment of this Act, the Secretary of
Health and Human Services shall issue guidance to States on how to
expand the provision of mental, emotional, and behavioral health
services covered by State plans (or waivers of such plans) under title
XIX of the Social Security Act (42 U.S.C. 1396 et seq.), including a
description of best practices for effective programs, service provision
for underserved communities, meeting the needs of children with medical
complexities, and recruitment and retention of providers.
(b) Mental, Emotional, and Behavioral Telehealth Services.--Not
later than 1 year after date of enactment of this Act, the Secretary of
Health and Human Services shall issue guidance to States on best
practices to sustain and enhance the availability of mental, emotional,
and behavioral telehealth services covered by State plans (or waivers
of such plans) under title XIX of the Social Security Act (42 U.S.C.
1396 et seq.), including expanding the originating site requirement,
delivering audio-only mental, emotional, and behavioral telehealth
services, and streamlining provider licensing, credentialing, and
enrollment protocols with respect to telehealth services furnished
across State lines.
SEC. 5. ENSURING CHILDREN RECEIVE TIMELY ACCESS TO CARE.
(a) Guidance to States on Flexibilities To Ensure Provider Capacity
To Provide Pediatric Mental, Emotional, and Behavioral Crisis Care.--
Not later than 60 days after the date of enactment of this Act, the
Secretary of Health and Human Services shall provide guidance to States
on best practices to support children in crisis or in need of intensive
mental, emotional, or behavioral health services by using flexibilities
for hospitals and other providers under applicable laws, regulations,
and guidance, including a description of how States are leveraging
existing flexibilities to deliver crisis care.
(b) Mandated Report to Congress Regarding Barriers to Repurposing
of Beds, Space, and Staff To Address Pediatric Behavioral Health
Needs.--
(1) In general.--Not later than 120 days after the date of
enactment of this Act, the Secretary of Health and Human
Services shall submit to the Congress a report with respect to
regulatory, legal, and other barriers to care across the crisis
continuum, including intermediate level care, such as intensive
outpatient care or partial hospitalization, that identifies
solutions to facilitate flexibility for children's hospitals
and other providers of mental, emotional, or behavioral health
services.
(2) Requirements.--In preparing a report under this
subsection, the Secretary of Health and Human Services shall
include in such report--
(A) a comprehensive list of laws, regulations, and
guidance impacting children's hospitals' and other
providers' ability to repurpose immediately beds,
space, and staff for children in need of mental,
emotional, or behavioral health services, including a
description of the rationale for each policy and
corresponding actions required to repurpose such beds,
space, and staff; and
(B) recommendations on how children's hospitals and
other providers can immediately expand access to
mental, emotional, and behavioral health services, such
as intensive outpatient care, partial hospitalization,
and residential care, while also ensuring high quality
and safety.
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