[Congressional Bills 118th Congress]
[From the U.S. Government Publishing Office]
[H.R. 6748 Introduced in House (IH)]
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118th CONGRESS
1st Session
H. R. 6748
To amend title XVIII of the Social Security Act to provide for coverage
of peer support services under the Medicare program.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
December 13, 2023
Ms. Chu (for herself and Mr. Smith of Nebraska) 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 peer support services under the Medicare program.
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 ``Promoting Effective and Empowering
Recovery Services in Medicare Act of 2023'' or the ``PEERS Act of
2023''.
SEC. 2. COVERAGE OF PEER SUPPORT SERVICES UNDER THE MEDICARE PROGRAM.
(a) Coverage.--Section 1861 of the Social Security Act (42 U.S.C.
1395x) is amended--
(1) in subsection (s)(2)--
(A) in subparagraph (JJ), by inserting ``and''
after the semicolon at the end; and
(B) by adding at the end the following new
subparagraph:
``(KK) peer support services (as defined in subsection
(nnn)) furnished on or after January 1, 2025;''; and
(2) by adding at the end the following new subsection:
``(nnn) Peer Support Services.--
``(1) Peer support services.--The term `peer support
services' means emotional, informational, instrumental, and
affiliational support services--
``(A) furnished--
``(i) by a Federally qualified health
center, a rural health clinic, a community
mental health center, or a certified community
behavioral health clinic (as described in
section 223 of the Protecting Access to
Medicare Act of 2014), using a peer support
specialist; and
``(ii) to an individual who has been
diagnosed with--
``(I) a mental disorder; or
``(II) a substance use disorder;
and
``(B) that are designed to assist such individual
in achieving recovery, integration in the community,
self-empowerment, and self-determination (as specified
by the Secretary).
``(2) Peer support specialist.--The term `peer support
specialist' means an individual who--
``(A) is recovering from a mental health or
substance use condition; and
``(B) is certified as qualified to furnish peer
support services under a certification process
consistent with the National Practice Guidelines for
Peer Supporters and inclusive of the Substance Abuse
and Mental Health Services Administration Core
Competencies for Peer Workers in Behavioral Health
Settings (as established by the State in which such
individual furnishes such services or under such
certification process determined appropriate by the
Secretary of Health and Human Services.''.
(b) Payment.--
(1) Community mental health centers and certified community
behavioral health clinics.--Section 1833(a)(1) of the Social
Security Act (42 U.S.C. 1395l(a)(1)) is amended--
(A) by striking ``and'' before ``(HH)''; and
(B) by inserting before the semicolon: ``, and (II)
with respect to peer support services (as defined in
section 1861(nnn)) furnished by a community mental
health center or a certified community behavioral
health clinic, the amount paid shall be an amount equal
to 80 percent of the lesser of the actual charge for
the services or the amount determined by a fee schedule
established by the Secretary for the purposes of this
subparagraph''.
(2) Inclusion as rhc and fqhc services.--Section
1861(aa)(1)(B) of the Social Security Act (42 U.S.C.
1395x(aa)(1)(B)) is amended--
(A) by striking ``or by a mental'' and inserting
``by a mental''; and
(B) by inserting ``or when using a peer support
specialist,'' after ``subsection (ll)(4)),''.
(c) Exclusion Modification.--Section 1862(a)(1) of the Social
Security Act (42 U.S.C. 1395y(a)(1)) is amended--
(1) in subparagraph (O), by striking ``and'' at the end;
(2) in subparagraph (P), by striking the semicolon at the
end and inserting ``, and''; and
(3) by adding at the end the following new subparagraph:
``(Q) in the case of peer support services (as defined in
section 1861(nnn)), which are not furnished by a rural health
clinic, a Federally qualified health center, a community mental
health center, or a certified community behavioral health
clinic;''.
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