[Congressional Bills 118th Congress]
[From the U.S. Government Publishing Office]
[S. 3628 Introduced in Senate (IS)]
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118th CONGRESS
2d Session
S. 3628
To amend title XVIII of the Social Security Act to improve mobility
crisis under the Medicare program.
_______________________________________________________________________
IN THE SENATE OF THE UNITED STATES
January 18, 2024
Ms. Cortez Masto (for herself and Mr. Cornyn) introduced the following
bill; which was read twice and referred to the Committee on Finance
_______________________________________________________________________
A BILL
To amend title XVIII of the Social Security Act to improve mobility
crisis 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 ``Medicare Mobility Crisis Improvement
Act''.
SEC. 2. PAYMENT FOR MOBILE CRISIS RESPONSE INTERVENTION SERVICES UNDER
PHYSICIAN FEE SCHEDULE.
Section 1848(b) of the Social Security Act (42 U.S.C. 1395w-4(b))
is amended by adding at the end the following new paragraph:
``(13) Mobile crisis response team services.--
``(A) In general.--Beginning January 1, 2025, the
Secretary shall, subject to the succeeding provisions
of this paragraph, make a single global payment (as
determined by the Secretary under subparagraph (C))
under this section for mobile crisis response team
services (as defined in subparagraph (B)) furnished by
a physician (as defined in section 1861(r)(1)),
physician assistant or nurse practitioner (as defined
in section 1861(aa)(5)(A)), clinical nurse specialist
(as defined in section 1861(aa)(5)(B)), clinical social
worker (as defined in section 1861(hh)(1)), or clinical
psychologist (as defined by the Secretary for purposes
of section 1861(ii)).
``(B) Definition of mobile crisis response team
services.--In this paragraph, the term `mobile crisis
response team services' means physicians' services that
are furnished outside of a hospital, other facility
setting, or physician office to an individual
experiencing a mental health or substance use disorder
crisis to--
``(i) provide screening and assessment for
the individual's mental health or substance use
disorder crisis;
``(ii) support the de-escalation of the
individual's mental health or substance use
disorder crisis;
``(iii) facilitate or support subsequent
referral to health, social, and other services,
as determined appropriate by the Secretary; or
``(iv) otherwise address the individual's
pressing behavioral health needs, as determined
appropriate by the Secretary.
``(C) Determination of single global payment.--
``(i) In general.--The Secretary shall
determine an appropriate global payment for
mobile crisis response team services under the
fee schedule under this section to account for
the work, practice expenses, and malpractice
expenses involved in furnishing physicians'
services that would typically be furnished to
an individual experiencing a mental health or
substance use disorder crisis to accomplish the
objectives described in clauses (i) through
(iv) of subparagraph (B) (as identified by the
Secretary).
``(ii) Relative values.--In determining
work, practice expenses, and malpractice
expenses under clause (i), the Secretary shall
account for differences in work, practice
expenses, and malpractice expenses between
furnishing physicians' services identified in
clause (i) in a physician office and the work,
practice expenses, and malpractice expenses
involved in furnishing such services at the
site at which at individual is experiencing a
mental or substance use disorder crisis,
including potential practice expenses
associated with transportation to such site.
``(iii) Ensuring no duplicate payment.--The
Secretary shall ensure that if a physician or
practitioner receives payment for mobile crisis
response team services under this paragraph,
additional payment is not made under this
section for physicians' services identified in
clause (i) that are furnished to the same
individual by the same physician or
practitioner on the same day on which such
mobile crisis response team services are
furnished.
``(D) Requirements for physicians and practitioners
receiving payment.--In order to receive payment for
mobile crisis response team services, a physician or
practitioner who submits a claim for payment for such
services must document, in a form and manner determined
appropriate by the Secretary, that the physician or
practitioner furnishing such services and any auxiliary
personnel (as defined in section 410.26(a)(1) of title
42, Code of Federal Regulations, or any successor
regulation) furnishing such services under the
supervision of the physician or practitioner--
``(i) are trained in trauma-informed care,
de-escalation strategies, and harm reduction;
``(ii) are capable of coordinating with
emergency response systems, crisis intervention
hotlines, and hospitals furnishing crisis
stabilization services (as defined in section
1833(t)(23)); and
``(iii) meet other criteria determined
appropriate by the Secretary to ensure quality
of care and program integrity.
``(E) Additional clarification.--The Secretary
shall allow for auxiliary personnel (as defined in
section 410.26(a)(1) of title 42, Code of Federal
Regulations, or any successor regulation), including
peer support specialists (as defined in subsection
(i)(4)(B)), to furnish mobile crisis response team
services under the supervision of a physician or
practitioner billing for such services under this
section.''.
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