[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[S. 3402 Introduced in Senate (IS)]

<DOC>






119th CONGRESS
  1st Session
                                S. 3402

To amend titles XVIII and XIX of the Social Security Act and the Public 
Health Service Act to improve the certified community behavioral health 
                clinic program, and for other purposes.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                            December 9, 2025

 Mr. Cornyn (for himself, Ms. Smith, Mr. Tillis, and Ms. Cortez Masto) 
introduced the following bill; which was read twice and referred to the 
                          Committee on Finance

_______________________________________________________________________

                                 A BILL


 
To amend titles XVIII and XIX of the Social Security Act and the Public 
Health Service Act to improve the certified community behavioral health 
                clinic 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.

    (a) Short Title.--This Act may be cited as the ``Ensuring 
Excellence in Mental Health Act''.
    (b) Table of Contents.--The table of contents for this Act is as 
follows:

Sec. 1. Short title.
TITLE I--STRENGTHENING AND PROVIDING COST-RELATED PAYMENT FOR CERTIFIED 
      COMMUNITY BEHAVIORAL HEALTH CLINICS IN THE MEDICAID PROGRAM

Sec. 101. Coordination of Medicaid-certified community behavioral 
                            health services with community behavioral 
                            health clinics operating grant program; 
                            community behavioral health clinics 
                            accreditation option.
Sec. 102. Establishing a Medicaid prospective payment system for 
                            certified community behavioral health 
                            clinics.
Sec. 103. Expanding certified community behavioral health clinic 
                            services within Medicaid demonstration 
                            program.
Sec. 104. Expanding certified community behavioral health clinic 
                            services covered under the Medicaid State 
                            plan.
  TITLE II--COVERAGE OF CERTIFIED COMMUNITY BEHAVIORAL HEALTH CLINIC 
                  SERVICES UNDER THE MEDICARE PROGRAM

Sec. 201. Coverage of certified community behavioral health clinic 
                            services under the Medicare program.
Sec. 202. Payment for certified community behavioral health clinic 
                            services under the Medicare program.
Sec. 203. Non-application of Medicare part B deductible for certified 
                            community behavioral health clinic 
                            services.
Sec. 204. Right to seek Payment Reimbursement Review Board review of 
                            cost reports.
Sec. 205. Extending safe harbor under anti-kickback statute to waivers 
                            of certified community behavioral health 
                            clinic coinsurance.
Sec. 206. Effective date.
             TITLE III--COMMUNITY BEHAVIORAL HEALTH CLINICS

Sec. 301. Community behavioral health clinics.
   TITLE IV--LIABILITY PROTECTION FOR CERTIFIED COMMUNITY BEHAVIORAL 
                        HEALTH CLINIC CLINICIANS

Sec. 401. Conferring protection under the Federal Tort Claims Act to 
                            clinicians in certified community 
                            behavioral health clinics.

TITLE I--STRENGTHENING AND PROVIDING COST-RELATED PAYMENT FOR CERTIFIED 
      COMMUNITY BEHAVIORAL HEALTH CLINICS IN THE MEDICAID PROGRAM

SEC. 101. COORDINATION OF MEDICAID-CERTIFIED COMMUNITY BEHAVIORAL 
              HEALTH SERVICES WITH COMMUNITY BEHAVIORAL HEALTH CLINICS 
              OPERATING GRANT PROGRAM; COMMUNITY BEHAVIORAL HEALTH 
              CLINICS ACCREDITATION OPTION.

    Section 1905(jj) of the Social Security Act (42 U.S.C. 1396d(jj)) 
is amended--
            (1) in paragraph (2)(C), by inserting before the period at 
        the end ``and including any such data as the State, by 
        agreement with the Secretary, shall access via the system 
        described in section 340J-3 of the Public Health Service 
        Act.''; and
            (2) by adding at the end the following new paragraph:
            ``(3) Accreditation.--In the case of services furnished on 
        or after January 1, 2026, at the option of the State, a State 
        may determine that an organization does not meet such criteria 
        as the Secretary may establish for certified community 
        behavioral health clinics pursuant to section 223 of the 
        Protecting Access to Medicare Act unless the organization has 
        received accreditation by an accreditation body approved under 
        section 340J-4 of the Public Health Service Act. An election by 
        a State under the preceding sentence shall not relieve a State 
        of the requirement to certify an organization under paragraph 
        (2)(A).''.

SEC. 102. ESTABLISHING A MEDICAID PROSPECTIVE PAYMENT SYSTEM FOR 
              CERTIFIED COMMUNITY BEHAVIORAL HEALTH CLINICS.

    Section 1902 of the Social Security Act (42 U.S.C. 1396a) is 
amended by adding at the end the following new subsection:
    ``(yy) Payment for Services Provided by Certified Community 
Behavioral Health Clinics.--
            ``(1) In general.--Beginning with fiscal year 2026, with 
        respect to services furnished on or after January 1, 2026, and 
        each succeeding fiscal year, a State that has elected in its 
        State plan under this title to furnish the services described 
        in section 1905(a)(31) shall provide under the plan for payment 
        for services furnished by a certified community behavioral 
        health clinic described in section 1905(jj)(2) (in this 
        subsection referred to as a `clinic') in accordance with the 
        provisions of this subsection.
            ``(2) Payment for services in initial year.--
                    ``(A) In general.--Subject to subparagraphs (B) and 
                (C) and the succeeding provisions of this subsection, 
                and in accordance with paragraph (1), for services 
                furnished by a clinic in the first fiscal year 
                beginning after September 30, 2025, for which a State 
                elects to provide for payment for services described in 
                section 1905(a)(31), the State shall provide for 
                payment for such services in an amount (calculated on 
                the basis of daily visits or unduplicated monthly 
                visits, at the State's election) that is equal to 100 
                percent of the average costs of the clinic which are 
                reasonable and related to the furnishing such services 
                during a base year corresponding to the fiscal year 
                preceding such initial fiscal year.
                    ``(B) Additional payment considerations.--
                            ``(i) In general.--A State may elect in its 
                        State plan to carry out any of the following, 
                        consistent with the methodology described in 
                        guidance issued under the authority of section 
                        223(b) of the Protecting Access to Medicare 
                        Act:
                                    ``(I) Establishing separate 
                                prospective payment system rates for 
                                special populations.
                                    ``(II) Using a system of outlier 
                                payments for a portion of costs of 
                                furnishing the covered benefit.
                                    ``(III) With respect to the crisis 
                                services included within the benefit 
                                described in section 1905(a)(31)--
                                            ``(aa) requiring that 
                                        clinics, in their cost reports, 
                                        segregate costs relating to 
                                        mobile crisis teams, emergency 
                                        crisis intervention services, 
                                        or crisis stabilization as 
                                        components of the covered 
                                        benefit described in section 
                                        1905(a)(31); and
                                            ``(bb) providing for a 
                                        prospective payment system rate 
                                        for any or all of such crisis 
                                        services, distinct from the 
                                        rate encompassing the remainder 
                                        of the services described in 
                                        section 1905(a)(31).
                            ``(ii) States with pama demonstration 
                        programs.--If a State electing to furnish 
                        services described in section 1905(a)(31) under 
                        its State plan, as of the year prior to the 
                        initial fiscal year described above, operated a 
                        demonstration program under section 223 of the 
                        Protecting Access to Medicare Act, such State 
                        may elect under the State plan to establish as 
                        its initial rate under this paragraph, for any 
                        clinic that participated in such demonstration, 
                        the rate that would otherwise have applied 
                        under the demonstration.
                            ``(iii) Use of estimated or projected 
                        data.--In the absence of complete actual cost 
                        data representing the provision of the full 
                        covered benefit in such base year, the State 
                        may provide in its State plan amendment to 
                        allow clinics to use estimated or projected 
                        data relating to specific services for which 
                        they lack cost experience.
                    ``(C) Inflation adjustment.--The per-unit rate 
                derived from the cost data described in subparagraph 
                (A) shall be annually adjusted by the inflationary 
                factor described in section 1834(aa)(2)(C), and shall 
                be adjusted to take into account any increase or 
                decrease in the scope of such services furnished by the 
                clinic in the fiscal year involved.
            ``(3) Payment for services in subsequent fiscal years.--
        Subject to the succeeding provisions of this subsection, for 
        services described in section 1905(a)(31) furnished by a clinic 
        after the initial fiscal year described in paragraph (2), the 
        State plan shall provide for payment for such services in an 
        amount (calculated on the basis of daily visits or unduplicated 
        monthly visits, at the State's election) that is equal to the 
        amount calculated under this subsection for such services and 
        clinic for the preceding fiscal year--
                    ``(A) increased by the percentage increase in the 
                inflationary factor described in section 1834(aa)(2)(C) 
                for such fiscal year; and
                    ``(B) adjusted to take into account any increase or 
                decrease in the scope of such services furnished by the 
                clinic during the fiscal year involved.
            ``(4) Establishment of initial fiscal year payment for new 
        clinics.--
                    ``(A) In general.--In any case in which an entity 
                first qualifies as a certified community behavioral 
                health clinic in a year after the first fiscal year in 
                which the State first provides for payment for the 
                services described in section 1905(a)(31) in accordance 
                with paragraph (1), the State plan shall provide for 
                payment for such services in the first fiscal year in 
                which the clinic so qualifies in an amount (calculated 
                on the basis of daily visits or unduplicated monthly 
                visits, at the State's election) that is equal to the 
                rates established under this subsection for other such 
                clinics located in the same or adjacent area with a 
                similar case load, or in the absence of any such 
                clinic, based on the reasonable projected costs per 
                visit of the clinic.
                    ``(B) Additional requirement.--Not later than the 
                second fiscal year in which a clinic described in 
                subparagraph (A) furnishes services described in 
                section 1905(a)(31)--
                            ``(i) the State shall establish a unique 
                        payment rate for the clinic based on the 
                        methodology described in paragraph (2), using 
                        reasonable and related costs from the clinic's 
                        first fiscal year of operation as the basis for 
                        establishing such rates; and
                            ``(ii) in any year following the 
                        establishment of an initial rate under this 
                        subparagraph, the State plan shall provide for 
                        the payment amount to be adjusted in accordance 
                        with paragraph (3) and (as applicable) 
                        reestablished in accordance with paragraph (5).
            ``(5) Optional periodic rebase of pps rates.--
        Notwithstanding the preceding paragraphs, a State may elect in 
        its State plan amendment to establish a new prospective payment 
        system rate for clinics on a periodic basis. Under such an 
        election, periodically (but not less frequently than every 3rd 
        fiscal year) after the initial year, as described in paragraph 
        (2), in which the State first furnishes the services described 
        in section 1905(a)(31), the State shall set a new rebased rate 
        for each clinic whose rate was initially set pursuant to 
        paragraph (2), except that costs from the fiscal year preceding 
        such rebasing year, rather than costs from the base year 
        described in paragraph (2), shall be used in establishing a new 
        cost-related rate for each clinic. States electing this option 
        shall also follow this methodology and schedule in periodically 
        establishing new rates for those clinics whose initial rates 
        were set as described in paragraph (4).
            ``(6) Administration in the case of managed care.--
                    ``(A) In general.--In the case of services 
                furnished by a certified community behavioral health 
                clinic pursuant to a contract between the clinic and a 
                managed care entity (as defined in section 
                1932(a)(1)(B)), the State plan shall provide for 
                payment to the clinic by the State of a supplemental 
                payment equal to the amount (if any) by which the 
                amount determined under the preceding paragraphs of 
                this subsection or as applicable, paragraph (7), 
                exceeds the amount of payments under the contract, with 
                such supplemental payment being made pursuant to a 
                payment schedule agreed to by the State and the 
                certified community behavioral health clinic, but not 
                less frequently than every 3 months.
                    ``(B) Option to delegate pps payment to managed 
                care entities through an alternative payment 
                methodology.--
                            ``(i) In general.--Notwithstanding 
                        subparagraph (A), nothing in this subsection 
                        shall be interpreted to preclude a State from 
                        amending its State plan to provide for an 
                        alternative payment methodology in accordance 
                        with paragraph (7), under which the State may 
                        delegate to a managed care entity (as defined 
                        in section 1932(a)(1)(B)) the responsibility to 
                        pay the clinic at least the rate determined 
                        under the preceding subparagraphs or as 
                        applicable, paragraph (7).
                            ``(ii) Requirements.--In making a 
                        delegation under clause (i), a State shall 
                        ensure that it complies with the requirements 
                        described in paragraph (7) and shall use 
                        reconciliation and oversight processes to 
                        ensure that each clinic is paid at least the 
                        amounts required under the preceding paragraphs 
                        of this subsection.
            ``(7) Alternative payment methodologies.--Notwithstanding 
        any other provision of this subsection, a State plan may 
        provide for payment in any year to a certified community 
        behavioral health clinic for services described in section 
        1905(a)(31) in an amount which is determined under an 
        alternative payment methodology that--
                    ``(A) is agreed to by the State and the clinic; and
                    ``(B) results in payment to the clinic of an amount 
                which is not less than the amount otherwise required to 
                be paid to the clinic under this subsection.''.

SEC. 103. EXPANDING CERTIFIED COMMUNITY BEHAVIORAL HEALTH CLINIC 
              SERVICES WITHIN MEDICAID DEMONSTRATION PROGRAM.

    (a) Additional Services Within Demonstration Program.--
            (1) In general.--Section 223(a)(2)(D) of the Protecting 
        Access to Medicare Act of 2014 (42 U.S.C. 1396a note), is 
        amended to read as follows:
                    ``(D) Scope of services.--Provision (in a manner 
                reflecting person-centered care) of at least the 
                following required services described in clause (i), 
                which may be furnished either directly or, if not 
                available directly, through formal relationships with 
                other providers, and at the discretion of the certified 
                community behavioral health clinic, at least 1 of the 
                following additional services described in clause (ii) 
                furnished directly by the clinic:
                            ``(i) Required services.--
                                    ``(I) Crisis mental health 
                                services, including 24-hour mobile 
                                crisis teams, emergency crisis 
                                intervention services, and crisis 
                                stabilization.
                                    ``(II) Screening, assessment, and 
                                diagnosis, including risk assessment.
                                    ``(III) Patient-centered treatment 
                                planning or similar processes, 
                                including risk assessment and crisis 
                                planning.
                                    ``(IV) Outpatient mental health and 
                                substance use services.
                                    ``(V) Outpatient clinic primary 
                                care screening and monitoring of key 
                                health indicators and health risk.
                                    ``(VI) Targeted case management.
                                    ``(VII) Psychiatric rehabilitation 
                                services.
                                    ``(VIII) Peer support and counselor 
                                services and family supports.
                                    ``(IX) Intensive, community-based 
                                mental health care for members of the 
                                Armed Forces and veterans, particularly 
                                those members and veterans located in 
                                rural areas, provided the care is 
                                consistent with minimum clinical mental 
                                health guidelines promulgated by the 
                                Veterans Health Administration 
                                including clinical guidelines contained 
                                in the Uniform Mental Health Services 
                                Handbook of such Administration.
                            ``(ii) Additional services.--The additional 
                        services described in this clause are--
                                    ``(I) services not described in 
                                clause (i); and
                                    ``(II) services that are 
                                appropriate to meet the health needs of 
                                the population served, including any of 
                                the primary health services described 
                                in section 330(b)(1)(A) of the Public 
                                Health Service Act.''.
            (2) Additional amendments.--Section 223 of the Protecting 
        Access to Medicare Act of 2014 (42 U.S.C. 1396a note), is 
        amended--
                    (A) in subsection (b)(1), by striking ``mental 
                health services'' and inserting ``certified community 
                behavioral health clinic services'';
                    (B) in subsection (d)(5)(D)--
                            (i) by inserting ``(including such State's 
                        prior use under such demonstration of a 
                        supplemental payment or `wraparound' framework 
                        for payments for services furnished under 
                        contract with a managed care entity)'' after 
                        ``established under subsection (c)''; and
                            (ii) by striking the period at the end and 
                        inserting the following: ``, and 
                        notwithstanding any Federal regulation 
                        concerning prohibition of additional payments 
                        for services covered under a contract with a 
                        managed care entity, a prepaid inpatient health 
                        plan, or a prepaid ambulatory health plan.''; 
                        and
                    (C) in subsection (e)--
                            (i) by redesignating paragraphs (1) through 
                        (4) as paragraphs (2) through (5); and
                            (ii) by inserting before paragraph (2) the 
                        following new paragraph:
            ``(1) Certified community behavioral health clinic 
        services.--The term `certified community behavioral health 
        clinic services' means any services required under clause (i) 
        of subsection (a)(2)(D) and any additional services described 
        in clause (ii) of such subsection to the extent that a 
        certified community behavioral health clinic elects to furnish 
        such services.''.
    (b) Effective Date.--The amendments made by this section shall 
apply with respect to services furnished on or after October 1, 2026.

SEC. 104. EXPANDING CERTIFIED COMMUNITY BEHAVIORAL HEALTH CLINIC 
              SERVICES COVERED UNDER THE MEDICAID STATE PLAN.

    (a) Additional Services Within Certified Community Behavioral 
Health Clinic Benefit.--Section 1905(jj)(1) of the Social Security Act 
(42 U.S.C. 1396d(jj)(1)) is amended to read as follows:
            ``(1) In general.--The term `certified community behavioral 
        health services' means the following required services 
        described in subparagraph (A), which may be furnished either 
        directly or, if not available directly, through formal 
        relationships with other providers, and at the discretion of 
        the certified community behavioral health clinic, at least 1 of 
        the following additional services described in subparagraph (B) 
        furnished directly by the clinic:
                    ``(A) Required services.--
                            ``(i) Crisis mental health services, 
                        including 24-hour mobile crisis teams, 
                        emergency crisis intervention services, and 
                        crisis stabilization.
                            ``(ii) Screening, assessment, and 
                        diagnosis, including risk assessment.
                            ``(iii) Patient-centered treatment planning 
                        or similar processes, including risk assessment 
                        and crisis planning.
                            ``(iv) Outpatient mental health and 
                        substance use services.
                            ``(v) Outpatient clinic primary care 
                        screening and monitoring of key health 
                        indicators and health risk.
                            ``(vi) Targeted case management.
                            ``(vii) Psychiatric rehabilitation 
                        services.
                            ``(viii) Peer support and counselor 
                        services and family supports.
                            ``(ix) Intensive, community-based mental 
                        health care for members of the Armed Forces and 
                        veterans who are eligible for medical 
                        assistance, particularly such members and 
                        veterans located in rural areas, provided the 
                        care is consistent with minimum clinical mental 
                        health guidelines promulgated by the Veterans 
                        Health Administration, including clinical 
                        guidelines contained in the Uniform Mental 
                        Health Services Handbook of such 
                        Administration.
                    ``(B) Additional services.--The additional services 
                described in this subparagraph are--
                            ``(i) services not described in 
                        subparagraph (A); and
                            ``(ii) services that are appropriate to 
                        meet the health needs of the population served, 
                        including any of the primary health services 
                        described in section 330(b)(1)(A) of the Public 
                        Health Service Act.''.
    (b) Effective Date.--The amendments made by this section shall 
apply with respect to services furnished on or after October 1, 2026.

  TITLE II--COVERAGE OF CERTIFIED COMMUNITY BEHAVIORAL HEALTH CLINIC 
                  SERVICES UNDER THE MEDICARE PROGRAM

SEC. 201. COVERAGE OF CERTIFIED COMMUNITY BEHAVIORAL HEALTH CLINIC 
              SERVICES UNDER THE MEDICARE PROGRAM.

    (a) Coverage.--Section 1861(s)(2) of the Social Security Act (42 
U.S.C. 1395x(s)(2)) is amended--
            (1) in subparagraph (JJ), by inserting ``and'' at the end; 
        and
            (2) by adding at the end the following new subparagraph:
            ``(KK) certified community behavioral health clinic 
        services (as defined in subsection (aa)(8)) furnished on or 
        after January 1, 2027.''.
    (b) Definitions.--Section 1861(aa) of the Social Security Act (42 
U.S.C. 1395x) is amended--
            (1) in the heading, by striking ``and Federally Qualified 
        Health Center Services'' and inserting ``, Federally Qualified 
        Health Center Services, and Certified Community Behavioral 
        Health Clinic Services''; and
            (2) by adding at the end the following new paragraph:
    ``(8) The terms `certified community behavioral health clinic 
services' and `certified community behavioral health clinic' have the 
meaning given those terms in paragraphs (1) and (2), respectively, of 
section 1905(jj).''.

SEC. 202. PAYMENT FOR CERTIFIED COMMUNITY BEHAVIORAL HEALTH CLINIC 
              SERVICES UNDER THE MEDICARE PROGRAM.

    (a) In General.--Section 1833(a)(1) of the Social Security Act (42 
U.S.C. 1395l(a)(1)) is amended--
            (1) by striking ``and (HH)'' and inserting ``(HH)''; and
            (2) by inserting before the semicolon at the end the 
        following: ``, and (II) with respect to certified community 
        behavioral health clinic services for which payment is made 
        under section 1834(aa), the amounts paid shall be equal to 80 
        percent of the lesser of the actual charge or the amount 
        determined under such section''.
    (b) Development and Implementation of Prospective Payment System.--
Section 1834 of the Social Security Act (42 U.S.C. 1395m) is amended by 
adding at the end the following new subsection:
    ``(aa) Development and Implementation of Prospective Payment System 
for Certified Community Behavioral Health Clinics.--
            ``(1) Development.--
                    ``(A) In general.--The Secretary shall develop a 
                prospective payment system for payment for community 
                behavioral health clinic services (as defined in 
                section 1861(aa)(8)) furnished by certified community 
                behavioral health clinics (as defined in such section) 
                under this title.
                    ``(B) Considerations and adjustments.--In 
                developing the system described in subparagraph (A), 
                the Secretary--
                            ``(i) shall--
                                    ``(I) take into account the type, 
                                intensity, and duration of services 
                                furnished by certified community 
                                behavioral health clinics; and
                                    ``(II) consider an appropriate unit 
                                of service and a general system design 
                                that provides for continued access to 
                                quality services; and
                            ``(ii) may include adjustments, including 
                        geographic adjustments, as determined 
                        appropriate by the Secretary.
            ``(2) Implementation.--
                    ``(A) In general.--For cost reporting periods 
                beginning on or after January 1, 2027, the Secretary 
                shall provide for payments of prospective payment rates 
                for certified community behavioral health clinic 
                services furnished by certified community behavioral 
                health clinics under this title in accordance with the 
                prospective payment system developed by the Secretary 
                under paragraph (1).
                    ``(B) Initial payments.--
                            ``(i) In general.--Subject to clause (ii), 
                        in the first year that such prospective payment 
                        system is implemented, the Secretary shall 
                        implement such system to reflect the national 
                        average allowable service costs of certified 
                        community behavioral health clinics on the 
                        basis of the most current audited cost report 
                        data for the 2 most recent fiscal years 
                        available to the Secretary. Initial payments 
                        shall be established without the application of 
                        a per visit limit or productivity screen and 
                        shall be based on national average costs per 
                        unit of service, updated as appropriate by the 
                        inflationary adjustment described in 
                        subparagraph (C).
                            ``(ii) Absence of data.--In the absence of 
                        complete cost report data described in clause 
                        (i), certified community behavioral health 
                        clinics may, at the Secretary's discretion, 
                        submit estimated or projected data relating to 
                        specific services.
                    ``(C) Payments in subsequent years.--Payment rates 
                in years after the year of implementation of such 
                system shall be the payment rates in the previous year 
                increased--
                            ``(i) in the first year after 
                        implementation of such system, by the 
                        percentage increase in the MEI (as defined in 
                        section 1842(i)(3)); and
                            ``(ii) in subsequent years--
                                    ``(I) by the percentage increase in 
                                a market basket of certified community 
                                behavioral health clinic services, 
                                designed by the Secretary; or
                                    ``(II) if such an index is not 
                                available, by the percentage increase 
                                in the Federally qualified health 
                                center market basket (as described in 
                                section 1834(o)(2)(B)(ii)(II)) for the 
                                year involved.
            ``(3) Periodic reevaluation of rates.--The Secretary may 
        periodically adjust the amounts that would otherwise be 
        applicable under paragraph (2) by a percentage determined 
        appropriate by the Secretary to reflect such factors as changes 
        in the intensity of certified community behavioral health 
        clinic services furnished within a unit of service, the average 
        cost of providing care per unit of service, and other factors 
        that the Secretary considers to be appropriate. Such adjustment 
        shall be made before the update under clause (i) or (ii) of 
        paragraph (2)(C) has been applied for the year.''.

SEC. 203. NON-APPLICATION OF MEDICARE PART B DEDUCTIBLE FOR CERTIFIED 
              COMMUNITY BEHAVIORAL HEALTH CLINIC SERVICES.

    Section 1833(b)(4) of the Social Security Act (42 U.S.C. 
1395l(b)(4)) is amended by inserting ``or certified community 
behavioral health clinic services'' before the comma at the end.

SEC. 204. RIGHT TO SEEK PAYMENT REIMBURSEMENT REVIEW BOARD REVIEW OF 
              COST REPORTS.

    Section 1878(j) of the Social Security Act (42 U.S.C. 1395oo(j)) is 
amended by striking ``and a Federally qualified health center'' and 
inserting ``, a Federally qualified health center, and a certified 
community behavioral health clinic''.

SEC. 205. EXTENDING SAFE HARBOR UNDER ANTI-KICKBACK STATUTE TO WAIVERS 
              OF CERTIFIED COMMUNITY BEHAVIORAL HEALTH CLINIC 
              COINSURANCE.

    Section 1128B(b)(3)(D) of the Social Security Act (42 U.S.C. 1320a-
7b(b)(3)(D)) is amended by inserting ``or a certified community 
behavioral health clinic'' after ``Federally qualified health care 
center''.

SEC. 206. EFFECTIVE DATE.

    The amendments made by this title shall apply with respect to 
services furnished on or after January 1, 2027.

             TITLE III--COMMUNITY BEHAVIORAL HEALTH CLINICS

SEC. 301. COMMUNITY BEHAVIORAL HEALTH CLINICS.

    Part D of title III of the Public Health Service Act (42 U.S.C. 
254b et seq.) is amended by adding at the end the following:

          ``Subpart XIII--Community Behavioral Health Clinics

``SEC. 340J. DEFINITIONS.

    ``In this subpart:
            ``(1) Certified community behavioral health clinic.--The 
        term `certified community behavioral health clinic' has the 
        meaning given the term in section 1905(jj)(2) of the Social 
        Security Act.
            ``(2) Certified community behavioral health services.--The 
        term `certified community behavioral health services' has the 
        meaning given the term in section 1905(jj)(1) of the Social 
        Security Act.

``SEC. 340J-1. OPERATING GRANTS FOR COMMUNITY BEHAVIORAL HEALTH 
              CLINICS.

    ``(a) In General.--The Secretary shall establish a grant program 
under which the Secretary shall award grants to eligible community 
behavioral health clinics to provide (in a manner reflecting person-
centered care) the full array of certified community behavioral health 
services.
    ``(b) Eligibility.--To be eligible to receive a grant under 
subsection (a), an entity shall be--
            ``(1) a certified community behavioral health clinic; or
            ``(2) a community behavioral health clinic that--
                    ``(A) indicates in the grant application that--
                            ``(i) it will use the grant funds to meet 
                        such criteria required to be a certified 
                        community behavioral health clinic; and
                            ``(ii) agrees to seek accreditation under 
                        section 340J-4(a), as the Secretary may 
                        require; and
                    ``(B) demonstrates how it can ensure access to care 
                for all individuals in the community through referral 
                or other formal arrangements with other providers of 
                services, in the case of an entity that specializes in 
                services to children or youth or to veterans.
    ``(c) Use of Funds.--A community behavioral health clinic that 
receives a grant under subsection (a)--
            ``(1) shall use the grant funds--
                    ``(A) to provide the services described in 
                subsection (a); and
                    ``(B) in the case of a community behavioral health 
                clinic described in subsection (b)(2), to attain 
                certification and accreditation as described in 
                subsection (b)(2)(A); and
            ``(2) may use the grant funds--
                    ``(A) to carry out other activities that--
                            ``(i) reduce costs associated with the 
                        provision of certified community behavioral 
                        health services;
                            ``(ii) improve access to, and availability 
                        of, certified community behavioral health 
                        services provided to individuals served by the 
                        community behavioral health clinic;
                            ``(iii) enhance the quality and 
                        coordination of certified community behavioral 
                        health services; or
                            ``(iv) improve the health status of 
                        communities; and
                    ``(B) to pay for--
                            ``(i) the costs of acquiring and leasing 
                        buildings and equipment (including the costs of 
                        amortizing the principal of, and paying 
                        interest on, loans);
                            ``(ii) costs relating to the purchase or 
                        lease of equipment, including data and 
                        information systems and behavioral health 
                        information technology to facilitate data 
                        reporting and other purposes;
                            ``(iii) the costs of in-service staff 
                        training and other operational or 
                        infrastructure costs identified by the 
                        Secretary; and
                            ``(iv) costs associated with expanding and 
                        modernizing existing buildings or constructing 
                        new buildings (including the costs of 
                        amortizing the principal of, and paying the 
                        interest on, loans), if such costs are 
                        specifically allowed for in the grant 
                        opportunity published by the Secretary.
    ``(d) Use of Nongrant Funds.--Nongrant funds described in 
subsection (g)(1)(B), including any such funds in excess of those 
originally expected, shall be used as permitted under this section, and 
may be used for such other purposes as are not specifically prohibited 
under this section if such use furthers the objectives of the project.
    ``(e) Term.--Grants awarded under subsection (a) shall be for a 
period of not more than 5 years.
    ``(f) Condition on Receipt of Funds.--The Secretary shall not make 
a grant to an applicant under subsection (a) unless the applicant 
provides assurances to the Secretary that within 120 days of receiving 
grant funding for the operation of the clinic, the applicant will 
submit for approval by the Secretary an implementation plan that 
describes how the applicant will--
            ``(1) provide the services described in subsection (a); and
            ``(2) in the case of a community behavioral health clinic 
        described in subsection (b)(2), attain certification and 
        accreditation as described in subsection (b)(2)(A).
    ``(g) Amount of Grant.--
            ``(1) In general.--Subject to paragraph (2), the amount of 
        a grant made in any fiscal year to a community behavioral 
        health clinic under subsection (a) shall be determined by the 
        Secretary based on information provided by the community 
        behavioral health clinic, but may not exceed an amount equal to 
        the difference between--
                    ``(A) the costs of operating the clinic to meet the 
                purposes and requirements of the grant program under 
                this section during such fiscal year; and
                    ``(B) the sum obtained by adding--
                            ``(i) the total State, local, and other 
                        operational funding provided to the clinic for 
                        such fiscal year; and
                            ``(ii) the fees, premiums, and third-party 
                        reimbursements that the clinic reasonably 
                        expects to receive for its operations in such 
                        fiscal year.
            ``(2) Requirement.--In determining the costs described in 
        paragraph (1)(A) with respect to a community behavioral health 
        clinic, the Secretary may estimate, based on an estimate of 
        anticipated costs provided by the applicable community 
        behavioral health clinic, the anticipated costs of such clinic 
        in--
                    ``(A) providing the services described in 
                subsection (a), including the anticipated costs of 
                providing any individual certified community behavioral 
                health service that the applicant entity does not have 
                experience providing at the time of submitting an 
                application for such grant; and
                    ``(B) if applicable, attain certification and 
                accreditation as described in subsection (b)(2)(A).
            ``(3) Payments.--The Secretary may--
                    ``(A) disperse funds awarded under subsection (a)--
                            ``(i) in advance or through reimbursement; 
                        and
                            ``(ii) in installments;
                    ``(B) make adjustments to such disbursements to 
                account for overpayments or underpayments.
    ``(h) Use of Accreditation in Monitoring Grant Progress.--
Regardless of whether the Secretary elects to use accreditation under 
section 340J-4(a) as a condition for award of an operating grant as 
described in subsection (b)(2)(A)(ii), the Secretary may take such 
accreditation into account in determining if an entity receiving a 
grant under this section is providing the services described in 
subsection (a) and, if applicable, meeting the criteria for 
certification described in subsection (b)(2)(A)(i).
    ``(i) Authorization of Appropriations.--
            ``(1) In general.--There is authorized to be appropriated 
        to carry out this section, $552,500,000 for each of fiscal 
        years 2026 through 2030.
            ``(2) Maintenance of funding.--The amount made available 
        under paragraph (1) shall supplement (and not supplant) any 
        other Federal funding made available for certified community 
        behavioral health clinics.
    ``(j) Study of Clinics Serving Specialized Populations.--Not later 
than 1 year after the date of enactment of this section, the Secretary 
shall publish guidance clarifying how clinics that focus on distinct 
populations, such as children or youth and veterans, may meet any 
relevant requirement to furnish appropriate treatment to individuals 
across the lifespan. Such guidance shall not affect clinics' 
qualification to participate in the demonstration program under section 
223(a)(1) of the Protecting Access to Medicare Act of 2014 or to 
furnish the services described in section 1905(a)(31) of the Social 
Security Act.''.

``SEC. 340J-2. TECHNICAL ASSISTANCE.

    ``(a) In General.--Not later than 180 days after the date of 
enactment of this section, the Secretary shall establish a program or 
programs through which the Secretary shall provide (directly or by 
grant or contract) technical assistance and other assistance to any of 
the following:
            ``(1) Entities that receive a grant under section 340J-1.
            ``(2) Entities participating in a Medicaid demonstration 
        program under section 223(d) of the Protecting Access to 
        Medicare Act.
            ``(3) Certified community behavioral health clinics 
        furnishing services under title XVIII or title XIX of the 
        Social Security Act.
            ``(4) Health or social service provider organizations 
        pursuing or considering seeking status as a certified community 
        behavioral health clinic or partnering with certified community 
        behavioral health clinics.
            ``(5) Other stakeholders, including demonstration planning 
        grant recipients and State Medicaid or behavioral health 
        officials, for the purpose of facilitating successful 
        implementation of the certified community behavioral health 
        clinic model.
    ``(b) Inclusions.--Assistance provided by the Secretary under 
subsection (a) may include technical and nonfinancial assistance, 
including--
            ``(1) fiscal and program management assistance;
            ``(2) operational and administrative support; and
            ``(3) information about the variety of resources available 
        under this part and how such resources best can be used to meet 
        the health and behavioral health needs of the communities 
        served by the entities.
    ``(c) Authorization of Appropriations.--There is authorized to be 
appropriated to carry out this section $8,000,000 for each of fiscal 
years 2026 through 2030.''.

``SEC. 340J-3. DATA INFRASTRUCTURE FOR COMMUNITY BEHAVIORAL HEALTH 
              CLINIC REPORTING.

    ``(a) In General.--Not later than 180 days after the date of 
enactment of this part, the Secretary shall establish a system under 
which the Secretary collects and analyzes data on community behavioral 
health clinics.
    ``(b) Scope of Data Collection.--The system established under 
subsection (a) shall be used by the Secretary to collect and analyze 
data from--
            ``(1) entities that receive a grant under section 340J-1; 
        and
            ``(2) organizations that provide certified community 
        behavioral health services, or have applied to provide such 
        services, under the Medicare program under title XVIII of the 
        Social Security Act or the Medicaid program under title XIX of 
        such Act.
    ``(c) Authorization of Appropriations.--There is authorized to be 
appropriated to carry out this section $51,000,000 for each of fiscal 
years 2026 through 2030.''.

``SEC. 340J-4. CERTIFIED COMMUNITY BEHAVIORAL HEALTH CLINIC 
              ACCREDITATION.

    ``(a) Accreditation Standards.--A clinic may be accredited as a 
certified community behavioral health clinic if the clinic--
            ``(1) meets the standards of an approved accreditation 
        body; and
            ``(2) authorizes the accreditation body to submit to the 
        Secretary (or such agency as the Secretary may designate) such 
        records or other information as the Secretary may require.
    ``(b) Approval of Accreditation Bodies.--
            ``(1) In general.--The Secretary may approve a private 
        nonprofit organization to be an accreditation body for the 
        accreditation of certified community behavioral health clinics 
        under subsection (a) if--
                    ``(A) using inspectors qualified to evaluate 
                quality of care in a behavioral health service setting, 
                the accreditation body agrees to inspect the clinic 
                with such frequency as is determined by the Secretary;
                    ``(B) the standards applied by the body in 
                determining whether or not to accredit a clinic 
                correspond to such criteria as are described in section 
                340J-1(b)(2), pursuant to the determination of the 
                Secretary, and are not less restrictive than such 
                criteria;
                    ``(C) there is adequate provision for assuring that 
                the standards of the accreditation body continue to be 
                met by the clinic;
                    ``(D) in the case of any clinic accredited, within 
                the prior 3 years, by the body which has had its 
                accreditation denied, suspended, withdrawn, or revoked 
                or which has had any other action taken against it by 
                the accrediting body, the accrediting body agrees to 
                submit to the Secretary the name of such clinic within 
                30 days of the action taken; and
                    ``(E) if the accreditation body has its approval 
                withdrawn by the Secretary, the body agrees to notify 
                each clinic accredited by the body of the withdrawal 
                within 10 days of the withdrawal.''.

   TITLE IV--LIABILITY PROTECTION FOR CERTIFIED COMMUNITY BEHAVIORAL 
                        HEALTH CLINIC CLINICIANS

SEC. 401. CONFERRING PROTECTION UNDER THE FEDERAL TORT CLAIMS ACT TO 
              CLINICIANS IN CERTIFIED COMMUNITY BEHAVIORAL HEALTH 
              CLINICS.

    Section 224(g)(4) of the Public Health Service Act (42 U.S.C. 233) 
is amended by adding at the end the following: ``or certified community 
behavioral health clinic as defined in section 1905(jj)(2) of the 
Social Security Act''.
                                 <all>