Federal Update

October 31, 2022

The Senate Finance Committee recently released draft legislative text of the mental health integration of care provisions to be included as a part of the Committee’s broader legislative effort to improve mental health care for Medicare, Medicaid, and Children’s Health Insurance Program (CHIP) beneficiaries.

In the draft are a number of key provisions:

  • Policies to Incentivize Integration of Certain Behavioral Health Services
    • Integration of Behavioral Health Care for Treatment of Mental Health and SUD in Primary Care
      • Requires testing of service delivery models to determine quality and cost
    • Payment for Mobile Crisis Response Intervention Services
      • Requires Medicare coverage of mobile crisis response teams as a single global payment
    • Payment for Crisis Stabilization Services
      • Requires coverage of crisis stabilization services as an outpatient department service
    • Additional Incentives for Behavioral Health Integration
      • Requires payment level alteration for certain HCPCS codes that incentivize behavioral health integration for 3 years
  • Policies to Increase Integration of Mental Health Services through Guidance
    • Guidance for Expanding Value-Based Arrangements and Alternative Payment Models in Medicare
      • Requires HHS to draft best practices on integrated behavioral health within primary care settings
    • Guidance to States on Supporting Mental Health and SUD Care Integration with Primary Care in Medicaid and CHIP
      • Requires an analysis of clinical outcomes amount different behavioral health integration models within the primary care setting
    • Guidance to States to Support Access to Community Social Supports and Services in Medicaid
      • Requires HHS to provide guidance to encourage collaboration between States, Medicaid MCOs, and community-based organizations in providing consumers with connections to social/non-medical supports
  • Additional Policies
    • Clarification on the Eligibility for Participation of Peer Support Specialists in Providing Behavioral Health Services in Medicare
      • Allows Medicare to directly reimburse certified peer recovery specialists
    • Making the Medicaid State Option to Provide Qualifying Community-Based Mobile Crisis Intervention Services Permanent
      • Creates a permanent state option to provide qualifying community based mobile crisis intervention services (previously time-limited to 5 years)

We have attached both the draft legislation and a summary produced by the National Council’s outside counsel for your review and use.

Next Steps:

Four of the five Senate Finance Committee Working Groups have released draft legislative text. We do not expect the Senate Finance Committee to hold a markup for this legislative proposal. We will keep you apprised of any additional information and/or momentum related to this legislative package, but would like to note that a potential vehicle for the package may be the health section of a possibly forthcoming Omnibus Spending Package.

Thank you so much, please let us know if you have any questions.