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Ensuring Excellence in Mental Health Act

S. 2993 Lead Sponsor: Sen. Debbie Stabenow (D-MI)
Co-Sponsors

H.R. 8543Lead Sponsors: Reps. Doris Matsui (D-CA-07), Larry Bucshon, M.D. (R-IN-08), Marc Molinaro (R-NY-19) and Angie Craig (D-MN-02)
Co-Sponsors

This proposed bill includes a number of provisions to support the continued expansion and funding of Certified Community Behavioral Health Clinics (CCBHC), the emerging model of care for increasing access to a full range of mental health and substance use treatment services nationwide.

Highlights

• $51M+ in authorizations
• Selected Highlights
  • Creates a Medicaid State Plan option for States to cover CCBHC services
  • Defines State Plan CCBHC services the same as the services are defined under the PAMA Section 223 Medicaid demonstration
  • Establishes a Medicaid CCBHC Prospective Payment System (PPS) and allows States to elect, via the State plan, an alternative payment methodology (APM) in lieu of the CCBHC PPS
  • Establishes CCBHC services as a Medicare Part B benefit, with the services defined the same as in the Medicaid program
  • Establishes a Medicare CCBHC PPS payment methodology
  • Makes amendments to the Public Health Service Act (PHSA) to authorize a permanent CCBHC operating grant and other CCBHC grant programs
  • Adds a new section to the PHSA authorizing the Secretary to issue CCBHC technical assistance grants
  • Authorizes creation of a new HHS data collection infrastructure to support the various CCBHC programs
  • Adds CCBHCs that are participating in Medicare or Medicaid as covered entities for purposes of the PHSA Section 340B drug pricing program
  • Authorizes HHS to select private nonprofit organizations to function as accrediting bodies for CCBHCs

Netsmart Advocacy: Netsmart, the BHIT Coalition, the National Council for Mental Wellbeing and other organizations are advocating for this legislation that will help ensure continued expansion and long-term sustainability of the highly effective CCBHC model of care. The data infrastructure and repository component would enable CCBHCs to track outcomes, improve access to services, and enhance processes and other factors specific to CCBHC services provided. Current focus is on reintroduction of the bill in the 119th Congress.

More Information
National Council for Mental Wellbeing Summary

Behavioral Health Information Technology Coordination Act

S. 2688 Lead Sponsors: Sen Markwayne Mullin (R-OK) and Sen. Catherine Cortez Masto (D-NV) Co-Sponsors

H.R. 5116 Lead Sponsors: Rep. Doris Matsui (D-CA-07), Rep. Ron Estes (R-KS-04), Rep. Sharice Davids (D-KS-03) and Rep. Bill Johnson (R-OH-06) Co-Sponsors

This proposed legislation would authorize grants totaling $100 million ($20 million per year over 5 years) to behavioral health providers to purchase software and support services needed to provide behavioral health care services. The Office of the National Coordinator for Health Information Technology (ONC) will administer the grant program. The agency would have up to 18 months after passage of the bill to issue a Notice of Funding Opportunity (NOFO).

With a significant focus on integrated care, program requirements specify that grantees use the funds to:

• Demonstrate the capacity to exchange patient clinical data with primary care physicians, medical specialty providers and acute care hospitals, psychiatric hospitals, and hospital emergency departments
• Promote, where feasible, the implementation and improvement of bi-directional integrated services, including evidence-informed screening, assessment, diagnosis, prevention, treatment, recovery, and coordinated discharge planning services for mental health and substance use disorders, and co-occurring physical health conditions and chronic diseases

Netsmart Advocacy: Netsmart and the BHIT Coalition provided recommendations on bill provisions and helped secure bill co-sponsors. Current focus is on reintroduction of the bill in the 119th Congress.

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Summary of the legislation

CMS Innovation in Behavioral Health (IBH) Model

This voluntary eight-state, D.C. and Territory model aims to improve health outcomes and overall quality of care for Medicare/Medicaid populations. The IBH Model will support care management teams, enabling providers to address behavioral health, physical health, and health-related social needs (HRSNs) in order to provide integrated, whole-person care. The IBH Model is also intended to guide community-based behavioral health practices from fee-for-service (FFS) to value-based payments.

The Four Key Program Pillars of the IBH Model – Care Integration, Care Management, Health Equity and Healthcare IT -- encompass key areas of whole-person care facilitated by Netsmart solutions, services and expertise.

Based on responses to a Notice of Funding Opportunity (NOFO), CMS announced on December 18, 2024 the selection of state Medicaid agencies in Michigan, New York, Oklahoma, and South Carolina to participate in IBH Model implementations beginning on January 1, 2025.

Netsmart Advocacy: As a founding member of the BHIT Coalition, Netsmart and other coalition members engaged in advocacy for CMS Innovation Center development of a behavioral health IT financing demonstration program per Sec. 6001 of the SUPPORT Act of 2018. Netsmart also provided behavioral health IT-related knowledge sharing and guidance for the IBH model. Current advocacy is focused on strongly encouraging HHS and CMS to complete the selection process for four additional state participants in the model.

More Information
CMS Announcement about Initial Four IBH States and IBH background info – Dec. 18, 2024