[Congressional Bills 117th Congress]
[From the U.S. Government Publishing Office]
[S. 4747 Introduced in Senate (IS)]

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117th CONGRESS
  2d Session
                                S. 4747

      To amend title XIX of the Social Security Act to expand the 
availability of mental, emotional, and behavioral health services under 
             the Medicaid program, and for other purposes.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                             August 2, 2022

Mr. Portman (for himself and Mr. Casey) introduced the following bill; 
     which was read twice and referred to the Committee on Finance

_______________________________________________________________________

                                 A BILL


 
      To amend title XIX of the Social Security Act to expand the 
availability of mental, emotional, and behavioral health services under 
             the Medicaid 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.

    This Act may be cited as the ``Investing in Kids' Mental Health Now 
Act of 2022''.

SEC. 2. TABLE OF CONTENTS.

    The table of contents for this Act is as follows:

Sec. 1. Short title.
Sec. 2. Table of contents.
Sec. 3. Payment rate increase for pediatric behavioral health services.
Sec. 4. Guidance to States on supporting mental, emotional, and 
                            behavioral health services, and on the 
                            availability of telehealth under Medicaid.
Sec. 5. Ensuring children receive timely access to care.

SEC. 3. PAYMENT RATE INCREASE FOR PEDIATRIC BEHAVIORAL HEALTH SERVICES.

    (a) Payment Rate Increase for Pediatric Behavioral Health 
Services.--Section 1902 of the Social Security Act (42 U.S.C. 1396a) is 
amended--
            (1) in subsection (a)(13)--
                    (A) in subparagraph (B), by striking ``and'' at the 
                end;
                    (B) in subparagraph (C), by adding ``and'' at the 
                end; and
                    (C) by adding at the end the following new 
                subparagraph:
                    ``(D) that, for a 1-year period that begins not 
                later than 6 months after the date of enactment of this 
                subparagraph, the State shall pay for pediatric mental, 
                emotional, and behavioral health services (as defined 
                in subsection (tt)) furnished during such period at a 
                rate that is at least 1 percent, and not more than 9 
                percent, higher than the rate that was applicable to 
                such services under the State plan as of the day before 
                the date that is 6 months before the date of enactment 
                of this subparagraph;''; and
            (2) by adding at the end the following new subsection:
    ``(tt) Pediatric Mental, Emotional, and Behavioral Health Services 
Defined.--For purposes of subsection (a)(13)(D), the term `pediatric 
mental, emotional, and behavioral health services' means at least 10 of 
the following services furnished by a health care provider, including 
hospitals, physicians, and other providers determined by the Secretary, 
for the purposes of screening for, identifying, diagnosing, or treating 
a mental, emotional, or behavioral health condition, whether furnished 
in-person or via telehealth:
            ``(1) Mental health and substance use disorder screenings.
            ``(2) Mental health development assessments.
            ``(3) Mental health behavior assessments and interventions.
            ``(4) Psychological and neuropsychological testing and 
        assessment.
            ``(5) Mental health primary prevention services.
            ``(6) Mental health and substance use disorder case 
        management services.
            ``(7) School-based mental health and substance use disorder 
        prevention, identification, and treatment services.
            ``(8) Child and adolescent psychiatry and psychology 
        services.
            ``(9) Partial hospitalization services.
            ``(10) Day program services.
            ``(11) Intensive outpatient services.
            ``(12) Eating disorder treatment services.
            ``(13) Outpatient services.
            ``(14) Crisis residential services.
            ``(15) Crisis intervention and stabilization.
            ``(16) Inpatient psychiatric and psychological services.
            ``(17) Individual therapy.
            ``(18) Family therapy.
            ``(19) Group therapy services.
            ``(20) Intensive in-home services.
            ``(21) Peer support services.
            ``(22) Provider-to-provider consultation services involving 
        primary care practitioners and mental health care specialists, 
        including child and adolescent specialists.
            ``(23) Substance use disorder screening, including SBIRT, 
        and treatment.
            ``(24) Medication management.
            ``(25) Any other pediatric mental, emotional, or behavioral 
        health service determined appropriate by the Secretary.''.
    (b) Under Medicaid Managed Care Plans.--Section 1932(f) of such Act 
(42 U.S.C. 1396u-2(f)) is amended--
            (1) in the header, by inserting ``and Pediatric Mental, 
        Emotional, and Behavioral Health'' before ``Services'';
            (2) by inserting ``and pediatric mental, emotional, and 
        behavioral health services described in section 
        1902(a)(13)(D)'' after ``section 1902(a)(13)(C)''; and
            (3) by striking ``such section'' and inserting ``section 
        1902(a)(13)''.
    (c) Increase in Payment Using Increased FMAP.--Section 1905 of the 
Social Security Act (42 U.S.C. 1396d) is amended by adding at the end 
the following new subsection:
    ``(jj) Increased FMAP for Additional Expenditures for Pediatric 
Mental, Emotional, and Behavioral Health Services.--Notwithstanding 
subsection (b), with respect to the portion of the amounts expended for 
medical assistance for services described in section 1902(a)(13)(D) 
that is furnished during the 1-year period described in such section 
and that is attributable to the increase to the payment rate applicable 
to such services required under such section (or, by application, 
section 1932(f)), the Federal medical assistance percentage for a State 
that is one of the 50 States or the District of Columbia shall be equal 
to 100 percent. The preceding sentence does not prohibit the payment of 
Federal financial participation based on the Federal medical assistance 
percentage for amounts in excess of those specified in such 
sentence.''.

SEC. 4. GUIDANCE TO STATES ON SUPPORTING MENTAL, EMOTIONAL, AND 
              BEHAVIORAL HEALTH SERVICES, AND ON THE AVAILABILITY OF 
              TELEHEALTH UNDER MEDICAID.

    (a) Mental, Emotional, and Behavioral Health Services.--Not later 
than 180 days after date of enactment of this Act, the Secretary of 
Health and Human Services shall issue guidance to States on how to 
expand the provision of mental, emotional, and behavioral health 
services covered by State plans (or waivers of such plans) under title 
XIX of the Social Security Act (42 U.S.C. 1396 et seq.), including a 
description of best practices for effective programs, service provision 
for underserved communities, meeting the needs of children with medical 
complexities, and recruitment and retention of providers.
    (b) Mental, Emotional, and Behavioral Telehealth Services.--Not 
later than 1 year after date of enactment of this Act, the Secretary of 
Health and Human Services shall issue guidance to States on best 
practices to sustain and enhance the availability of mental, emotional, 
and behavioral telehealth services covered by State plans (or waivers 
of such plans) under title XIX of the Social Security Act (42 U.S.C. 
1396 et seq.), including expanding the originating site requirement, 
delivering audio-only mental, emotional, and behavioral telehealth 
services, and streamlining provider licensing, credentialing, and 
enrollment protocols with respect to telehealth services furnished 
across State lines.

SEC. 5. ENSURING CHILDREN RECEIVE TIMELY ACCESS TO CARE.

    (a) Guidance to States on Flexibilities To Ensure Provider Capacity 
To Provide Pediatric Mental, Emotional, and Behavioral Crisis Care.--
Not later than 60 days after the date of enactment of this Act, the 
Secretary of Health and Human Services shall provide guidance to States 
on best practices to support children in crisis or in need of intensive 
mental, emotional, or behavioral health services by using flexibilities 
for hospitals and other providers under applicable laws, regulations, 
and guidance, including a description of how States are leveraging 
existing flexibilities to deliver crisis care.
    (b) Mandated Report to Congress Regarding Barriers to Repurposing 
of Beds, Space, and Staff To Address Pediatric Behavioral Health 
Needs.--
            (1) In general.--Not later than 120 days after the date of 
        enactment of this Act, the Secretary of Health and Human 
        Services shall submit to the Congress a report with respect to 
        regulatory, legal, and other barriers to care across the crisis 
        continuum, including intermediate level care, such as intensive 
        outpatient care or partial hospitalization, that identifies 
        solutions to facilitate flexibility for children's hospitals 
        and other providers of mental, emotional, or behavioral health 
        services.
            (2) Requirements.--In preparing a report under this 
        subsection, the Secretary of Health and Human Services shall 
        include in such report--
                    (A) a comprehensive list of laws, regulations, and 
                guidance impacting children's hospitals' and other 
                providers' ability to repurpose immediately beds, 
                space, and staff for children in need of mental, 
                emotional, or behavioral health services, including a 
                description of the rationale for each policy and 
                corresponding actions required to repurpose such beds, 
                space, and staff; and
                    (B) recommendations on how children's hospitals and 
                other providers can immediately expand access to 
                mental, emotional, and behavioral health services, such 
                as intensive outpatient care, partial hospitalization, 
                and residential care, while also ensuring high quality 
                and safety.
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