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<dc:title>117 S4747 IS: Investing in Kids’ Mental Health Now Act of 2022</dc:title>
<dc:publisher>U.S. Senate</dc:publisher>
<dc:date>2022-08-02</dc:date>
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<dc:language>EN</dc:language>
<dc:rights>Pursuant to Title 17 Section 105 of the United States Code, this file is not subject to copyright protection and is in the public domain.</dc:rights>
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<distribution-code display="yes">II</distribution-code><congress>117th CONGRESS</congress><session>2d Session</session><legis-num>S. 4747</legis-num><current-chamber>IN THE SENATE OF THE UNITED STATES</current-chamber><action><action-date date="20220802">August 2, 2022</action-date><action-desc><sponsor name-id="S349">Mr. Portman</sponsor> (for himself and <cosponsor name-id="S309">Mr. Casey</cosponsor>) introduced the following bill; which was read twice and referred to the <committee-name committee-id="SSFI00">Committee on Finance</committee-name></action-desc></action><legis-type>A BILL</legis-type><official-title>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. </official-title></form><legis-body style="OLC" display-enacting-clause="yes-display-enacting-clause" id="H2846A5264E434D65B908E32131212B98"><section section-type="section-one" id="H5A2DD4C82CD9475B8A5439E495ABA7FB"><enum>1.</enum><header>Short title</header><text display-inline="no-display-inline">This Act may be cited as the <quote><short-title>Investing in Kids’ Mental Health Now Act of 2022</short-title></quote>.</text></section><section id="H81D3588FA9994834940B9117059800C4"><enum>2.</enum><header>Table of contents</header><text display-inline="no-display-inline">The table of contents for this Act is as follows:</text><toc><toc-entry level="section" idref="H5A2DD4C82CD9475B8A5439E495ABA7FB">Sec. 1. Short title.</toc-entry><toc-entry level="section" idref="H81D3588FA9994834940B9117059800C4">Sec. 2. Table of contents.</toc-entry><toc-entry level="section" idref="HFB896498BAAD40C2A4AA55DA2DBFA2C3">Sec. 3. Payment rate increase for pediatric behavioral health services.</toc-entry><toc-entry level="section" idref="HAD3FF4AD0B9D46B188FBF48E85308E6C">Sec. 4. Guidance to States on supporting mental, emotional, and behavioral health services, and on the availability of telehealth under Medicaid.</toc-entry><toc-entry level="section" idref="H9827258819A44CF7A422CEBD1730C4BA">Sec. 5. Ensuring children receive timely access to care.</toc-entry></toc></section><section id="HFB896498BAAD40C2A4AA55DA2DBFA2C3"><enum>3.</enum><header>Payment rate increase for pediatric behavioral health services</header><subsection id="H35D3D1A3F06D415F83D10D4C0A7541E8"><enum>(a)</enum><header>Payment rate increase for pediatric behavioral health services</header><text>Section 1902 of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1396a">42 U.S.C. 1396a</external-xref>) is amended—</text><paragraph id="H5EDB2314D85E49B88302FFEE49FAB613"><enum>(1)</enum><text>in subsection (a)(13)—</text><subparagraph id="HA8D618920E1049099402AEF63A8DA02D"><enum>(A)</enum><text>in subparagraph (B), by striking <quote>and</quote> at the end;</text></subparagraph><subparagraph id="H4D6B3D99184A495F82CDE5920E36567E"><enum>(B)</enum><text>in subparagraph (C), by adding <quote>and</quote> at the end; and</text></subparagraph><subparagraph id="H8714463D22EE4CDEA1EC6F1ED013E44B"><enum>(C)</enum><text>by adding at the end the following new subparagraph:</text><quoted-block style="OLC" id="H229D95D9F25B4B98AC5030EC03EAB41A"><subparagraph id="H16EF07EC4DC44FB8BBAB15A6AF55FDD3"><enum>(D)</enum><text>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;</text></subparagraph><after-quoted-block>; and</after-quoted-block></quoted-block></subparagraph></paragraph><paragraph id="H10AAA7ED12B74AC594E3BE994FDD3D9A"><enum>(2)</enum><text>by adding at the end the following new subsection:</text><quoted-block style="OLC" id="H8DF5DC676A834BCE98C912F5372B42C3"><subsection id="H877888056D58493EB13AFEA6E3F116AF"><enum>(tt)</enum><header>Pediatric mental, emotional, and behavioral health services defined</header><text display-inline="yes-display-inline">For purposes of subsection (a)(13)(D), the term <term>pediatric mental, emotional, and behavioral health services</term> 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:</text><paragraph id="H1B1C1384685D44D9B1A3B48B1AA5217D"><enum>(1)</enum><text>Mental health and substance use disorder screenings.</text></paragraph><paragraph id="H227314D8690543229B4337BD78707E39"><enum>(2)</enum><text>Mental health development assessments.</text></paragraph><paragraph id="H6708003068A3434BBDD7729052A83B4A"><enum>(3)</enum><text>Mental health behavior assessments and interventions.</text></paragraph><paragraph id="idB231EA91281C4E278BAEE6DE47FCFB6B"><enum>(4)</enum><text>Psychological and neuropsychological testing and assessment.</text></paragraph><paragraph id="id577F6735B98C4C73ABC0E84066443D70"><enum>(5)</enum><text>Mental health primary prevention services.</text></paragraph><paragraph id="idBD506E0CBED547879C79AA44100F57BE"><enum>(6)</enum><text>Mental health and substance use disorder case management services.</text></paragraph><paragraph id="idFAF809CC096347A8BAD70ABF95BF3CB5"><enum>(7)</enum><text>School-based mental health and substance use disorder prevention, identification, and treatment services.</text></paragraph><paragraph id="H309910854D674664B99D5FE4C92A6254"><enum>(8)</enum><text>Child and adolescent psychiatry and psychology services.</text></paragraph><paragraph id="H953EC2DC973540E18DE00BE66C4942FA"><enum>(9)</enum><text>Partial hospitalization services.</text></paragraph><paragraph id="HFE8CA863C5E844A0823670B5188B9F41"><enum>(10)</enum><text>Day program services.</text></paragraph><paragraph id="H2F7BDDD1BBA14066AF2CC98BA6B8A88C"><enum>(11)</enum><text>Intensive outpatient services.</text></paragraph><paragraph id="HFE786F0CCEC7479E9B2C6F9C515F9045"><enum>(12)</enum><text>Eating disorder treatment services.</text></paragraph><paragraph id="HE1389F771A3F48F894AB6E13F9227AAE"><enum>(13)</enum><text>Outpatient services.</text></paragraph><paragraph id="H61F581640CB140E1BD4C4EAF22F608B3"><enum>(14)</enum><text>Crisis residential services.</text></paragraph><paragraph id="H929E29391BAB4CBE9C6789F7C2794781"><enum>(15)</enum><text>Crisis intervention and stabilization.</text></paragraph><paragraph id="H323C0DF2B8ED42CFB19C7C1E7174A623"><enum>(16)</enum><text>Inpatient psychiatric and psychological services.</text></paragraph><paragraph id="HA5423D9074BF44DC9A6A979350BDAE46"><enum>(17)</enum><text>Individual therapy.</text></paragraph><paragraph id="HC3D52C80F90447FDAA3E58D2FF351D16"><enum>(18)</enum><text>Family therapy.</text></paragraph><paragraph id="HC8A6A60FC6EB4D98861FEFECBC28E1E4"><enum>(19)</enum><text>Group therapy services.</text></paragraph><paragraph id="H7F2AD6C3E595403898359AB314E13A74"><enum>(20)</enum><text>Intensive in-home services.</text></paragraph><paragraph id="HB602B8C34F89416B9861D10DB2204D58"><enum>(21)</enum><text>Peer support services.</text></paragraph><paragraph id="H5AB15660F256463A818625DD574AAB88"><enum>(22)</enum><text>Provider-to-provider consultation services involving primary care practitioners and mental health care specialists, including child and adolescent specialists.</text></paragraph><paragraph id="H832B3EFDC41B4B6D98CA86F72C56AA50"><enum>(23)</enum><text>Substance use disorder screening, including SBIRT, and treatment.</text></paragraph><paragraph id="id1EE8A9EE30B446CBB3C3902558807BBF"><enum>(24)</enum><text>Medication management.</text></paragraph><paragraph id="id1523FDE565264FF89AAF8CFD35E1FADE"><enum>(25)</enum><text>Any other pediatric mental, emotional, or behavioral health service determined appropriate by the Secretary.</text></paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block></paragraph></subsection><subsection id="HBBDB651371154DDC81E32C9AC5997158"><enum>(b)</enum><header>Under medicaid managed care plans</header><text>Section 1932(f) of such Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1396u-2">42 U.S.C. 1396u–2(f)</external-xref>) is amended—</text><paragraph id="HBB6AD4BEBDFE43B1A0E31692251A8CCC"><enum>(1)</enum><text>in the header, by inserting <quote><header-in-text level="subsection" style="OLC">and pediatric mental, emotional, and behavioral health</header-in-text></quote> before <quote><header-in-text level="subsection" style="OLC">Services</header-in-text></quote>; </text></paragraph><paragraph id="HC38D68A61D1D4BEBAD87EDC3DF7644F0"><enum>(2)</enum><text>by inserting <quote>and pediatric mental, emotional, and behavioral health services described in section 1902(a)(13)(D)</quote> after <quote>section 1902(a)(13)(C)</quote>; and</text></paragraph><paragraph id="H1FF2FA7A27964C648EA7BA9964CFD44B"><enum>(3)</enum><text>by striking <quote>such section</quote> and inserting <quote>section 1902(a)(13)</quote>. </text></paragraph></subsection><subsection id="H183FD5273F74405581F34796841B2E68"><enum>(c)</enum><header>Increase in payment using increased FMAP</header><text display-inline="yes-display-inline">Section 1905 of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1396d">42 U.S.C. 1396d</external-xref>) is amended by adding at the end the following new subsection:</text><quoted-block style="OLC" id="H13098A60557B462686A9F35D17392E04"><subsection id="HAD3E26630024450B80C3F14DAFA47EA7"><enum>(jj)</enum><header>Increased FMAP for additional expenditures for pediatric mental, emotional, and behavioral health services</header><text>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.</text></subsection><after-quoted-block>.</after-quoted-block></quoted-block></subsection></section><section id="HAD3FF4AD0B9D46B188FBF48E85308E6C"><enum>4.</enum><header>Guidance to States on supporting mental, emotional, and behavioral health services, and on the availability of telehealth under Medicaid</header><subsection id="H9F6447769CE24946B78D0BC8DEAFE4B2"><enum>(a)</enum><header>Mental, emotional, and behavioral health services</header><text>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 (<external-xref legal-doc="usc" parsable-cite="usc/42/1396">42 U.S.C. 1396 et seq.</external-xref>), 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.</text></subsection><subsection id="H1F8B0A61A10044FD96B0CA37B8EAE05E"><enum>(b)</enum><header>Mental, emotional, and behavioral telehealth services</header><text display-inline="yes-display-inline">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 (<external-xref legal-doc="usc" parsable-cite="usc/42/1396">42 U.S.C. 1396 et seq.</external-xref>), 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.</text></subsection></section><section id="H9827258819A44CF7A422CEBD1730C4BA"><enum>5.</enum><header>Ensuring children receive timely access to care</header><subsection id="H337AB43588C5410CBB599F588F26105C"><enum>(a)</enum><header>Guidance to States on flexibilities To ensure provider capacity To provide pediatric mental, emotional, and behavioral crisis care</header><text>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.</text></subsection><subsection id="H6F8540A84CC34C908EC3E9CC534BBEBF"><enum>(b)</enum><header>Mandated report to Congress regarding barriers to repurposing of beds, space, and staff To address pediatric behavioral health needs</header><paragraph id="HB983EDFA38C74A55B8A412A0F83968C2"><enum>(1)</enum><header>In general</header><text>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.</text></paragraph><paragraph id="H810FB57781B149729027103299059F69"><enum>(2)</enum><header>Requirements</header><text display-inline="yes-display-inline">In preparing a report under this subsection, the Secretary of Health and Human Services shall include in such report—</text><subparagraph id="H6FEAA624F78143B6B7D0B65089EE9A19"><enum>(A)</enum><text>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</text></subparagraph><subparagraph id="H8799BE40533446D3B60C08B4B3E8182F"><enum>(B)</enum><text>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.</text></subparagraph></paragraph></subsection></section></legis-body></bill> 

