[Congressional Bills 118th Congress]
[From the U.S. Government Publishing Office]
[S. 669 Introduced in Senate (IS)]

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118th CONGRESS
  1st Session
                                 S. 669

  To amend title XVIII of the Social Security Act to expand access to 
                 psychological and behavioral services.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                             March 7, 2023

  Mr. Brown (for himself, Ms. Collins, Mr. Heinrich, and Mr. Mullin) 
introduced the following bill; which was read twice and referred to the 
                          Committee on Finance

_______________________________________________________________________

                                 A BILL


 
  To amend title XVIII of the Social Security Act to expand access to 
                 psychological and behavioral services.

    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 ``Increasing Mental Health Options Act 
of 2023''.

SEC. 2. EXPANDING ELIGIBILITY FOR INCENTIVES TO PRACTICE IN RURAL AND 
              UNDERSERVED AREAS.

    Section 1833(m) of the Social Security Act (42 U.S.C. 1395l(m)) is 
amended--
            (1) in paragraph (1)--
                    (A) by inserting ``(A)'' before ``In the case''; 
                and
                    (B) by adding at the end the following new 
                subparagraph:
    ``(B) In the case of services furnished by a clinical psychologist 
(as defined by the Secretary for purposes of section 1861(ii)) in a 
year (beginning with 2025) to an individual, who is covered under the 
insurance program established by this part and who incurs expenses for 
such services, in an area that is designated (under section 
332(a)(1)(A) of the Public Health Service Act) as a health professional 
shortage area as identified by the Secretary prior to the beginning of 
such year, in addition to the amount otherwise paid under this part, 
there also shall be paid to the clinical psychologist (or to an 
employer or facility in the cases described in clause (A) of section 
1842(b)(6)) (on a monthly or quarterly basis) from the Federal 
Supplementary Medical Insurance Trust Fund an amount equal to 10 
percent of the payment amount for the service under this part''; and
            (2) in paragraph (2), by inserting ``or clinical 
        psychologist'' after ``physician''.

SEC. 3. ELIMINATING UNNECESSARY OVERSIGHT AND APPROVAL REQUIREMENTS FOR 
              BEHAVIORAL HEALTH SERVICES PROVIDED BY CLINICAL 
              PSYCHOLOGISTS.

    (a) Comprehensive Outpatient Rehabilitation Facilities.--Section 
1835(a)(2)(E)(iii) of the Social Security Act (42 U.S.C. 
1395n(a)(2)(E)(iii)) is amended by inserting ``, except that an 
individual receiving qualified psychologist services as described in 
section 1861(ii) may be under the care of a clinical psychologist with 
respect to such services to the extent authorized under State law'' 
before the semicolon.
    (b) Skilled Nursing Facilities.--Section 1819(b) of such Act (42 
U.S.C. 1395i-3(b)) is amended--
            (1) in paragraph (5)(G), by inserting ``clinical 
        psychologist,'' after ``nurse practitioner,''; and
            (2) in paragraph (6)(A), by inserting ``, except that a 
        resident receiving qualified psychologist services as described 
        in section 1861(ii) may be under the supervision of a clinical 
        psychologist with respect to such services to the extent 
        authorized under State law'' before the semicolon.
    (c) Partial Hospitalization Services.--
            (1) Section 1835(a)(2)(F)(iii) of the Social Security Act 
        (42 U.S.C. 1395n(a)(2)(F)(iii)) is amended by inserting ``, 
        except that an individual receiving qualified psychologist 
        services as described in section 1861(ii) may be under the care 
        of a clinical psychologist with respect to such services to the 
        extent authorized under State law'' before the period.
            (2) Section 1861(ff)(1) of such Act (42 U.S.C. 
        1395x(ff)(1)) is amended by inserting ``(or, in the case of 
        qualified psychologist services, under the supervision of a 
        clinical psychologist to the extent authorized under State 
        law)'' after ``under the supervision of a physician''.
    (d) Home Health Services.--
            (1) Section 1861(m) of such Act (42 U.S.C. 1395x(m)) is 
        amended--
                    (A) in paragraph (6), by striking ``and'' at the 
                end;
                    (B) in paragraph (7), by inserting ``and'' after 
                the semicolon; and
                    (C) by inserting after paragraph (7) the following 
                new paragraph:
            ``(8) an individual receiving qualified psychologist 
        services may be under the care of a clinical psychologist with 
        respect to such services to the extent authorized under State 
        law;''.
            (2) Section 1891(a)(3)(F) of such Act (42 U.S.C. 
        1395bbb(a)(3)(F)) is amended by inserting ``clinical 
        psychologist,'' after ``physician,''.
    (e) Inpatient Psychiatric Hospital Services.--Section 1814(a)(2)(A) 
of such Act (42 U.S.C. 1395f(a)(2)(A)) is amended by inserting ``(or, 
in the case of qualified psychologist services, under the supervision 
of a clinical psychologist to the extent authorized under State law)'' 
after ``under the supervision of a physician''.
    (f) Rule of Construction.--In accordance with section 410.71(e) of 
title 42, Code of Federal Regulations (or any successor regulation), 
nothing in the provisions of, and amendments made by, this section 
shall be construed as changing or eliminating existing requirements 
regarding clinical consultation by clinical psychologists with a 
beneficiary's physician, in accordance with accepted professional 
ethical norms and taking into consideration patient confidentiality.
    (g) Effective Date.--The amendments made by this section shall 
apply to services furnished on or after January 1, 2025.
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