[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[H.R. 8487 Introduced in House (IH)]
<DOC>
119th CONGRESS
2d Session
H. R. 8487
To amend titles XVIII and XIX of the Social Security Act to adjust
coverage and payment for certified community behavioral health clinic
services under the Medicare and Medicaid programs, and for other
purposes.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
April 23, 2026
Ms. Matsui (for herself, Mr. Pfluger, Ms. Craig, Mr. Alford, Mr. Tonko,
Mr. Fitzpatrick, and Mr. Goldman of Texas) introduced the following
bill; which was referred to the Committee on Energy and Commerce, and
in addition to the Committee on Ways and Means, for a period to be
subsequently determined by the Speaker, in each case for consideration
of such provisions as fall within the jurisdiction of the committee
concerned
_______________________________________________________________________
A BILL
To amend titles XVIII and XIX of the Social Security Act to adjust
coverage and payment for certified community behavioral health clinic
services under the Medicare and Medicaid programs, 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 ``Ensuring Excellence in Mental Health
Act''.
SEC. 2. TABLE OF CONTENTS.
The table of contents for this Act is as follows:
Sec. 1. Short title.
Sec. 2. Table of contents.
TITLE I--STRENGTHENING AND PROVIDING COST-RELATED PAYMENT FOR CERTIFIED
COMMUNITY BEHAVIORAL HEALTH CLINICS UNDER THE MEDICAID PROGRAM
Sec. 101. Coordination of Medicaid certified community behavioral
health clinic services with CCBHC operating
grant program; CCBHC accreditation option.
Sec. 102. Establishing a prospective payment system for certified
community behavioral health clinics.
Sec. 103. Expanding CCBHC services within Medicaid demonstration
program.
Sec. 104. Expanding scope of CCBHC services covered under the Medicaid
program.
TITLE II--COVERAGE OF CERTIFIED COMMUNITY BEHAVIORAL HEALTH CLINIC
SERVICES UNDER THE MEDICARE PROGRAM
Sec. 201. Coverage of certified community behavioral health clinic
services under the medicare program.
Sec. 202. Payment for certified community behavioral health clinic
services under the medicare program.
Sec. 203. Non-application of Medicare part B deductible for CCBHC
services.
Sec. 204. Right to seek review of cost reports from Provider
Reimbursement Review Board.
Sec. 205. Extending safe harbor under Anti-Kickback Statute to waivers
of CCBHC coinsurance.
Sec. 206. Effective date.
TITLE III--COMMUNITY BEHAVIORAL HEALTH CLINIC GRANTS
Sec. 301. Operating grants, technical assistance, data infrastructure,
and accreditation for community behavioral
health clinics.
TITLE IV--LIABILITY PROTECTION FOR CERTIFIED COMMUNITY BEHAVIORAL
HEALTH CLINIC CLINICIANS
Sec. 401. Conferring protection under the Federal Tort Claims Act to
clinicians in certified community
behavioral health clinics.
TITLE I--STRENGTHENING AND PROVIDING COST-RELATED PAYMENT FOR CERTIFIED
COMMUNITY BEHAVIORAL HEALTH CLINICS UNDER THE MEDICAID PROGRAM
SECTION 101. COORDINATION OF MEDICAID CERTIFIED COMMUNITY BEHAVIORAL
HEALTH CLINIC SERVICES WITH CCBHC OPERATING GRANT
PROGRAM; CCBHC ACCREDITATION OPTION.
Section 1905(jj)(2) of the Social Security Act (42 U.S.C.
1396d(jj)(2)) is amended--
(1) in subparagraph (B)--
(A) by inserting ``(or providing or referring
through formal relationships, as applicable)'' after
``furnishing'';
(B) by striking ``described in paragraph (1)'' and
inserting ``described in paragraph (1)(B)''; and
(C) by striking ``and'' at the end;
(2) in subparagraph (C), by striking the period at the end
and inserting ``, and including any such data as the State, by
agreement with the Secretary, shall access via the system
described in section 340J-3 of the Public Health Service Act;
and''; and
(3) by adding at the end the following new subparagraph:
``(D) beginning January 1, 2026, at the option of
the State, has received accreditation by an
accreditation body approved under section 340J-4 of the
Public Health Service Act.''.
SEC. 102. ESTABLISHING A PROSPECTIVE PAYMENT SYSTEM FOR CERTIFIED
COMMUNITY BEHAVIORAL HEALTH CLINICS.
(a) In General.--Section 1902 of the Social Security Act (42 U.S.C.
1396a) is amended by adding at the end the following new subsection:
``(yy) Payment for Services Provided by Certified Community
Behavioral Health Clinics.--
``(1) In general.--Beginning with fiscal year 2026 with
respect to services furnished on or after January 1, 2026, and
for each succeeding fiscal year, if a State elects to make
medical assistance available for certified community behavioral
health clinic services under section 1905(a)(31), the State
plan shall provide for payment for such services furnished by
(or under arrangement with) a certified community behavioral
health clinic described in section 1905(jj)(2) (in this
subsection referred to as a `clinic') in accordance with the
provisions of this subsection.
``(2) Prospective payment system.--
``(A) In general.--Subject to paragraph (4), a
State shall provide for payment for certified community
behavioral health clinic services furnished by (or
under arrangement with) a clinic in the first fiscal
year (or portion of a fiscal year) described in
paragraph (1) for which a State elects to provide
medical assistance for such services under section
1905(a)(31) under a prospective payment system
developed by the State in accordance with this
paragraph.
``(B) Unit of payment.--In establishing the system
under subparagraph (A), the State shall apply as the
unit of service--
``(i) daily visits; or
``(ii) monthly visits (excluding repeat
visits from the same individual).
``(C) System design.--Under the system under
subparagraph (A), the State may, consistent with the
methodology described in guidance issued under section
223(b) of the Protecting Access to Medicare Act of
2014--
``(i) establish separate prospective
payment system rates for special populations;
``(ii) use a system of outlier payments for
a portion of costs of furnishing certified
community behavioral health clinic services; or
``(iii) with respect to certified community
behavioral health clinic services that are
crisis services--
``(I) require that each cost report
of a clinic segregate costs relating to
mobile crisis teams, emergency crisis
intervention services, or crisis
stabilization from other components of
the services described in section
1905(a)(31); and
``(II) provide for a prospective
payment system rate for any or all of
such crisis services that is distinct
from the rate encompassing the
remainder of the services described in
section 1905(a)(31).
``(D) Payment basis.--Subject to subparagraph (E),
the State shall provide for computation of a
prospective payment amount for an individual certified
community behavioral health clinic under the system
under subparagraph (A) as follows:
``(i) For the first fiscal year (or portion
of a fiscal year) for which a State elects to
provide medical assistance for such services
under section 1905(a)(31), such amount--
``(I) in the case of a State that
did not operate a demonstration program
under section 223 of the Protecting
Access to Medicare Act of 2014 during a
base year corresponding to the fiscal
year immediately preceding such first
fiscal year (or portion of a fiscal
year), shall be equal to 100 percent of
the costs of the clinic which are
reasonable and related to the
furnishing of such services during such
base year; and
``(II) in the case of a State that
did operate a demonstration program
under section 223 of the Protecting
Access to Medicare Act of 2014 during
such base year, shall be equal to, at
the option of the State--
``(aa) the amount described
in subclause (I); or
``(bb) the amount that
would have otherwise applied
with respect to such services
under such demonstration.
``(ii) For each subsequent fiscal year for
which a State elects to provide medical
assistance for such services under section
1905(a)(31), such amount shall be, subject to
subparagraph (F), the amount calculated under
this subparagraph for the preceding fiscal
year--
``(I) increased by the percentage
increase described in section
1834(aa)(3)(C) for the calendar year in
which such preceding fiscal year began;
and
``(II) adjusted to take into
account any increase or decrease in the
scope of such services furnished by the
clinic during the fiscal year involved.
``(E) Establishment of initial fiscal year payment
for new clinics.--For purposes of subparagraph (D)--
``(i) in the case of a certified community
behavioral health clinic that does not have
available complete actual cost data
representing the provision of all certified
community behavioral health clinic services
provided in the base year described in clause
(i)(I) of such subparagraph, the State may use
estimated or projected data relating to
specific services for which the clinics lack
cost experience; and
``(ii) in the case of an entity that first
enrolls under this title as a certified
community behavioral health clinic in a year
after the first fiscal year in which the State
first provides for payment for the services
described in section 1905(a)(31) in accordance
with paragraph (1)--
``(I) for the first fiscal year in
which the clinic furnishes such
services, the amount determined by the
State for such clinic shall be--
``(aa) determined on the
basis of the amounts
established under this
paragraph for other such
clinics located in the same or
adjacent area (as defined by
the Secretary) with a similar
case load; or
``(bb) in the absence of
any such clinic, based on the
reasonable projected costs per
visit of the clinic;
``(II) for the second fiscal year
in which the clinic furnishes such
services, the amount determined by the
State for such clinic shall be
determined under clause (i)(I) of such
subparagraph on the basis of the
reasonable and related costs and visits
from the clinic's first fiscal year of
operation; and
``(III) for the third and each
subsequent fiscal year in which the
clinic furnishes such services, the
amount determined by the State for such
clinic shall be determined under clause
(ii) of such subparagraph.
``(F) Rebasing.--A State may periodically (but no
less frequently than every third fiscal year after the
first fiscal year described in subparagraph (D)) rebase
the prospective payment amount determined under
subparagraph (D) such that costs from the fiscal year
preceding the rebasing year, rather than costs from the
base year described in clause (i)(I) of such
subparagraph, shall be used in establishing a new cost-
related rate for each clinic. Such rebasing shall
include those clinics with initial rates determined
under subparagraph (E).
``(3) Administration in the case of managed care.--
``(A) In general.--In the case of services
furnished by a certified community behavioral health
clinic pursuant to a contract between the clinic and a
managed care entity (as defined in section
1932(a)(1)(B)) or other specified entity (as defined in
1903(m)(9)(D)(iii)), the State shall provide for
payment to the clinic by the State of a supplemental
payment equal to the amount (if any) by which the
amount determined under the preceding paragraphs of
this subsection (or paragraph (4), as applicable)
exceeds the amount of payments provided under the
contract. Such supplemental payment shall be made
pursuant to a payment schedule agreed to by the State
and the clinic, but in no case less frequently than
every 4 months.
``(B) Option to delegate pps payment to managed
care entities through an alternative payment
methodology.--Notwithstanding subparagraph (A), nothing
in this subsection shall be interpreted to preclude a
State from amending its State plan to provide for an
alternative payment methodology under paragraph (4),
under which the State may delegate to a managed care
entity, as defined in section 1932(a)(1)(B), the
responsibility to pay the clinic at least the rate
determined under the preceding subparagraphs (or
paragraph (4), as applicable), provided that the State
shall meet all requirements described in paragraph (4),
and shall use oversight processes to ensure that each
clinic is paid at least the amounts required under the
preceding paragraphs of this subsection.
``(4) Alternative payment methodologies.--Notwithstanding
any other provision of this subsection, the State plan may
provide for payment in any fiscal year to a certified community
behavioral health clinic for services described in paragraph
(31) of section 1905(a) in an amount which is determined under
an alternative payment methodology that--
``(A) is agreed to by the State and the clinic; and
``(B) results in payment to the clinic of an amount
which is not less than the amount otherwise required to
be paid to the clinic under this subsection.''.
(b) Requirement To Use Prospective Payment System Under Benchmark
or Benchmark Equivalent Coverage.--Section 1937(b)(4) of the Social
Security Act (42 U.S.C. 1396u-7(b)(4)) is amended--
(1) in the paragraph heading, by inserting ``; coverage of
ccbhc services'' after ``FQHC services'';
(2) by redesignating subparagraphs (A) and (B) as clauses
(i) and (ii), respectively, and adjusting the margins
accordingly;
(3) by striking ``this section, a State'' and inserting:
``this section--
``(A) a State''; and
(4) by adding at the end the following new subparagraph:
``(B) in the case that a State provides for medical
assistance for certified community behavioral health
clinic services (as defined in section 1905(jj)(1))
through enrollment of an individual with benchmark
coverage or benchmark equivalent coverage under this
section, payment for such services shall be made in
accordance with the requirements of section
1902(yy).''.
SEC. 103. EXPANDING CCBHC SERVICES WITHIN MEDICAID DEMONSTRATION
PROGRAM.
(a) Additional Services Within Demonstration Program.--Section 223
of the Protecting Access to Medicare Act of 2014 (42 U.S.C. 1396a note)
is amended--
(1) in section (a)(2)(D)--
(A) by redesignating clauses (i) through (ix) as
subclauses (I) through (IX), respectively, and
adjusting the margins accordingly;
(B) by striking ``Provision'' and all that follows
through ``relationships with other providers:'' and
inserting:
``(i) In general.--Provision (in a manner
reflecting person-centered care) of--
``(I) the required CCBHC services
(as defined in clause (ii)); and
``(II) the additional CCBHC
services (as defined in clause (iii)).
``(ii) Required ccbhc services.--For
purposes of clause (i), the term `required
CCBHC services' means any of the following
services which, if not available directly
through the certified community behavioral
health clinic, are provided or referred through
formal relationships with other providers:'';
and
(C) by adding at the end the following new clause:
``(iii) Additional ccbhc services.--For
purposes of clause (i), the term `additional
CCBHC services' means services available
directly through the certified community
behavioral health clinic--
``(I) that are not required CCBHC
services (as defined in clause (ii));
``(II) that are appropriate to meet
the health needs of the population
served; and
``(III) which may include any of
the primary health services defined in
section 330 (b)(1)(A) of the Public
Health Service Act.'';
(2) in subsection (b)(1), by striking ``mental health
services'' and inserting ``certified community behavioral
health clinic services''; and
(3) in subsection (e)--
(A) by redesignating paragraphs (1) through (4) as
paragraphs (2) through (5), respectively; and
(B) by inserting before paragraph (2), as so
redesignated, the following new paragraph:
``(1) Certified community behavioral health clinic
services.--The term `certified community behavioral health
clinic services' means--
``(A) required CCBHC services (as defined in
subsection (a)(2)(D)(ii)); and
``(B) additional CCBHC services (as defined in
subsection (a)(2)(D)(iii)), to the extent that a
certified community behavioral health clinic elects to
furnish any such services.''.
(b) Effective Date.--The amendments made by this section shall
apply with respect to services furnished on or after October 1, 2026.
SEC. 104. EXPANDING SCOPE OF CCBHC SERVICES COVERED UNDER THE MEDICAID
PROGRAM.
(a) Additional Services Within CCBHC Benefit.--Section 1905(jj) of
the Social Security Act (42 U.S.C. 1396d(jj)) is amended--
(1) in the subsection heading, by inserting ``; Certified
Community Behavioral Health Clinic'' after ``Certified
Community Behavioral Health Clinic Services''; and
(2) in paragraph (1)--
(A) in the paragraph heading, by striking ``In
general'' and inserting ``Certified community
behavioral health clinic services'';
(B) by redesignating subparagraphs (A) through (I)
as clauses (i) through (ix), respectively, and
adjusting the margins accordingly;
(C) by striking ``The term'' and all that follows
through ``relationships with other providers:'' and
inserting:
``(A) In general.--The term `certified community
behavioral health clinic services' means--
``(i) the required CCBHC services (as
defined in subparagraph (B)); and
``(ii) the additional CCBHC services (as
defined in subparagraph (C)).
``(B) Required ccbhc services.--For purposes of
subparagraph (A), the term `required CCBHC services'
means any of the following services when furnished to
an individual as a patient of a certified community
behavioral health clinic (as defined in paragraph (2)),
in a manner reflecting person-centered care and which,
if not available directly through a certified community
behavioral health clinic, may be provided or referred
through formal relationships with other providers:'';
and
(D) by adding at the end the following new
subparagraph:
``(C) Additional ccbhc services.--For purposes of
subparagraph (A), the term `additional CCBHC services'
means services furnished to an individual as a patient
of a certified community behavioral health clinic (as
defined in paragraph (2)), in a manner reflecting
person-centered care--
``(i) that are not required CCBHC services
under subparagraph (B);
``(ii) that are appropriate to meet the
health needs of the population served; and
``(iii) which may include any of the
primary health services defined in section
330(b)(1) of the Public Health Service Act.''.
(b) Effective Date.--The amendments made by this section shall
apply with respect to services furnished on or after October 1, 2026.
TITLE II--COVERAGE OF CERTIFIED COMMUNITY BEHAVIORAL HEALTH CLINIC
SERVICES UNDER THE MEDICARE PROGRAM
SEC. 201. COVERAGE OF CERTIFIED COMMUNITY BEHAVIORAL HEALTH CLINIC
SERVICES UNDER THE MEDICARE PROGRAM.
(a) Coverage.--Section 1861(s)(2) of the Social Security Act (42
U.S.C. 1395x(s)(2)) is amended--
(1) in subparagraph (JJ), by adding ``and'' at the end; and
(2) by adding at the end the following new subparagraph:
``(KK) certified community behavioral health clinic
services (as defined in subsection (aa)(8)) furnished on or
after January 1, 2027.''.
(b) Definitions.--Section 1861(aa) of the Social Security Act (42
U.S.C. 1395x) is amended--
(1) in the heading, by striking ``and Federally Qualified
Health Center Services'' and inserting ``, Federally Qualified
Health Center Services, and Certified Community Behavioral
Health Clinic Services''; and
(2) by adding at the end the following new paragraph:
``(8) The terms `certified community behavioral health clinic
services' and `certified community behavioral health clinic' have the
meaning given each such term in section 1905(jj).''.
SEC. 202. PAYMENT FOR CERTIFIED COMMUNITY BEHAVIORAL HEALTH CLINIC
SERVICES UNDER THE MEDICARE PROGRAM.
(a) In General.--Section 1833(a)(1) of the Social Security Act (42
U.S.C. 1395l(a)(1)) is amended--
(1) by striking ``and (HH)'' and inserting ``(HH)''; and
(2) by inserting before the semicolon at the end the
following: ``, and (II) with respect to certified community
behavioral health clinic services (as defined in section
1861(aa)(8)), the amounts paid shall be equal to 80 percent of
the lesser of the actual charge or the amount determined under
section 1834(aa)''.
(b) Development and Implementation of Prospective Payment System.--
Section 1834 of the Social Security Act (42 U.S.C. 1395m) is amended by
adding at the end the following new subsection:
``(aa) Development and Implementation of Prospective Payment System
for Certified Community Behavioral Health Clinics.--
``(1) In general.--The Secretary shall develop a
prospective payment system for payment to certified community
behavioral health clinic services (as defined in section
1861(aa)(8)) furnished by certified community behavioral health
clinics (as defined in such section) under this title. In
establishing such system, the Secretary--
``(A) shall take into account the type, intensity,
and duration of services furnished by certified
community behavioral health clinics; and
``(B) may incorporate such adjustments, including
geographic adjustments, as the Secretary determines
appropriate.
``(2) Unit of payment.--In establishing a prospective
payment amount under the system under this subsection, the
Secretary shall consider an appropriate unit of service and a
general system design that provides for continued access to
quality services.
``(3) Payment basis.--Under the system under this
subsection, the Secretary shall provide for computation of a
prospective payment amount for services furnished during a year
as follows:
``(A) For 2027, such amount shall be based on the
average costs of such clinics which are reasonable (as
determined without the application of a per visit
payment limit or productivity screen and prior to the
application of section 1866(a)(2)(A)(ii)) and related
to the furnishing of the services described in section
1905(jj)(1)(B), as determined on the basis of the most
current audited cost report data for 2 consecutive
fiscal years available to the Secretary. In the absence
of complete actual cost data representing the provision
of such services during the relevant fiscal years,
certified community behavioral health clinics may, at
the Secretary's discretion, submit estimated or
projected data relating to specific services.
``(B) For 2028, such amount shall be equal to the
amount determined under subparagraph (A), increased by
the percentage increase in the MEI (as defined in
section 1842(i)(3)) for the year involved.
``(C) For 2029 and each subsequent year, such
amount shall be equal to the amount determined under
this paragraph for the preceding year, increased by the
percentage increase in a market basket of certified
community behavioral health clinic services designed by
the Secretary (or, if such an index is not available,
by the percentage increase in the federally-qualified
health center market basket (as described in section
1834(o)(2)(B)(ii)(II))) for the year involved.
``(4) Periodic reevaluation of rates.--The Secretary may,
from time to time, adjust the amounts that would otherwise be
applicable under paragraph (3) for a year by a percentage
determined appropriate by the Secretary to reflect such factors
as changes in the intensity of services furnished within a unit
of service, the average cost of providing care per unit of
service, and other factors that the Secretary considers to be
relevant. Such adjustment shall be made before the update under
paragraph (2)(C) has been applied for the year.''.
SEC. 203. NON-APPLICATION OF MEDICARE PART B DEDUCTIBLE FOR CCBHC
SERVICES.
Section 1833(b)(4) of the Social Security Act (42 U.S.C.
1395l(b)(4)) is amended by inserting ``or certified community
behavioral health clinic services'' after ``such deductible shall not
apply to Federally qualified health center services''.
SEC. 204. RIGHT TO SEEK REVIEW OF COST REPORTS FROM PROVIDER
REIMBURSEMENT REVIEW BOARD.
Section 1878(j) of the Social Security Act (42 U.S.C. 1395oo(j)) is
amended by striking ``and a Federally qualified health center'' and
inserting ``, a Federally qualified health center, and a certified
community behavioral health clinic''.
SEC. 205. EXTENDING SAFE HARBOR UNDER ANTI-KICKBACK STATUTE TO WAIVERS
OF CCBHC COINSURANCE.
Section 1128B(b)(3)(D) of the Social Security Act (42 U.S.C. 1320a-
7b(b)(3)(D)) is amended by inserting ``or a certified community
behavioral health clinic'' after ``Federally qualified health care
center''.
SEC. 206. EFFECTIVE DATE.
The amendments made by this title shall apply with respect to
services furnished on or after January 1, 2026.
TITLE III--COMMUNITY BEHAVIORAL HEALTH CLINIC GRANTS
SEC. 301. OPERATING GRANTS, TECHNICAL ASSISTANCE, DATA INFRASTRUCTURE,
AND ACCREDITATION FOR COMMUNITY BEHAVIORAL HEALTH
CLINICS.
Part D of title III of the Public Health Service Act (42 U.S.C.
254b et seq.) is amended by adding at the end the following new
subpart:
``Subpart XIII--Community Behavioral Health Clinics
``SEC. 340J. DEFINITIONS.
``In this subpart:
``(1) Certified community behavioral health clinic.--The
term `certified community behavioral health clinic' has the
meaning given such term in section 1905(jj)(2) of the Social
Security Act.
``(2) Certified community behavioral health clinic
services.--The term `certified community behavioral health
clinic services' has the meaning given such term in section
1905(jj)(1) of the Social Security Act.
``SEC. 340J-1. OPERATING GRANTS FOR COMMUNITY BEHAVIORAL HEALTH
CLINICS.
``(a) In General.--The Secretary shall establish a grant program
under which the Secretary shall award grants to eligible community
behavioral health clinics to provide (in a manner reflecting person-
centered care) certified community behavioral health clinic services
that are required CCBHC services (as defined in section 1905(jj)(1)(B)
of the Social Security Act).
``(b) Eligibility; Selection.--
``(1) Eligibility.--An entity is eligible to receive a
grant under subsection (a) if such entity is--
``(A) a certified community behavioral health
clinic; or
``(B) a community behavioral health clinic that
indicates in the grant application that the clinic will
use the grant funds to meet the criteria established by
the Secretary under section 223(a) of the Protecting
Access to Medicare Act of 2014 as of March 2023, and
any subsequent updates to such criteria.
``(2) Selection.--In selecting eligible entities to receive
a grant under subsection (a), the Secretary--
``(A) may elect to impose as a condition for the
receipt of a grant under this section that the entity
be accredited, per section 340J-4(a);
``(B) may award a grant to an entity described in
paragraph (1)(B) that specializes in providing services
to children, youth, or veterans, if such entity
demonstrates to the satisfaction of the Secretary that
the entity can ensure access to care for all
individuals in the relevant community served by the
entity through referral or other formal arrangements
with other providers of services; and
``(C) may establish additional conditions for the
receipt of a grant under this section to--
``(i) ensure improved geographic
distribution of community behavioral health
clinics;
``(ii) prioritize the awarding of grants to
eligible entities that serve communities with
elevated behavioral health needs;
``(iii) prioritize eligible entities that
are prepared to offer all required CCBHC
services (as defined in section 1905(jj)(1)(B)
of the Social Security Act); and
``(iv) ensure consistency in planning with
State CCBHC programs.
``(c) Use of Funds.--An eligible entity that receives a grant under
subsection (a)--
``(1) shall use the grant funds--
``(A) to provide certified community behavioral
health clinic services; and
``(B) in the case of an entity described in
subparagraph (B) of subsection (b)(1), to meet the
criteria described in such subparagraph; and
``(2) may use the grant funds--
``(A) to carry out other activities that--
``(i) reduce costs associated with the
provision of certified community behavioral
health clinic services;
``(ii) improve access to, and availability
of, certified community behavioral health
clinic services provided to individuals in the
relevant community served by the community
behavioral health clinic;
``(iii) enhance the quality and
coordination of certified community behavioral
health clinic services; or
``(iv) otherwise improve the health status
of communities; and
``(B) to pay for--
``(i) the costs of acquiring and leasing
buildings and equipment (including the costs of
amortizing the principal of, and paying
interest on, loans);
``(ii) costs relating to the purchase or
lease of equipment, including data and
information systems and behavioral health
information technology to facilitate data
reporting and other purposes;
``(iii) the costs of in-service staff
training and other operational or
infrastructure costs as the Secretary
determines appropriate; or
``(iv) costs associated with expanding and
modernizing existing buildings or constructing
new buildings (including the costs of
amortizing the principal of, and paying the
interest on, loans), if such costs are
specifically allowed for in the grant
opportunity published by the Secretary.
``(d) Use of Nongrant Funds.--Amounts described in subsection
(g)(1)(B), including any such funds in excess of those estimated under
such subsection, shall be used as permitted under this section, and may
be used for such other purposes as are not specifically prohibited
under this section if such use furthers the objectives of the grant.
``(e) Term.--Grants awarded under subsection (a) shall be for a
period of not more than 5 years.
``(f) Condition on Receipt of Funds.--The Secretary may not award a
grant to an eligible entity under subsection (a) unless the entity
provides assurances to the Secretary that, not later than 120 days
after receiving notice that the entity has been selected under
subsection (b)(2) to receive a grant, the entity will submit to the
Secretary for approval an implementation plan that describes how the
entity will--
``(1) provide certified community behavioral health clinic
services; and
``(2) in the case of an entity described in subparagraph
(B) of subsection (b)(1), to meet the criteria described in
such subparagraph.
``(g) Amount of Grant.--
``(1) In general.--Subject to paragraph (2), in determining
the amount of a grant made in any fiscal year to an eligible
entity under subsection (a), the Secretary shall take into
account information provided by the entity with respect to the
following:
``(A) The total State, local, and other operational
funding provided to the entity for such fiscal year.
``(B) The fees, premiums, and third-party
reimbursements that the entity reasonably expects to
receive for items and services furnished during such
fiscal year.
``(C) The costs to the entity of meeting the
purposes and requirements of the grant program under
this section during such fiscal year, as estimated by
the Secretary based upon the anticipated costs to the
entity of--
``(i) providing certified community
behavioral health clinic services, including
the anticipated costs of providing any
individual certified community behavioral
health service that the entity does not have
experience providing at the time of submitting
an application for such grant; and
``(ii) in the case of an entity described
in subparagraph (B) of subsection (b)(1),
meeting the criteria described in such
subparagraph.
``(2) Payments.--The Secretary may award grants under
subsection (a) in such form and manner as the Secretary
determines appropriate (including by making grant amounts
available in advance or through reimbursement, and including by
making such amounts available in installments), and may adjust
grant amounts to account for overpayments or underpayments.
``(h) Use of Accreditation in Monitoring Grant Progress.--
Regardless of whether the Secretary elects under subsection (b) to use
accreditation under section 340J-4(a) as a condition for the award of a
grant under subsection (a), the Secretary may take such accreditation
into account in determining whether an entity receiving such a grant is
providing the services described in subsection (a) and, if applicable,
meeting such criteria as are described in subsection (b)(2).
``(i) Authorization of Appropriations.--
``(1) In general.--There is authorized to be appropriated
to carry out this section $552,500,000 for each of fiscal years
2026 through 2030.
``(2) Maintenance of funding.--The amount made available
under paragraph (1) shall supplement (and not supplant) any
other Federal funding made available for certified community
behavioral health clinics.
``(j) Guidance for Clinics Serving Specialized Populations.--Not
later than 1 year after the date of enactment of this section, the
Secretary shall publish guidance clarifying how certified community
behavioral health clinics that focus on distinct populations, such as
children, youth, or veterans, may meet any relevant requirement to
furnish appropriate treatment to all individuals. Such guidance shall
not affect such clinics' qualification to participate in the
demonstration program under section 223(d) of the Protecting Access to
Medicare Act of 2014 or to furnish the services described under section
1905(a)(31) of the Social Security Act.
``SEC. 340J-2. TECHNICAL ASSISTANCE.
``(a) In General.--Not later than 180 days after the date of
enactment of the Ensuring Excellence in Mental Health Act, the
Secretary shall establish a program or programs through which the
Secretary shall provide (either through the Department of Health and
Human Services or by grant or contract) technical assistance, and such
other assistance as the Secretary determines appropriate, to any of the
following:
``(1) Entities receiving a grant under section 340J-1.
``(2) Entities participating in a demonstration program
under section 223(d) of the Protecting Access to Medicare Act
of 2014.
``(3) Certified community behavioral health clinics (as
defined in sections 1861(aa)(8) and 1905(jj)(2) of the Social
Security Act) furnishing services under title XVIII or title
XIX of such Act.
``(4) Health or social service provider organizations
pursuing or considering certified community behavioral health
clinic status or partnering with certified community behavioral
health clinics.
``(5) States and territories, for the purpose of assisting
in the consideration of demonstration programs carried out
under section 223(d) of the Protecting Access to Medicare Act
of 2014, the planning and development of new State certified
community behavioral health clinic programs, or the ongoing
implementation and improvement of established State certified
community behavioral health clinic programs.
``(6) Other stakeholders, for the purpose of facilitating
the successful implementation of the certified community
behavioral health clinic model.
``(b) Inclusions.--Assistance provided by the Secretary under
subsection (a) may include technical and nonfinancial assistance,
including, but not limited to--
``(1) fiscal and program management assistance;
``(2) operational and administrative support; and
``(3) the provision of information to the entities about
the variety of resources available under this part and how
those resources can be best used to meet the health and
behavioral health needs of the communities served by the
entities.
``(c) Authorization of Appropriations.--There is authorized to be
appropriated to carry out this section $8,000,000 for each of fiscal
years 2026 through 2030.
``SEC. 340J-3. DATA INFRASTRUCTURE FOR COMMUNITY BEHAVIORAL HEALTH
CLINIC REPORTING.
``(a) In General.--Not later than 180 days after the date of
enactment of the Ensuring Excellence in Mental Health Act, the
Secretary shall establish a system under which the Secretary shall
collect and analyze data on community behavioral health clinics.
``(b) Scope of Data Collection.--The system established under
subsection (a) shall be used by the Secretary to collect and analyze
data from--
``(1) entities that receive a grant under section 340J-1;
and
``(2) certified community behavioral health clinics (as
defined in sections 1861(aa)(8) and 1905(jj)(2) of the Social
Security Act) furnishing services under title XVIII or title
XIX of such Act.
``(c) Authorization of Appropriations.--There is authorized to be
appropriated to carry out this section $51,000,000 for each of fiscal
years 2026 through 2030.
``SEC. 340J-4. CERTIFIED COMMUNITY BEHAVIORAL HEALTH CLINIC
ACCREDITATION.
``(a) Accreditation Standards.--A clinic is accredited as a
certified community behavioral health clinic under this section if the
clinic--
``(1) is accredited by an accreditation body approved by
the Secretary under subsection (b); and
``(2) authorizes the accreditation body to submit to the
Secretary (or such agency as the Secretary may designate) such
records or other information as the Secretary may require.
``(b) Approval of Accreditation Bodies.--The Secretary may approve
a private nonprofit organization to be an accreditation body for the
accreditation of certified community behavioral health clinics under
subsection (a) if--
``(1) the accreditation body agrees to inspect the clinic,
using inspectors qualified to evaluate quality of care in a
behavioral health service setting, with such frequency the
Secretary determines appropriate;
``(2) the Secretary determines that the standards applied
by the accreditation body in determining whether or not to
accredit a clinic correspond to (and are not less restrictive
than) the criteria described in section 340J-1(b)(1)(B);
``(3) the accreditation body has made adequate assurances
that the standards of the accreditation body continue to be met
by each clinic that it accredited;
``(4) the accreditation body agrees that, for the 3-year
period following accreditation of a clinic, in the case that
the accreditation body suspends, withdraws, or revokes such
accreditation, denies an application to renew such
accreditation, or takes any other disciplinary action with
respect to such clinic, the accreditation body shall submit to
the Secretary the name of such clinic not later than 30 days
after such action is taken;
``(5) the accreditation body agrees that, in the case that
its approval is withdrawn by the Secretary, the body will
notify each clinic accredited by the body of the withdrawal
within 10 days of the withdrawal; and
``(6) the accreditation body complies with such other
requirements as the Secretary determines appropriate.
``(c) Oversight of Accreditation Bodies.--The Secretary may provide
ongoing oversight of accrediting bodies approved under subsection (b).
Such ongoing oversight may include the following actions:
``(1) Providing continual oversight and review of approved
accreditation processes through regular communication with such
bodies.
``(2) Providing additional review of individual certified
community behavioral health clinic accreditations to assure
alignment with the criteria established by the Secretary under
section 223(a) of the Protecting Access to Medicare Act of 2014
and, in cases where potential issues are identified with
individual certified community behavioral health clinic
accreditations, to provide review of such issues.
``(3) Mediating disputes between providers seeking
certified community behavioral health clinic accreditation and
approved accreditation bodies.
``(4) Providing ongoing support and coordination across
approved accreditation bodies.
``(5) In cases where an approved accreditation body is
found to not provide accreditation in alignment with the
criteria established by the Secretary under section 223(a) of
the Protecting Access to Medicare Act of 2014, developing a
process to terminate the approval provided under subsection (b)
with respect to such body.
``(6) Periodically reviewing accreditation body processes
and renewing the approval provided under subsection (b) with
respect to such bodies.
``(7) Such other activities as the Secretary determines
necessary for the oversight of accreditation bodies approved
under subsection (b).''.
TITLE IV--LIABILITY PROTECTION FOR CERTIFIED COMMUNITY BEHAVIORAL
HEALTH CLINIC CLINICIANS
SEC. 401. CONFERRING PROTECTION UNDER THE FEDERAL TORT CLAIMS ACT TO
CLINICIANS IN CERTIFIED COMMUNITY BEHAVIORAL HEALTH
CLINICS.
Section 224(g)(4) of the Public Health Service Act (42 U.S.C.
233(g)(4)) is amended by inserting ``or a certified community
behavioral health clinic (as defined in section 1905(jj)(2) of the
Social Security Act)'' before the period at the end.
<all>