119 HR 8487 IH: Ensuring Excellence in Mental Health Act
U.S. House of Representatives
2026-04-23
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EN
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.
1.This Act may be cited as the Ensuring Excellence in Mental Health Act
. 2.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.
<enum>I</enum><header>Strengthening and providing cost-related payment for certified community behavioral health clinics under the Medicaid program</header>
<section id="H901B72F9B7FD409ABF53B5001F8579A2" section-type="section-one"><enum>101.</enum><header>Coordination of Medicaid certified community behavioral health clinic services with CCBHC operating grant program; CCBHC accreditation option</header><text display-inline="no-display-inline">Section 1905(jj)(2) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1396d">42 U.S.C. 1396d(jj)(2)</external-xref>) is amended—</text> <paragraph id="HF6CBD2E4908E4E1094393E1E51FC25FB" commented="no"><enum>(1)</enum><text>in subparagraph (B)—</text>
<subparagraph id="HEA2DEAE07EAB479095D8D8B104878301" commented="no"><enum>(A)</enum><text>by inserting <quote>(or providing or referring through formal relationships, as applicable)</quote> after <quote>furnishing</quote>;</text></subparagraph> <subparagraph id="HC1FBB2D0B6244C4A9D2B3F53AC685BB3"><enum>(B)</enum><text>by striking <quote>described in paragraph (1)</quote> and inserting <quote>described in paragraph (1)(B)</quote>; and</text> </subparagraph>
<subparagraph id="H3E4E93E59D4C4C74A473F034E95E4DB6" commented="no"><enum>(C)</enum><text>by striking <quote>and</quote> at the end;</text></subparagraph></paragraph> <paragraph id="H74AE4C530057477EB1E44E655E73F068"><enum>(2)</enum><text>in subparagraph (C), by striking the period at the end and inserting <quote>, 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</quote>; and</text></paragraph>
<paragraph id="H0116C4C4E10A4952A88D6418ECE6D7A3"><enum>(3)</enum><text>by adding at the end the following new subparagraph:</text> <quoted-block id="HA402FCD54CA940F5AA88BCC53A6F2247" style="OLC"> <subparagraph id="HF46F3DE8DEAD4725BB9DA72B50960741"><enum>(D)</enum><text>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.</text></subparagraph><after-quoted-block>.</after-quoted-block></quoted-block></paragraph></section>
<section id="HFAF580B06E834036A250B18BBC18F4E3"><enum>102.</enum><header>Establishing a prospective payment system for certified community behavioral health clinics</header>
<subsection id="HC53885FFFD0A4F52ABE07989E3138C5C"><enum>(a)</enum><header>In general</header><text display-inline="yes-display-inline">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 by adding at the end the following new subsection:</text> <quoted-block id="HBE650730722E4DC79E675EECAF912EF9" style="OLC"> <subsection id="HD51429D9EA5E497683367DF6BABAAC20"><enum>(yy)</enum><header>Payment for services provided by certified community behavioral health clinics</header> <paragraph id="HAAFFB8D1FB0149CF968D02867B6FA0D0"><enum>(1)</enum><header>In general</header><text>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 <quote>clinic</quote>) in accordance with the provisions of this subsection.</text> </paragraph>
<paragraph id="HDEDA6AFA089640B1A31C06C0D6AA0FB0" commented="no"><enum>(2)</enum><header>Prospective payment system</header>
<subparagraph id="H5479838497764916AE6F1CA859B6E9CF" commented="no"><enum>(A)</enum><header>In general</header><text display-inline="yes-display-inline">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.</text></subparagraph> <subparagraph id="HB8D0F8BC8C524676A14D006927B80DAC" commented="no"><enum>(B)</enum><header>Unit of payment</header><text>In establishing the system under subparagraph (A), the State shall apply as the unit of service—</text>
<clause id="H95117A388DAB4CEDB77ACA1B0CE130F4" commented="no"><enum>(i)</enum><text>daily visits; or</text></clause> <clause id="H1B1B789A733F42F797C20818F1731CCC" commented="no"><enum>(ii)</enum><text>monthly visits (excluding repeat visits from the same individual).</text></clause></subparagraph>
<subparagraph id="HCE72635372EB4B56837FD151B1FA5EED" commented="no"><enum>(C)</enum><header>System design</header><text display-inline="yes-display-inline">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—</text> <clause id="H994E027CBA8145FFB7E0652891A02BFE" commented="no"><enum>(i)</enum><text>establish separate prospective payment system rates for special populations;</text></clause>
<clause id="HA407DCBD420A406FB41ED4B4EFD5BCCB" commented="no"><enum>(ii)</enum><text display-inline="yes-display-inline">use a system of outlier payments for a portion of costs of furnishing certified community behavioral health clinic services; or</text></clause> <clause id="H15EAA9C1FB794DCFABC1B3E5C1680307" commented="no"><enum>(iii)</enum><text display-inline="yes-display-inline">with respect to certified community behavioral health clinic services that are crisis services—</text>
<subclause id="H488875431C26427C9E22A319972B4EBD" commented="no"><enum>(I)</enum><text>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</text></subclause> <subclause id="H1FD5103BBD95427AAB3503AEB5029EF5" commented="no"><enum>(II)</enum><text>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).</text></subclause></clause></subparagraph>
<subparagraph id="H2582763CD6124562958B6F4A16E66F87" commented="no"><enum>(D)</enum><header>Payment basis</header><text display-inline="yes-display-inline">Subject to <internal-xref idref="H983EDC1C5CF7457394A1A5121841EA32" legis-path="(yy)(2)(E)">subparagraph (E)</internal-xref>, the State shall provide for computation of a prospective payment amount for an individual certified community behavioral health clinic under the system under <internal-xref idref="H5479838497764916AE6F1CA859B6E9CF" legis-path="(yy)(2)(A)">subparagraph (A)</internal-xref> as follows:</text> <clause id="H915691A19B964366975C189D180FA981" commented="no"><enum>(i)</enum><text>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—</text>
<subclause id="HDF72ECE5A309465CB249EDD709EAA2D0" commented="no"><enum>(I)</enum><text>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</text></subclause> <subclause id="H1BB52FB0D3204988BD930FA7F4C17B5B" commented="no"><enum>(II)</enum><text>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—</text>
<item id="H8EC522D46CF34CC8A08A2549A3350DF2" commented="no"><enum>(aa)</enum><text>the amount described in <internal-xref idref="HDF72ECE5A309465CB249EDD709EAA2D0" legis-path="(yy)(2)(D)(i)(I)">subclause (I)</internal-xref>; or</text></item> <item id="HDC457BD205AA4A90929BAF5068D833E6" commented="no"><enum>(bb)</enum><text>the amount that would have otherwise applied with respect to such services under such demonstration.</text></item></subclause> </clause>
<clause id="HABA13443D88549FBA808878EC03AF0CB" commented="no"><enum>(ii)</enum><text display-inline="yes-display-inline">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 <internal-xref idref="H865B224D00304FE6BC703151AC53E55E" legis-path="(yy)(2)(F)">subparagraph (F)</internal-xref>, the amount calculated under this subparagraph for the preceding fiscal year—</text> <subclause id="H2E7807B73B214C4FB29341246633455F" commented="no"><enum>(I)</enum><text>increased by the percentage increase described in section 1834(aa)(3)(C) for the calendar year in which such preceding fiscal year began; and</text></subclause>
<subclause id="H6074FBFE98854DA5A9DFC3312C215791" commented="no"><enum>(II)</enum><text>adjusted to take into account any increase or decrease in the scope of such services furnished by the clinic during the fiscal year involved.</text> </subclause></clause> </subparagraph> <subparagraph id="H983EDC1C5CF7457394A1A5121841EA32" commented="no"><enum>(E)</enum><header>Establishment of initial fiscal year payment for new clinics</header><text>For purposes of <internal-xref idref="H2582763CD6124562958B6F4A16E66F87" legis-path="(yy)(2)(D)">subparagraph (D)</internal-xref>—</text>
<clause id="H9E47CC6403F0415081CBDA8C5A7ED9C8" commented="no"><enum>(i)</enum><text>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</text></clause> <clause id="HB40C221D4B9A447D8869BB247D0B8774" commented="no"><enum>(ii)</enum><text>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 <internal-xref idref="HAAFFB8D1FB0149CF968D02867B6FA0D0" legis-path="(yy)(1)">paragraph (1)</internal-xref>—</text>
<subclause id="H769D9BCA878C4F9E8B8CBC40717143C6" commented="no"><enum>(I)</enum><text display-inline="yes-display-inline">for the first fiscal year in which the clinic furnishes such services, the amount determined by the State for such clinic shall be—</text> <item id="H3E3A00382E024B2EB7A4893587F8B6E9" commented="no"><enum>(aa)</enum><text>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</text></item>
<item id="H383632045E874356BF7ABDFF4BC59583" commented="no"><enum>(bb)</enum><text>in the absence of any such clinic, based on the reasonable projected costs per visit of the clinic;</text></item></subclause> <subclause id="H12500D17FE984D51A905646A9EFED60C" commented="no"><enum>(II)</enum><text>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</text></subclause>
<subclause id="H679CD8808ECB4E47A5108A8B2FB49831" commented="no"><enum>(III)</enum><text display-inline="yes-display-inline">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.</text> </subclause></clause></subparagraph> <subparagraph id="H865B224D00304FE6BC703151AC53E55E" commented="no"><enum>(F)</enum><header>Rebasing</header><text>A State may periodically (but no less frequently than every third fiscal year after the first fiscal year described in <internal-xref idref="H2582763CD6124562958B6F4A16E66F87" legis-path="(yy)(2)(D)">subparagraph (D)</internal-xref>) rebase the prospective payment amount determined under <internal-xref idref="H2582763CD6124562958B6F4A16E66F87" legis-path="(yy)(2)(D)">subparagraph (D)</internal-xref> 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 <internal-xref idref="H983EDC1C5CF7457394A1A5121841EA32" legis-path="(yy)(2)(E)">subparagraph (E)</internal-xref>.</text></subparagraph></paragraph>
<paragraph id="H8CF06C9E20E44007AC88A9AE5EAC49ED" commented="no"><enum>(3)</enum><header>Administration in the case of managed care</header>
<subparagraph id="H6080BCACB2394A60909122447BE359A4" commented="no"><enum>(A)</enum><header>In general</header><text>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.</text></subparagraph> <subparagraph id="H402F951264674224ADE0EFA18C007190" commented="no"><enum>(B)</enum><header>Option to delegate PPS payment to managed care entities through an alternative payment methodology</header><text display-inline="yes-display-inline">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.</text> </subparagraph></paragraph>
<paragraph id="H72C78656D3CA40739A45504FEA2F7254" commented="no"><enum>(4)</enum><header>Alternative payment methodologies</header><text>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—</text> <subparagraph id="H839CFE4BA5124B0DB1A3806728CC0A8A" commented="no"><enum>(A)</enum><text>is agreed to by the State and the clinic; and</text></subparagraph>
<subparagraph id="HD9C558EA26A04B8083194B4B7B26445D" commented="no"><enum>(B)</enum><text>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.</text></subparagraph></paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block> </subsection> <subsection id="HE927A7E2029145FD991191912A4F2856"> <enum>(b)</enum> <header>Requirement To use prospective payment system under benchmark or benchmark equivalent coverage</header> <text>Section 1937(b)(4) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1396u-7">42 U.S.C. 1396u–7(b)(4)</external-xref>) is amended—</text>
<paragraph id="HA35F47B20CCF44FDB19D8A73EAEA0391">
<enum>(1)</enum>
<text display-inline="yes-display-inline">in the paragraph heading, by inserting <quote><header-in-text level="paragraph" style="OLC">; coverage of CCBHC services</header-in-text></quote> after <quote><header-in-text level="paragraph" style="OLC">FQHC services</header-in-text></quote>;</text>
</paragraph>
<paragraph id="HA784D77160664C0F90FF256FBA63F799">
<enum>(2)</enum>
<text>by redesignating subparagraphs (A) and (B) as clauses (i) and (ii), respectively, and adjusting the margins accordingly;</text>
</paragraph>
<paragraph id="H83A97C6DC8E14A36AD89BDC6F2C5E958">
<enum>(3)</enum>
<text>by striking <quote>this section, a State</quote> and inserting:</text> <quoted-block style="OLC" id="H7BE01085872A42098B239CCA659D45D2" display-inline="yes-display-inline"> <text display-inline="yes-display-inline">this section—</text>
<subparagraph id="H1224F12CAB6F4BBE9A6A6CC006EA2779">
<enum>(A)</enum>
<text display-inline="yes-display-inline">a State</text> </subparagraph> <after-quoted-block>; and</after-quoted-block> </quoted-block> </paragraph> <paragraph id="H45F6A1C91CFA469B89937BD80BA5B30A" commented="no"> <enum>(4)</enum> <text>by adding at the end the following new subparagraph:</text>
<quoted-block style="OLC" id="HA4FCDB920E384A53BA9F00C0CA9E639D"
display-inline="no-display-inline">
<subparagraph id="H1FC19B4036364FFF9475B8C473AAD0F1">
<enum>(B)</enum>
<text display-inline="yes-display-inline">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).</text>
</subparagraph>
<after-quoted-block>.</after-quoted-block>
</quoted-block>
</paragraph>
</subsection></section>
<section id="HF31AD634D37D400CA36917A2F6619917"><enum>103.</enum><header>Expanding CCBHC services within Medicaid demonstration program</header>
<subsection id="H8DCB9B4F22F0420DBA0134C6DDEB5640"><enum>(a)</enum><header>Additional services within demonstration program</header><text>Section 223 of the Protecting Access to Medicare Act of 2014 (<external-xref legal-doc="usc" parsable-cite="usc/42/1396a">42 U.S.C. 1396a</external-xref> note) is amended—</text> <paragraph id="HBD73A800A7DD4AECBF9A2D32916441DC"><enum>(1)</enum><text>in section (a)(2)(D)—</text>
<subparagraph id="H90F8244FEF564850815E00AC89671A86"><enum>(A)</enum><text>by redesignating clauses (i) through (ix) as subclauses (I) through (IX), respectively, and adjusting the margins accordingly;</text></subparagraph> <subparagraph id="HA3E2C8A900D0406991A573921A59BF3A"><enum>(B)</enum><text>by striking <quote>Provision</quote> and all that follows through <quote>relationships with other providers:</quote> and inserting:</text>
<quoted-block style="OLC" id="H422F8F8515EA4666919C1A7270AE1D2D" display-inline="no-display-inline">
<clause id="H4B36B2F37C434248814DBCCD574D94B4"><enum>(i)</enum><header>In general</header><text display-inline="yes-display-inline">Provision (in a manner reflecting person-centered care) of—</text> <subclause id="HCD04A7CD748F4114B3C4603C2786B81A"><enum>(I)</enum><text display-inline="yes-display-inline">the required CCBHC services (as defined in clause (ii)); and</text></subclause>
<subclause id="H5FD290012DA643F09F88A85E6CFBD085"><enum>(II)</enum><text>the additional CCBHC services (as defined in clause (iii)).</text></subclause></clause> <clause id="H8DFE348228174AB3B197F51CB148102D"><enum>(ii)</enum><header>Required CCBHC services</header><text display-inline="yes-display-inline">For purposes of clause (i), the term <term>required CCBHC services</term> 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:</text></clause><after-quoted-block>; and</after-quoted-block></quoted-block></subparagraph>
<subparagraph id="H3BA0E13A23D149C5B7F39A6663E2B12C"><enum>(C)</enum><text>by adding at the end the following new clause:</text> <quoted-block style="OLC" id="HD61C74EDB8144065BFA17A9664306DB6" display-inline="no-display-inline"> <clause id="H2DC1E88FAFCD4509B3B4D9B5621441D4"><enum>(iii)</enum><header>Additional CCBHC services</header><text display-inline="yes-display-inline">For purposes of clause (i), the term <term>additional CCBHC services</term> means services available directly through the certified community behavioral health clinic—</text>
<subclause id="HBED8626DA527432ABF754511DC8ACC75"><enum>(I)</enum><text display-inline="yes-display-inline">that are not required CCBHC services (as defined in clause (ii));</text></subclause> <subclause id="H1BAD66417EA14872B9A372F621B3E4E7"><enum>(II)</enum><text>that are appropriate to meet the health needs of the population served; and</text></subclause>
<subclause id="HD1C809C339334A15A60591E89F6BA375"><enum>(III)</enum><text>which may include any of the primary health services defined in section 330 (b)(1)(A) of the Public Health Service Act.</text></subclause></clause><after-quoted-block>;</after-quoted-block></quoted-block> </subparagraph> </paragraph> <paragraph id="HFAEAA059A0C04E1A9D210FB5BFDCEB6A"><enum>(2)</enum><text>in subsection (b)(1), by striking <quote>mental health services</quote> and inserting <quote>certified community behavioral health clinic services</quote>; and</text></paragraph>
<paragraph id="HEBFC14E347064AAF8EDE483C3F45EDFA"><enum>(3)</enum><text display-inline="yes-display-inline">in subsection (e)—</text> <subparagraph id="HB50BAF71AE384C3C94CF95F414346B48"><enum>(A)</enum><text>by redesignating paragraphs (1) through (4) as paragraphs (2) through (5), respectively; and</text></subparagraph>
<subparagraph id="HC436BED973834C48BC92309E6D347690"><enum>(B)</enum><text>by inserting before paragraph (2), as so redesignated, the following new paragraph:</text> <quoted-block id="H9F7DE9C3673C48E38AFB925BBCB4C79A" style="OLC"> <paragraph id="H0842DD44CCD24BA598267618B3CF252E"><enum>(1)</enum><header>Certified community behavioral health clinic services</header><text>The term <term>certified community behavioral health clinic services</term> means—</text>
<subparagraph id="H26222984152A4F87B13F430AE5A133BA"><enum>(A)</enum><text>required CCBHC services (as defined in subsection (a)(2)(D)(ii)); and</text></subparagraph> <subparagraph id="H872AE89837DF4CB2B30993B33FDD3CC7"><enum>(B)</enum><text>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.</text></subparagraph></paragraph><after-quoted-block>.</after-quoted-block></quoted-block></subparagraph></paragraph></subsection>
<subsection id="H5EE0A19CCEC249649F66AC71C14F3AF6"><enum>(b)</enum><header>Effective date</header><text>The amendments made by this section shall apply with respect to services furnished on or after October 1, 2026.</text></subsection></section> <section id="HE78D6C254FDF4BF69BA9E1281A12DB15"><enum>104.</enum><header>Expanding scope of CCBHC services covered under the Medicaid program</header> <subsection id="H60B20ABBF45D4729A80B21CAFCF9A364"><enum>(a)</enum><header>Additional services within CCBHC benefit</header><text>Section 1905(jj) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1396d">42 U.S.C. 1396d(jj)</external-xref>) is amended—</text>
<paragraph id="HB99F6EAFE87549B89058C8545D615FF2">
<enum>(1)</enum>
<text>in the subsection heading, by inserting <quote><header-in-text level="subsection" style="OLC">; certified community behavioral health clinic</header-in-text></quote> after <quote><header-in-text level="subsection" style="OLC">Certified community behavioral health clinic services</header-in-text></quote>; and</text>
</paragraph>
<paragraph id="H75B3FE23B6C54A7A9F8C3202DADCECEC"><enum>(2)</enum><text>in paragraph (1)—</text> <subparagraph id="H6D8E215330D5464387A610D25BF2AD87"><enum>(A)</enum><text>in the paragraph heading, by striking <quote><header-in-text level="paragraph" style="OLC">In general</header-in-text></quote> and inserting <quote><header-in-text level="paragraph" style="OLC">Certified community behavioral health clinic services</header-in-text></quote>;</text></subparagraph>
<subparagraph id="H04D1D620D26B402E9B87EF114902B699"><enum>(B)</enum><text>by redesignating subparagraphs (A) through (I) as clauses (i) through (ix), respectively, and adjusting the margins accordingly;</text></subparagraph> <subparagraph id="H435312EB065F4065A421A4455D5B8577"><enum>(C)</enum><text>by striking <quote>The term</quote> and all that follows through <quote>relationships with other providers:</quote> and inserting:</text>
<quoted-block style="OLC" id="H3B6598A070EE41F282C82390D682826D" display-inline="no-display-inline">
<subparagraph id="H6A0C8E252A6F41C2B05788BE3E57A559"><enum>(A)</enum><header>In general</header><text display-inline="yes-display-inline">The term <term>certified community behavioral health clinic services</term> means—</text> <clause id="HFBA0215BB754402A825EF11255ABD6B0"><enum>(i)</enum><text>the required CCBHC services (as defined in subparagraph (B)); and</text></clause>
<clause id="H0D033551639D4E8A8EC5E380730DBA1F"><enum>(ii)</enum><text>the additional CCBHC services (as defined in subparagraph (C)).</text></clause></subparagraph> <subparagraph id="H30562DF681764270A848F1BD43D88AB8"><enum>(B)</enum><header>Required CCBHC services</header><text display-inline="yes-display-inline">For purposes of subparagraph (A), the term <term>required CCBHC services</term> 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:</text></subparagraph><after-quoted-block>; and</after-quoted-block></quoted-block></subparagraph>
<subparagraph id="H1FF27066E7DE47B9B1E6621D4AE212AF"><enum>(D)</enum><text>by adding at the end the following new subparagraph:</text> <quoted-block style="OLC" id="HF5880FB5DF3D4BECB5E0D2C5FD4D248B" display-inline="no-display-inline"> <subparagraph id="HDE867FDC8C814A91BEC235407B10A192"><enum>(C)</enum><header>Additional CCBHC services</header><text display-inline="yes-display-inline">For purposes of subparagraph (A), the term <term>additional CCBHC services</term> 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—</text>
<clause id="HE3F253C68FAE47DEBFAB55E1FE29686E"><enum>(i)</enum><text>that are not required CCBHC services under subparagraph (B);</text></clause> <clause id="H7D2FE6B6657E4C539956CB09AA55D124"><enum>(ii)</enum><text>that are appropriate to meet the health needs of the population served; and</text></clause>
<clause id="HDED89D4F00144011802048A2D22BCBA6"><enum>(iii)</enum><text>which may include any of the primary health services defined in section 330(b)(1) of the Public Health Service Act.</text></clause></subparagraph><after-quoted-block>.</after-quoted-block></quoted-block></subparagraph></paragraph> </subsection> <subsection id="H3546D55FDA3540CA9BF53C6A0FB7257A"><enum>(b)</enum><header>Effective date</header><text>The amendments made by this section shall apply with respect to services furnished on or after October 1, 2026.</text></subsection></section>
<enum>II</enum><header>Coverage of certified community behavioral health clinic services under the Medicare program</header>
<section id="HAD396434B2EA424BB135C326BB227E04" commented="no"><enum>201.</enum><header>Coverage of certified community behavioral health clinic services under the medicare program</header>
<subsection id="H8D71D8F1090549AB99B19988653F89A5" commented="no"><enum>(a)</enum><header>Coverage</header><text>Section 1861(s)(2) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1395x">42 U.S.C. 1395x(s)(2)</external-xref>) is amended—</text> <paragraph id="H96C74053C8B84635B199AC21556B32AE" commented="no"><enum>(1)</enum><text>in subparagraph (JJ), by adding <quote>and</quote> at the end; and</text></paragraph>
<paragraph id="H59DC542C8E6A4FA1BC69443F4C945FB5" commented="no"><enum>(2)</enum><text>by adding at the end the following new subparagraph:</text> <quoted-block id="H1CADC69647D54FC390F6620F8A09753B" style="OLC"> <subparagraph id="H380211AFEBBD4FE49B6D47864115B44A" commented="no" indent="up1"><enum>(KK)</enum><text>certified community behavioral health clinic services (as defined in subsection (aa)(8)) furnished on or after January 1, 2027.</text></subparagraph><after-quoted-block>.</after-quoted-block></quoted-block></paragraph></subsection>
<subsection id="H2595B11A588F41DA895AA20044118D60" commented="no"><enum>(b)</enum><header>Definitions</header><text>Section 1861(aa) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1395x">42 U.S.C. 1395x</external-xref>) is amended—</text> <paragraph id="HFACEED1CF8A94B80B1E9F6830F040895" commented="no"><enum>(1)</enum><text>in the heading, by striking <quote><header-in-text level="subsection" style="OLC">and Federally Qualified Health Center Services</header-in-text></quote> and inserting <quote><header-in-text level="subsection" style="OLC">, Federally qualified health center services, and certified community behavioral health clinic services</header-in-text></quote>; and</text></paragraph>
<paragraph id="H599A0838B859415C829DACA6ADFA5B75" commented="no"><enum>(2)</enum><text>by adding at the end the following new paragraph:</text> <quoted-block id="HC2B9BA495FE14158A20C3C5A52200F2C" style="OLC"> <paragraph id="HBE4F8D853C6B49A0A8B9CA4954BDC767" commented="no" indent="up1"><enum>(8)</enum><text>The terms <term>certified community behavioral health clinic services</term> and <term>certified community behavioral health clinic</term> have the meaning given each such term in section 1905(jj).</text></paragraph><after-quoted-block>.</after-quoted-block></quoted-block></paragraph></subsection></section>
<section id="H515E04E929F74D5B9AE51E63F3CC1FBB" commented="no"><enum>202.</enum><header>Payment for certified community behavioral health clinic services under the medicare program</header>
<subsection id="HDB161BD09E9E41EB9B53BBD65143479D" commented="no"><enum>(a)</enum><header>In general</header><text>Section 1833(a)(1) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1395l">42 U.S.C. 1395l(a)(1)</external-xref>) is amended—</text> <paragraph id="H6156BFA32D364F9FB463C32EDB866B44" commented="no"><enum>(1)</enum><text>by striking <quote>and (HH)</quote> and inserting <quote>(HH)</quote>; and</text></paragraph>
<paragraph id="H0AAD9BF059F549B38B0C248F625E99F0" commented="no"><enum>(2)</enum><text>by inserting before the semicolon at the end the following: <quote>, 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)</quote>.</text></paragraph></subsection> <subsection id="H32F0FDBD48584F6E94AE6BD5FB51D728" commented="no"><enum>(b)</enum><header>Development and implementation of prospective payment system</header><text display-inline="yes-display-inline">Section 1834 of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1395m">42 U.S.C. 1395m</external-xref>) is amended by adding at the end the following new subsection:</text>
<quoted-block style="OLC" id="H19A859BA5BE94F20806C71A6C9CEA9C0" display-inline="no-display-inline">
<subsection id="H750E3D5902ED4C82AE45EAFC4AF0FC06" commented="no"><enum>(aa)</enum><header>Development and implementation of prospective payment system for certified community behavioral health clinics</header></subsection>
<paragraph id="H660578D60FB949589B4ACE7C1AEEC1D0" commented="no"><enum>(1)</enum><header>In general</header><text>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—</text> <subparagraph id="H59EE177A269848EA93B9F86B5EAE54EA"><enum>(A)</enum><text>shall take into account the type, intensity, and duration of services furnished by certified community behavioral health clinics; and</text></subparagraph>
<subparagraph id="HEF29A705475B4554B9ED1BEC8718EE42"><enum>(B)</enum><text>may incorporate such adjustments, including geographic adjustments, as the Secretary determines appropriate.</text></subparagraph></paragraph> <paragraph id="HFB1249DA87C14BB4A1EDD4C6C406AC9B" commented="no"><enum>(2)</enum><header>Unit of payment</header><text>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.</text></paragraph>
<paragraph id="H0A0E501592D84571AC1CABD0F14F4128" commented="no"><enum>(3)</enum><header>Payment basis</header><text>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:</text> <subparagraph id="H7A420B40DD0A408A993BB478180DD672" commented="no"><enum>(A)</enum><text>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.</text> </subparagraph>
<subparagraph id="HFFC8B59D0C214562ADF0510A8EA1FAF8"><enum>(B)</enum><text>For 2028, such amount shall be equal to the amount determined under <internal-xref idref="H7A420B40DD0A408A993BB478180DD672" legis-path="(3)(A)">subparagraph (A)</internal-xref>, increased by the percentage increase in the MEI (as defined in section 1842(i)(3)) for the year involved.</text></subparagraph> <subparagraph id="H13D41B56EEE94F64B3E0FF0FBAA82253"> <enum>(C)</enum> <text>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.</text>
</subparagraph></paragraph>
<paragraph id="H4B460F1C137A473EBD108BC9A1C722DF" commented="no"><enum>(4)</enum><header>Periodic reevaluation of rates</header><text>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.</text></paragraph><after-quoted-block>.</after-quoted-block></quoted-block></subsection></section> <section id="HF4D449A520D84BAEAB791199E62DB19F" commented="no"><enum>203.</enum><header>Non-application of Medicare part B deductible for CCBHC services</header><text display-inline="no-display-inline">Section 1833(b)(4) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1395l">42 U.S.C. 1395l(b)(4)</external-xref>) is amended by inserting <quote>or certified community behavioral health clinic services</quote> after <quote>such deductible shall not apply to Federally qualified health center services</quote>.</text></section>
<section id="H07FC7777782D487FA9FAC12DD93CECD7" commented="no"><enum>204.</enum><header>Right to seek review of cost reports from Provider Reimbursement Review Board</header><text display-inline="no-display-inline">Section 1878(j) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1395oo">42 U.S.C. 1395oo(j)</external-xref>) is amended by striking <quote>and a Federally qualified health center</quote> and inserting <quote>, a Federally qualified health center, and a certified community behavioral health clinic</quote>.</text></section> <section id="H66449FFF890A457D90B33CB6C475296F" commented="no"><enum>205.</enum><header>Extending safe harbor under Anti-Kickback Statute to waivers of CCBHC coinsurance</header><text display-inline="no-display-inline">Section 1128B(b)(3)(D) of the Social Security Act (42 U.S.C. 1320a–7b(b)(3)(D)) is amended by inserting <quote>or a certified community behavioral health clinic</quote> after <quote>Federally qualified health care center</quote>.</text></section>
<section id="H0C111951E5F743CC9A37BAC0852E3E02" commented="no"><enum>206.</enum><header>Effective date</header><text display-inline="no-display-inline">The amendments made by this title shall apply with respect to services furnished on or after January 1, 2026.</text></section> <enum>III</enum><header>Community behavioral health clinic grants</header> <section id="H5A94FA2245D64BF284A0B2D2957B4945"><enum>301.</enum><header>Operating grants, technical assistance, data infrastructure, and accreditation for community behavioral health clinics</header><text display-inline="no-display-inline">Part D of title III of the Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/254b">42 U.S.C. 254b et seq.</external-xref>) is amended by adding at the end the following new subpart:</text>
<quoted-block id="HF70A847C2AB24C1FADA59DCA8EC6A5E5" style="OLC">
<subpart id="H3210B0D6563A490184D3E52C86076925"><enum>XIII</enum><header>Community behavioral health clinics</header>
<section id="H786BB4DA208649ABA562A3846E57D2DB"><enum>340J.</enum><header>Definitions</header><text display-inline="no-display-inline">In this subpart:</text> <paragraph id="H9616788B1C97401FB46EBDCD19336EC6"> <enum>(1)</enum> <header>Certified community behavioral health clinic</header> <text>The term <term>certified community behavioral health clinic</term> has the meaning given such term in section 1905(jj)(2) of the Social Security Act.</text>
</paragraph>
<paragraph id="HCC76E8B6D51D4A35BC67DBAD3226F157"><enum>(2)</enum><header>Certified community behavioral health clinic services</header><text>The term <term>certified community behavioral health clinic services</term> has the meaning given such term in section 1905(jj)(1) of the Social Security Act.</text></paragraph></section> <section id="H9806E7010EB2410FA0A1AF1AFCECB3BC"><enum>340J–1.</enum><header>Operating grants for community behavioral health clinics</header> <subsection id="HA0E56DE5E11C4780B7F4520A771DA7A9"><enum>(a)</enum><header>In general</header><text>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).</text></subsection>
<subsection id="HAA15D6B89B5B4E23AA32608EC14AADA6" commented="no"><enum>(b)</enum><header>Eligibility; selection</header>
<paragraph id="HE9F24505D8F446A1A23496F986A8DC9B" commented="no"><enum>(1)</enum><header>Eligibility</header><text>An entity is eligible to receive a grant under subsection (a) if such entity is—</text> <subparagraph id="H5B164B0DAFBB46A7B4A05B23534CB08C" commented="no"><enum>(A)</enum><text>a certified community behavioral health clinic; or</text></subparagraph>
<subparagraph id="HBE28418E214D42718C4A8483C5F418AC" commented="no"><enum>(B)</enum><text>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.</text></subparagraph></paragraph> <paragraph id="H85AA8484EFAA4800B06D2CC8B88A0320" commented="no"><enum>(2)</enum><header>Selection</header><text>In selecting eligible entities to receive a grant under subsection (a), the Secretary—</text>
<subparagraph id="H5858C17441EA41AABE0D7EFB6B27B090" commented="no"><enum>(A)</enum><text>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);</text></subparagraph> <subparagraph id="HA817DCF38E3943CD9D8D1544C0608D32" commented="no"><enum>(B)</enum><text>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</text> </subparagraph>
<subparagraph id="H0E581319BC1B442B8B5C6F30299FA42D" commented="no"><enum>(C)</enum><text>may establish additional conditions for the receipt of a grant under this section to—</text> <clause id="H4B2300194BB342108964160F39E139B9" commented="no"><enum>(i)</enum><text>ensure improved geographic distribution of community behavioral health clinics;</text></clause>
<clause id="H1965DEC9B2274BC58D4C7EE92D69E52D" commented="no"><enum>(ii)</enum><text>prioritize the awarding of grants to eligible entities that serve communities with elevated behavioral health needs;</text></clause> <clause id="H69AD5936E57945D6A3FFD427A7CC969A" commented="no"><enum>(iii)</enum><text>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</text></clause>
<clause id="HAE2999E5D8DA43B1B019802AE994826C"><enum>(iv)</enum><text>ensure consistency in planning with State CCBHC programs.</text></clause></subparagraph></paragraph></subsection> <subsection id="HF3DDC2F154444A4A86C600A7F68CFA3C"><enum>(c)</enum><header>Use of funds</header><text>An eligible entity that receives a grant under subsection (a)—</text>
<paragraph id="H1F3FAEE8AB3C4FD491B46AD691AD4002"><enum>(1)</enum><text>shall use the grant funds—</text> <subparagraph id="HA76BC6D70E044496AAF9FA77A88A6259"><enum>(A)</enum><text>to provide certified community behavioral health clinic services; and</text></subparagraph>
<subparagraph id="H85DB29F2E2D04D2883E0A829DEA8B801"><enum>(B)</enum><text>in the case of an entity described in subparagraph (B) of subsection (b)(1), to meet the criteria described in such subparagraph; and</text></subparagraph></paragraph> <paragraph id="H6ACE52131C1F48409F63EA8111086ADC"><enum>(2)</enum><text>may use the grant funds—</text>
<subparagraph id="H69F0AB80F5184B5A83D16E22D4BAB397"><enum>(A)</enum><text>to carry out other activities that—</text> <clause id="H2613699BE53146248D6C081F04A6F375"><enum>(i)</enum><text>reduce costs associated with the provision of certified community behavioral health clinic services;</text></clause>
<clause id="HEEAD88E7CCA8429DAA6BEB50C8402633"><enum>(ii)</enum><text>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;</text></clause> <clause id="H97DC1847651F44F58AC6ED9C61C9A11F"><enum>(iii)</enum><text>enhance the quality and coordination of certified community behavioral health clinic services; or</text></clause>
<clause id="HD9957CF21CC54AC890555674D7316566" commented="no"><enum>(iv)</enum><text>otherwise improve the health status of communities; and</text> </clause></subparagraph> <subparagraph id="H481928950F73409ABAAF11622E36CF00"><enum>(B)</enum><text>to pay for—</text>
<clause id="H4C649813A1ED4F188076CA4055250CD3"><enum>(i)</enum><text>the costs of acquiring and leasing buildings and equipment (including the costs of amortizing the principal of, and paying interest on, loans);</text></clause> <clause id="HCADEC3EC919F431CAC24C12DE1B7AE1D"><enum>(ii)</enum><text>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;</text></clause>
<clause id="HD94FF9DB4C5E4B14959DB56344AAA400"><enum>(iii)</enum><text>the costs of in-service staff training and other operational or infrastructure costs as the Secretary determines appropriate; or</text></clause> <clause id="H0C4E29FEBA654F53B2819EB93BE5DAE0"><enum>(iv)</enum><text>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.</text></clause></subparagraph></paragraph></subsection>
<subsection id="H1B59B5CA22554E59897D43FD231B1CAC" commented="no"><enum>(d)</enum><header>Use of nongrant funds</header><text>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.</text></subsection> <subsection id="H2DB68DF3F6DB40F79F8073CF571E41A5"><enum>(e)</enum><header>Term</header><text>Grants awarded under subsection (a) shall be for a period of not more than 5 years.</text></subsection>
<subsection id="H1946D7115611438D8F9A24082A9982BB"><enum>(f)</enum><header>Condition on receipt of funds</header><text>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—</text> <paragraph id="H74BF4270A5754B6E8691ABDC3EE0A91A"><enum>(1)</enum><text>provide certified community behavioral health clinic services; and</text></paragraph>
<paragraph id="H0EF4D82ABE474A81A3F7084CA50FA6F4" commented="no"><enum>(2)</enum><text display-inline="yes-display-inline">in the case of an entity described in subparagraph (B) of subsection (b)(1), to meet the criteria described in such subparagraph.</text></paragraph></subsection> <subsection id="H189B604C33D448B8AAFCBA474952404C" commented="no"><enum>(g)</enum><header>Amount of grant</header> <paragraph id="HED29CC2F602B4F12A038717872F66004" commented="no"><enum>(1)</enum><header>In general</header><text>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:</text>
<subparagraph id="HD8843189AA56476FA167E2C4383DC7CF" commented="no"><enum>(A)</enum><text>The total State, local, and other operational funding provided to the entity for such fiscal year.</text></subparagraph> <subparagraph id="H618FBAA84FB242F0B50CFA5B3ACD636A" commented="no"><enum>(B)</enum><text>The fees, premiums, and third-party reimbursements that the entity reasonably expects to receive for items and services furnished during such fiscal year.</text></subparagraph>
<subparagraph id="H6791ACDF439E4DBC9C35A0DAEBDC8096" commented="no"><enum>(C)</enum><text>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—</text> <clause id="HF5A4766DCAE34135B5FB6CE01F637D50"><enum>(i)</enum><text>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</text></clause>
<clause id="HA73E030C7E634BDB8E4D9AD0C5366B2B"><enum>(ii)</enum><text>in the case of an entity described in subparagraph (B) of subsection (b)(1), meeting the criteria described in such subparagraph.</text> </clause></subparagraph></paragraph> <paragraph id="HFDA03307A42F4CB8AC6D5D08443BDEC9" commented="no"><enum>(2)</enum><header>Payments</header><text>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.</text> </paragraph></subsection>
<subsection id="H9DE1A229FF034C21944C47E9F67CE96A"><enum>(h)</enum><header>Use of accreditation in monitoring grant progress</header><text>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).</text></subsection> <subsection id="H7B46534124494B47905835F72D2C522C"><enum>(i)</enum><header>Authorization of appropriations</header> <paragraph id="HC697FC69BAD442F193062E9748B2B11A"><enum>(1)</enum><header>In general</header><text>There is authorized to be appropriated to carry out this section $552,500,000 for each of fiscal years 2026 through 2030.</text></paragraph>
<paragraph id="H6590497974FD4FD8A9DDFBE71C1506FC"><enum>(2)</enum><header>Maintenance of funding</header><text>The amount made available under paragraph (1) shall supplement (and not supplant) any other Federal funding made available for certified community behavioral health clinics.</text></paragraph></subsection> <subsection id="HEABF9B4D9EE145C599994ED11E66AAC4" commented="no"><enum>(j)</enum><header>Guidance for clinics serving specialized populations</header><text>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.</text></subsection></section>
<section id="H915064B771B9432BA2C4E58ABF3720C4"><enum>340J–2.</enum><header>Technical assistance</header>
<subsection id="H59AF6344B2B54A3AA1DFD3B99C7AC6A6"><enum>(a)</enum><header>In general</header><text display-inline="yes-display-inline">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:</text> <paragraph id="H497DF7520D7D442F86C15C9CE8324FA9"><enum>(1)</enum><text>Entities receiving a grant under section 340J–1.</text></paragraph>
<paragraph id="HFE870CECE0B54D46A37C389CF04CD9A8"><enum>(2)</enum><text>Entities participating in a demonstration program under section 223(d) of the Protecting Access to Medicare Act of 2014.</text></paragraph> <paragraph id="H8B2E9B4A94B743F79CAA66CE99D82BB2"><enum>(3)</enum><text>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.</text></paragraph>
<paragraph id="HC1823FDBAAE246F9AC98DEAC281717E0"><enum>(4)</enum><text>Health or social service provider organizations pursuing or considering certified community behavioral health clinic status or partnering with certified community behavioral health clinics.</text></paragraph> <paragraph id="HD7703069C5F342CD9532314905B23D58"><enum>(5)</enum><text>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.</text></paragraph>
<paragraph id="HD2CB2C99012A4DB6A5CCC0D9B67DC120"><enum>(6)</enum><text>Other stakeholders, for the purpose of facilitating the successful implementation of the certified community behavioral health clinic model.</text></paragraph></subsection> <subsection id="HA1AA985E51D94E6E8304556657152D2C"><enum>(b)</enum><header>Inclusions</header><text>Assistance provided by the Secretary under subsection (a) may include technical and nonfinancial assistance, including, but not limited to—</text>
<paragraph id="H971578E4F14243718D56DEB12E25B46C"><enum>(1)</enum><text>fiscal and program management assistance;</text> </paragraph> <paragraph id="H079B4ECAC52F4961BF00E40E4384AAC7"><enum>(2)</enum><text>operational and administrative support; and</text></paragraph>
<paragraph id="HDAE5B12B8D7B4819AC8A06BFD62B6BF3"><enum>(3)</enum><text>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.</text></paragraph></subsection> <subsection id="H732D7A2287654002952C28FEB5ED3004"><enum>(c)</enum><header>Authorization of appropriations</header><text display-inline="yes-display-inline">There is authorized to be appropriated to carry out this section $8,000,000 for each of fiscal years 2026 through 2030.</text></subsection></section>
<section id="H19C489861F3245D08A0EF343F571D032"><enum>340J–3.</enum><header>Data infrastructure for community behavioral health clinic reporting</header>
<subsection id="H175453FF85484B4094206D63C469956F"><enum>(a)</enum><header>In general</header><text>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.</text></subsection> <subsection id="HCBBE6BC0A40A43B2B101A408E2B0E5BF"><enum>(b)</enum><header>Scope of data collection</header><text>The system established under subsection (a) shall be used by the Secretary to collect and analyze data from—</text>
<paragraph id="HB0B6C7638578455C83FA227250FDC778"><enum>(1)</enum><text>entities that receive a grant under section 340J–1; and</text></paragraph> <paragraph id="H5983C4B89906411DB4B5BA9EB97FFDDA"><enum>(2)</enum><text>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.</text></paragraph> </subsection>
<subsection id="H74A05819EC44496DA0D4D1418C90CAF0"><enum>(c)</enum><header>Authorization of appropriations</header><text>There is authorized to be appropriated to carry out this section $51,000,000 for each of fiscal years 2026 through 2030.</text></subsection></section> <section id="H9BDFDB4DCC4B4C92BF05019794F4C925"><enum>340J–4.</enum><header>Certified community behavioral health clinic accreditation</header> <subsection id="H4056100391624C5A9F903A76BF9754A0"><enum>(a)</enum><header>Accreditation standards</header><text>A clinic is accredited as a certified community behavioral health clinic under this section if the clinic—</text>
<paragraph id="H78020DD9CCA54E9189D73A33E5C0121E"><enum>(1)</enum><text>is accredited by an accreditation body approved by the Secretary under subsection (b); and</text></paragraph> <paragraph id="H69B66C5979324844981BC3093237330B"><enum>(2)</enum><text>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.</text></paragraph></subsection>
<subsection id="HE20D29DBE70E41F9ACCC8C4381FD549A"><enum>(b)</enum><header>Approval of accreditation bodies</header><text>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—</text> <paragraph id="H7BA3A32B9D7D41049D0A9E36FA7675E5"><enum>(1)</enum><text display-inline="yes-display-inline">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;</text></paragraph>
<paragraph id="HECB32F098041403C9D6CA194D8E6924E"><enum>(2)</enum><text>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);</text></paragraph> <paragraph id="H29362666172745A3BEAEABECDE9C7C88" commented="no"><enum>(3)</enum><text>the accreditation body has made adequate assurances that the standards of the accreditation body continue to be met by each clinic that it accredited;</text> </paragraph>
<paragraph id="HF9D769D3635B48668FEFDCA5A5F232D5"><enum>(4)</enum><text>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;</text></paragraph> <paragraph id="H4F9CEF07C1784E3A933D6A8AFE1AF0DD"><enum>(5)</enum><text>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</text></paragraph>
<paragraph id="H3761CF000D704FFFB07DBB2CC8000B6E"><enum>(6)</enum><text>the accreditation body complies with such other requirements as the Secretary determines appropriate.</text></paragraph></subsection> <subsection id="HDD8DF2B8A4F64DABA4BC239767A029E7"><enum>(c)</enum><header>Oversight of accreditation bodies</header><text>The Secretary may provide ongoing oversight of accrediting bodies approved under subsection (b). Such ongoing oversight may include the following actions:</text>
<paragraph id="HB73019B52F484A14A7DE1D9A0D420D35"><enum>(1)</enum><text>Providing continual oversight and review of approved accreditation processes through regular communication with such bodies.</text></paragraph> <paragraph id="HB900E01F92F643D7A86FFF123D557101"><enum>(2)</enum><text>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.</text></paragraph>
<paragraph id="H6E89D98DA61440C5A60AC9301B2EA010"><enum>(3)</enum><text>Mediating disputes between providers seeking certified community behavioral health clinic accreditation and approved accreditation bodies.</text></paragraph> <paragraph id="HCA992B80627E44F5A156E76038BE9106"><enum>(4)</enum><text>Providing ongoing support and coordination across approved accreditation bodies.</text></paragraph>
<paragraph id="H95649BAA879244AF995A7F05D085B4E4"><enum>(5)</enum><text display-inline="yes-display-inline">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.</text></paragraph> <paragraph id="HE7615BE61D154006928206F7F79D6731"><enum>(6)</enum><text display-inline="yes-display-inline">Periodically reviewing accreditation body processes and renewing the approval provided under subsection (b) with respect to such bodies.</text></paragraph>
<paragraph id="H0A231FEE387E49AAA7B322D7EA6219E0"><enum>(7)</enum><text>Such other activities as the Secretary determines necessary for the oversight of accreditation bodies approved under subsection (b).</text></paragraph></subsection></section></subpart> <after-quoted-block>.</after-quoted-block></quoted-block></section> <enum>IV</enum><header>Liability protection for certified community behavioral health clinic clinicians</header> <section id="H4F136E0822C54F09B0B4753579FE31D5"><enum>401.</enum><header>Conferring protection under the Federal Tort Claims Act to clinicians in certified community behavioral health clinics</header><text display-inline="no-display-inline">Section 224(g)(4) of the Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/233">42 U.S.C. 233(g)(4)</external-xref>) is amended by inserting <quote>or a certified community behavioral health clinic (as defined in section 1905(jj)(2) of the Social Security Act)</quote> before the period at the end.</text></section>