[114th Congress Public Law 97]
[From the U.S. Government Publishing Office]
[[Page 2193]]
IMPROVING ACCESS TO EMERGENCY PSYCHIATRIC CARE ACT
[[Page 129 STAT. 2194]]
Public Law 114-97
114th Congress
An Act
To extend and expand the Medicaid emergency psychiatric demonstration
project. <<NOTE: Dec. 11, 2015 - [S. 599]>>
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled, <<NOTE: Improving Access
to Emergency Psychiatric Care Act.>>
SECTION 1. <<NOTE: 42 USC 1305 note.>> SHORT TITLE.
This Act may be cited as the ``Improving Access to Emergency
Psychiatric Care Act''.
SEC. 2. EXTENSION AND EXPANSION OF MEDICAID EMERGENCY PSYCHIATRIC
DEMONSTRATION PROJECT.
(a) In General.--Subsection (d) of section 2707 of Public Law 111-
148 (42 U.S.C. 1396a note) is amended to read as follows:
``(d) Length of Demonstration Project.-- <<NOTE: Time period.>>
``(1) In general.--Except as provided in paragraphs (2) and
(3), the demonstration project established under this section
shall be conducted for a period of 3 consecutive years.
``(2) Temporary extension of participation eligibility for
selected states.--
``(A) In general.--Subject to subparagraph (B) and
paragraph (4), a State selected as an eligible State to
participate in the demonstration project on or prior to
March 13, 2012, shall, upon the request of the State, be
permitted to continue to participate in the
demonstration project through September 30, 2016, if--
``(i) <<NOTE: Determination.>> the Secretary
determines that the continued participation of the
State in the demonstration project is projected
not to increase net program spending under title
XIX of the Social Security Act; and
``(ii) <<NOTE: Certification.>> the Chief
Actuary of the Centers for Medicare & Medicaid
Services certifies that such extension for that
State is projected not to increase net program
spending under title XIX of the Social Security
Act.
``(B) Notice of projections.--The Secretary shall
provide each State selected to participate in the
demonstration project on or prior to March 13, 2012,
with notice of the determination and certification made
under subparagraph (A) for the State.
``(3) Extension and expansion of demonstration project.--
``(A) Additional extension.--Taking into account the
recommendations submitted to Congress under subsection
(f)(3), the Secretary may permit an eligible State
participating in the demonstration project as of the
date such recommendations are submitted to continue to
participate
[[Page 129 STAT. 2195]]
in the project through December 31, 2019, if, with
respect to the State--
``(i) <<NOTE: Determination.>> the Secretary
determines that the continued participation of the
State in the demonstration project is projected
not to increase net program spending under title
XIX of the Social Security Act; and
``(ii) <<NOTE: Certification.>> the Chief
Actuary of the Centers for Medicare & Medicaid
Services certifies that the continued
participation of the State in the demonstration
project is projected not to increase net program
spending under title XIX of the Social Security
Act.
``(B) Option for expansion to additional states.--
Taking into account the recommendations submitted to
Congress pursuant to subsection (f)(3), the Secretary
may expand the number of eligible States participating
in the demonstration project through December 31, 2019,
if, with respect to any new eligible State--
``(i) <<NOTE: Determination.>> the Secretary
determines that the participation of the State in
the demonstration project is projected not to
increase net program spending under title XIX of
the Social Security Act; and
``(ii) <<NOTE: Certification.>> the Chief
Actuary of the Centers for Medicare & Medicaid
Services certifies that the participation of the
State in the demonstration project is projected
not to increase net program spending under title
XIX of the Social Security Act.
``(C) Notice of projections.--The Secretary shall
provide each State participating in the demonstration
project as of the date the Secretary submits
recommendations to Congress under subsection (f)(3), and
any additional State that applies to be added to the
demonstration project, with notice of the determination
and certification made for the State under subparagraphs
(A) and (B), respectively, and the standards used to
make such determination and certification--
``(i) <<NOTE: Deadline.>> in the case of a
State participating in the demonstration project
as of the date the Secretary submits
recommendations to Congress under subsection
(f)(3), not later than August 31, 2016; and
``(ii) in the case of an additional State that
applies to be added to the demonstration project,
prior to the State making a final election to
participate in the project.
``(4) <<NOTE: Deadline. Review.>> Authority to ensure budget
neutrality.--The Secretary annually shall review each
participating State's demonstration project expenditures to
ensure compliance with the requirements of paragraphs (2)(A)(i),
(2)(A)(ii), (3)(A)(i), (3)(A)(ii), (3)(B)(i), and (3)(B)(ii) (as
applicable). <<NOTE: Determination.>> If the Secretary
determines with respect to a State's participation in the
demonstration project that the State's net program spending
under title XIX of the Social Security Act has increased as a
result of the State's participation in the project, the
Secretary shall treat the demonstration project excess
expenditures of the State as an overpayment under title XIX of
the Social Security Act.''.
(b) Funding.--Subsection (e) of section 2707 of such Act (42 U.S.C.
1396a note) is amended--
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(1) in the subsection heading, by striking ``Limitations on
Federal'';
(2) in paragraph (2)--
(A) in the paragraph heading, by striking ``5-
year''; and
(B) by striking ``through December 31, 2015'' and
inserting ``until expended'';
(3) by striking paragraph (3);
(4) by redesignating paragraphs (4) and (5) as paragraphs
(3) and (4), respectively;
(5) in paragraph (3) (as so redesignated), by striking ``and
the availability of funds'' and inserting ``(other than States
deemed to be eligible States through the application of
subsection (c)(4))''; and
(6) in paragraph (4) (as so redesignated)--
(A) in the first sentence--
(i) by inserting ``(other than a State deemed
to be an eligible State through the application of
subsection (c)(4))'' after ``eligible State''; and
(ii) by striking ``paragraph (4)'' and
inserting ``paragraph (3)''; and
(B) by inserting after the first sentence the
following: ``In addition to any payments made to an
eligible State under the preceding sentence, the
Secretary shall, during any period in effect under
paragraph (2) or (3) of subsection (d), or during any
period in which a law described in subsection (f)(4)(C)
is in effect, pay each eligible State (including any
State deemed to be an eligible State through the
application of subsection (c)(4)), an amount each
quarter equal to the Federal medical assistance
percentage of expenditures in the quarter during such
period for medical assistance described in subsection
(a). Payments made to a State for emergency psychiatric
demonstration services under this section during the
extension period shall be treated as medical assistance
under the State plan for purposes of section 1903(a)(1)
of the Social Security Act (42 U.S.C. 1396b(a)(1)).''.
(c) Recommendations to Congress.--Subsection (f) of section 2707 of
such Act (42 U.S.C. 1396a note) is amended by adding at the end the
following:
``(3) Recommendation to congress regarding extension and
expansion of project. <<NOTE: Deadline. Public information.>> --
Not later than September 30, 2016, the Secretary shall submit to
Congress and make available to the public recommendations based
on an evaluation of the demonstration project, including the use
of appropriate quality measures, regarding--
``(A) whether the demonstration project should be
continued after September 30, 2016; and
``(B) whether the demonstration project should be
expanded to additional States.
``(4) Recommendation to congress regarding permanent
extension and nationwide expansion.-- <<NOTE: Deadline. Public
information.>>
``(A) In general.--Not later than April 1, 2019, the
Secretary shall submit to Congress and make available to
the public recommendations based on an evaluation of the
demonstration project, including the use of appropriate
quality measures, regarding--
[[Page 129 STAT. 2197]]
``(i) whether the demonstration project should
be permanently continued after December 31, 2019,
in 1 or more States; and
``(ii) whether the demonstration project
should be expanded (including on a nationwide
basis).
``(B) Requirements. <<NOTE: Certification.>> --Any
recommendation submitted under subparagraph (A) to
permanently continue the project in a State, or to
expand the project to 1 or more other States (including
on a nationwide basis) shall include a certification
from the Chief Actuary of the Centers for Medicare &
Medicaid Services that permanently continuing the
project in a particular State, or expanding the project
to a particular State (or all States) is projected not
to increase net program spending under title XIX of the
Social Security Act.
``(C) Congressional approval required.--The
Secretary shall not permanently continue the
demonstration project in any State after December 31,
2019, or expand the demonstration project to any
additional State after December 31, 2019, unless
Congress enacts a law approving either or both such
actions and the law includes provisions that--
``(i) ensure that each State's participation
in the project complies with budget neutrality
requirements; and
``(ii) require the Secretary to treat any
expenditures of a State participating in the
demonstration project that are excess of the
expenditures projected under the budget neutrality
standard for the State as an overpayment under
title XIX of the Social Security Act.
``(5) Funding.--Of the unobligated balances of amounts
available in the Centers for Medicare & Medicaid Services
Program Management account, $100,000 shall be available to carry
out this subsection and shall remain available until
expended.''.
(d) Conforming Amendments.--Section 2707 of such Act (42 U.S.C.
1396a note) is amended--
(1) in subsection (a), in the matter before paragraph (1),
by inserting ``publicly or'' after ``institution for mental
diseases that is'';
(2) in subsection (c)--
(A) in paragraph (1), by striking ``An eligible
State'' and inserting ``Except as otherwise provided in
paragraph (4), an eligible State'';
(B) in paragraph (3), by striking ``A State shall''
and inserting ``Except as otherwise provided in
paragraph (4), a State shall''; and
(C) by adding at the end the following:
``(4) Nationwide availability.--In the event that the
Secretary makes a recommendation pursuant to subsection (f)(4)
that the demonstration project be expanded on a national basis,
any State that has submitted or submits an application pursuant
to paragraph (2) shall be deemed to have been selected to be an
eligible State to participate in the demonstration project.'';
and
[[Page 129 STAT. 2198]]
(3) in the heading for subsection (f), by striking ``and
Report'' and inserting ``, Report, and Recommendations''.
(e) <<NOTE: 42 USC 1396a note.>> Effective Date.--The amendments
made by this section shall take effect on the date of the enactment of
this Act.
Approved December 11, 2015.
LEGISLATIVE HISTORY--S. 599:
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SENATE REPORTS: No. 114-101 (Comm. on Finance).
CONGRESSIONAL RECORD, Vol. 161 (2015):
Sept. 28, considered and passed Senate.
Nov. 16, considered and passed House, amended.
Nov. 19, Senate concurred in House amendment.
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