119-hr4022

[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[H.R. 4022 Introduced in House

    (IH) ]

<DOC>

119th CONGRESS
 1st Session
 H. R. 4022

 To amend title XIX of the Social Security Act to remove the exclusion 
 from medical assistance under the Medicaid Program of items and 
 services for patients in an institution for mental diseases, and for 
 other purposes.

_______________________________________________________________________

 IN THE HOUSE OF REPRESENTATIVES

 June 17, 2025

Mr. Carbajal (for himself and Mr. Bacon) introduced the following bill; 
 which was referred to the Committee on Energy and Commerce

_______________________________________________________________________

 A BILL

 To amend title XIX of the Social Security Act to remove the exclusion 
 from medical assistance under the Medicaid Program of items and 
 services for patients in an institution for mental diseases, 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 ``Increasing Behavioral Health 
Treatment Act''.

SEC. 2. REMOVAL OF MEDICAID EXCLUSION FROM MEDICAL ASSISTANCE OF ITEMS 
 AND SERVICES FURNISHED TO PATIENTS IN AN INSTITUTION FOR 
 MENTAL DISEASES IF STATE SUBMITS PLAN FOR PROVIDING 
 APPROPRIATE OUTPATIENT CARE TO SUCH PATIENTS.

    (a) Removal of Exclusion.--

    (1) In general.--The first sentence of 

section 1905

    (a) of 
 the Social Security Act (42 U.S.C. 1396d

    (a) ) is amended, in the 
 matter following paragraph

    (32) --
        (A) by striking ``such term does not include--'' 
 and all that follows through ``
        (A) any'' and inserting 
 ``such term does not include any'';
        (B) by striking ``; or'' and inserting a period; 
 and
            (C) by striking subparagraph
        (B) .

    (2) Conforming amendments to permit medical assistance for 
 imd patients under 65 years of age.--The following provisions 
 of such Act are each amended by striking ``65 years of age or 
 older'' and ``65 years of age or over'' each place it appears:
        (A) Paragraphs

    (20) and

    (21) of 

section 1902

    (a) (42 
 U.S.C. 1396a

    (a) ).
        (B) Section 1905

    (a)

    (14) (42 U.S.C. 1396d

    (a)

    (14) ).
            (C) Section 1919

    (e)

    (7)
        (B)
            (i) 
            (I) (42 U.S.C. 
 1396r

    (e)

    (7)
        (B)
            (i) 
            (I) ).

    (b) Reporting and Plan Requirement.--

Section 1902

    (a)

    (20) of the 
Social Security Act (42 U.S.C. 1396a

    (a)

    (20) ) is amended--

    (1) in subparagraph
        (B) , by striking ``and'' at the end; 
 and

    (2) by adding at the end the following new subparagraphs:
 ``
            (D) provide for a plan to achieve (and for the 
 annual submission to the Secretary of actions taken by 
 the State, and progress with respect to such actions, 
 to achieve)--
 ``
            (i) increased access to outpatient and 
 community-based behavioral health care, with 
 respect to individuals furnished services in an 
 institution for mental diseases, especially for 
 individuals transitioning from such an 
 institution;
 ``
            (ii) increased availability of services 
 made available through crisis call centers, 
 mobile crisis units, coordinated community 
 crisis response that involves law enforcement 
 and other first responders, observation or 
 assessment centers, and on-going community-
 based services (such as intensive outpatient 
 services, assertive community treatment, and 
 services in integrated care settings such as 
 the Certified Community Behavioral Health 
 Clinic model) (such services referred to as 
 crisis stabilization services) for individuals 
 experiencing a serious mental illness (as such 
 term is defined for purposes of title V of the 
 Public Health Service Act), serious emotional 
 disturbance, or substance use disorder crisis;
 ``
            (iii) improved data sharing and 
 coordination between physical health, mental 
 health, and addiction treatment providers 
 (including hospitals and community-based 
 behavioral health facilities) and first 
 responders to improve health outcomes for 
 individuals furnished services in an 
 institution for mental diseases, who are 
 experiencing a serious mental illness (as so 
 defined), serious emotional disturbance, or 
 substance use disorder crisis;
 ``
        (E) provide for the demonstration of--
 ``
            (i) State policies to ensure individuals 
 receiving medical assistance under the State 
 plan who receive care in psychiatric hospitals 
 and residential treatment settings are 
 consistently screened for co-morbid physical 
 health conditions and substance use disorders 
 prior to or upon admission, and that 
 participating facilities have the capacity to 
 address co-morbid physical health conditions 
 during stays in such psychiatric hospitals and 
 residential treatment settings either through 
 on-site medical services or external referrals 
 and care coordination;
 ``
            (ii) established strategies of the State 
 for identifying and engaging individuals, 
 particularly adolescents and young adults, 
 experiencing a serious mental illness (as such 
 term is defined for purposes of title V of the 
 Public Health Service Act), serious emotional 
 disturbance, or substance use disorder crisis; 
 and
 ``
            (iii) established utilization review 
 policies of the State Medicaid agency or 
 Medicaid managed care organizations, as 
 applicable, to ensure individuals receiving 
 medical assistance under the State plan receive 
 treatment at clinically appropriate levels of 
 care and services are generally delivered in 
 the least restrictive environment; and
 ``
        (F) report to the Secretary (in a form and manner 
 specified by the Secretary), with respect to each year 
 beginning on or after the date of the enactment of this 
 subparagraph--
 ``
            (i) in the aggregate and by facility 
 type, costs and utilization for institutions 
 for mental diseases and inpatient psychiatric 
 hospitals that are not such institutions;
 ``
            (ii) the number of individuals 
 experiencing a serious mental illness (as such 
 term is defined for purposes of title V of the 
 Public Health Service Act), serious emotional 
 disturbance, or substance use disorder crisis 
 who received medical assistance under the State 
 plan during the year;
 ``
            (iii) the length of the stay of each such 
 individual in an institution for mental 
 disease; and
 ``
            (iv) the type of outpatient treatment, 
 including medication assisted treatment, each 
 such individual received after being discharged 
 from such institution;''.
            (c) Effective Date.--

    (1) In general.--Subject to paragraph

    (2) , the amendments 
 made by this section shall take effect on the date of the 
 enactment of this Act and shall apply to State plans beginning 
 on such date.

    (2) Exception if state legislation required.--In the case 
 of a State plan for medical assistance under title XIX of the 
 Social Security Act which the Secretary of Health and Human 
 Services determines requires State legislation (other than 
 legislation appropriating funds) in order for the plan to meet 
 the additional requirement imposed by the amendments made by 
 this section, the State plan shall not be regarded as failing 
 to comply with the requirements of such title solely on the 
 basis of its failure to meet this additional requirement before 
 the first day of the first calendar quarter beginning after the 
 close of the first regular session of the State legislature 
 that begins after the date of the enactment of this Act. For 
 purposes of the previous sentence, in the case of a State that 
 has a 2-year legislative session, each year of such session 
 shall be deemed to be a separate regular session of the State 
 legislature.
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