HR4022-119

What This Bill Does

The Increasing Behavioral Health Treatment Act relaxes Medicaid's institution for mental diseases exclusion while tying the change to community-care planning. It amends the definition of medical assistance so the exclusion for services furnished to patients in an IMD is removed in the covered circumstances, and deletes references limiting certain IMD-related coverage to people age 65 or older. It also requires state Medicaid plans to include a plan, with annual submissions to HHS on actions and progress, for increased access to outpatient and community-based behavioral health care for people furnished services in an IMD, especially people transitioning out. States must address crisis call centers, mobile crisis units, coordinated community crisis response involving law enforcement and first responders, observation or assessment centers, intensive outpatient services, assertive community treatment, and integrated care settings such as certified community behavioral health clinics. The plan must also improve data sharing and coordination among physical health, mental health, addiction treatment providers, hospitals, community behavioral health facilities, and first responders. The bill therefore expands Medicaid financing for institutional behavioral health treatment but requires states to build outpatient, crisis, screening, and transition systems around that coverage.

Who Benefits and How

Medicaid patients in IMDs benefit if treatment in psychiatric or substance-use institutions can be covered by Medicaid. People transitioning from IMDs benefit from state plans for outpatient and community-based behavioral health care. Crisis call centers benefit from state planning for increased availability of crisis stabilization services. Mobile crisis units benefit from inclusion in required state crisis stabilization planning. Community behavioral health providers benefit from coordination, data-sharing, and integrated care expectations.

Who Bears the Burden and How

State Medicaid agencies must submit plans and annual progress updates on outpatient access, crisis services, data sharing, screening, and transitions. HHS Medicaid staff must review state plans and annual submissions tied to IMD coverage. Psychiatric hospitals must coordinate with outpatient and community-based providers as transition planning expands. Law enforcement first responders may be drawn into coordinated crisis response systems. Federal taxpayers bear higher Medicaid spending if IMD services become covered more often.

Key Provisions

• Expands Medicaid medical assistance for services furnished to patients in institutions for mental diseases.
• Deletes age-65 IMD references in multiple Medicaid provisions.
• Requires state plans for outpatient and community-based behavioral health access for IMD patients.
• Requires increased crisis stabilization services such as call centers, mobile crisis units, and assessment centers.
• Requires improved data sharing and coordination across health, behavioral health, addiction treatment, hospital, and first responder systems.
• Requires annual state progress submissions to HHS.