To amend titles XVIII and XIX of the Social Security Act to reform and improve mental health and substance use care under the Medicare and Medicaid programs, and for other purposes.
Analysis under review: This bill has generated analysis that may be too generic or incomplete. Clause-level evidence remains available below.
Summary
What This Bill Does
The bill provides payment under the Medicare physician fee schedule for inherently complex evaluation and management visits related to integrated mental health and substance use disorder care Section 1848(b) of the Social, creates parity in mental health and substance use disorder benefits under Medicare Advantage and prescription drug plans Section 1852 of the Social Security Act (42 U.S.C, and requires behavioral health measures and incentivizing behavioral health care quality Section 1853(o) of the Social Security Act (42 U.S.C. It relies on compliance mandates, definition changes, appropriations, and reporting requirements. The main policy areas are Agriculture, Healthcare, Environment, and Science & Space.
Who Benefits and How
Public beneficiaries or protected communities affected by the clause could face reduced risk, Patients and health care consumers affected by the bill could face reduced risk, and Environmental and public health interests affected by the bill could face lower compliance burdens.
Who Bears the Burden and How
Federal, state, or local agencies responsible for implementing the clause would take on compliance duties, Patients and health care consumers affected by the bill would take on compliance duties, and Researchers and scientific institutions affected by the bill would take on compliance duties.
Key Provisions
- Provides payment under the Medicare physician fee schedule for inherently complex evaluation and management visits related to integrated mental health and substance use disorder care Section 1848(b) of the Social...
- Creates parity in mental health and substance use disorder benefits under Medicare Advantage and prescription drug plans Section 1852 of the Social Security Act (42 U.S.C.
- Requires behavioral health measures and incentivizing behavioral health care quality Section 1853(o) of the Social Security Act (42 U.S.C.
- Requires providing information on behavioral health coverage to promote informed choice Section 1851(d)(4) of the Social Security Act (42 U.S.C.
- Provides requiring MA organizations to maintain accurate and updated provider directories Section 1852(c) of the Social Security Act (42 U.S.C.
Evidence Chain:
This summary is generated from the full bill text using AI analysis. Expand "Detailed Analysis" below for identified beneficiaries/burden bearers with clause-level evidence links.
At a Glance
What This Bill Does
The bill provides payment under the Medicare physician fee schedule for inherently complex evaluation and management visits related to integrated mental health and substance use disorder care Section 1848(b) of the Social, creates parity in mental health and substance use disorder benefits under Medicare Advantage and prescription drug plans Section 1852 of the Social Security Act (42 U.S.C, and requires behavioral health measures and incentivizing behavioral health care quality Section 1853(o) of the Social Security Act (42 U.S.C.
Key Policy Areas
Agriculture, Healthcare, Environment, Science & Space
Primary Purpose
The bill provides payment under the Medicare physician fee schedule for inherently complex evaluation and management visits related to integrated mental health and substance use disorder care Section 1848(b) of the Social, creates parity in mental health and substance use disorder benefits under Medicare Advantage and prescription drug plans Section 1852 of the Social Security Act (42 U.S.C, and requires behavioral health measures and incentivizing behavioral health care quality Section 1853(o) of the Social Security Act (42 U.S.C.
Policy Domains
Whole bill
Identified Gains
- Public beneficiaries or protected communities affected by the clause
- Patients and health care consumers affected by the bill
- Environmental and public health interests affected by the bill
- Financial services firms and customers affected by the bill
- Tribal governments and members affected by the bill
Identified Costs
- Federal, state, or local agencies responsible for implementing the clause
- Patients and health care consumers affected by the bill
- Researchers and scientific institutions affected by the bill
- Homeowners, tenants, or housing market participants affected by the bill
- Financial services firms and customers affected by the bill
Sponsors
Legislative Progress
IntroducedMr. Bennet (for himself and Mr. Wyden) introduced the following …
Impact analysis is available but no clear stakeholder effects identified. View clause-level analysis →
Bill Structure & Actor Mappings
Who is "The Secretary" in each section?
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