Finance Committee Unveils Mental Health Care Integration Discussion Draft

Washington, D.C.--U.S. Senate Finance Committee Ranking Member Mike Crapo (R-Idaho), Chairman Ron Wyden (D-Oregon), Senator Catherine Cortez Masto (D-Nevada) and Senator John Cornyn (R-Texas) today released a discussion draft of legislation aimed at creating better care integration of mental and physical health care services and expanding access to crisis care and follow up services to get Americans the longer-term care they need.

“Especially for rural Americans and communities facing health care provider shortages, integrating behavioral health into the primary care setting can expand access while strengthening the doctor-patient relationship,” said Crapo.  “The reforms included in this discussion draft would take important steps toward improving care quality and generating cost savings for patients and taxpayers alike. I thank my colleagues for their vital work on these proposals, and I look forward to hearing feedback from stakeholders on how we can further enhance these policies.” 

“For too long, mental health and physical health have been deeply separated in this country,” said Wyden. “These policies will begin to allow health care providers to work together more than ever before to connect their patients with the mental health care they need. I am very pleased that the draft contains robust improvements for crisis response and stabilization, which is critical to safeguarding Americans struggling with their mental health. I want to thank Ranking Member Crapo and Senators Cortez Masto and Cornyn for all of their hard work crafting this discussion draft. The Finance Committee will continue working to bring these and other mental health care improvements to Americans in need.”

“I’ve worked to promote Nevadans’ mental and physical health, and this bipartisan legislation will make sure that Nevadans have greater access to critical mental health resources, particularly during a mental health crisis,” said Cortez Masto. “This is a critical step in creating a true continuum of crisis care for mental and behavioral health issues that provides the right services at the right time to those who need them. I won’t stop working until that’s a reality for those in mental health crisis and their loved ones.”

“High-quality care for Americans grappling with a mental health crisis is an urgent and growing need,” said Cornyn. “This bipartisan legislation would help medical providers merge behavioral health care and primary care services while increasing access to crisis stabilization services, and I am grateful to Ranking Member Crapo, Chairman Wyden, and Senator Cortez Masto for their work on this issue.” 

The discussion draft includes policies that would:

• Increase payment rates to help providers integrate behavioral health and primary care.
• Create a standardized payment in Medicare for mobile crisis response team services, including a screening and assessment of the Medicare beneficiary’s mental health or substance use disorder crisis, services to support de-escalation of the individual’s mental health or substance use disorder crisis, and referrals for health and social services.
• Create a bundled payment in Medicare for crisis stabilization services including observation care, screening for suicide risk, screening for violence risk, assessment of immediate physical health needs, and other services.
• Ensure peer support specialists may participate in furnishing behavioral health integration services to Medicare beneficiaries.
• Make mobile crisis intervention services a permanent state option available to states eligible for federal Medicaid match funding.
• Direct the Centers for Medicare & Medicaid Services (CMS) to inform states of best practices and recommendations for building a crisis care continuum financed by Medicaid and CHIP, and provide funding for technical assistance and planning grants for states.
• Require CMS to provide best practices to health care providers on integrating behavioral health care into the primary care setting and encourage CMS to consider models that include behavioral health integration.
• Direct CMS to conduct an analysis of integration models in Medicaid.
• Establish CMS technical assistance for providers seeking to integrate behavioral health and primary care.
• Require CMS to issue guidance outlining flexibilities and best practices for partnering between states, Medicaid managed care organizations, and community based organizations to address health related social needs.

This discussion draft on the mental health integration is the fourth legislative draft the Finance Committee has released since kicking off its bipartisan mental health initiative. The first, released in May, focused on telehealth policies. The second, released in June, focused on youth mental health. The third, released in September, focused on expanding the mental health care workforce. Other discussion drafts may be released. The committee is committed to fully paying for any mental health package with bipartisan, consensus-driven offsets. 

A summary of the provisions is available here. The full text of the discussion draft is available here. 

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