Sec. 501. Enhanced Medicaid coverage relating to certain mental health services
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Section 1902(a) of the Social Security Act ( 42 U.S.C. 1396a(a) ) is amended by inserting after paragraph
(77)the following new paragraph: not prohibit payment under the plan for a mental health service or primary care service furnished to an individual at a federally qualified community behavioral health center (as defined in section 1905(l)(4)) or a federally qualified health center (as defined in section 1861(aa)(3)) for which payment would otherwise be payable under the plan, with respect to such individual, if such service were not a same-day qualifying service (as defined in subsection (ll)); . Section 1902 of the Social Security Act ( 42 U.S.C. 1396a ) is amended by adding at the end the following new subsection: For purposes of subsection (a)(78), the term same-day qualifying service means— a primary care service furnished to an individual by a provider at a facility on the same day a mental health service is furnished to such individual by such provider (or another provider) at the facility; and a mental health service furnished to an individual by a provider at a facility on the same day a primary care service is furnished to such individual by such provider (or another provider) at the facility. . Section 1905 of the Social Security Act ( 42 U.S.C. 1396d ) is amended— in subsection (a)(16)— by inserting
(A)before effective ; and by inserting before the semicolon at the end the following:
(B)qualified inpatient psychiatric hospital services (as defined in subsection (h)(3)) for individuals over 21 years of age and under 65 years of age, and
(C)psychiatric residential treatment facility services (as defined in subsection (h)(4)) for individuals over 21 years of age and under 65 years of age ; in the subdivision
(B)that follows paragraph (29), by inserting (other than services described in subparagraphs
(B)and
(C)of paragraph
(16)for individuals described in such subparagraphs) after mental diseases ; and in subsection (h), by adding at the end the following new paragraphs: For purposes of subsection (a)(16)(B), the term qualified inpatient psychiatric hospital services means, with respect to individuals described in such subsection, services described in subparagraphs
(A)and
(B)of paragraph
(1)that are furnished in an acute care psychiatric unit in a State-operated psychiatric hospital or a psychiatric hospital (as defined section 1861(f)) if such unit or hospital, as applicable, has a facilitywide average (determined on an annual basis) length of stay of less than 30 days. For purposes of subsection (a)(16)(C), the term psychiatric residential treatment facility services means, with respect to individuals described in such subsection, services described in subparagraphs
(A)and
(B)of paragraph
(1)that are furnished in a psychiatric residential treatment facility (as defined in section 484.353 of title 42, Code of Federal Regulations, as in effect on December 9, 2013). . Subject to paragraph (2), the amendments made this section shall apply to items and services furnished after the first day of the first calendar year that begins after the date of the enactment of this section. In the case of a State plan under title XIX of the Social Security Act, which the Secretary of Health and Human Services determines requires State legislation in order for the respective plan to meet any requirement imposed by amendments made by this section, the respective plan shall not be regarded as failing to comply with the requirements of such title solely on the basis of its failure to meet such an 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 enactment of this section. For purposes of the previous sentence, in the case of a State that has a 2-year legislative session, each year of the session shall be considered to be a separate regular session of the State legislature.
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Sec. 501
Enhanced Medicaid coverage relating to certain mental health services
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