Sec. 303. Extension of Community Mental Health Services demonstration program
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Section 223(d)(3) of the Protecting Access to Medicare Act of 2014 ( 42 U.S.C. 1396a note) is amended by striking December 20, 2019 and inserting March 31, 2021 . Subparagraph
(B)of section 223(d)(5) of the Protecting Access to Medicare Act of 2014 ( 42 U.S.C. 1396a note) is amended to read as follows: The Federal matching percentage specified in this subparagraph is with respect to medical assistance described in subparagraph
(A)that is furnished— to a newly eligible individual described in paragraph
(2)of section 1905(y) of the Social Security Act ( 42 U.S.C. 1396d(y) ), the matching rate applicable under paragraph
(1)of that section; and to an individual who is not a newly eligible individual (as so described) but who is eligible for medical assistance under the State Medicaid program, the enhanced FMAP applicable to the State or, for fiscal quarters beginning on or after January 1, 2020, the matching rate determined for the State and quarter under clause (ii). For purposes of clause (i)(II), the matching rate determined for a State and fiscal quarter under this clause shall be— for the fiscal quarter beginning on January 1, 2020, a percentage equal to the enhanced FMAP applicable to the State reduced by a number of percentage points equal to 1/6 of the percentage points difference between the enhanced FMAP applicable to the State and the Federal medical assistance percentage applicable to the State under section 1905(b) of the Social Security Act ( 42 U.S.C. 1396d(b) ); for the fiscal quarter beginning on April 1, 2020, a percentage equal to the enhanced FMAP applicable to the State reduced by a number of percentage points equal to 1/3 of the percentage points difference between the enhanced FMAP applicable to the State and the Federal medical assistance percentage applicable to the State under section 1905(b) of the Social Security Act ( 42 U.S.C. 1396d(b) ); for the fiscal quarter beginning on July 1, 2020, a percentage equal to the enhanced FMAP applicable to the State reduced by a number of percentage points equal to 1/2 of the percentage points difference between the enhanced FMAP applicable to the State and the Federal medical assistance percentage applicable to the State under section 1905(b) of the Social Security Act ( 42 U.S.C. 1396d(b) ); for the fiscal quarter beginning on October 1, 2020, a percentage equal to the enhanced FMAP applicable to the State reduced by a number of percentage points equal to 2/3 of the percentage points difference between the enhanced FMAP applicable to the State and the Federal medical assistance percentage applicable to the State under section 1905(b) of the Social Security Act ( 42 U.S.C. 1396d(b) ); for the fiscal quarter beginning on January 1, 2021, a percentage equal to the enhanced FMAP applicable to the State reduced by a number of percentage points equal to 5/6 of the percentage points difference between the enhanced FMAP applicable to the State and the Federal medical assistance percentage applicable to the State under section 1905(b) of the Social Security Act ( 42 U.S.C. 1396d(b) ); and for the fiscal quarter beginning on April 1, 2021, and each subsequent fiscal quarter, a percentage equal to the Federal medical assistance percentage applicable to the State under section 1905(b) of the Social Security Act ( 42 U.S.C. 1396d(b) ). . Section 223(d)(5) of the Protecting Access to Medicare Act of 2014 ( 42 U.S.C. 1396a note) is amended by adding at the end the following new subparagraph: The amount of any overpayment made to a State under this paragraph shall be deemed an overpayment to the State under title XIX of the Social Security Act ( 42 U.S.C. 1396 et seq.) to be disallowed against the State's regular quarterly draw for all Medicaid spending under section 1903(d)(2) of such Act ( 42 U.S.C. 1396b(d)(2) ). . The Comptroller General of the United States shall conduct 1 or more studies on certified community behavioral health clinics participating in the demonstration program established under section 223 of the Protecting Access to Medicare Act of 2014 ( 42 U.S.C. 1396a note) that shall include the following: An evaluation of encounter data submissions and other reporting submitted by certified community behavioral health clinics participating in the demonstration program, including identifying challenges faced in collecting, submitting, and ensuring the quality of the data submitted, as well as— an evaluation of the extent to which the Centers for Medicare & Medicaid Services and States face challenges validating encounter data for completeness and accuracy; an assessment of requirements imposed on such certified community behavioral health clinics for collecting and submitting encounter data; an assessment of any challenges such certified community behavioral health clinics face in collecting and submitting encounter data; and an assessment of the efficacy of automated checks conducted on encounter data submitted by such certified community behavioral health clinics for completeness and accuracy. An evaluation of the payment arrangement for certified community behavioral health clinics participating in the demonstration program and of payment arrangements for all certified community behavioral health clinics, including any challenges related to the accuracy of payments, such as— the extent to which the Secretary of Health and Human Services and States participating in the demonstration program can monitor the accuracy of payments made under the program to certified community behavioral health clinics participating in the program; any challenges associated with requiring the Secretary of Health and Human Services to accurately assess the comparative impact of the certified community behavioral health clinics participating in such program, as compared to certified community behavioral health clinics that are not participating in such program, on the Federal and State costs for furnishing a full range of mental health services (including inpatient, emergency and ambulatory services); and any comparisons of payment arrangements by certified community behavioral health clinics and the degree to which there are payment disparities among such clinics for furnishing the same or similar services. An evaluation of the quality of data submissions by States and certified community behavioral health clinics participating in the demonstration program, including the extent to which— the Secretary of Health and Human Services faced challenges validating the quality of data submitted by such States and such certified community behavioral health clinics; the quality measures used to evaluate certified community behavioral health clinics participating in the demonstration program compare with the measures reported by certified community behavioral health clinics that are not participating in the program; and the quality measures being reported by certified community behavioral health clinics participating in the demonstration program offer insights on the quality of care provided at, and the health status of individuals treated by, such clinics. An assessment of the extent to which the certified community behavioral health clinics participating in the demonstration program expanded the services they offer, as compared to certified community behavioral health clinics that are not participating in the program, and if so, what factored into the decision to expand. Such recommendations as the Comptroller General determines appropriate for improving— the reporting, accuracy, and validation of encounter data; accuracy in payments to certified community behavioral health clinics under State programs under title XIX of the Social Security Act ( 42 U.S.C. 1396 et seq.) and quality monitoring of such clinics; and quality measure reporting and replacing process-driven quality measures with outcome-based measures that reflect improvements in patient functional status. Not later than December 31, 2020, the Comptroller General of the United States shall submit to Congress a report containing the findings of the study conducted under paragraph (1).
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Sec. 303
Extension of Community Mental Health Services demonstration program
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