Sec. 112. Recurring analysis and publication of Medicaid health care data related to mental health services

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A research copy — for the controlling text, always check the official state or federal source. Not legal advice.

The Secretary, on a biennial basis, shall link, analyze, and publish on a publicly available website Medicaid data reported by States through the Transformed Medicaid Statistical Information System (T–MSIS) (or a successor system) relating to mental health services provided to individuals enrolled in Medicaid, including an analysis by age. Such enrollee information shall be de-identified of any personally identifying information, shall adhere to privacy standards established by the Department of Health and Human Services, and shall be aggregated to protect the privacy of enrollees, as necessary.

Each publication of such analysis shall include for each State available data for the following measures: The number and percentage of individuals by age enrolled in the State Medicaid plan or waiver of such plan in each of the major enrollment categories (as defined in a letter, to be made publicly available on the website of the Medicaid and CHIP Payment and Access Commission, from the Medicaid and CHIP Payment and Access Commission to the Secretary) who have been diagnosed with a mental health condition and whether such individuals are enrolled under the State Medicaid plan or waiver of such plan, including the specific waiver authority under which they are enrolled, to the extent available.

A list of the mental health treatment services, including specifying adult and pediatric services, by each major type of service, such as counseling, intensive home-based services, intensive care coordination, crisis services tailored to children and youth, youth peer support services, family-to-family support, inpatient hospitalization, and other appropriate services as identified by the Secretary, for which beneficiaries in each State received at least 1 service under the State Medicaid plan or a waiver of such plan.

The number and percentage of individuals by age with a substance use disorder diagnosis enrolled in the State Medicaid plan or waiver of such plan who received services for a mental health condition under such plan or waiver by each major type of service specified under paragraph

(2)within each major setting type, such as outpatient, inpatient, residential, and other home-based and community-based settings. The number of services provided under the State Medicaid plan or waiver of such plan per individual with a mental health diagnosis, including by age, enrolled in such plan or waiver for each major type of service specified under paragraph (2). The number and percentage of individuals by age enrolled in the State Medicaid plan or waiver by major enrollment category, who received mental health services through— a Medicaid managed care entity (as defined in section 1932(a)(1)(B) of the Social Security Act ( 42 U.S.C. 1396u–2(a)(1)(B) )), including the number of such individuals who received such assistance through a prepaid inpatient health plan (as defined by the Secretary) or a prepaid ambulatory health plan (as defined by the Secretary); a fee-for-service payment model; or an alternative payment model, to the extent available. The number and percentage of individuals by age with a mental health diagnosis who received mental health services in an outpatient or home-based and community-based setting after receiving services in an inpatient or residential setting and the number of services received by such individuals in the outpatient or home-based and community-based setting. The number and percentage of inpatient admissions by age in which services for a mental health condition were provided to an individual enrolled in the State Medicaid plan or a waiver of such plan that occurred within 30 days after discharge from a hospital or inpatient facility in which services for a mental health condition previously were provided to such individual, disaggregated by type of facility, to the extent such information is available. The number of emergency department visits by an individual by age enrolled in the State Medicaid plan or a waiver of such plan for treatment of a mental health condition within 7 days of such individual being discharged from a hospital inpatient facility in which services for a mental health condition were provided, or from a mental health facility, an independent psychiatric wing of acute care hospital, or an intermediate care facility for individuals with intellectual disabilities, disaggregated by type of facility, to the extent such information is available. The number and percentage of individuals by age enrolled in the State Medicaid plan or a waiver of such plan— who received an assessment to diagnose a mental health condition; and the number of mental health services provided to individuals described in subparagraph

(A)in the 30 days post-assessment. Prescription National Drug Code codes, fill dates, and number of days supply of any covered outpatient drug (as defined in section 1927(k)(2) of the Social Security Act ( 42 U.S.C. 1396r-8(k)(2) ) to treat a mental health condition that were dispensed to an individual by age enrolled in the State Medicaid plan or waiver with an episode described in paragraph

(7)or

(8)during any period that occurs after the individual’s discharge date defined in paragraph

(7)or

(8)(as applicable), and before the admission date applicable under paragraph

(7)or the date of the emergency department visit applicable under paragraph (8). Not later than 18 months after the date of enactment of this Act, the Secretary shall make publicly available the first analysis required by subsection (a). The report required under paragraph

(1)and updates required under paragraph

(3)shall— use data and definitions from the Transformed Medicaid Statistical Information System ( T–MSIS ) (or a successor system) data set that is no more than 12 months old on the date that the report or update is published; and as appropriate, include a description with respect to each State of the quality and completeness of the data and caveats describing the limitations of the data reported to the Secretary by the State that is sufficient to communicate the appropriate uses for the information. Not later than 3 years after the date of enactment of this Act, the Secretary shall publish a revised publication of the analysis required by subsection

(a)that allows for a research-ready and publicly accessible interface of the publication that is developed after consultation with stakeholders on the usability of the data contained in the publication. Section 1015 of the SUPPORT for Patients and Communities Act ( Public Law 115–271 ) is amended— in subsection (a)(3), by striking through 2024 ; and in subsection (b), by adding at the end the following new paragraph: The Secretary shall publish in the Federal Register a system of records notice that modifies the system of records notice required under paragraph

(1)to provide that— the data specified in paragraph

(2)shall be published on a publicly available website; and such data shall be de-identified of any personally identifying information, shall adhere to privacy standards established by the Department of Health and Human Services, and shall be aggregated to protect the privacy of enrollees, as necessary. Not later than January 1, 2025, the Secretary shall initiate the data sharing activities outlined in the notice required under paragraph (1), as modified pursuant to this paragraph. . In this section: The term Secretary means the Secretary of Health and Human Services. The term State has the meaning given that term in section 1101(a)(1) of the Social Security Act ( 42 U.S.C. 1301(a)(1) ) for purposes of title XIX of such Act.

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