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November 10, 2022

Draft Finance Committee 4th discussion on mental health proposes greater integration of mental and physical health care, and promotes crisis care

Washington, DC Senate Finance Committee Chairman Ron Wyden (R-R), Ranked Member Mike Crapo (R-Idaho), Sens. Kathryn Cortez Masto (D-Nevada) and Sen. John Cornyn (R-Texas) today released a discussion draft of legislation aimed at creating Better integration of care from mental and physical health care services, and expanded access to crisis care and follow-up services to provide Americans with the long-term care they need.

“For too long, mental health has been severely separated from physical health in this country,” Wyden said. These policies will begin to allow healthcare 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 powerful improvements to crisis response and stabilization, which is critical to protecting Americans struggling with their mental health. I’d like to thank Ranker Crapo, Senators Cortez Masto, and Cornyn for their hard work drafting this debate. The Finance Committee will continue to work to achieve these and other mental health care improvements for Americans in 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.” Crapo said. “The reforms included in this discussion draft will take important steps toward improving quality of care and achieving 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 strengthen these policies.”

“I have worked to strengthen the mental and physical health of the state of Nevadan, and this bipartisan legislation will ensure Nevadans have greater access to important mental health resources, especially during a mental health crisis,” Cortez Masto said. “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 for those who need them. I will not stop working until this becomes a reality for those experiencing a mental health crisis and their loved ones.”

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

The discussion draft includes policies that would:

• Increase rates of payment to help providers integrate behavioral health and primary care.
• Establish a consolidated push in Medicare for Mobile Crisis Response Team services, including screening and evaluation of a Medicare beneficiary’s mental health or substance use disorder crisis, services to support de-escalation of an individual’s mental health or substance use disorder crisis, and referrals to health and social services.
• Create a pooled payment in Medicare for crisis stabilization services including observational care, screening for suicide risk, screening for risk of violence, immediate physical health needs assessment, and other services.
• Ensure that peer support professionals may be involved in providing behavioral health integration services to Medicare beneficiaries.
• Make mobile crisis intervention services a permanent option for states eligible for federal Medicaid match funding.
• Direct the Centers for Medicare and Medicaid Services (CMS) to inform states of best practices and recommendations for building a continuum of crisis care with Medicaid and CHIP funding, and provide funding for technical assistance and grant planning to states.
• Require CMS to provide health care providers with best practices on integrating behavioral health care into the primary care setting and encourage CMS to consider models that incorporate behavioral health integration.
• Directing CMS to perform an analysis of Medicaid integration models.
• Create CMS technology assistance for providers seeking to integrate behavioral health and primary care.
• Request CMS to issue guidance outlining flexibility 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 mental health integration is the fourth legislative draft the Finance Committee has passed since the launch of its bipartisan mental health initiative. the firstreleased in May, focused on telehealth policies. The secondreleased in June, focused on youth mental health. Third, released in September, focused on expanding the mental health care workforce. Other discussion drafts may be edited. The committee is committed to paying in full for any mental health package with bipartisan, consensus-driven compensation.

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

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