Several APA Services advocacy priorities moved a major step forward on November 8, 2023, with the Senate Finance Committee’s passage of the Better Mental Health Care, Lower Drug Cost, and Extenders Act. The legislation builds on the committee’s substantial efforts during the 117th Congress to develop responses to the ongoing mental health crisis.
The legislation would make psychologists and other nonphysician providers eligible for Medicare bonus payments for mental health and substance use services provided to patients in mental health professional shortage areas, beginning in 2026. Currently, these bonus payments are only paid to physicians. The legislation also increases the size of the bonus payments from 10% to 15%.
The legislation includes provisions from the Connecting Our Medical Providers with Links to Expand Tailored and Effective (COMPLETE) Care Act (S. 1378opens in new window). A companion version of this bill was recently introduced in the House (H.R. 5819) by Representatives Michelle Steel (R-California) and Dan Kildee (D-Michigan). Like S. 1378/H.R. 5819, the Finance Committee’s legislation would increase Medicare reimbursement rates for behavioral health integration services by 75% in 2026, 50% in 2027, and 25% in 2028. The legislation would also require the U.S. Department of Health and Human Services (HHS) to provide technical assistance to primary care practices on adopting behavioral health integration models, including both the Primary Care Behavioral Health model and the Collaborative Care Model. APA Services has long been a champion of the COMPLETE Care Act, and of a model-agnostic approach to expanding adoption of integrated primary and behavioral healthcare.
The legislation would require Medicare Advantage (MA) organizations to improve the accuracy of their provider directories, in order to address concerns about “ghost networks” of mental health service providers who appear to be on an insurers’ panel but are not actually available. APA Services shared recommendations to Finance Committee staff on this important issue, which was the subject of a hearing earlier this year. Under the legislation approved on November 8, MA plans would be required to verify provider directory information at least every 90 days, and to submit annual reports to HHS on the accuracy of their networks, including with respect to specialties with high inaccuracy rates, such as providers specializing in mental health care. Beginning in 2027, HHS would be required to post provider directory accuracy scores.
The Finance Committee bill seeks to improve access to behavioral health services under Medicaid and the Children’s Health Insurance Program by requiring HHS to issue guidance on strategies to increase mental health and substance use disorder care provider capacity, such as through improved reimbursement, recruitment, training, and technical assistance. The bill also requires HHS to develop similar guidance to states on improving mental health and substance use disorder services for at-risk children and youth, including the delivery of culturally competent, developmentally appropriate, and trauma-informed services.
Importantly, the Finance Committee bill mitigates the 3.4% cut in Medicare Physician Fee Schedule payment rates recently announced by Centers for Medicare & Medicaid Services for 2024. Under current law, the 2024 cut will be mitigated by a 1.25% increase included in legislation passed by Congress at the end of 2022. The legislation passed by the committee increases this statutory increase to 2.5% for 2024. According to Finance Committee Chairman Ron Wyden (D-Oregon), the committee “will take a deeper look at Medicare physician payment” next year.
APA Services applauds Chairman Wyden, Ranking Member Mike Crapo (R-Idaho), and the rest of the Finance Committee in approving legislation to respond to the ongoing mental health crisis in our country, and we look forward to working with them in the months ahead on further policy changes to increase access to psychologists’ services.
