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To amend title XVIII of the Social Security Act to provide incentives for behavioral health integration.
Summary
This bill provides Medicare payment incentives for primary care practices that integrate behavioral health services. For three years (2027-2029), Medicare payment rates for behavioral health integration services would be increased at 175 percent of normal rates in 2027, declining to 150 percent in 2028 and 125 percent in 2029. The bill waives budget-neutrality requirements so these payment increases do not need to be offset by reductions elsewhere. The bill also directs the Secretary of Health and Human Services to establish a technical assistance program by January 1, 2026 to help primary care practices adopt behavioral health integration models, including the Collaborative Care Model and Primary Care Behavioral Health model. Funding is appropriated for the technical assistance program through fiscal year 2029.
AI-generated plain-language summary of the bill text — neutral, and may be imperfect. See the full text below for the exact wording.
Sponsor (1)
1 cosponsor
- Sen. Cornyn, John [R-TX] (R-TX)
Actions (2)
- Mar 11, 2025 Read twice and referred to the Committee on Finance. · senate
- Mar 11, 2025 Introduced in Senate
Similar bills (6)
Bills with similar text or summary — includes reintroductions across Congresses. Ranked by semantic similarity of the bill text (computed locally); a neutral discovery aid, not a claim the bills are duplicates.
Full text
IN THE SENATE OF THE UNITED STATES
March 11 (legislative day, March 10), 2025
Ms. Cortez Masto (for herself and Mr. Cornyn) introduced the following bill; which was read twice and referred to the Committee on Finance
A BILL
To amend title XVIII of the Social Security Act to provide incentives for behavioral health integration.
Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the “Connecting Our Medical Providers with Links to Expand Tailored and Effective Care” or the “COMPLETE Care Act”.
SEC. 2. MEDICARE INCENTIVES FOR BEHAVIORAL HEALTH INTEGRATION WITH PRIMARY CARE.
(a) Incentives.—
(1) In general.—Section 1848(b) of the Social Security Act (42 U.S.C. 1395w-4(b)) is amended by adding at the end the following new paragraph:
“(13) Incentives for behavioral health integration.—
“(A) In general.—For services described in subparagraph (B) that are furnished during 2027, 2028, or 2029, instead of the payment amount that would otherwise be determined under this section for such year, the payment amount shall be equal to the applicable percent (as defined in subparagraph (C)) of such payment amount for such year.
“(B) Services described.—The services described in this subparagraph are services identified, as of January 1, 2024, by HCPCS codes 99484, 99492, 99493, 99494, G2214, and G0323 (and any successor or similar codes as determined appropriate by the Secretary).
“(C) Applicable percent.—In this paragraph, the term ‘applicable percent’ means, with respect to a service described in subparagraph (A), the following:
“(i) For services furnished during 2027 , 175 percent.
“(ii) For services furnished during 2028, 150 percent.
“(iii) For services furnished during 2029, 125 percent.”.
(2) Waiver of budget neutrality.—Section 1848(c)(2)(B)(iv) of such Act (42 U.S.C. 1395w-4(c)(2)(B)(iv)) is amended—
(A) in subclause (V), by striking “and” at the end;
(B) in subclause (VI), by striking the period at the end and inserting “; and” and
(C) by adding at the end the following new subclause:
“(VII) the increase in payment amounts as a result of the application of subsection (b)(13) shall not be taken into account in applying clause
(ii)(II) for 2027, 2028, or 2029.”.
(b) Technical Assistance for the Adoption of Behavioral Health Integration.—
(1) In general.—Not later than January 1, 2026, the Secretary of Health and Human Services (in this subsection referred to as the “Secretary”) shall enter into contracts or agreements with appropriate entities to offer technical assistance to primary care practices that are seeking to adopt behavioral health integration models in such practices.
(2) Behavioral health integration models.—For purposes of paragraph (1), behavioral health integration models include the Collaborative Care Model (with services identified as of January 1, 2024, by HCPCS codes 99492, 99493, 99494, and G2214 (and any successor codes)), the Primary Care Behavioral Health model (with services identified as of January 1, 2024, by HCPCS codes 99484 and G0323 (and any successor code)), and other models identified by the Secretary.
(3) Implementation.—Notwithstanding any other provision of law, the Secretary may implement the provisions of this subsection by program instruction or otherwise.
(4) Funding.—In addition to amounts otherwise available, there is appropriated to the Secretary for each of fiscal years 2025 through 2029, out of any money in the Treasury not otherwise appropriated, such sums as are necessary, to remain available until expended, for purposes of carrying out this subsection. <all>
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