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HB 5371

Human services: medical services; certified community behavioral health clinics; provide certification and funding for. Amends 1939 PA 280 (MCL 400.1 - 400.119b) by adding sec. 109o.

2023-2024 Regular Session Introduced by Noah Arbit and 26 co-sponsors

HB 5371 would create a Medicaid prospective payment system to fund certified community behavioral health clinics in Michigan, aligning with federal rules for predictable payments.

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Bill Summary · HB 5371

Summary — HB 5371 (Certified Community Behavioral Health Clinics / CCBHCs)

Status: Passed Michigan House (Dec 12, 2024); referred to Committee on Government Operations. Enactment is contingent on companion bill HB 5372.

Purpose / Intent

HB 5371 directs the Michigan Department of Health and Human Services (DHHS) to create a Medicaid funding model — a prospective payment system (PPS) — for certified community behavioral health clinics (CCBHCs). The bill’s goal is to align state program rules and payment methodology with federal CCBHC requirements and federal Medicaid payment rules so that CCBHCs receive predictable advance payments for the services they provide.

Key provisions

  • Requires DHHS, consistent with federal law and regulations, to develop a Medicaid prospective payment system to fund:
    • Certified community behavioral health clinics;
    • Community mental health service programs, nonprofit or private organizations, or individual providers certified as CCBHCs and licensed by DHHS.
  • Payment system must fully comply with federal payment methodologies; DHHS must apply for all necessary CMS waivers/approvals (e.g., 1115 waiver if required).
  • Implementation deadline (subject to federal approval): no later than October 1, 2027 (versions earlier/introduced referenced Jan 1, 2028).
  • DHHS must issue implementing policies/rules (or promulgate rules) addressing:
    • Continued compliance with licensing/certification;
    • Mitigation of conflicts of interest with prepaid inpatient health plans and prevention of access barriers;
    • Prohibition and clear definitions of retaliatory actions between providers and community mental health service programs, and procedures for investigating/ adjudicating such claims;
    • Dispute resolution processes including appointment, timelines, and compensation standards for independent adjudicators;
    • Enforcement and penalties (fines, contract suspension, loss of CCBHC certification).
  • DHHS is not required to implement the section unless the Legislature appropriates sufficient funds to administer it (subsection in the H‑5 substitute).
  • Definitions explicitly include nonprofit/local government behavioral health authorities and tribal/IHS/urban Indian programs where applicable.

Who is affected

  • DHHS (rulemaking, waiver applications, program administration);
  • Community mental health service programs (CMHSPs), nonprofit and private mental health providers seeking CCBHC certification;
  • Tribal, Indian Health Service, and urban Indian behavioral health programs (explicitly included);
  • Prepaid inpatient health plans (conflict mitigation provisions);
  • Medicaid enrollees and other patients served by CCBHCs (individuals with mental health and substance use disorders), including uninsured individuals served by CCBHCs.

Fiscal and timeline implications

  • Michigan was participating in a federal CCBHC demonstration through Sept 30, 2027. FY 2024–25 DHHS appropriations for supplemental CCBHC costs total $525.9 million Gross ($128.4 million GF/GP), intended to support 33 CCBHCs (plus 3 additional locations) beginning Jan 1, 2025.
  • Estimated average additional cost per new CCBHC: ~$14.5 million Gross (~$3.5 million GF/GP).
  • If Michigan continues CCBHCs after the federal demonstration (at a lower federal reimbursement rate), HB 5372 would require continued state participation; estimated additional state cost under FY 2024–25 FMAP rates: about $90 million annually.
  • Implementation of the PPS depends on federal approvals and legislative appropriation of sufficient funds.

Procedural / Other notes

  • HB 5371, as passed by the House, is linked to HB 5372; neither bill takes effect unless both are enacted.
  • Key deadlines and administrative requirements depend on receiving CMS approvals for the payment model.

Compiled from official sources — confirm details with the bill’s official record.

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