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HR 8487

Ensuring Excellence in Mental Health Act

119th Congress Introduced by Mark Alford and 5 co-sponsors

The bill would expand and modify Medicare and Medicaid coverage and payments for certified community behavioral health clinics to improve access and funding.

Introduced in House
1
WeVote Research Nonpartisan
Bill Summary · HR 8487

Summary of HR 8487 (118th or 119th Congress? Note: Session 119)

Format: The bill aims to amend titles XVIII and XIX of the Social Security Act to adjust coverage and payment for certified community behavioral health clinic (CCBHC) services under Medicare and Medicaid, and for other purposes. The following summary reflects the information available from the bill’s title and action history.

1. Purpose and Intent

  • The bill seeks to modify federal coverage and reimbursement for certified community behavioral health clinic services under both Medicare (Title XVIII) and Medicaid (Title XIX).
  • The overarching goal is to expand, adjust, or otherwise modify access to and compensation for CCBHC services to better align with contemporary behavioral health needs and care delivery models.

2. Key Provisions and Changes (Provisional highlights based on title)

  • Medicare (Title XVIII):

    • Adjustments to coverage for services delivered by certified community behavioral health clinics.
    • Potential changes to payment methodologies, eligibility, and scope of services recognized as covered under Medicare for CCBHCs.
    • Possible updates to the certification or qualifying criteria for clinics to be reimbursed under Medicare.

  • Medicaid (Title XIX):

    • Adjustments to coverage for CCBHC services under the Medicaid program.
    • Revisions to payment rates, payer policies, and/or the structure of reimbursement to CCBHCs.
    • Potential alignment with federal rules on certified CCBHCs, including expansion of services, enrollment processes, and performance or quality requirements.

  • Other Provisions:

    • The bill could include additional provisions related to data reporting, program integrity, and coordination with other health services.
    • Potential timelines or phase-in periods for implementing changes to coverage and payment.

3. Who or What Would Be Affected

  • Certified Community Behavioral Health Clinics (CCBHCs):

    • Direct impact on reimbursement rates and coverage for Medicare and Medicaid patients.
    • Possible changes to clinic certification requirements and ongoing participation criteria.

  • Medicare Beneficiaries:

    • Access to CCBHC services and whether those services are covered or reimbursed under Medicare, including any changes in out-of-pocket cost considerations.

  • Medicaid Beneficiaries:

    • Access to CCBHC services under state Medicaid programs, with potential changes in service scope and funding mechanisms.

  • State Medicaid Agencies and Managed Care Plans:

    • Implementation of any new payment structures or coverage requirements for CCBHCs, including administrative changes and reporting.

4. Procedural and Timeline Aspects

  • Introduction and Referral:

    • Introduced in the House and referred on 2026-04-23.
    • Referred to the Committee on Energy and Commerce and, in addition, to the Committee on Ways and Means for consideration of provisions within their jurisdiction.

  • Sponsorship:

    • Primary sponsors and co-sponsors include:
    • Paul Tonko (co-sponsor)
    • August Pfluger (co-sponsor)
    • Doris Matsui (co-sponsor)
    • Angie Craig (co-sponsor)
    • Brian Fitzpatrick (co-sponsor)
    • Mark Alford (co-sponsor)

  • Legislative Path:

    • As with many health care reform bills, passage would require committee markup, floor consideration, and potential reconciliation if there is a Senate counterpart or differing bill.
    • Any final enactment would require signature by the President.

Notes

  • The bill’s text would provide precise details on:
    • Specific changes to payment rates (e.g., prospective payment systems, per-visit payments, or case-matching standards).
    • Eligibility criteria for clinics to be certified CCBHCs.
    • Definitions of “certified community behavioral health clinic” and the exact services covered.
    • Phase-in periods, funding authorizations, and any sunset or extension provisions.

For readers seeking a deeper understanding, reviewing the full bill text and subsequent committee reports will provide exact figures, service definitions, and implementation timelines.

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

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