I 

114TH CONGRESS 

2D SESSION H. R. 4569 

To amend the Protecting Access to Medicare Act of 2014 (PAMA) to extend 

and expand the Medicaid community mental health services demonstration program. 

IN THE HOUSE OF REPRESENTATIVES 

FEBRUARY 12, 2016 

Ms. MATSUI (for herself and Mr. LANCE) introduced the following bill; which 

was referred to the Committee on Energy and Commerce 

A BILL 

To amend the Protecting Access to Medicare Act of 2014 

(PAMA) to extend and expand the Medicaid community 

mental health services demonstration program. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Extend Excellence in 

5 Mental Health Act of 2016’’. 


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1 SEC. 2. EXTENSION AND EXPANSION OF MEDICAID COMMU2 NITY MENTAL HEALTH SERVICES DEM3 ONSTRATION PROGRAM. 

4 (a) IN GENERAL.—Paragraph (3) of section 223(d) 

5 of the Protecting Access to Medicare Act of 2014 (Public 

6 Law 113–93; 42 U.S.C. 1396a note) is amended to read 

7 as follows: 

8 ‘‘(3) NUMBER AND LENGTH OF DEMONSTRA9 TION PROGRAMS.— 

10 ‘‘(A) IN GENERAL.—Except as provided in 

11 subparagraphs (B) and (C), not more than 8 

12 States shall be selected for 2-year demonstra13 tion programs under this subsection. 

14 ‘‘(B) THREE-YEAR EXTENSION.—A State 

15 selected to participate in the demonstration 

16 project under this subsection shall, upon the re17 quest of the State, be permitted to continue to 

18 participate in the demonstration project for an 

19 additional 3-year period, if the Secretary makes 

20 the determination specified in subparagraph 

21 (D) with respect to the State. The Secretary 

22 shall provide each such State with notice of that 

23 determination. 

24 ‘‘(C) EXPANSION TO ADDITIONAL

25 STATES.— 


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1 ‘‘(i) IN GENERAL.—The Secretary 

2 may expand the number of eligible States 

3 participating in the demonstration project, 

4 if, with respect to any such State, the Sec5 retary makes the determination specified in 

6 subparagraph (D). The period of the par7 ticipation of any such eligible State in the 

8 demonstration project shall end on Decem9 ber 31, 2022, regardless of the date on 

10 which the State begins participating in the 

11 demonstration project. 

12 ‘‘(ii) NOTIFICATION.—The Secretary 

13 shall provide each State that applies to be 

14 added to the demonstration project under 

15 this subsection with notice of the deter16 mination under subparagraph (D) and the 

17 standards used to make such determina18 tion. 

19 ‘‘(D) DETERMINATION.—The determina20 tion specified in this subparagraph is that the 

21 Secretary determines that, in the case of a re22 quest under subparagraph (B) or an expansion 

23 of the demonstration project under subpara24 graph (C)— 


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1 ‘‘(i) the continued participation of a 

2 State in the demonstration project under 

3 this subsection or an expansion of the 

4 project to any additional State (as applica5 ble) will measurably improve access to, and 

6 participation in, services described in sub7 section (a)(2)(D) by individuals eligible for 

8 medical assistance under the State Med9 icaid program; and 

10 ‘‘(ii) any such State is in full compli11 ance with the reporting requirements 

12 under paragraph (7) and any quality re13 porting requirements established by the 

14 Secretary.’’. 

15 (b) CLARIFICATION CONCERNING COVERAGE OF

16 CLINICAL VISITS.—Section 223(b) of the Protecting Ac17 cess to Medicare Act of 2014 is amended by adding at 

18 the end the following new paragraph: 

19 ‘‘(3) SERVICES INCLUDED IN CLINICAL VIS20 ITS.—For purposes of implementing the guidance 

21 under paragraph (1), a ‘clinical visit’ shall include— 

22 ‘‘(A) behavioral health services provided 

23 on-site; 

24 ‘‘(B) services authorized under subsection 

25 (a)(2)(D) furnished outside the clinic in a comVerDate Sep 11 2014 00:38 Feb 17, 2016 Jkt 059200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\H4569.IH H4569

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1 munity setting, including a homeless shelter, 

2 penal facility, or other community setting (as 

3 identified by the Secretary); and 

4 ‘‘(C) telehealth services.’’. 

Æ 


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