I 

118TH CONGRESS 

2D SESSION H. R. 10419 

To amend title XVIII of the Social Security Act to establish a Medicare 

demonstration program relating to crisis response services. 

IN THE HOUSE OF REPRESENTATIVES 

DECEMBER 16, 2024 

Mr. CA ́RDENAS (for himself, Mr. VEASEY, Mr. SCHWEIKERT, and Mr. 

FITZPATRICK) introduced the following bill; which was referred to the 

Committee on Ways and Means, and in addition to the Committee on Energy and Commerce, for a period to be subsequently determined by the 

Speaker, in each case for consideration of such provisions as fall within 

the jurisdiction of the committee concerned 

A BILL 

To amend title XVIII of the Social Security Act to establish 

a Medicare demonstration program relating to crisis response services. 

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 ‘‘Crisis Care Access and 

5 Response Expansion for Behavioral Health Act of 2024’’ 

6 or the ‘‘CARE for Behavioral Health Act of 2024’’. 


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1 SEC. 2. ESTABLISHING A MEDICARE DEMONSTRATION PRO2 GRAM RELATING TO CRISIS RESPONSE SERV3 ICES. 

4 Part E of title XVIII of the Social Security Act (42 

5 U.S.C. 1395x et seq.) is amended by inserting after sec6 tion 1866G the following new section: 

7 ‘‘SEC. 1866H. CRISIS RESPONSE SERVICES DEMONSTRA8 TION PROGRAM. 

9 ‘‘(a) IN GENERAL.—Not later than January 1, 2026, 

10 the Secretary shall establish a crisis response services 

11 demonstration program (in this section referred to as the 

12 ‘demonstration program’) to determine whether payment 

13 for crisis response services furnished to applicable individ14 uals by participating providers results in— 

15 ‘‘(1) a reduction in emergency department vis16 its; 

17 ‘‘(2) increased access to crisis response services; 

18 ‘‘(3) a reduction in expenditures under this 

19 title; or 

20 ‘‘(4) improved behavioral health outcomes. 

21 ‘‘(b) PARTICIPATING PROVIDERS.— 

22 ‘‘(1) IN GENERAL.—Subject to paragraph (3), 

23 the Secretary shall designate an eligible provider as 

24 a participating provider for purposes of the dem25 onstration program if such eligible provider submits 

26 an application to the Secretary at such time and in 


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1 such manner as specified by the Secretary and dem2 onstrates that the provider meets the standards es3 tablished by the Secretary under paragraph (2). 

4 ‘‘(2) STANDARDS.—The Secretary, in coordina5 tion with the Assistant Secretary for Mental Health 

6 and Substance Use, shall specify standards that an 

7 eligible provider must meet in order to be designated 

8 as a participating provider under paragraph (1). 

9 Such standards shall include the following: 

10 ‘‘(A) Standards relating to the minimum 

11 set of crisis response services to be furnished by 

12 a participating provider under the demonstra13 tion program. 

14 ‘‘(B) Standards relating to access to such 

15 services, including a requirement that such pro16 vider be available to furnish such services 24 

17 hours per day, 7 days per week, and have a 

18 physician (which may include a psychiatrist), 

19 nurse practitioner, or physician assistant so 

20 available to furnish such services. 

21 ‘‘(C) Standards relating to the provision of 

22 such services, including— 

23 ‘‘(i) standards relating to the quali24 fications of individuals who may furnish 


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1 such services, in accordance with applicable 

2 State licensure requirements; 

3 ‘‘(ii) standards relating to collabora4 tion of such individuals with other entities 

5 (such as community first responders and 

6 community-based organizations) to ensure 

7 appropriate case management and adher8 ence to best practices; 

9 ‘‘(iii) standards relating to the receipt 

10 of individuals from appropriate providers 

11 of services, suppliers, and other entities 

12 (such as law enforcement entities, edu13 cational institutions, and community-based 

14 organizations); and 

15 ‘‘(iv) a requirement that such services 

16 may only be terminated once an individual 

17 is stabilized or transferred to receive care 

18 from another appropriate provider of serv19 ices, supplier, or entity. 

20 ‘‘(3) TERMINATION OF DESIGNATION.— 

21 ‘‘(A) IN GENERAL.—The Secretary shall 

22 terminate a designation of a participating pro23 vider under paragraph (1) if— 


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1 ‘‘(i) the Secretary determines that 

2 such provider no longer meets the stand3 ards specified under paragraph (2); or 

4 ‘‘(ii) such provider fails to meets such 

5 quality standards as the Secretary deter6 mines appropriate. 

7 ‘‘(B) PERMISSIVE TERMINATION.—The 

8 Secretary may terminate a designation of a par9 ticipating provider under paragraph (1) for 

10 such other reasons as determined appropriate 

11 by the Secretary. 

12 ‘‘(c) PAYMENT.— 

13 ‘‘(1) IN GENERAL.—Payment for crisis response 

14 services furnished by a participating provider under 

15 the demonstration program shall be equal to 100 

16 percent of the lesser of the amount charged by such 

17 provider or an amount determined under the pay18 ment basis established by the Secretary under para19 graph (2). 

20 ‘‘(2) PAYMENT BASIS.—The Secretary shall es21 tablish a single payment amount for crisis response 

22 services furnished to an applicable individual by a 

23 participating provider during a month. Such amount 

24 shall be equal to the average (as determined by the 

25 Secretary) costs incurred by eligible providers in furVerDate Sep 11 2014 00:40 Jan 22, 2025 Jkt 059200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\H10419.IH H10419

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1 nishing such services to an individual during a 

2 month. 

3 ‘‘(3) SOURCE OF PAYMENT.—Payment for crisis 

4 response services furnished by a participating pro5 vider under the demonstration program shall be 

6 made from the Federal Supplementary Medical In7 surance Trust Fund established under section 1841. 

8 ‘‘(d) EVALUATION AND MONITORING.—The Sec9 retary shall evaluate each participating provider under the 

10 demonstration program to assess whether the results de11 scribed in subsection (a) have been achieved. 

12 ‘‘(e) REPORT.—Not later than 3 years after the date 

13 of the enactment of this section, the Secretary shall con14 duct an independent evaluation of the demonstration pro15 gram and submit to Congress a report on such program. 

16 Such report shall include an analysis of the following: 

17 ‘‘(1) Whether such program has achieved re18 sults described in subsection (a). 

19 ‘‘(2) The quality of crisis response services fur20 nished under such program. 

21 ‘‘(3) Any reduction in jail incarceration attrib22 utable to such program. 

23 ‘‘(4) The number of individuals furnished serv24 ices under such program who were not voluntarily so 

25 furnished such services. 


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1 ‘‘(f) DEFINITIONS.—In this section: 

2 ‘‘(1) APPLICABLE INDIVIDUAL.—The term ‘ap3 plicable individual’ means an individual who— 

4 ‘‘(A) is entitled to benefits under part A 

5 and enrolled under part B; 

6 ‘‘(B) is not enrolled in a Medicare Advan7 tage plan under part C or a PACE program 

8 under section 1894; and 

9 ‘‘(C) meets such other criteria as deter10 mined appropriate by the Secretary. 

11 ‘‘(2) BEHAVIORAL HEALTH URGENT CARE FA12 CILITY.—The term ‘behavioral health urgent care fa13 cility’ means an ambulatory facility where individ14 uals experiencing a mental or behavioral health crisis 

15 may walk in without an appointment to receive crisis 

16 assessment services, crisis intervention services, 

17 medication, and connection to other appropriate 

18 services. 

19 ‘‘(3) CRISIS RECEIVING AND STABILIZATION FA20 CILITY.—The term ‘crisis receiving and stabilization 

21 facility’ means a subacute inpatient facility or other 

22 facility specified by the Secretary that provides 

23 short-term observation and stabilization services to 

24 individuals experiencing a mental or behavioral 

25 health crisis. 


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1 ‘‘(4) CRISIS RESPONSE SERVICES.—The term 

2 ‘crisis response services’ means mental or behavioral 

3 health services that are furnished to an individual 

4 experiencing a mental or behavioral health crisis 

5 to— 

6 ‘‘(A) provide screening and assessment for 

7 the individual’s mental health or substance use 

8 disorder crisis; 

9 ‘‘(B) support the de-escalation of the indi10 vidual’s mental health or substance use disorder 

11 crisis; 

12 ‘‘(C) facilitate or support subsequent refer13 ral to health, social, and other services, as de14 termined appropriate by the Secretary; or 

15 ‘‘(D) otherwise address the individual’s 

16 pressing behavioral health needs, as determined 

17 appropriate by the Secretary. 

18 ‘‘(5) ELIGIBLE PROVIDER.—The term ‘eligible 

19 provider’ means a provider of crisis response services 

20 that is a mobile crisis response team, a crisis receiv21 ing and stabilization facility, a behavioral health ur22 gent care facility, or such other provider of services 

23 or supplier determined appropriate by the Secretary. 

24 ‘‘(6) MOBILE CRISIS RESPONSE TEAM.—The 

25 term ‘mobile crisis response team’ means a team of 


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1 physicians or practitioners (as described in section 

2 1842(b)(18)(C)) that is available to furnish crisis re3 sponse services to an individual experiencing a men4 tal or behavioral health crisis in the individual’s 

5 home or at the individual’s workplace or another 

6 community-based location in a timely manner. 

7 ‘‘(g) FUNDING.—For purposes of administering and 

8 carrying out the demonstration program, other than for 

9 payments for services furnished under the program, in ad10 dition to funds otherwise appropriated, the Secretary shall 

11 provide for the transfer to the Center for Medicare & Med12 icaid Services Program Management Account from the 

13 Federal Hospital Insurance Trust Fund under section 

14 1817 and the Federal Supplementary Medical Insurance 

15 Trust Fund under section 1841 of this title (in propor16 tions determined appropriate by the Secretary) of such 

17 sums as the Secretary determines are necessary for such 

18 purposes. Amounts transferred under this subsection shall 

19 remain available until expended.’’. 

Æ 


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