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[Congressional Bills 118th Congress]
[From the U.S. Government Publishing Office]
[S. 3498 Introduced in Senate (IS)]

<DOC>

118th CONGRESS
  1st Session
                                S. 3498

To amend title XVIII of the Social Security Act to provide for coverage 
          of peer support services under the Medicare program.

_______________________________________________________________________

                   IN THE SENATE OF THE UNITED STATES

                           December 13, 2023

Ms. Cortez Masto (for herself and Mr. Cassidy) 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 for coverage 
          of peer support services under the Medicare program.

    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 ``Promoting Effective and Empowering 
Recovery Services in Medicare Act of 2023'' or the ``PEERS Act of 
2023''.

SEC. 2. COVERAGE OF PEER SUPPORT SERVICES UNDER THE MEDICARE PROGRAM.

    (a) Coverage.--Section 1861 of the Social Security Act (42 U.S.C. 
1395x) is amended--
            (1) in subsection (s)(2)--
                    (A) in subparagraph (JJ), by inserting ``and'' 
                after the semicolon at the end; and
                    (B) by adding at the end the following new 
                subparagraph:
            ``(KK) peer support services (as defined in subsection 
        (nnn)) furnished on or after January 1, 2025;''; and
            (2) by adding at the end the following new subsection:
    ``(nnn) Peer Support Services.--
            ``(1) Peer support services.--The term `peer support 
        services' means emotional, informational, instrumental, and 
        affiliational support services--
                    ``(A) furnished--
                            ``(i) by a Federally qualified health 
                        center, a rural health clinic, a community 
                        mental health center, or a certified community 
                        behavioral health clinic (as described in 
                        section 223 of the Protecting Access to 
                        Medicare Act of 2014), using a peer support 
                        specialist; and
                            ``(ii) to an individual who has been 
                        diagnosed with--
                                    ``(I) a mental disorder; or
                                    ``(II) a substance use disorder; 
                                and
                    ``(B) that are designed to assist such individual 
                in achieving recovery, integration in the community, 
                self-empowerment, and self-determination (as specified 
                by the Secretary).
            ``(2) Peer support specialist.--The term `peer support 
        specialist' means an individual who--
                    ``(A) is recovering from a mental health or 
                substance use condition; and
                    ``(B) is certified as qualified to furnish peer 
                support services under a certification process 
                consistent with the National Practice Guidelines for 
                Peer Supporters and inclusive of the Substance Abuse 
                and Mental Health Services Administration Core 
                Competencies for Peer Workers in Behavioral Health 
                Settings (as established by the State in which such 
                individual furnishes such services or under such 
                certification process determined appropriate by the 
                Secretary of Health and Human Services.''.
    (b) Payment.--
            (1) Community mental health centers and certified community 
        behavioral health clinics.--Section 1833(a)(1) of the Social 
        Security Act (42 U.S.C. 1395l(a)(1)) is amended--
                    (A) by striking ``and'' before ``(HH)''; and
                    (B) by inserting before the semicolon: ``, and (II) 
                with respect to peer support services (as defined in 
                section 1861(nnn)) furnished by a community mental 
                health center or a certified community behavioral 
                health clinic, the amount paid shall be an amount equal 
                to 80 percent of the lesser of the actual charge for 
                the services or the amount determined by a fee schedule 
                established by the Secretary for the purposes of this 
                subparagraph''.
            (2) Inclusion as rhc and fqhc services.--Section 
        1861(aa)(1)(B) of the Social Security Act (42 U.S.C. 
        1395x(aa)(1)(B)) is amended--
                    (A) by striking ``or by a mental'' and inserting 
                ``by a mental''; and
                    (B) by inserting ``or when using a peer support 
                specialist,'' after ``subsection (ll)(4)),''.
    (c) Exclusion Modification.--Section 1862(a)(1) of the Social 
Security Act (42 U.S.C. 1395y(a)(1)) is amended--
            (1) in subparagraph (O), by striking ``and'' at the end;
            (2) in subparagraph (P), by striking the semicolon at the 
        end and inserting ``, and''; and
            (3) by adding at the end the following new subparagraph:
            ``(Q) in the case of peer support services (as defined in 
        section 1861(nnn)), which are not furnished by a rural health 
        clinic, a Federally qualified health center, a community mental 
        health center, or a certified community behavioral health 
        clinic;''.
                                 <all>
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