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[Congressional Bills 118th Congress]
[From the U.S. Government Publishing Office]
[S. 3628 Introduced in Senate (IS)]

<DOC>

118th CONGRESS
  2d Session
                                S. 3628

  To amend title XVIII of the Social Security Act to improve mobility 
                   crisis under the Medicare program.

_______________________________________________________________________

                   IN THE SENATE OF THE UNITED STATES

                            January 18, 2024

Ms. Cortez Masto (for herself and Mr. Cornyn) 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 improve mobility 
                   crisis 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 ``Medicare Mobility Crisis Improvement 
Act''.

SEC. 2. PAYMENT FOR MOBILE CRISIS RESPONSE INTERVENTION SERVICES UNDER 
              PHYSICIAN FEE SCHEDULE.

    Section 1848(b) of the Social Security Act (42 U.S.C. 1395w-4(b)) 
is amended by adding at the end the following new paragraph:
            ``(13) Mobile crisis response team services.--
                    ``(A) In general.--Beginning January 1, 2025, the 
                Secretary shall, subject to the succeeding provisions 
                of this paragraph, make a single global payment (as 
                determined by the Secretary under subparagraph (C)) 
                under this section for mobile crisis response team 
                services (as defined in subparagraph (B)) furnished by 
                a physician (as defined in section 1861(r)(1)), 
                physician assistant or nurse practitioner (as defined 
                in section 1861(aa)(5)(A)), clinical nurse specialist 
                (as defined in section 1861(aa)(5)(B)), clinical social 
                worker (as defined in section 1861(hh)(1)), or clinical 
                psychologist (as defined by the Secretary for purposes 
                of section 1861(ii)).
                    ``(B) Definition of mobile crisis response team 
                services.--In this paragraph, the term `mobile crisis 
                response team services' means physicians' services that 
                are furnished outside of a hospital, other facility 
                setting, or physician office to an individual 
                experiencing a mental health or substance use disorder 
                crisis to--
                            ``(i) provide screening and assessment for 
                        the individual's mental health or substance use 
                        disorder crisis;
                            ``(ii) support the de-escalation of the 
                        individual's mental health or substance use 
                        disorder crisis;
                            ``(iii) facilitate or support subsequent 
                        referral to health, social, and other services, 
                        as determined appropriate by the Secretary; or
                            ``(iv) otherwise address the individual's 
                        pressing behavioral health needs, as determined 
                        appropriate by the Secretary.
                    ``(C) Determination of single global payment.--
                            ``(i) In general.--The Secretary shall 
                        determine an appropriate global payment for 
                        mobile crisis response team services under the 
                        fee schedule under this section to account for 
                        the work, practice expenses, and malpractice 
                        expenses involved in furnishing physicians' 
                        services that would typically be furnished to 
                        an individual experiencing a mental health or 
                        substance use disorder crisis to accomplish the 
                        objectives described in clauses (i) through 
                        (iv) of subparagraph (B) (as identified by the 
                        Secretary).
                            ``(ii) Relative values.--In determining 
                        work, practice expenses, and malpractice 
                        expenses under clause (i), the Secretary shall 
                        account for differences in work, practice 
                        expenses, and malpractice expenses between 
                        furnishing physicians' services identified in 
                        clause (i) in a physician office and the work, 
                        practice expenses, and malpractice expenses 
                        involved in furnishing such services at the 
                        site at which at individual is experiencing a 
                        mental or substance use disorder crisis, 
                        including potential practice expenses 
                        associated with transportation to such site.
                            ``(iii) Ensuring no duplicate payment.--The 
                        Secretary shall ensure that if a physician or 
                        practitioner receives payment for mobile crisis 
                        response team services under this paragraph, 
                        additional payment is not made under this 
                        section for physicians' services identified in 
                        clause (i) that are furnished to the same 
                        individual by the same physician or 
                        practitioner on the same day on which such 
                        mobile crisis response team services are 
                        furnished.
                    ``(D) Requirements for physicians and practitioners 
                receiving payment.--In order to receive payment for 
                mobile crisis response team services, a physician or 
                practitioner who submits a claim for payment for such 
                services must document, in a form and manner determined 
                appropriate by the Secretary, that the physician or 
                practitioner furnishing such services and any auxiliary 
                personnel (as defined in section 410.26(a)(1) of title 
                42, Code of Federal Regulations, or any successor 
                regulation) furnishing such services under the 
                supervision of the physician or practitioner--
                            ``(i) are trained in trauma-informed care, 
                        de-escalation strategies, and harm reduction;
                            ``(ii) are capable of coordinating with 
                        emergency response systems, crisis intervention 
                        hotlines, and hospitals furnishing crisis 
                        stabilization services (as defined in section 
                        1833(t)(23)); and
                            ``(iii) meet other criteria determined 
                        appropriate by the Secretary to ensure quality 
                        of care and program integrity.
                    ``(E) Additional clarification.--The Secretary 
                shall allow for auxiliary personnel (as defined in 
                section 410.26(a)(1) of title 42, Code of Federal 
                Regulations, or any successor regulation), including 
                peer support specialists (as defined in subsection 
                (i)(4)(B)), to furnish mobile crisis response team 
                services under the supervision of a physician or 
                practitioner billing for such services under this 
                section.''.
                                 <all>
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