I 

117TH CONGRESS 

1ST SESSION H. R. 2611 

To amend title XIX of the Social Security Act to remove the exclusion 

from medical assistance under the Medicaid Program of items and services for patients in an institution for mental diseases, and for other 

purposes. 

IN THE HOUSE OF REPRESENTATIVES 

APRIL 16, 2021 

Mrs. NAPOLITANO introduced the following bill; which was referred to the 

Committee on Energy and Commerce 

A BILL 

To amend title XIX of the Social Security Act to remove 

the exclusion from medical assistance under the Medicaid 

Program of items and services for patients in an institution for mental diseases, and for other purposes. 

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 ‘‘Increasing Behavioral 

5 Health Treatment Act’’. 


pbinns on DSKJLVW7X2PROD with BILLS
2 

•HR 2611 IH

1 SEC. 2. REMOVAL OF MEDICAID EXCLUSION FROM MED2 ICAL ASSISTANCE OF ITEMS AND SERVICES 

3 FURNISHED TO PATIENTS IN AN INSTITU4 TION FOR MENTAL DISEASES IF STATE SUB5 MITS PLAN FOR PROVIDING APPROPRIATE 

6 OUTPATIENT CARE TO SUCH PATIENTS. 

7 (a) REMOVAL OF EXCLUSION.— 

8 (1) IN GENERAL.—The first sentence of section 

9 1905(a) of the Social Security Act (42 U.S.C. 

10 1396d(a)) is amended, in the matter following para11 graph (30)— 

12 (A) by striking ‘‘such term does not in13 clude—’’ and all that follows through ‘‘(A) any’’ 

14 and inserting ‘‘such term does not include any’’; 

15 (B) by striking ‘‘; or’’ and inserting a pe16 riod; and 

17 (C) by striking subparagraph (B). 

18 (2) CONFORMING AMENDMENTS TO PERMIT

19 MEDICAL ASSISTANCE FOR IMD PATIENTS UNDER 65

20 YEARS OF AGE.—The following provisions of such 

21 Act are each amended by striking ‘‘65 years of age 

22 or older’’ and ‘‘65 years of age or over’’ each place 

23 it appears: 

24 (A) Paragraphs (20) and (21) of section 

25 1902(a) (42 U.S.C. 1396a(a)). 


pbinns on DSKJLVW7X2PROD with BILLS
3 

•HR 2611 IH

1 (B) Section 1905(a)(14) (42 U.S.C. 

2 1396d(a)(14)). 

3 (C) Section 1919(e)(7)(B)(i)(I) (42 U.S.C. 

4 1396r(e)(7)(B)(i)(I)). 

5 (b) REPORTING AND PLAN REQUIREMENT.—Section 

6 1902(a)(20) of the Social Security Act (42 U.S.C. 

7 1396a(a)(20)) is amended— 

8 (1) in subparagraph (B), by striking at the end 

9 ‘‘and’’; 

10 (2) by adding at the end the following new sub11 paragraphs: 

12 ‘‘(D) provide for a plan to achieve (and for 

13 the annual submission to the Secretary of ac14 tions taken by the State, and progress with re15 spect to such actions, to achieve)— 

16 ‘‘(i) increased access to outpatient and 

17 community-based behavioral health care, 

18 with respect to individuals furnished serv19 ices in an institution for mental diseases, 

20 especially for individuals transitioning from 

21 such an institution; 

22 ‘‘(ii) increased availability of services 

23 made available through crisis call centers, 

24 mobile crisis units, coordinated community 

25 crisis response that involves law enforceVerDate Sep 11 2014 00:12 Jun 09, 2021 Jkt 019200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\H2611.IH H2611

pbinns on DSKJLVW7X2PROD with BILLS
4 

•HR 2611 IH

1 ment and other first responders, observa2 tion or assessment centers, and on-going 

3 community-based services (such as inten4 sive outpatient services, assertive commu5 nity treatment, and services in integrated 

6 care settings such as the Certified Commu7 nity Behavioral Health Clinic model) (such 

8 services referred to as crisis stabilization 

9 services) for individuals experiencing a se10 rious mental illness (as such term is de11 fined for purposes of title V of the Public 

12 Health Service Act), serious emotional dis13 turbance, or substance use disorder crisis; 

14 ‘‘(iii) improved data sharing and co15 ordination between physical health, mental 

16 health, and addiction treatment providers 

17 (including hospitals and community-based 

18 behavioral health facilities) and first re19 sponders to improve health outcomes for 

20 individuals furnished services in an institu21 tion for mental diseases, who are experi22 encing a serious mental illness (as so de23 fined), serious emotional disturbance, or 

24 substance use disorder crisis; 

25 ‘‘(E) provide for the demonstration of— 


pbinns on DSKJLVW7X2PROD with BILLS
5 

•HR 2611 IH

1 ‘‘(i) State policies to ensure individ2 uals receiving medical assistance under the 

3 State plan who receive care in psychiatric 

4 hospitals and residential treatment settings 

5 are consistently screened for co-morbid 

6 physical health conditions and substance 

7 use disorders prior to or upon admission, 

8 and that participating facilities have the 

9 capacity to address co-morbid physical 

10 health conditions during stays in such psy11 chiatric hospitals and residential treatment 

12 settings either through on-site medical 

13 services or external referrals and care co14 ordination; 

15 ‘‘(ii) established strategies of the 

16 State for identifying and engaging individ17 uals, particularly adolescents and young 

18 adults, experiencing a serious mental ill19 ness (as such term is defined for purposes 

20 of title V of the Public Health Service 

21 Act), serious emotional disturbance, or 

22 substance use disorder crisis; and 

23 ‘‘(iii) established utilization review 

24 policies of the State Medicaid agency or 

25 Medicaid managed care organizations, as 


pbinns on DSKJLVW7X2PROD with BILLS
6 

•HR 2611 IH

1 applicable, to ensure individuals receiving 

2 medical assistance under the State plan re3 ceive treatment at clinically appropriate 

4 levels of care and services are generally de5 livered in the least restrictive environment; 

6 and 

7 ‘‘(F) reporting to the Secretary (in a form 

8 and manner specified by the Secretary) of, with 

9 respect to each year beginning on or after the 

10 date of the enactment of this subparagraph— 

11 ‘‘(i) in the aggregate and by facility 

12 type, costs and utilization for institutions 

13 for mental diseases and inpatient psy14 chiatric hospitals that are not such institu15 tions; 

16 ‘‘(ii) the number of individuals experi17 encing a serious mental illness (as such 

18 term is defined for purposes of title V of 

19 the Public Health Service Act), serious 

20 emotional disturbance, or substance use 

21 disorder crisis who received medical assist22 ance under the State plan during the year; 

23 ‘‘(iii) the length of the stay of each 

24 such individual in an institution for mental 

25 disease; and 


pbinns on DSKJLVW7X2PROD with BILLS
7 

•HR 2611 IH

1 ‘‘(iv) the type of outpatient treatment, 

2 including medication assisted treatment, 

3 each such individual received after being 

4 discharged from such institution;’’. 

5 (c) EFFECTIVE DATE.— 

6 (1) IN GENERAL.—Subject to paragraph (2), 

7 the amendments made by this section shall take ef8 fect on the date of the enactment of this Act and 

9 shall apply to State plans beginning on such date. 

10 (2) EXCEPTION IF STATE LEGISLATION RE11 QUIRED.—In the case of a State plan for medical as12 sistance under title XIX of the Social Security Act 

13 which the Secretary of Health and Human Services 

14 determines requires State legislation (other than leg15 islation appropriating funds) in order for the plan to 

16 meet the additional requirement imposed by the 

17 amendments made by this section, the State plan 

18 shall not be regarded as failing to comply with the 

19 requirements of such title solely on the basis of its 

20 failure to meet this additional requirement before 

21 the first day of the first calendar quarter beginning 

22 after the close of the first regular session of the 

23 State legislature that begins after the date of the en24 actment of this Act. For purposes of the previous 

25 sentence, in the case of a State that has a 2-year 


pbinns on DSKJLVW7X2PROD with BILLS
8 

•HR 2611 IH

1 legislative session, each year of such session shall be 

2 deemed to be a separate regular session of the State 

3 legislature. 

Æ 


pbinns on DSKJLVW7X2PROD with BILLS