II 

118TH CONGRESS 

1ST SESSION S. 1378 

To amend title XVIII of the Social Security Act to provide incentives for 

behavioral health integration under the Medicare program. 

IN THE SENATE OF THE UNITED STATES 

APRIL 27, 2023 

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 provide 

incentives for behavioral health integration under the 

Medicare 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 ‘‘Connecting Our Med5 ical Providers with Links to Expand Tailored and Effec6 tive Care’’ or the ‘‘COMPLETE Care Act’’. 

7 SEC. 2. INCENTIVES FOR BEHAVIORAL HEALTH INTEGRA8 TION. 

9 (a) INCENTIVES.— 


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1 (1) IN GENERAL.—Section 1848(b) of the So2 cial Security Act (42 U.S.C. 1395w–4(b)) is amend3 ed by adding at the end the following new para4 graph: 

5 ‘‘(13) INCENTIVES FOR BEHAVIORAL HEALTH

6 INTEGRATION.— 

7 ‘‘(A) IN GENERAL.—For services described 

8 in subparagraph (B) that are furnished during 

9 2025, 2026, or 2027, instead of the payment 

10 amount that would otherwise be determined 

11 under this section for such year, the payment 

12 amount shall be equal to the applicable percent 

13 (as defined in subparagraph (C)) of such pay14 ment amount for such year. 

15 ‘‘(B) SERVICES DESCRIBED.—The services 

16 described in this subparagraph are services 

17 identified, as of January 1, 2023, by HCPCS 

18 codes 99484, 99492, 99493, 99494, and G2214 

19 (and any successor or similar codes as deter20 mined appropriate by the Secretary). 

21 ‘‘(C) APPLICABLE PERCENT.—In this 

22 paragraph, the term ‘applicable percent’ means, 

23 with respect to a service described in subpara24 graph (A), the following: 


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1 ‘‘(i) For services furnished during 

2 2025 , 175 percent. 

3 ‘‘(ii) For services furnished during 

4 2026, 150 percent. 

5 ‘‘(iii) For services furnished during 

6 2027, 125 percent.’’. 

7 (2) WAIVER OF BUDGET NEUTRALITY.—Section 

8 1848(c)(2)(B)(iv) of such Act (42 U.S.C. 1395w– 

9 4(c)(2)(B)(iv)) is amended— 

10 (A) in subclause (V), by striking ‘‘and’’ at 

11 the end; 

12 (B) in subclause (VI), by striking the pe13 riod at the end and inserting ‘‘; and’’; and 

14 (C) by adding at the end the following new 

15 subclause: 

16 ‘‘(VII) the increase in payment 

17 amounts as a result of the application 

18 of subsection (b)(13) shall not be 

19 taken into account in applying clause 

20 (ii)(II) for 2025, 2026, or 2027.’’. 

21 (b) QUALITY MEASUREMENT.— 

22 (1) IN GENERAL.—Section 1833(z) of the So23 cial Security Act (42 U.S.C. 1395l(z)) is amended— 

24 (A) by redesignating paragraph (4) as 

25 paragraph (5); and 


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1 (B) by inserting after paragraph (3) the 

2 following new paragraph: 

3 ‘‘(4) QUALITY MEASUREMENT RELATING TO

4 BEHAVIORAL HEALTH INTEGRATION.— 

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

6 establish quality measurement reporting re7 quirements for applicable physicians and practi8 tioners (as defined in subparagraph (B)) with 

9 respect to the extent to which clinician practices 

10 are integrating behavioral health services and 

11 primary care services, in accordance with the 

12 succeeding provisions of this paragraph. 

13 ‘‘(B) APPLICABLE PHYSICIANS AND PRAC14 TITIONERS.—For purposes of this paragraph, 

15 the term ‘applicable physician or practitioner’ 

16 means, with respect to a year, a physician or a 

17 practitioner described in section 1842(b)(18)(C) 

18 who is participating in an eligible alternative 

19 payment entity for which the associated alter20 native payment model involves the delivery of 

21 primary care services to beneficiaries who may 

22 have the need for mental health or substance 

23 use disorder services, as determined by the Sec24 retary. 


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1 ‘‘(C) QUALITY REPORTING BY SELECTED

2 PHYSICIANS AND PRACTITIONERS.—With re3 spect to each year beginning on or after the 

4 date that is one year after one or more meas5 ures are first specified under subparagraph (D), 

6 an applicable physician or practitioner shall 

7 submit to the Secretary data on quality meas8 ures specified under such subparagraph. Such 

9 data shall be submitted in a form and manner, 

10 and at a time, specified by the Secretary for 

11 purposes of this subparagraph. 

12 ‘‘(D) QUALITY MEASURES.— 

13 ‘‘(i) IN GENERAL.—Subject to clause 

14 (ii), any measure specified by the Secretary 

15 under this subparagraph must have been 

16 endorsed by the entity with a contract 

17 under section 1890(a). 

18 ‘‘(ii) EXCEPTION.—In the case of a 

19 specified area or medical topic determined 

20 appropriate by the Secretary for which a 

21 feasible and practical measure has not 

22 been endorsed by the entity with a contract 

23 under section 1890(a), the Secretary may 

24 specify a measure that is not so endorsed 

25 as long as due consideration is given to 


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1 measures that have been endorsed or 

2 adopted by a consensus organization iden3 tified by the Secretary. 

4 ‘‘(E) IMPLEMENTATION.—The Secretary 

5 may use quality measures developed pursuant 

6 to this paragraph in— 

7 ‘‘(i) the shared savings program under 

8 section 1899; and 

9 ‘‘(ii) the Primary Care First Model, 

10 the Accountable Care Organization Real11 izing Equity, Access, and Community 

12 Health (ACO REACH) Model, and any 

13 other alternative payment model (as de14 fined in paragraph (3)(C)) as determined 

15 appropriate by the Secretary.’’. 

16 (2) CONFORMING AMENDMENT RELATING TO

17 CONVENING MULTI-STAKEHOLDER GROUPS.—Section 

18 1890(b)(7)(B)(i)(I) of the Social Security Act (42 

19 U.S.C. 1395aaa(b)(7)(B)(i)(I)) is amended by in20 serting ‘‘1833(z)(4),’’ after ‘‘1833(t)(17),’’. 

21 (c) TECHNICAL ASSISTANCE FOR THE ADOPTION OF

22 BEHAVIORAL HEALTH INTEGRATION.— 

23 (1) IN GENERAL.—Not later than January 1, 

24 2025, the Secretary of Health and Human Services 

25 shall enter into contracts or agreements with approVerDate Sep 11 2014 03:38 May 06, 2023 Jkt 039200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\S1378.IS S1378

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1 priate entities to offer technical assistance to pri2 mary care practices that are seeking to adopt behav3 ioral health integration models in such practices. 

4 (2) BEHAVIORAL HEALTH INTEGRATION MOD5 ELS.—For purposes of paragraph (1), behavioral 

6 health integration models include the Collaborative 

7 Care Model (with services identified as of January 

8 1, 2023, by HCPCS codes 99492, 99493, 99494, 

9 and G2214 (and any successor codes)), the Primary 

10 Care Behavioral Health model (with services identi11 fied as of January 1, 2023, by HCPCS code 99484 

12 (and any successor code)), and other models identi13 fied by the Secretary. 

14 (3) FUNDING.—In addition to amounts other15 wise available, there is appropriated to the Secretary 

16 of Health and Human Services for each of fiscal 

17 years 2024 through 2027, out of any money in the 

18 Treasury not otherwise appropriated, such sums as 

19 are necessary, to remain available until expended, 

20 for purposes of carrying out this subsection. 

Æ 


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