I 

118TH CONGRESS 

1ST SESSION H. R. 5819 

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

behavioral health integration under the Medicare program. 

IN THE HOUSE OF REPRESENTATIVES 

SEPTEMBER 28, 2023 

Mrs. STEEL (for herself, Mr. KILDEE, Mrs. FLETCHER, Mr. BILIRAKIS, Mr. 

PFLUGER, Ms. LEE of Nevada, and Mr. MOLINARO) introduced the following bill; which was referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, 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 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 Act’’ or the ‘‘COMPLETE Care Act’’. 


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1 SEC. 2. INCENTIVES FOR BEHAVIORAL HEALTH INTEGRA2 TION. 

3 (a) INCENTIVES.— 

4 (1) IN GENERAL.—Section 1848(b) of the So5 cial Security Act (42 U.S.C. 1395w–4(b)) is amend6 ed by adding at the end the following new para7 graph: 

8 ‘‘(13) INCENTIVES FOR BEHAVIORAL HEALTH

9 INTEGRATION.— 

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

11 in subparagraph (B) that are furnished during 

12 2025, 2026, or 2027, instead of the payment 

13 amount that would otherwise be determined 

14 under this section for such year, the payment 

15 amount shall be equal to the applicable percent 

16 (as defined in subparagraph (C)) of such pay17 ment amount for such year. 

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

19 described in this subparagraph are services 

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

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

22 (and any successor or similar codes as deter23 mined appropriate by the Secretary). 

24 ‘‘(C) APPLICABLE PERCENT.—In this 

25 paragraph, the term ‘applicable percent’ means, 


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1 with respect to a service described in subpara2 graph (A), the following: 

3 ‘‘(i) For services furnished during 

4 2025, 175 percent. 

5 ‘‘(ii) For services furnished during 

6 2026, 150 percent. 

7 ‘‘(iii) For services furnished during 

8 2027, 125 percent.’’. 

9 (2) WAIVER OF BUDGET NEUTRALITY.—Section 

10 1848(c)(2)(B)(iv) of such Act (42 U.S.C. 1395w– 

11 4(c)(2)(B)(iv)) is amended— 

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

13 the end; 

14 (B) in subclause (VI), by striking the pe15 riod at the end and inserting ‘‘; and’’; and 

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

17 subclause: 

18 ‘‘(VII) the increase in payment 

19 amounts as a result of the application 

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

21 taken into account in applying clause 

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

23 (b) QUALITY MEASUREMENT.— 

24 (1) IN GENERAL.—Section 1833(z) of the So25 cial Security Act (42 U.S.C. 1395l(z)) is amended— 


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1 (A) by redesignating paragraph (4) as 

2 paragraph (5); and 

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

4 following new paragraph: 

5 ‘‘(4) QUALITY MEASUREMENT RELATING TO

6 BEHAVIORAL HEALTH INTEGRATION.— 

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

8 establish quality measurement reporting re9 quirements for applicable physicians and practi10 tioners (as defined in subparagraph (B)) with 

11 respect to the extent to which clinician practices 

12 are integrating behavioral health services and 

13 primary care services, in accordance with the 

14 succeeding provisions of this paragraph. 

15 ‘‘(B) APPLICABLE PHYSICIANS AND PRAC16 TITIONERS.—For purposes of this paragraph, 

17 the term ‘applicable physician or practitioner’ 

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

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

20 who is participating in an eligible alternative 

21 payment entity for which the associated alter22 native payment model involves the delivery of 

23 primary care services to beneficiaries who may 

24 have the need for mental health or substance 


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1 use disorder services, as determined by the Sec2 retary. 

3 ‘‘(C) QUALITY REPORTING BY SELECTED

4 PHYSICIANS AND PRACTITIONERS.—With re5 spect to each year beginning on or after the 

6 date that is one year after one or more meas7 ures are first specified under subparagraph (D), 

8 an applicable physician or practitioner shall 

9 submit to the Secretary data on quality meas10 ures specified under such subparagraph. Such 

11 data shall be submitted in a form and manner, 

12 and at a time, specified by the Secretary for 

13 purposes of this subparagraph. 

14 ‘‘(D) QUALITY MEASURES.— 

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

16 (ii), any measure specified by the Secretary 

17 under this subparagraph must have been 

18 endorsed by the entity with a contract 

19 under section 1890(a). 

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

21 specified area or medical topic determined 

22 appropriate by the Secretary for which a 

23 feasible and practical measure has not 

24 been endorsed by the entity with a contract 

25 under section 1890(a), the Secretary may 


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1 specify a measure that is not so endorsed 

2 as long as due consideration is given to 

3 measures that have been endorsed or 

4 adopted by a consensus organization iden5 tified by the Secretary. 

6 ‘‘(E) IMPLEMENTATION.—The Secretary 

7 may use quality measures developed pursuant 

8 to this paragraph in— 

9 ‘‘(i) the shared savings program under 

10 section 1899; and 

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

12 the Accountable Care Organization Real13 izing Equity, Access, and Community 

14 Health (ACO REACH) Model, and any 

15 other alternative payment model (as de16 fined in paragraph (3)(C)) as determined 

17 appropriate by the Secretary.’’. 

18 (2) CONFORMING AMENDMENT RELATING TO

19 CONVENING MULTI-STAKEHOLDER GROUPS.—Section 

20 1890(b)(7)(B)(i)(I) of the Social Security Act (42 

21 U.S.C. 1395aaa(b)(7)(B)(i)(I)) is amended by in22 serting ‘‘1833(z)(4),’’ after ‘‘1833(t)(17),’’. 

23 (c) TECHNICAL ASSISTANCE FOR THE ADOPTION OF

24 BEHAVIORAL HEALTH INTEGRATION.— 


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

2 2025, the Secretary of Health and Human Services 

3 shall enter into contracts or agreements with appro4 priate entities to offer technical assistance to pri5 mary care practices that are seeking to adopt behav6 ioral health integration models in such practices. 

7 (2) BEHAVIORAL HEALTH INTEGRATION MOD8 ELS.—For purposes of paragraph (1), behavioral 

9 health integration models include the Collaborative 

10 Care Model (with services identified as of January 

11 1, 2023, by HCPCS codes 99492, 99493, 99494, 

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

13 Care Behavioral Health model (with services identi14 fied as of January 1, 2023, by HCPCS code 99484 

15 (and any successor code)), and other models identi16 fied by the Secretary. 

17 (3) FUNDING.—In addition to amounts other18 wise available, there is appropriated to the Secretary 

19 of Health and Human Services for each of fiscal 

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

21 Treasury not otherwise appropriated, such sums as 

22 are necessary, to remain available until expended, 

23 for purposes of carrying out this subsection. 

Æ 


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