I 

117TH CONGRESS 

1ST SESSION H. R. 3450 

To amend title XIX of the Social Security Act to provide a higher Federal 

matching rate for increased expenditures under Medicaid for behavioral 

health services (including those related to mental health and substance 

use), and for other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

MAY 20, 2021 

Mr. TONKO (for himself, Mr. TRONE, and Mr. FITZPATRICK) 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 provide 

a higher Federal matching rate for increased expenditures under Medicaid for behavioral health services (including those related to mental health and substance 

use), 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 ‘‘Medicaid Bump Act’’. 


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1 SEC. 2. HIGHER FEDERAL MATCH FOR INCREASED EX2 PENDITURES UNDER MEDICAID FOR BEHAV3 IORAL HEALTH SERVICES. 

4 (a) IN GENERAL.—Section 1903 of the Social Secu5 rity Act (42 U.S.C. 1396b) is amended— 

6 (1) in subsection (a)(5)— 

7 (A) by striking ‘‘an amount equal’’ and in8 serting ‘‘(A) an amount equal’’; and 

9 (B) by adding at the end the following: 

10 ‘‘and 

11 ‘‘(B) subject to subsection (b)(6), an 

12 amount equal to 90 percent of the amount by 

13 which— 

14 ‘‘(i) the sum of the amounts expended 

15 during such quarter which are attributable 

16 to the offering, arranging, and furnishing 

17 (directly or on a contract basis) under the 

18 State plan (or under a waiver of the plan) 

19 of behavioral health services (including 

20 those related to mental health and sub21 stance use), exceeds 

22 ‘‘(ii) the sum of the amounts ex23 pended during the corresponding quarter 

24 in the 4-quarter period ending on March 

25 31, 2019, which are attributable to the of26 fering, arranging, and furnishing (directly 


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1 or on a contract basis) under the State 

2 plan (or under a waiver of the plan) of 

3 such services, plus’’; and 

4 (2) in subsection (b), by adding at the end the 

5 following new paragraph: 

6 ‘‘(6) ACCOUNTABILITY AND MAINTENANCE OF

7 EFFORT REQUIREMENTS FOR ADDITIONAL FEDERAL

8 FUNDING FOR INCREASED EXPENDITURES FOR BE9 HAVIORAL HEALTH SERVICES.—As conditions for re10 ceiving the funds the Secretary is otherwise obli11 gated to pay to a State under subsection (a)(5)(B), 

12 a State shall meet the following requirements: 

13 ‘‘(A) SUPPLEMENT, NOT SUPPLANT.—The 

14 State shall use the funds received under such 

15 subsection to supplement, not supplant, the 

16 level of State funds expended for the offering, 

17 arranging, and furnishing (directly or on a con18 tract basis) under the State plan (or under a 

19 waiver of the plan) of behavioral health services 

20 (including those related to mental health and 

21 substance use) through programs and activities 

22 in effect as of April 1, 2021. 

23 ‘‘(B) USE OF FUNDS FOR ACTIVITIES

24 THAT IMPROVE DELIVERY OF BEHAVIORAL

25 HEALTH SERVICES.—The State shall use the 


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1 funds received under such subsection for activi2 ties that increase the capacity, efficiency, and 

3 quality in the provision of behavioral health 

4 services (including those related to mental 

5 health and substance use) delivered by pro6 viders, including through increases in payment 

7 rates for providers of those services and the 

8 adoption of other measures that ensure a reduc9 tion in staff turnover.’’. 

10 (b) SUB-REGULATORY GUIDANCE.—Not later than 

11 180 days after the date of enactment of this Act, the Sec12 retary of Health and Human Services shall issue sub-regu13 latory guidance to States specifying the services that are 

14 behavioral health services for purposes of subparagraph 

15 (B) of section 1903(a)(5) of the Social Security Act (42 

16 U.S.C. 1396b(a)(5)), as added by subsection (a). 

17 (c) EFFECTIVE DATE.—The amendments made by 

18 this section shall apply with respect to calendar quarters 

19 beginning on or after January 1 of the year beginning 

20 after one year after the date of the enactment of this Act. 

21 SEC. 3. REPORT REGARDING BEHAVIORAL HEALTH SERV22 ICE. 

23 Not later than 1 year after the date of enactment 

24 of this Act, and annually thereafter, the Secretary of 

25 Health and Human Services shall submit to the ComVerDate Sep 11 2014 05:02 Jun 26, 2021 Jkt 019200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\H3450.IH H3450

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1 mittee on Energy and Commerce of the House of Rep2 resentatives and the Committee on Finance of the Senate 

3 a report regarding behavioral health services (including 

4 those related to mental health and substance use) provided 

5 under title XIX of the Social Security Act (42 U.S.C. 

6 1396 et seq.) in each State, specifying the payment rates 

7 for such services, the rationale for deriving such payment 

8 rates, and utilization of such services, as such data are 

9 available. 

Æ 


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