Extend Excellence in Mental Health Act of 2016

To amend the Protecting Access to Medicare Act of 2014 (PAMA) to extend and expand the Medicaid community mental health services demonstration program. 1. Short title This Act may be cited as the Extend Excellence in Mental Health Act of 2016 2. Extension and expansion of Medicaid community mental health services demonstration program (a) In general Paragraph (3) of section 223(d) of the Protecting Access to Medicare Act of 2014 ( Public Law 113–93 42 U.S.C. 1396a (3) Number and length of demonstration programs (A) In general Except as provided in subparagraphs (B) and (C), not more than 8 States shall be selected for 2-year demonstration programs under this subsection. (B) Three-year extension A State selected to participate in the demonstration project under this subsection shall, upon the request of the State, be permitted to continue to participate in the demonstration project for an additional 3-year period, if the Secretary makes the determination specified in subparagraph (D) with respect to the State. The Secretary shall provide each such State with notice of that determination. (C) Expansion to additional States (i) In general The Secretary may expand the number of eligible States participating in the demonstration project, if, with respect to any such State, the Secretary makes the determination specified in subparagraph (D). The period of the participation of any such eligible State in the demonstration project shall end on December 31, 2022, regardless of the date on which the State begins participating in the demonstration project. (ii) Notification The Secretary shall provide each State that applies to be added to the demonstration project under this subsection with notice of the determination under subparagraph (D) and the standards used to make such determination. (D) Determination The determination specified in this subparagraph is that the Secretary determines that, in the case of a request under subparagraph (B) or an expansion of the demonstration project under subparagraph (C)— (i) the continued participation of a State in the demonstration project under this subsection or an expansion of the project to any additional State (as applicable) will measurably improve access to, and participation in, services described in subsection (a)(2)(D) by individuals eligible for medical assistance under the State Medicaid program; and (ii) any such State is in full compliance with the reporting requirements under paragraph (7) and any quality reporting requirements established by the Secretary. . (b) Clarification concerning coverage of clinical visits Section 223(b) of the Protecting Access to Medicare Act of 2014 is amended by adding at the end the following new paragraph: (3) Services included in clinical visits For purposes of implementing the guidance under paragraph (1), a clinical visit (A) behavioral health services provided on-site; (B) services authorized under subsection (a)(2)(D) furnished outside the clinic in a community setting, including a homeless shelter, penal facility, or other community setting (as identified by the Secretary); and (C) telehealth services. .

Summary: Extend Excellence in Mental Health Act of 2016 This bill amends the Protecting Access to Medicare Act of 2014 to extend and expand the Medicaid community mental health services demonstration program. Under current law, the program is limited to no more than eight states. The Centers for Medicare & Medicaid Services (CMS) shall extend an existing program and may expand the number of programs if, with respect to the requesting state, CMS determines that: (1) the state's participation in the program will measurably improve access to, and participation in, specified behavioral health services; and (2) the state is in full compliance with specified reporting requirements. The bill also specifies that, for purposes of implementing specified CMS guidance on demonstration program testing, a "clinical visit" includes on-site behavioral health services, certain community services, and telehealth services.