of providing for a full continuum of ambulatory be-
havioral health care services.
(B) DEFINITIONS.—
(i) WRAP AROUND MENTAL HEALTH
SERVICES
DEFINED.—The term ‘‘wrap
around mental health services’’ means
comprehensive outpatient mental health
services furnished to an individual pursu-
ant to an individualized treatment plan de-
veloped by a mental health professional, in
consultation with the family of the indi-
vidual (if available). Such services are fur-
nished to the individual through a com-
prehensive, multidisciplinary health and so-
cial services delivery system that provides
coordinated therapeutic interventions, in-
cluding medical services, psychotherapy
services, occupational therapy services, and
social work services.
(ii) LICENSED MENTAL HEALTH PRO-
FESSIONAL.—The term ‘‘mental health
professional’’ means any of the following
individuals who are licensed by the State in
which the individual furnishes services (as
that term is described in paragraphs (1),
(2)(M), and (2)(N) (as the case may be) of
section 1861(s) of the Social Security Act
(42 U.S.C. 1395x(s))) to design and exe-
cute treatment plans described in clause (i)
without the supervision of another health
care practitioner:
(I) A physician, as defined in sec-
tion 1861(r)(1) of such Act (42
U.S.C. 1395x(r)(1)).
(II) A clinical psychologist, as de-
fined by the Secretary pursuant to
section 1861(ii) of such Act (42
U.S.C. 1395x(ii)).
(III) A clinical social worker, as
defined in section 1861(hh) of such
Act (42 U.S.C. 1395x(hh)).
(2) SELECTION OF CENTERS.—For purposes of
implementing such project, the Secretary shall select
for participation in the project community mental
health centers that serve populations in three dif-
ferent States, one of which predominantly serves
rural populations.
(3) CAPITATED PAYMENT.—The Secretary shall
establish and make prospective monthly payments of
a capitation amount for individuals receiving wrap
around mental health services under this project.
(4) EVALUATION AND REPORT.—
(A) EVALUATION.—The Secretary shall
evaluate the project. Such evaluation shall in-
clude an examination of—
(i) the project’s effect on the health,
well-being, condition, and functional level
of beneficiaries receiving wrap around
mental health services;
(ii) any savings to the medicare pro-
gram by reason of capitated payments for
wrap around medical services consisting of
partial hospitalization services (as that
term is defined in section 1861(ff) of the
Social Security Act (42 U.S.C. 1395x(ff));
(iii) the impact of basing payment for
such services on a capitated basis; and
(iv) the project’s effect on utilization
of inpatient services (including inpatient
mental health services) and associated
costs.
(B) REPORT.—Not later than four years
after the date of the enactment of this Act, the
Secretary shall submit to Congress a report
containing a statement of the findings and con-
clusions of the Secretary pursuant to the eval-
uation conducted under subparagraph (A), to-
gether with any recommendations for legislation
the Secretary considers appropriate with respect
to—
(i) the provision of additional mental
health services by community mental
health centers under partial hospitalization
services; and
(ii) payment for such services on a
capitated basis.
(5) DURATION.—The project shall be conducted
for a three year period.
(6) FUNDING.—The Secretary shall provide for
the transfer from the Federal Hospital Insurance
Trust Fund, established under section 1817 of the
Social Security Act (42 U.S.C. 1395i), of such funds
as are necessary for the costs of carrying out the
demonstration project under this subsection.
SEC. 5. INFORMATION REQUIREMENTS.
(a) INFORMATION FROM GROUP HEALTH PLANS.—
Section 1862(b) of the Social Security Act (42 U.S.C.
1395y(b)) is amended by adding at the end the following:
‘‘(7) INFORMATION
FROM
GROUP
HEALTH
PLANS.—
‘‘(A) PROVISION
OF
INFORMATION
BY
GROUP HEALTH PLANS.—The administrator of
a group health plan subject to the requirements
of paragraph (1) shall provide to the Secretary
such of the information elements described in
subparagraph (C) as the Secretary specifies,
and in such manner and at such times as the
Secretary may specify (but not more frequently
than four times per year), with respect to each
individual covered under the plan who is enti-
tled to any benefits under this title.
‘‘(B) PROVISION OF INFORMATION BY EM-
PLOYERS AND EMPLOYEE ORGANIZATIONS.—An
employer (or employee organization) that main-
tains or participates in a group health plan sub-
ject to the requirements of paragraph (1) shall
provide to the administrator of the plan such of
the information elements required to be pro-
vided under subparagraph (A), and in such
manner and at such times as the Secretary may
specify, at a frequency consistent with that re-
quired under subparagraph (A) with respect to
each individual described in subparagraph (A)