SEC. 2. EXTENSION AND EXPANSION OF MEDICAID COMMU-
NITY 
MENTAL 
HEALTH 
SERVICES 
DEM-
ONSTRATION 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 note) is amended to read 
as follows: 
‘‘(3) NUMBER AND LENGTH OF DEMONSTRA-
TION PROGRAMS.— 
‘‘(A) IN GENERAL.—Except as provided in 
subparagraphs (B) and (C), not more than 8 
States shall be selected for 2-year demonstra-
tion programs under this subsection. 
‘‘(B) THREE-YEAR EXTENSION.—A State 
selected to participate in the demonstration 
project under this subsection shall, upon the re-
quest 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.— 
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‘‘(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 Sec-
retary makes the determination specified in 
subparagraph (D). The period of the par-
ticipation of any such eligible State in the 
demonstration project shall end on Decem-
ber 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 deter-
mination under subparagraph (D) and the 
standards used to make such determina-
tion. 
‘‘(D) DETERMINATION.—The determina-
tion specified in this subparagraph is that the 
Secretary determines that, in the case of a re-
quest under subparagraph (B) or an expansion 
of the demonstration project under subpara-
graph (C)— 
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‘‘(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 applica-
ble) will measurably improve access to, and 
participation in, services described in sub-
section (a)(2)(D) by individuals eligible for 
medical assistance under the State Med-
icaid program; and 
‘‘(ii) any such State is in full compli-
ance with the reporting requirements 
under paragraph (7) and any quality re-
porting requirements established by the 
Secretary.’’. 
(b) CLARIFICATION
CONCERNING
COVERAGE
OF 
CLINICAL VISITS.—Section 223(b) of the Protecting Ac-
cess to Medicare Act of 2014 is amended by adding at 
the end the following new paragraph: 
‘‘(3) SERVICES
INCLUDED
IN
CLINICAL
VIS-
ITS.—For purposes of implementing the guidance 
under paragraph (1), a ‘clinical visit’ shall include— 
‘‘(A) behavioral health services provided 
on-site; 
‘‘(B) services authorized under subsection 
(a)(2)(D) furnished outside the clinic in a com-
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munity setting, including a homeless shelter, 
penal facility, or other community setting (as 
identified by the Secretary); and 
‘‘(C) telehealth services.’’. 
Æ 
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