I 
119TH CONGRESS 
1ST SESSION H. R. 4745 
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 
JULY 23, 2025 
Mr. TONKO (for himself 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 expendi-
tures under Medicaid for behavioral health services (in-
cluding those related to mental health and substance 
use), and for other purposes. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Medicaid Bump Act’’. 
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SEC. 2. HIGHER FEDERAL MATCH FOR INCREASED EX-
PENDITURES UNDER MEDICAID FOR BEHAV-
IORAL HEALTH SERVICES. 
(a) IN GENERAL.—Section 1903 of the Social Secu-
rity Act (42 U.S.C. 1396b) is amended— 
(1) in subsection (a)(5)— 
(A) by striking ‘‘an amount equal’’ and in-
serting ‘‘(A) an amount equal’’; and 
(B) by adding at the end the following: 
‘‘and 
‘‘(B) subject to subsection (b)(6), an 
amount equal to 90 percent of the amount by 
which— 
‘‘(i) the sum of the amounts expended 
during such quarter which are attributable 
to the offering, arranging, and furnishing 
(directly or on a contract basis) under the 
State plan (or under a waiver of the plan) 
of behavioral health services (including 
those related to mental health and sub-
stance use), exceeds 
‘‘(ii) the sum of the amounts ex-
pended during the corresponding quarter 
in the 4-quarter period ending on March 
31, 2019, which are attributable to the of-
fering, arranging, and furnishing (directly 
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or on a contract basis) under the State 
plan (or under a waiver of the plan) of 
such services, plus’’; and 
(2) in subsection (b), by adding at the end the 
following new paragraph: 
‘‘(6) ACCOUNTABILITY AND MAINTENANCE OF 
EFFORT REQUIREMENTS FOR ADDITIONAL FEDERAL 
FUNDING FOR INCREASED EXPENDITURES FOR BE-
HAVIORAL HEALTH SERVICES.—As a condition for 
receiving the funds the Secretary is otherwise obli-
gated to pay to a State under subsection (a)(5)(B), 
a State shall meet the following requirements: 
‘‘(A) SUPPLEMENT, NOT SUPPLANT.—The 
State shall use the funds received under such 
subsection to supplement, not supplant, the 
level of State funds expended for the offering, 
arranging, and furnishing (directly or on a con-
tract basis) under the State plan (or under a 
waiver of the plan) of behavioral health services 
(including those related to mental health and 
substance use) through programs and activities 
in effect as of April 1, 2021. 
‘‘(B) USE
OF
FUNDS
FOR
ACTIVITIES 
THAT
IMPROVE
DELIVERY
OF
BEHAVIORAL 
HEALTH
SERVICES.—The State shall use the 
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funds received under such subsection for activi-
ties that increase the capacity, efficiency, and 
quality in the provision of behavioral health 
services (including those related to mental 
health and substance use) delivered by pro-
viders, including through increases in payment 
rates for providers of those services and the 
adoption of other measures that ensure a reduc-
tion in staff turnover.’’. 
(b) SUB-REGULATORY GUIDANCE.—Not later than 
180 days after the date of enactment of this Act, the Sec-
retary of Health and Human Services shall issue sub-regu-
latory guidance to States specifying the services that are 
behavioral health services for purposes of subparagraph 
(B) of section 1903(a)(5) of the Social Security Act (42 
U.S.C. 1396b(a)(5)), as added by subsection (a). 
(c) EFFECTIVE DATE.—The amendments made by 
this section shall apply with respect to calendar quarters 
beginning on or after January 1 of the year beginning 1 
year after the date of the enactment of this Act. 
SEC. 3. REPORT REGARDING BEHAVIORAL HEALTH SERV-
ICE. 
Not later than 1 year after the date of enactment 
of this Act, and annually thereafter, the Secretary of 
Health and Human Services shall submit to the Com-
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mittee on Energy and Commerce of the House of Rep-
resentatives and the Committee on Finance of the Senate 
a report regarding behavioral health services (including 
those related to mental health and substance use) provided 
under title XIX of the Social Security Act (42 U.S.C. 
1396 et seq.) in each State, specifying the payment rates 
for such services, the rationale for deriving such payment 
rates, and utilization of such services, as such data are 
available. 
Æ 
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