in section 1861(s)(7) shall provide coverage under 
such section for ambulance services to transport an 
individual experiencing a mental or behavioral health 
crisis to an appropriate facility, such as a commu-
nity mental health center (as defined in section 
1861(ff)(3)(B)) or other facility or provider identi-
fied by the Secretary as part of the crisis response 
continuum of care under section 2 of the Behavioral 
Health Crisis Services Expansion Act, as appro-
priate, for crisis response services described in sec-
tion 1861(s)(2)(II).’’. 
(B) CONFORMING
AMENDMENT.—Section 
1861(s)(7) of such Act (42 U.S.C. 1395x(s)(7)) 
is amended by striking ‘‘section 1834(l)(14)’’ 
and inserting ‘‘paragraphs (14) and (18) of sec-
tion 1834(l)’’. 
(5) EFFECTIVE DATE.—The amendments made 
by this subsection shall apply to services furnished 
on or after the date that is 3 years after the date 
of the enactment of this Act. 
(b) MANDATORY COVERAGE OF CRISIS RESPONSE 
SERVICES UNDER THE MEDICAID PROGRAM.— 
(1) IN GENERAL.—Title XIX of the Social Se-
curity Act (42 U.S.C. 1396 et seq.) is amended— 
VerDate Sep 11 2014 
22:13 Oct 20, 2021
Jkt 029200
PO 00000
Frm 00011
Fmt 6652
Sfmt 6201
E:\BILLS\H5611.IH
H5611
pamtmann on DSKBC07HB2PROD with BILLS
(A) in section 1902(a)(10)(A), in the mat-
ter preceding clause (i), by striking ‘‘and (30)’’ 
and inserting ‘‘(30), and (31)’’; and 
(B) in section 1905— 
(i) in subsection (a)— 
(I) in paragraph (30), by striking 
‘‘; and’’ and inserting a semicolon; 
(II) by redesignating paragraph 
(31) as paragraph (32); and 
(III) by inserting the following 
paragraph after paragraph (30): 
‘‘(31) subject to subsection (jj), crisis response 
services (as defined in section 1861(lll)); and’’; and 
(ii) by adding at the end the following 
new subsection: 
‘‘(jj) EXCEPTION
TO REQUIREMENT TO PROVIDE 
COVERAGE FOR CRISIS RESPONSE SERVICES.—The re-
quirement to provide services described in paragraph (31) 
of subsection (a) shall not apply with respect to a State 
for a fiscal year, if before the beginning of such year the 
State certifies to the satisfaction of the Secretary that im-
plementing such requirement statewide for all individuals 
eligible to enroll in the State plan (or waiver of the State 
plan) would not be feasible by reason of a shortage of 
qualified providers of crisis response services, or facilities 
VerDate Sep 11 2014 
22:13 Oct 20, 2021
Jkt 029200
PO 00000
Frm 00012
Fmt 6652
Sfmt 6201
E:\BILLS\H5611.IH
H5611
pamtmann on DSKBC07HB2PROD with BILLS
providing such treatment, that will contract with the State 
or a managed care entity with which the State has a con-
tract 
under 
section 
1903(m) 
or 
under 
section 
1905(t)(3).’’. 
(2) PRESUMPTIVE
ELIGIBILITY
DETERMINA-
TION BY CRISIS RESPONSE SERVICE PROVIDERS.— 
Section 1902(a)(47)(B) of the Social Security Act 
(42 U.S.C. 1396a(a)(47)(B)) is amended by insert-
ing ‘‘or provider of crisis response services (as de-
fined in section 1861(lll))’’ after ‘‘any hospital’’. 
(3) EFFECTIVE DATE.— 
(A) IN GENERAL.—Except as provided in 
subparagraph (B), the amendments made by 
this section shall take effect on the date that is 
3 years after the date of the enactment of this 
Act. 
(B) DELAY PERMITTED IF STATE LEGISLA-
TION REQUIRED.—In the case of a State plan 
under title XIX of the Social Security Act (42 
U.S.C. 1396 et seq.) which the Secretary of 
Health and Human Services determines re-
quires State legislation (other than legislation 
appropriating funds) in order for the plan to 
meet the additional requirements imposed by 
the amendments made by this section, the State 
VerDate Sep 11 2014 
22:13 Oct 20, 2021
Jkt 029200
PO 00000
Frm 00013
Fmt 6652
Sfmt 6201
E:\BILLS\H5611.IH
H5611
pamtmann on DSKBC07HB2PROD with BILLS
plan shall not be regarded as failing to comply 
with the requirements of such title solely on the 
basis of the failure of the plan to meet such ad-
ditional requirements before the first day of the 
first calendar quarter beginning after the close 
of the first regular session of the State legisla-
ture that begins after the date of enactment of 
this Act. For purposes of the previous sentence, 
in the case of a State that has a 2-year legisla-
tive session, each year of such session shall be 
deemed to be a separate regular session of the 
State legislature. 
(c) 
ESSENTIAL
HEALTH
BENEFITS.—Section 
1302(b)(1)(E) of the Patient Protection and Affordable 
Care Act (42 U.S.C. 18022(b)(1)(E)) is amended by in-
serting ‘‘and crisis response services (as defined in section 
1861(lll) of the Social Security Act)’’ before the period. 
(d) GROUP HEALTH PLANS.—Section 2707 of the 
Public Health Service Act (42 U.S.C. 300gg–6) is amend-
ed by adding at the end the following: 
‘‘(e) CRISIS RESPONSE SERVICES.—A group health 
plan or a health insurance issuer that offers health insur-
ance coverage in the large group market shall ensure that 
such coverage includes crisis response services (as defined 
in section 1861(lll) of the Social Security Act).’’. 
VerDate Sep 11 2014 
22:13 Oct 20, 2021
Jkt 029200
PO 00000
Frm 00014
Fmt 6652
Sfmt 6201
E:\BILLS\H5611.IH
H5611
pamtmann on DSKBC07HB2PROD with BILLS
(e) TRICARE COVERAGE.— 
(1) IN
GENERAL.—The Secretary of Defense 
shall provide coverage under the TRICARE program 
for crisis response services, as defined in section 
1861(lll) of the Social Security Act (42 U.S.C. 
1395x) (as amended by section 3). 
(2) TRICARE PROGRAM
DEFINED.—In this 
section, the term ‘‘TRICARE program’’ has the 
meaning given the term in section 1072 of title 10, 
United States Code. 
(f) REIMBURSEMENT FOR CRISIS RESPONSE SERV-
ICES
FOR VETERANS.—Section 1725(f)(1) of title 38, 
United States Code, is amended, in the matter preceding 
subparagraph (A), by inserting ‘‘, including crisis response 
services (as defined in subsection (lll) of section 1861 of 
the Social Security Act (42 U.S.C. 1395x)),’’ after ‘‘serv-
ices’’. 
(g) COVERAGE UNDER FEHB.— 
(1) IN
GENERAL.—Section 8902 of title 5, 
United States Code, is amended by adding at the 
end the following: 
‘‘(p) Each contract for a plan under this chapter shall 
require the carrier to provide coverage for crisis response 
services, as that term is defined in subsection (lll) of sec-
tion 1861 of the Social Security Act (42 U.S.C. 1395x).’’. 
VerDate Sep 11 2014 
22:13 Oct 20, 2021
Jkt 029200
PO 00000
Frm 00015
Fmt 6652
Sfmt 6201
E:\BILLS\H5611.IH
H5611
pamtmann on DSKBC07HB2PROD with BILLS