I 
118TH CONGRESS 
2D SESSION H. R. 10419 
To amend title XVIII of the Social Security Act to establish a Medicare 
demonstration program relating to crisis response services. 
IN THE HOUSE OF REPRESENTATIVES 
DECEMBER 16, 2024 
Mr. CA´RDENAS (for himself, Mr. VEASEY, Mr. SCHWEIKERT, and Mr. 
FITZPATRICK) introduced the following bill; which was referred to the 
Committee on Ways and Means, and in addition to the Committee on En-
ergy and Commerce, for a period to be subsequently determined by the 
Speaker, in each case for consideration of such provisions as fall within 
the jurisdiction of the committee concerned 
A BILL 
To amend title XVIII of the Social Security Act to establish 
a Medicare demonstration program relating to crisis re-
sponse services. 
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 ‘‘Crisis Care Access and 
Response Expansion for Behavioral Health Act of 2024’’ 
or the ‘‘CARE for Behavioral Health Act of 2024’’. 
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SEC. 2. ESTABLISHING A MEDICARE DEMONSTRATION PRO-
GRAM RELATING TO CRISIS RESPONSE SERV-
ICES. 
Part E of title XVIII of the Social Security Act (42 
U.S.C. 1395x et seq.) is amended by inserting after sec-
tion 1866G the following new section: 
‘‘SEC. 1866H. CRISIS RESPONSE SERVICES DEMONSTRA-
TION PROGRAM. 
‘‘(a) IN GENERAL.—Not later than January 1, 2026, 
the Secretary shall establish a crisis response services 
demonstration program (in this section referred to as the 
‘demonstration program’) to determine whether payment 
for crisis response services furnished to applicable individ-
uals by participating providers results in— 
‘‘(1) a reduction in emergency department vis-
its; 
‘‘(2) increased access to crisis response services; 
‘‘(3) a reduction in expenditures under this 
title; or 
‘‘(4) improved behavioral health outcomes. 
‘‘(b) PARTICIPATING PROVIDERS.— 
‘‘(1) IN GENERAL.—Subject to paragraph (3), 
the Secretary shall designate an eligible provider as 
a participating provider for purposes of the dem-
onstration program if such eligible provider submits 
an application to the Secretary at such time and in 
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such manner as specified by the Secretary and dem-
onstrates that the provider meets the standards es-
tablished by the Secretary under paragraph (2). 
‘‘(2) STANDARDS.—The Secretary, in coordina-
tion with the Assistant Secretary for Mental Health 
and Substance Use, shall specify standards that an 
eligible provider must meet in order to be designated 
as a participating provider under paragraph (1). 
Such standards shall include the following: 
‘‘(A) Standards relating to the minimum 
set of crisis response services to be furnished by 
a participating provider under the demonstra-
tion program. 
‘‘(B) Standards relating to access to such 
services, including a requirement that such pro-
vider be available to furnish such services 24 
hours per day, 7 days per week, and have a 
physician (which may include a psychiatrist), 
nurse practitioner, or physician assistant so 
available to furnish such services. 
‘‘(C) Standards relating to the provision of 
such services, including— 
‘‘(i) standards relating to the quali-
fications of individuals who may furnish 
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such services, in accordance with applicable 
State licensure requirements; 
‘‘(ii) standards relating to collabora-
tion of such individuals with other entities 
(such as community first responders and 
community-based organizations) to ensure 
appropriate case management and adher-
ence to best practices; 
‘‘(iii) standards relating to the receipt 
of individuals from appropriate providers 
of services, suppliers, and other entities 
(such as law enforcement entities, edu-
cational institutions, and community-based 
organizations); and 
‘‘(iv) a requirement that such services 
may only be terminated once an individual 
is stabilized or transferred to receive care 
from another appropriate provider of serv-
ices, supplier, or entity. 
‘‘(3) TERMINATION OF DESIGNATION.— 
‘‘(A) IN
GENERAL.—The Secretary shall 
terminate a designation of a participating pro-
vider under paragraph (1) if— 
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‘‘(i) the Secretary determines that 
such provider no longer meets the stand-
ards specified under paragraph (2); or 
‘‘(ii) such provider fails to meets such 
quality standards as the Secretary deter-
mines appropriate. 
‘‘(B) 
PERMISSIVE
TERMINATION.—The 
Secretary may terminate a designation of a par-
ticipating provider under paragraph (1) for 
such other reasons as determined appropriate 
by the Secretary. 
‘‘(c) PAYMENT.— 
‘‘(1) IN GENERAL.—Payment for crisis response 
services furnished by a participating provider under 
the demonstration program shall be equal to 100 
percent of the lesser of the amount charged by such 
provider or an amount determined under the pay-
ment basis established by the Secretary under para-
graph (2). 
‘‘(2) PAYMENT BASIS.—The Secretary shall es-
tablish a single payment amount for crisis response 
services furnished to an applicable individual by a 
participating provider during a month. Such amount 
shall be equal to the average (as determined by the 
Secretary) costs incurred by eligible providers in fur-
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nishing such services to an individual during a 
month. 
‘‘(3) SOURCE OF PAYMENT.—Payment for crisis 
response services furnished by a participating pro-
vider under the demonstration program shall be 
made from the Federal Supplementary Medical In-
surance Trust Fund established under section 1841. 
‘‘(d) EVALUATION
AND MONITORING.—The Sec-
retary shall evaluate each participating provider under the 
demonstration program to assess whether the results de-
scribed in subsection (a) have been achieved. 
‘‘(e) REPORT.—Not later than 3 years after the date 
of the enactment of this section, the Secretary shall con-
duct an independent evaluation of the demonstration pro-
gram and submit to Congress a report on such program. 
Such report shall include an analysis of the following: 
‘‘(1) Whether such program has achieved re-
sults described in subsection (a). 
‘‘(2) The quality of crisis response services fur-
nished under such program. 
‘‘(3) Any reduction in jail incarceration attrib-
utable to such program. 
‘‘(4) The number of individuals furnished serv-
ices under such program who were not voluntarily so 
furnished such services. 
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‘‘(f) DEFINITIONS.—In this section: 
‘‘(1) APPLICABLE INDIVIDUAL.—The term ‘ap-
plicable individual’ means an individual who— 
‘‘(A) is entitled to benefits under part A 
and enrolled under part B; 
‘‘(B) is not enrolled in a Medicare Advan-
tage plan under part C or a PACE program 
under section 1894; and 
‘‘(C) meets such other criteria as deter-
mined appropriate by the Secretary. 
‘‘(2) BEHAVIORAL HEALTH URGENT CARE FA-
CILITY.—The term ‘behavioral health urgent care fa-
cility’ means an ambulatory facility where individ-
uals experiencing a mental or behavioral health crisis 
may walk in without an appointment to receive crisis 
assessment services, crisis intervention services, 
medication, and connection to other appropriate 
services. 
‘‘(3) CRISIS RECEIVING AND STABILIZATION FA-
CILITY.—The term ‘crisis receiving and stabilization 
facility’ means a subacute inpatient facility or other 
facility specified by the Secretary that provides 
short-term observation and stabilization services to 
individuals experiencing a mental or behavioral 
health crisis. 
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‘‘(4) CRISIS
RESPONSE
SERVICES.—The term 
‘crisis response services’ means mental or behavioral 
health services that are furnished to an individual 
experiencing a mental or behavioral health crisis 
to— 
‘‘(A) provide screening and assessment for 
the individual’s mental health or substance use 
disorder crisis; 
‘‘(B) support the de-escalation of the indi-
vidual’s mental health or substance use disorder 
crisis; 
‘‘(C) facilitate or support subsequent refer-
ral to health, social, and other services, as de-
termined appropriate by the Secretary; or 
‘‘(D) otherwise address the individual’s 
pressing behavioral health needs, as determined 
appropriate by the Secretary. 
‘‘(5) ELIGIBLE PROVIDER.—The term ‘eligible 
provider’ means a provider of crisis response services 
that is a mobile crisis response team, a crisis receiv-
ing and stabilization facility, a behavioral health ur-
gent care facility, or such other provider of services 
or supplier determined appropriate by the Secretary. 
‘‘(6) MOBILE
CRISIS
RESPONSE
TEAM.—The 
term ‘mobile crisis response team’ means a team of 
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physicians or practitioners (as described in section 
1842(b)(18)(C)) that is available to furnish crisis re-
sponse services to an individual experiencing a men-
tal or behavioral health crisis in the individual’s 
home or at the individual’s workplace or another 
community-based location in a timely manner. 
‘‘(g) FUNDING.—For purposes of administering and 
carrying out the demonstration program, other than for 
payments for services furnished under the program, in ad-
dition to funds otherwise appropriated, the Secretary shall 
provide for the transfer to the Center for Medicare & Med-
icaid Services Program Management Account from the 
Federal Hospital Insurance Trust Fund under section 
1817 and the Federal Supplementary Medical Insurance 
Trust Fund under section 1841 of this title (in propor-
tions determined appropriate by the Secretary) of such 
sums as the Secretary determines are necessary for such 
purposes. Amounts transferred under this subsection shall 
remain available until expended.’’. 
Æ 
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