More Behavioral Health Providers Act
Bill: S.5042 | Sponsor: Sen. Stabenow, Debbie (D-MI)
Policy area: Health

Summary:
More Behavioral Health Providers Act
This bill provides for additional Medicare payments to health care practitioners who provide services in mental health professional shortage areas for individual with mental health or substance use disorders. The bill applies to physicians, physician assistants, nurse practitioners, clinical nurse specialists, clinical social workers, clinical psychologists, marriage and family therapists, and mental health counselors.

To amend title XVIII of the Social Security Act to expand eligibility 
  for incentives under the Medicare health professional shortage area 
 bonus program to practitioners furnishing mental health and substance 
                         use disorder services.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``More Behavioral Health Providers 
Act''.

SEC. 2. EXPANDING ELIGIBILITY FOR INCENTIVES UNDER THE MEDICARE HEALTH 
              PROFESSIONAL SHORTAGE AREA BONUS PROGRAM TO PRACTITIONERS 
              FURNISHING MENTAL HEALTH AND SUBSTANCE USE DISORDER 
              SERVICES.

    Section 1833(m) of the Social Security Act (42 U.S.C. 1395l(m)) is 
amended--
            (1) by striking paragraph (1) and inserting the following 
        new paragraph:
    ``(1) In the case of--
            ``(A) physicians' services (other than specified health 
        services that are eligible for the additional payment under 
        subparagraph (B)) furnished in a year to an individual, who is 
        covered under the insurance program established by this part 
        and who incurs expenses for such services, in an area that is 
        designated (under section 332(a)(1)(A) of the Public Health 
        Service Act) as a health professional shortage area as 
        identified by the Secretary prior to the beginning of such 
        year, in addition to the amount otherwise paid under this part, 
        there also shall be paid to the physician (or to an employer or 
        facility in the cases described in clause (A) of section 
        1842(b)(6)) (on a monthly or quarterly basis) from the Federal 
        Supplementary Medical Insurance Trust Fund an amount equal to 
        10 percent of the payment amount for the service under this 
        part; and
            ``(B) specified health services (as defined in paragraph 
        (5)) furnished in a year to an individual, who is covered under 
        the insurance program established by this part and who incurs 
        expenses for such services, in an area that is designated 
        (under such section 332(a)(1)(A)) as a mental health 
        professional shortage area as identified by the Secretary prior 
        to the beginning of such year, in addition to the amount 
        otherwise paid under this part, there also shall be paid to the 
        physician or applicable practitioner (as defined in paragraph 
        (6)) (or to an employer or facility in the cases described in 
        clause (A) of section 1842(b)(6)) (on a monthly or quarterly 
        basis) from such Trust Fund an amount equal to 15 percent of 
        the payment amount for the service under this part.'';
            (2) in paragraph (2)--
                    (A) by striking ``in paragraph (1)'' and inserting 
                ``in subparagraph (A) or (B) of paragraph (1)'';
                    (B) by inserting ``or, in the case of specified 
                health services, the physician or applicable 
                practitioner'' after ``physician'';
            (3) in paragraph (3), by striking ``in paragraph (1)'' and 
        inserting ``in subparagraph (A) or (B) of paragraph (1)'';
            (4) in paragraph (4)--
                    (A) in subparagraph (B), by inserting ``or 
                applicable practitioner'' after ``physician''; and
                    (B) in subparagraph (C), by inserting ``or 
                applicable practitioner'' after ``physician''; and
            (5) by adding at the end the following new paragraph:
    ``(5) In this subsection, the term `specified health services' 
means services otherwise covered under this part that are furnished on 
or after January 1, 2024, by a physician or an applicable practitioner 
to an individual--
            ``(A) for purposes of diagnosis, evaluation, or treatment 
        of a mental health disorder, as determined by the Secretary; or
            ``(B) with a substance use disorder diagnosis for purposes 
        of treatment of such disorder or co-occurring mental health 
        disorder, as determined by the Secretary.
    ``(6) In this subsection, the term `applicable practitioner' means 
the following:
            ``(A) A physician assistant, nurse practitioner, or 
        clinical nurse specialist (as defined in section 1861(aa)(5)).
            ``(B) A clinical social worker (as defined in section 
        1861(hh)(1)).
            ``(C) A clinical psychologist (as defined by the Secretary 
        for purposes of section 1861(ii)).
            ``(D) A marriage and family therapist (as defined in 
        section 1861(lll)(2)).
            ``(E) A mental health counselor (as defined in section 
        1861(lll)(4)).''.
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