II 113th CONGRESS 1st Session S. 1517 IN THE SENATE OF THE UNITED STATES September 18, 2013 Mr. Whitehouse introduced the following bill; which was read twice and referred to the Committee on Finance A BILL To amend the Public Health Services Act and the Social Security Act to extend health information technology assistance eligibility to behavioral health, mental health, and substance abuse professionals and facilities, and for other purposes.

1. Short title This Act may be cited as the Behavioral Health Information Technology Act of 2013 . 2. Extension of health information technology assistance for behavioral health and mental health and substance abuse Section 3000(3) of the Public Health Services Act ( 42 U.S.C. 300jj(3) ) is amended by inserting a behavioral or mental health professional (as defined in section 331(a)(3)(E)(i)), a substance abuse professional, a psychiatric hospital (as defined in section 1861(f) of the Social Security Act), a community mental health center that meets the criteria specified in section 1913(c) (including community mental health centers that are operated by county behavioral health agencies), a residential or outpatient mental health or substance abuse treatment facility, before and any other category . 3. Extension of eligibility for medicare and medicaid health information technology implementation assistance (a) Payment incentives for eligible professionals under the medicare program Section 1848 of the Social Security Act (42 U.S.C. 1395w–4) is amended— (1) in subsection (a)(7)— (A) in subparagraph (E), by adding at the end the following new clause: (iv) Additional eligible professional The term additional eligible professional means either of the following: (I) A clinical psychologist providing qualified psychologist services (as defined in section 1861(ii)). (II) A clinical social worker (as defined in section 1861(hh)(1)). ; and (B) by adding at the end the following new subparagraph: (F) Application to additional eligible professionals The Secretary shall apply the provisions of this paragraph with respect to an additional eligible professional in the same manner as such provisions apply to an eligible professional, except in applying subparagraph (A)— (i) in clause (i), the reference to 2015 shall be deemed a reference to 2019; (ii) in clause (ii), the references to 2015, 2016, and 2017 shall be deemed references to 2019, 2020, and 2021, respectively; and (iii) in clause (iii), the reference to 2018 shall be deemed a reference to 2022. ; and (2) in subsection (o)— (A) in paragraph (5), by adding at the end the following new subparagraph: (D) Additional eligible professional The term additional eligible professional means either of the following: (i) A clinical psychologist providing qualified psychologist services (as defined in section 1861(ii)). (ii) A clinical social worker (as defined in section 1861(hh)(1)). ; and (B) by adding at the end the following new paragraph: (6) Application to additional eligible professionals The Secretary shall apply the provisions of this subsection with respect to an additional eligible professional in the same manner as such provisions apply to an eligible professional, except in applying— (A) paragraph (1)(A)(ii), the reference to 2016 shall be deemed a reference to 2020; (B) paragraph (1)(B)(ii), the references to 2011 and 2012 shall be deemed references to 2015 and 2016, respectively; (C) paragraph (1)(B)(iii), the references to 2013 shall be deemed references to 2017; (D) paragraph (1)(B)(v), the references to 2014 shall be deemed references to 2018; and (E) paragraph (1)(E), the reference to 2011 shall be deemed a reference to 2015. . (b) Eligible hospitals Section 1886 of the Social Security Act (42 U.S.C. 1395ww) is amended— (1) in subsection (b)(3)(B)(ix), by adding at the end the following new subclause: (V) The Secretary shall apply the provisions of this subsection with respect to an additional eligible hospital (as defined in subsection (n)(6)(C)) in the same manner as such provisions apply to an eligible hospital except in applying— (aa) subclause (I), the references to 2015, 2016, and 2017 shall be deemed references to 2019, 2020, and 2021, respectively; and (bb) subclause (III), the reference to 2015 shall be deemed a reference to 2019. ; and (2) in subsection (n)— (A) in paragraph (6), by adding at the end the following new subparagraph: (C) Additional eligible hospital The term additional eligible hospital means an inpatient hospital that is a psychiatric hospital (as defined in section 1861(f)). ; and (B) by adding at the end the following new paragraph: (7) Application to additional eligible hospitals The Secretary shall apply the provisions of this subsection with respect to an additional eligible hospital in the same manner as such provisions apply to an eligible hospital, except in applying— (A) paragraph (2)(E)(ii), the references to 2013 and 2015 shall be deemed references to 2017 and 2019, respectively; and (B) paragraph (2)(G)(i), the reference to 2011 shall be deemed a reference to 2015. . (c) Medicaid providers Section 1903(t) of the Social Security Act (42 U.S.C. 1396b(t)) is amended— (1) in paragraph (2)(B)— (A) in clause (i), by striking , or and inserting a semicolon; (B) in clause (ii), by striking the period at the end and inserting ; or ; and (C) by adding at the end the following new clause: (iii) an additional Medicaid provider. ; (2) in paragraph (3)— (A) in subparagraph (B), by inserting after and below clause (v) the following new sentence: Such term includes an additional eligible professional. ; and (B) by adding at the end the following new subparagraphs: (G) The term additional eligible professional means— (i) a clinical psychologist providing qualified psychologist services (as defined in section 1861(ii)), if such clinical psychologist is practicing in an outpatient setting that— (I) is led by a clinical psychologist; and (II) is not otherwise receiving payment under paragraph (1) as a Medicaid provider described in paragraph (2)(B); and (ii) a clinical social worker (as defined in section 1861(hh)(1)), if such clinical social worker is practicing in an outpatient clinic that— (I) is led by a clinical social worker; and (II) is not otherwise receiving payment under paragraph (1) as a Medicaid provider described in paragraph (2)(B). (H) The term additional Medicaid provider means— (i) a public hospital that is principally a psychiatric hospital (as defined in section 1861(f)); (ii) a private hospital that is principally a psychiatric hospital (as defined in section 1861(f)) and that has at least 10 percent of its patient volume (as estimated in accordance with a methodology established by the Secretary) attributable to individuals who are receiving medical assistance under this title; (iii) a community mental health center meeting the criteria specified in section 1913(c) of the Public Health Service Act; or (iv) a residential or outpatient mental health or substance abuse treatment facility that— (I) is accredited by the Joint Commission on Accreditation of Healthcare Organizations, the Commission on Accreditation of Rehabilitation Facilities, the Council on Accreditation, or any other national accrediting agency recognized by the Secretary; and (II) has at least 10 percent of its patient volume (as estimated in accordance with a methodology established by the Secretary) attributable to individuals who are receiving medical assistance under this title. ; and (3) by adding at the end the following new paragraph: (11) (A) The Secretary shall apply the provisions of this subsection and subsection (a)(3)(F) with respect to an additional eligible professional who is a Medicaid provider described in paragraph (2)(A) in the same manner as such provisions apply to any other eligible professional who is a Medicaid provider described in paragraph (2)(A), except in applying— (i) paragraph (4)(A)(i), the reference to 2016 shall be deemed a reference to 2020; and (ii) paragraph (4)(A)(iii), the reference to 2021 shall be deemed a reference to 2025. (B) The Secretary shall apply the provisions of this subsection and subsection (a)(3)(F) with respect to an additional Medicaid provider in the same manner as such provisions apply to any other Medicaid provider described in paragraph (2)(B), except in applying paragraph (4)(D)(i), the reference to 2016 shall be deemed a reference to 2020. . (d) Medicare Advantage organizations Section 1853 of the Social Security Act ( 42 U.S.C. 1395w–23 ) is amended— (1) in subsection (l)— (A) in paragraph (1)— (i) by inserting or additional eligible professionals (as described in paragraph (9)) after paragraph (2) ; and (ii) by inserting and additional eligible professionals before under such sections ; (B) in paragraph (3)(B)— (i) in clause (i) in the matter preceding subclause (I), by inserting or an additional eligible professional described in paragraph (9) after paragraph (2) ; and (ii) in clause (ii)— (I) in the matter preceding subclause (I), by inserting or an additional eligible professional described in paragraph (9) after paragraph (2) ; and (II) in subclause (I), by inserting or an additional eligible professional, respectively, after eligible professional ; (C) in paragraph (3)(C), by inserting and additional eligible professionals after all eligible professionals ; (D) in paragraph (4)(D), by adding at the end the following new sentence: In the case that a qualifying MA organization attests that not all additional eligible professionals of the organization are meaningful EHR users with respect to an applicable year, the Secretary shall apply the payment adjustment under this paragraph based on the proportion of all such additional eligible professionals of the organization that are not meaningful EHR users for such year. ; (E) in paragraph (6)(A), by inserting and, as applicable, each additional eligible professional described in paragraph (9) after paragraph (2) ; (F) in paragraph (6)(B), by inserting and, as applicable, each additional eligible hospital described in paragraph (9) after subsection (m)(1) ; (G) in paragraph (7)(A), by inserting and, as applicable, additional eligible professionals after eligible professionals ; (H) in paragraph (7)(B), by inserting and, as applicable, additional eligible professionals after eligible professionals ; (I) in paragraph (8)(B), by inserting and additional eligible professionals described in paragraph (9) after paragraph (2) ; and (J) by adding at the end the following new paragraph: (9) Additional eligible professional described With respect to a qualifying MA organization, an additional eligible professional described in this paragraph is an additional eligible professional (as defined for purposes of section 1848(o)) who— (A) (i) is employed by the organization; or (ii) (I) is employed by, or is a partner of, an entity that through contract with the organization furnishes at least 80 percent of the entity’s Medicare patient care services to enrollees of such organization; and (II) furnishes at least 80 percent of the professional services of the additional eligible professional covered under this title to enrollees of the organization; and (B) furnishes, on average, at least 20 hours per week of patient care services. ; and (2) in subsection (m)— (A) in paragraph (1)— (i) by inserting or additional eligible hospitals (as described in paragraph (7)) after paragraph (2) ; and (ii) by inserting and additional eligible hospitals before under such sections ; (B) in paragraph (3)(A)(i), by inserting or additional eligible hospital after eligible hospital ; (C) in paragraph (3)(A)(ii), by inserting or an additional eligible hospital after eligible hospital in each place it occurs; (D) in paragraph (3)(B)— (i) in clause (i), by inserting or an additional eligible hospital described in paragraph (7) after paragraph (2) ; and (ii) in clause (ii)— (I) in the matter preceding subclause (I), by inserting or an additional eligible hospital described in paragraph (7) after paragraph (2) ; and (II) in subclause (I), by inserting or an additional eligible hospital, respectively, after eligible hospital ; (E) in paragraph (4)(A), by inserting or one or more additional eligible hospitals (as defined in section 1886(n)), as appropriate, after section 1886(n)(6)(A)) ; (F) in paragraph (4)(D), by adding at the end the following new sentence: In the case that a qualifying MA organization attests that not all additional eligible hospitals of the organization are meaningful EHR users with respect to an applicable period, the Secretary shall apply the payment adjustment under this paragraph based on the methodology specified by the Secretary, taking into account the proportion of such additional eligible hospitals, or discharges from such hospitals, that are not meaningful EHR users for such period. ; (G) in paragraph (5)(A), by inserting and, as applicable, each additional eligible hospital described in paragraph (7) after paragraph (2) ; (H) in paragraph (5)(B), by inserting and additional eligible hospitals, as applicable, after eligible hospitals ; (I) in paragraph (6)(B), by inserting and additional eligible hospitals described in paragraph (7) after paragraph (2) ; and (J) by adding at the end the following new paragraph: (7) Additional eligible hospital described With respect to a qualifying MA organization, an additional eligible hospital described in this paragraph is an additional eligible hospital (as defined in section 1886(n)(6)(C)) that is under common corporate governance with such organization and serves individuals enrolled under an MA plan offered by such organization. .