II 118th CONGRESS 1st Session S. 669 IN THE SENATE OF THE UNITED STATES March 7, 2023 Mr. Brown (for himself, Ms. Collins , Mr. Heinrich , and Mr. Mullin ) introduced the following bill; which was read twice and referred to the Committee on Finance A BILL To amend title XVIII of the Social Security Act to expand access to psychological and behavioral services.

1. Short title This Act may be cited as the Increasing Mental Health Options Act of 2023 . 2. Expanding eligibility for incentives to practice in rural and underserved areas Section 1833(m) of the Social Security Act ( 42 U.S.C. 1395l(m) ) is amended— (1) in paragraph (1)— (A) by inserting (A) before In the case ; and (B) by adding at the end the following new subparagraph: (B) In the case of services furnished by a clinical psychologist (as defined by the Secretary for purposes of section 1861(ii)) in a year (beginning with 2025) 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 clinical psychologist (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 (2) in paragraph (2), by inserting or clinical psychologist after physician . 3. Eliminating unnecessary oversight and approval requirements for behavioral health services provided by clinical psychologists (a) Comprehensive Outpatient Rehabilitation Facilities Section 1835(a)(2)(E)(iii) of the Social Security Act ( 42 U.S.C. 1395n(a)(2)(E)(iii) ) is amended by inserting , except that an individual receiving qualified psychologist services as described in section 1861(ii) may be under the care of a clinical psychologist with respect to such services to the extent authorized under State law before the semicolon. (b) Skilled Nursing Facilities Section 1819(b) of such Act ( 42 U.S.C. 1395i–3(b) ) is amended— (1) in paragraph (5)(G), by inserting clinical psychologist, after nurse practitioner, ; and (2) in paragraph (6)(A), by inserting , except that a resident receiving qualified psychologist services as described in section 1861(ii) may be under the supervision of a clinical psychologist with respect to such services to the extent authorized under State law before the semicolon. (c) Partial hospitalization services (1) Section 1835(a)(2)(F)(iii) of the Social Security Act ( 42 U.S.C. 1395n(a)(2)(F)(iii) ) is amended by inserting , except that an individual receiving qualified psychologist services as described in section 1861(ii) may be under the care of a clinical psychologist with respect to such services to the extent authorized under State law before the period. (2) Section 1861(ff)(1) of such Act ( 42 U.S.C. 1395x(ff)(1) ) is amended by inserting (or, in the case of qualified psychologist services, under the supervision of a clinical psychologist to the extent authorized under State law) after under the supervision of a physician . (d) Home health services (1) Section 1861(m) of such Act ( 42 U.S.C. 1395x(m) ) is amended— (A) in paragraph (6), by striking and at the end; (B) in paragraph (7), by inserting and after the semicolon; and (C) by inserting after paragraph (7) the following new paragraph: (8) an individual receiving qualified psychologist services may be under the care of a clinical psychologist with respect to such services to the extent authorized under State law; . (2) Section 1891(a)(3)(F) of such Act ( 42 U.S.C. 1395bbb(a)(3)(F) ) is amended by inserting clinical psychologist, after physician, . (e) Inpatient psychiatric hospital services Section 1814(a)(2)(A) of such Act ( 42 U.S.C. 1395f(a)(2)(A) ) is amended by inserting (or, in the case of qualified psychologist services, under the supervision of a clinical psychologist to the extent authorized under State law) after under the supervision of a physician . (f) Rule of construction In accordance with section 410.71(e) of title 42, Code of Federal Regulations (or any successor regulation), nothing in the provisions of, and amendments made by, this section shall be construed as changing or eliminating existing requirements regarding clinical consultation by clinical psychologists with a beneficiary’s physician, in accordance with accepted professional ethical norms and taking into consideration patient confidentiality. (g) Effective date The amendments made by this section shall apply to services furnished on or after January 1, 2025.