On Sept. 21, the House Ways and Means Committee marked up and advanced bipartisan legislation to expand access to behavioral health care for Medicare beneficiaries, promote physician well-being, and improve provider network adequacy and transparency for individuals with commercial insurance.
In his opening statement, Chair Richard Neal (D-Mass.) reflected upon the “outpouring of interest” the committee received after holding a series of mental health hearings earlier this year [refer to Washington Highlights, Feb. 4, March 4]. He applauded the bipartisan nature of the committee’s work, stating, “With today’s markup, we are strengthening mental health care across the continuum.”
Ranking Member Kevin Brady (R-Texas) echoed in his opening statement Neal’s comments about the timeliness of the mental health provisions under consideration. “Mental health has always been an important issue, but during the pandemic, all Americans saw even greater mental health challenges as a result of COVID lockdowns and lack of access to care they needed.”
The package was organized into five components, or committee prints, four of which are germane to the provision of mental health care under Medicare and commercial insurance plans.
Committee Print 117-1, “Improvements to Medicare Inpatient and Outpatient Mental Health Services," would address a gap in the continuum of behavioral health services available to Medicare beneficiaries by extending coverage for intermediate-level treatment options. The legislation would provide Medicare coverage for intensive outpatient programs — structured treatment programs for individuals with behavioral health conditions who need at least nine hours of services per week but do not require hospitalization. In addition, the legislation would direct the secretary of the Department of Health and Human Services (HHS) to revise and improve Medicare payments directed to psychiatric hospitals and psychiatric units.
In one exchange, Rep. Lloyd Doggett (D-Texas) expressed his frustration that members and their staff were not provided with sufficient advanced notice of the legislative text, limiting their ability to review the provisions and draft amendments. In addition, he expressed concerns that the Congressional Budget Office has yet to provide a score assessing the budgetary impact of the proposed legislation.
Committee Print 117-2, “Improvements to the Medicare Program Related to Physician Services and Education,” would allow Medicare to cover services rendered by marriage and family therapists and mental health counselors. In addition, the legislation would remove regulatory barriers that prevent physicians who are employed by a hospital from accessing mental health programs offered by said hospital, thereby addressing physician burnout and promoting well-being. The legislation would direct the secretary of the HHS to make providers aware of existing behavioral health integration services codes that allow providers to integrate physical and behavioral health care for Medicare beneficiaries.
Committee Print 117-4, “Improved Information in Provider Directories, Plan Definitions and Crisis Services for Private Insurance Plans,” would build upon additional requirements for provider directories under the No Surprises Act (P.L. 116-260) by requiring providers to inform health plans on an annual basis whether they are accepting new patients and if telehealth modalities are available. In addition, this legislation would direct the secretaries of the HHS and the departments of Labor and the Treasury to conduct a joint public outreach campaign to inform individuals with commercial insurance regarding federal requirements for coverage of mental health crisis services.
Committee Print 117-5, “Improved Information for Network Coverage and Plan Documents in Private Insurance Plans,” would require insurers to disclose the number and percentage of behavioral health providers who accept their coverage in a given service area, and furthermore, directs the HHS secretary to develop a ranking system to assess provider network adequacy. In addition, the legislation would require health plans to submit information about their behavioral health benefits in a standardized, machine-readable format so that researchers and web application developers can easily compare plans.
These measures will now proceed to the floor of the House of Representatives for consideration.
- Washington Highlights