Ensuring Excellence in Mental Health Act
Sponsored By: Senator John Cornyn
Introduced
Summary
This bill would build a unified national framework to strengthen and expand certified community behavioral health clinics. It would set new Medicaid and Medicare payment rules, create a multi-year federal grant program, broaden clinic services, and extend liability protections for clinic clinicians.
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- Families and patients: Medicare coverage of certified community behavioral health clinic services would begin January 1, 2027, and Medicaid demonstrations and State plan clarifications would expand CCBHC service scope effective October 1, 2026. Part B deductible would not apply to CCBHC services.
- Providers and States: The bill would require a Medicaid prospective payment system for CCBHCs beginning in fiscal year 2026 and would establish a Medicare prospective payment system starting in 2027 with initial cost-based rates, annual inflation updates, and optional payment enhancements.
- Clinics and program support: A new operating grant program would authorize $552.5 million per year for fiscal years 2026 through 2030, plus $8 million per year for technical assistance and $51 million per year for data infrastructure; the bill would also allow accreditation options and extend Federal Tort Claims Act coverage to CCBHC clinicians.
*Would increase federal spending by about $3.1 billion for 2026–2030 from the authorized grants and support funds.*
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Bill Overview
Analyzed Economic Effects
3 provisions identified: 2 benefits, 0 costs, 1 mixed.
Medicaid CCBHC service and payment
If enacted, States could furnish certified community behavioral health clinic services under Medicaid using a prospective payment system starting in fiscal year 2026 (services on or after January 1, 2026). A clinic's initial PPS payment year would be set at 100% of its average reasonable and related base‑year costs, and rates would be adjusted each year for inflation and scope changes. States must make quarterly supplemental payments when managed care pays less than the PPS and may set separate rates for special populations, outliers, and crisis services.
Grants, accreditation, and clinic support
If enacted, the bill would create federal supports to strengthen community behavioral health clinics. Congress would be authorized to provide $552.5 million per year for operating grants for FY2026–FY2030, plus $8 million per year for technical assistance and $51 million per year for a data system. Grants could cover the gap between clinic operating costs and other expected funding, last up to five years, and require implementation plans and reporting. The Secretary would also set approval rules for accreditation bodies and extend Federal Tort Claims Act protection to clinicians working in qualifying clinics.
Medicare CCBHC coverage and payments
If enacted, Medicare would cover certified community behavioral health clinic services for care furnished on or after January 1, 2027. Medicare would use a new clinic prospective payment system and pay 80% of the lesser of a clinic's actual charge or the PPS-determined amount. The Medicare Part B deductible would not apply to these services. Because Medicare pays 80%, patients could face up to 20% coinsurance unless a clinic waives it; the bill would extend an Anti‑Kickback safe harbor to allow some coinsurance waivers and would let clinics seek Medicare Payment Reimbursement Review Board review of cost reports.
Sponsors & CoSponsors
Sponsor
John Cornyn
TX • R
Cosponsors
Tina Smith
MN • D
Sponsored 12/9/2025
Thomas Tillis
NC • R
Sponsored 12/9/2025
Catherine Cortez Masto
NV • D
Sponsored 12/9/2025
Roll Call Votes
No roll call votes available for this bill.
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