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119-hr-10876119th CongressWALLET
Behavioral Healthcare Deregulation Act
Sponsored By: Representative Kelly, Mike [R-PA-16]
Introduced
Summary
Expands Medicare access to mental health care by removing the 190‑day inpatient psychiatric limit and boosting payments for integrated behavioral health services.
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- Patients and families: It would eliminate Medicare's 190‑day lifetime limit on inpatient psychiatric hospital care and bar payment reductions when a patient was admitted after an involuntary commitment. These changes apply to items and services furnished on or after October 1, 2027.
- Medicare payments for integrated care: For select behavioral health integration services tied to HCPCS codes 99484, 99492, 99493, 99494, G2214, and G0323, Medicare payments would be increased to 175% in 2027, 150% in 2028, and 125% in 2029. The bill also prevents those payment increases from being offset by the usual budget neutrality adjustments for 2027 through 2029.
- Providers and rollout support: It would remove certain statutory regulatory references that constrain behavioral health providers by amending sections 1861(f) and 1886(s)(4). The Secretary must offer technical assistance to primary care practices adopting integration models by January 1, 2027, with appropriations of such sums as necessary for fiscal years 2027 through 2031.
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Bill Overview
Analyzed Economic Effects
2 provisions identified: 2 benefits, 0 costs, 0 mixed.
Higher Medicare pay for integrated care
If enacted, Medicare would pay providers higher rates for certain behavioral health integration services in 2027–2029. Services tied to HCPCS codes 99484, 99492, 99493, 99494, G2214, and G0323 (and successor codes) would be paid at 175% in 2027, 150% in 2028, and 125% in 2029 of the otherwise-determined amount. Those increased payments would not be offset by the usual physician fee schedule budget-neutrality adjustment for 2027–2029. The bill would also require HHS to contract for technical assistance to help primary care practices adopt integrated behavioral health models by January 1, 2027, with funding appropriated for fiscal years 2027–2031.
Medicare payment protection after commitment
If enacted, Medicare could not reduce a specified payment rule for inpatient psychiatric hospital services furnished on or after October 1, 2027, when the patient was admitted following a State involuntary commitment order. This change protects provider payment for those stays rather than create a new payment to the patient. It could help keep inpatient psychiatric care available for people admitted after involuntary commitment.
Sponsors & CoSponsors
Sponsor
Kelly, Mike [R-PA-16]
PA • R
Cosponsors
There are no cosponsors for this bill.
Roll Call Votes
No roll call votes available for this bill.
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