Ensuring Excellence in Mental Health Act
Sponsored By: Senator Cornyn, John [R-TX]
Introduced
Summary
Expand and standardize certified community behavioral health clinics (CCBHCs) across Medicare, Medicaid, and public health programs. The bill creates payment systems, grants, accreditation rules, data systems, technical assistance, and liability protections to grow access to crisis care and integrated behavioral health services.
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Bill Overview
Analyzed Economic Effects
10 provisions identified: 9 benefits, 0 costs, 1 mixed.
Federal grants to expand clinics
If enacted, the bill would create a federal operating grant program to help clinics meet certification, expand services, and build data systems. Grants could last up to five years, require an implementation plan within 120 days, and cannot exceed the gap between program costs and other expected funding. Congress could authorize $552.5 million per year for each of fiscal years 2026 through 2030 to fund the program.
Medicaid payment rules for behavioral clinics
If enacted, States that choose the Medicaid option would pay certified community behavioral clinics under a prospective payment system starting in fiscal year 2026 for services on or after January 1, 2026. A clinic's first-year PPS rate would equal 100% of its base‑year average cost per visit (daily or monthly, at the State's election). States could do rebasing, separate rates for special populations, and outlier payments, and must make up shortfalls when managed care payments fall below the PPS amount at least quarterly.
Medicare coverage for community clinics
If enacted, Medicare would cover certified community behavioral health clinic services for dates of service on or after January 1, 2027. The Medicare Part B deductible would not apply to those clinic services starting that date. Certified clinics would also get the right to seek payment review under rules similar to Federally Qualified Health Centers.
More behavioral health services for Medicaid
If enacted, the bill would expand and codify the set of services CCBHCs must provide under the Medicaid State plan benefit for services on or after October 1, 2026. Required services would include 24‑hour mobile crisis teams, crisis stabilization, screening and risk assessment, outpatient mental health and substance use care, basic primary care screening and monitoring, targeted case management, peer and family supports, and intensive community‑based care for eligible veterans and service members.
Medicare payment system for clinics
If enacted, the Secretary would create a Medicare prospective payment system for certified community behavioral health clinic services for cost reporting periods beginning on or after January 1, 2027 and for services on or after that date. Initial payments would reflect national average allowable service costs from recent audited cost reports and would not include per‑visit limits in the first year. For some services, Medicare would pay 80% of the lesser of the clinic's charge or the PPS amount, and future updates would use the Medicare Economic Index and then a CCBHC market basket.
Clinic coinsurance waiver safe harbor
If enacted, the bill would extend the anti‑kickback safe harbor for waiving coinsurance to certified community behavioral health clinics for services on or after January 1, 2027. That would make it clearer that CCBHCs can lawfully waive coinsurance like Federally Qualified Health Centers, which could lower what some patients pay out of pocket.
Approved accreditation for clinics
If enacted, the bill would allow the Secretary to approve private nonprofit accrediting organizations to accredit clinics as certified CCBHCs. Approved accreditors must meet inspection and reporting standards, and States could opt to require accreditation for Medicaid participation for services on or after January 1, 2026 while statutory certification still applies.
Federal liability protection for clinicians
If enacted, the bill would add certified community behavioral health clinics to the Public Health Service Act provision that extends Federal Tort Claims Act‑related protections to clinicians. That would extend federal liability protections to clinicians who work in certified CCBHCs and could help with recruitment and retention of clinic staff.
National data for community clinics
If enacted, the Secretary would create a system, within 180 days, to collect and analyze data from grant recipients and clinics that provide or applied to provide certified community behavioral health services. Congress could authorize $51 million per year for fiscal years 2026 through 2030 to build and run the data system.
Technical help for behavioral clinics
If enacted, the Secretary would set up, within 180 days, a technical assistance program to help clinics, States, and other stakeholders with certification, fiscal and program management, and operations. The bill would authorize $8 million per year for fiscal years 2026 through 2030 to run this assistance program.
Sponsors & CoSponsors
Sponsor
Cornyn, John [R-TX]
TX • R
Cosponsors
Sen. Smith, Tina [D-MN]
MN • D
Sponsored 12/9/2025
Sen. Tillis, Thomas [R-NC]
NC • R
Sponsored 12/9/2025
Sen. Cortez Masto, Catherine [D-NV]
NV • D
Sponsored 12/9/2025
Roll Call Votes
No roll call votes available for this bill.
View on Congress.gov