H.R. 8487

[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[H.R. 8487 Introduced in House (IH)]

<DOC>

119th CONGRESS
2d Session
H. R. 8487

To amend titles XVIII and XIX of the Social Security Act to adjust 
coverage and payment for certified community behavioral health clinic 
services under the Medicare and Medicaid programs, and for other 
purposes.

_______________________________________________________________________

IN THE HOUSE OF REPRESENTATIVES

April 23, 2026

Ms. Matsui (for herself, Mr. Pfluger, Ms. Craig, Mr. Alford, Mr. Tonko, 
Mr. Fitzpatrick, and Mr. Goldman of Texas) introduced the following 
bill; which was referred to the Committee on Energy and Commerce, and 
in addition to the Committee on Ways and Means, for a period to be 
subsequently determined by the Speaker, in each case for consideration 
of such provisions as fall within the jurisdiction of the committee 
concerned

_______________________________________________________________________

A BILL

To amend titles XVIII and XIX of the Social Security Act to adjust 
coverage and payment for certified community behavioral health clinic 
services under the Medicare and Medicaid programs, and for other 
purposes.

Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

This Act may be cited as the ``Ensuring Excellence in Mental Health 
Act''.

SEC. 2. TABLE OF CONTENTS.

The table of contents for this Act is as follows:

Sec. 1. Short title.
Sec. 2. Table of contents.
TITLE I--STRENGTHENING AND PROVIDING COST-RELATED PAYMENT FOR CERTIFIED 
COMMUNITY BEHAVIORAL HEALTH CLINICS UNDER THE MEDICAID PROGRAM

Sec. 101. Coordination of Medicaid certified community behavioral 
health clinic services with CCBHC operating 
grant program; CCBHC accreditation option.
Sec. 102. Establishing a prospective payment system for certified 
community behavioral health clinics.
Sec. 103. Expanding CCBHC services within Medicaid demonstration 
program.
Sec. 104. Expanding scope of CCBHC services covered under the Medicaid 
program.
TITLE II--COVERAGE OF CERTIFIED COMMUNITY BEHAVIORAL HEALTH CLINIC 
SERVICES UNDER THE MEDICARE PROGRAM

Sec. 201. Coverage of certified community behavioral health clinic 
services under the medicare program.
Sec. 202. Payment for certified community behavioral health clinic 
services under the medicare program.
Sec. 203. Non-application of Medicare part B deductible for CCBHC 
services.
Sec. 204. Right to seek review of cost reports from Provider 
Reimbursement Review Board.
Sec. 205. Extending safe harbor under Anti-Kickback Statute to waivers 
of CCBHC coinsurance.
Sec. 206. Effective date.
TITLE III--COMMUNITY BEHAVIORAL HEALTH CLINIC GRANTS

Sec. 301. Operating grants, technical assistance, data infrastructure, 
and accreditation for community behavioral 
health clinics.
TITLE IV--LIABILITY PROTECTION FOR CERTIFIED COMMUNITY BEHAVIORAL 
HEALTH CLINIC CLINICIANS

Sec. 401. Conferring protection under the Federal Tort Claims Act to 
clinicians in certified community 
behavioral health clinics.

TITLE I--STRENGTHENING AND PROVIDING COST-RELATED PAYMENT FOR CERTIFIED 
COMMUNITY BEHAVIORAL HEALTH CLINICS UNDER THE MEDICAID PROGRAM

SECTION 101. COORDINATION OF MEDICAID CERTIFIED COMMUNITY BEHAVIORAL 
HEALTH CLINIC SERVICES WITH CCBHC OPERATING GRANT 
PROGRAM; CCBHC ACCREDITATION OPTION.

Section 1905(jj)(2) of the Social Security Act (42 U.S.C. 
1396d(jj)(2)) is amended--
(1) in subparagraph (B)--
(A) by inserting ``(or providing or referring 
through formal relationships, as applicable)'' after 
``furnishing'';
(B) by striking ``described in paragraph (1)'' and 
inserting ``described in paragraph (1)(B)''; and
(C) by striking ``and'' at the end;
(2) in subparagraph (C), by striking the period at the end 
and inserting ``, and including any such data as the State, by 
agreement with the Secretary, shall access via the system 
described in section 340J-3 of the Public Health Service Act; 
and''; and
(3) by adding at the end the following new subparagraph:
``(D) beginning January 1, 2026, at the option of 
the State, has received accreditation by an 
accreditation body approved under section 340J-4 of the 
Public Health Service Act.''.

SEC. 102. ESTABLISHING A PROSPECTIVE PAYMENT SYSTEM FOR CERTIFIED 
COMMUNITY BEHAVIORAL HEALTH CLINICS.

(a) In General.--Section 1902 of the Social Security Act (42 U.S.C. 
1396a) is amended by adding at the end the following new subsection:
``(yy) Payment for Services Provided by Certified Community 
Behavioral Health Clinics.--
``(1) In general.--Beginning with fiscal year 2026 with 
respect to services furnished on or after January 1, 2026, and 
for each succeeding fiscal year, if a State elects to make 
medical assistance available for certified community behavioral 
health clinic services under section 1905(a)(31), the State 
plan shall provide for payment for such services furnished by 
(or under arrangement with) a certified community behavioral 
health clinic described in section 1905(jj)(2) (in this 
subsection referred to as a `clinic') in accordance with the 
provisions of this subsection.
``(2) Prospective payment system.--
``(A) In general.--Subject to paragraph (4), a 
State shall provide for payment for certified community 
behavioral health clinic services furnished by (or 
under arrangement with) a clinic in the first fiscal 
year (or portion of a fiscal year) described in 
paragraph (1) for which a State elects to provide 
medical assistance for such services under section 
1905(a)(31) under a prospective payment system 
developed by the State in accordance with this 
paragraph.
``(B) Unit of payment.--In establishing the system 
under subparagraph (A), the State shall apply as the 
unit of service--
``(i) daily visits; or
``(ii) monthly visits (excluding repeat 
visits from the same individual).
``(C) System design.--Under the system under 
subparagraph (A), the State may, consistent with the 
methodology described in guidance issued under section 
223(b) of the Protecting Access to Medicare Act of 
2014--
``(i) establish separate prospective 
payment system rates for special populations;
``(ii) use a system of outlier payments for 
a portion of costs of furnishing certified 
community behavioral health clinic services; or
``(iii) with respect to certified community 
behavioral health clinic services that are 
crisis services--
``(I) require that each cost report 
of a clinic segregate costs relating to 
mobile crisis teams, emergency crisis 
intervention services, or crisis 
stabilization from other components of 
the services described in section 
1905(a)(31); and
``(II) provide for a prospective 
payment system rate for any or all of 
such crisis services that is distinct 
from the rate encompassing the 
remainder of the services described in 
section 1905(a)(31).
``(D) Payment basis.--Subject to subparagraph (E), 
the State shall provide for computation of a 
prospective payment amount for an individual certified 
community behavioral health clinic under the system 
under subparagraph (A) as follows:
``(i) For the first fiscal year (or portion 
of a fiscal year) for which a State elects to 
provide medical assistance for such services 
under section 1905(a)(31), such amount--
``(I) in the case of a State that 
did not operate a demonstration program 
under section 223 of the Protecting 
Access to Medicare Act of 2014 during a 
base year corresponding to the fiscal 
year immediately preceding such first 
fiscal year (or portion of a fiscal 
year), shall be equal to 100 percent of 
the costs of the clinic which are 
reasonable and related to the 
furnishing of such services during such 
base year; and
``(II) in the case of a State that 
did operate a demonstration program 
under section 223 of the Protecting 
Access to Medicare Act of 2014 during 
such base year, shall be equal to, at 
the option of the State--
``(aa) the amount described 
in subclause (I); or
``(bb) the amount that 
would have otherwise applied 
with respect to such services 
under such demonstration.
``(ii) For each subsequent fiscal year for 
which a State elects to provide medical 
assistance for such services under section 
1905(a)(31), such amount shall be, subject to 
subparagraph (F), the amount calculated under 
this subparagraph for the preceding fiscal 
year--
``(I) increased by the percentage 
increase described in section 
1834(aa)(3)(C) for the calendar year in 
which such preceding fiscal year began; 
and
``(II) adjusted to take into 
account any increase or decrease in the 
scope of such services furnished by the 
clinic during the fiscal year involved.
``(E) Establishment of initial fiscal year payment 
for new clinics.--For purposes of subparagraph (D)--
``(i) in the case of a certified community 
behavioral health clinic that does not have 
available complete actual cost data 
representing the provision of all certified 
community behavioral health clinic services 
provided in the base year described in clause 
(i)(I) of such subparagraph, the State may use 
estimated or projected data relating to 
specific services for which the clinics lack 
cost experience; and
``(ii) in the case of an entity that first 
enrolls under this title as a certified 
community behavioral health clinic in a year 
after the first fiscal year in which the State 
first provides for payment for the services 
described in section 1905(a)(31) in accordance 
with paragraph (1)--
``(I) for the first fiscal year in 
which the clinic furnishes such 
services, the amount determined by the 
State for such clinic shall be--
``(aa) determined on the 
basis of the amounts 
established under this 
paragraph for other such 
clinics located in the same or 
adjacent area (as defined by 
the Secretary) with a similar 
case load; or
``(bb) in the absence of 
any such clinic, based on the 
reasonable projected costs per 
visit of the clinic;
``(II) for the second fiscal year 
in which the clinic furnishes such 
services, the amount determined by the 
State for such clinic shall be 
determined under clause (i)(I) of such 
subparagraph on the basis of the 
reasonable and related costs and visits 
from the clinic's first fiscal year of 
operation; and
``(III) for the third and each 
subsequent fiscal year in which the 
clinic furnishes such services, the 
amount determined by the State for such 
clinic shall be determined under clause 
(ii) of such subparagraph.
``(F) Rebasing.--A State may periodically (but no 
less frequently than every third fiscal year after the 
first fiscal year described in subparagraph (D)) rebase 
the prospective payment amount determined under 
subparagraph (D) such that costs from the fiscal year 
preceding the rebasing year, rather than costs from the 
base year described in clause (i)(I) of such 
subparagraph, shall be used in establishing a new cost-
related rate for each clinic. Such rebasing shall 
include those clinics with initial rates determined 
under subparagraph (E).
``(3) Administration in the case of managed care.--
``(A) In general.--In the case of services 
furnished by a certified community behavioral health 
clinic pursuant to a contract between the clinic and a 
managed care entity (as defined in section 
1932(a)(1)(B)) or other specified entity (as defined in 
1903(m)(9)(D)(iii)), the State shall provide for 
payment to the clinic by the State of a supplemental 
payment equal to the amount (if any) by which the 
amount determined under the preceding paragraphs of 
this subsection (or paragraph (4), as applicable) 
exceeds the amount of payments provided under the 
contract. Such supplemental payment shall be made 
pursuant to a payment schedule agreed to by the State 
and the clinic, but in no case less frequently than 
every 4 months.
``(B) Option to delegate pps payment to managed 
care entities through an alternative payment 
methodology.--Notwithstanding subparagraph (A), nothing 
in this subsection shall be interpreted to preclude a 
State from amending its State plan to provide for an 
alternative payment methodology under paragraph (4), 
under which the State may delegate to a managed care 
entity, as defined in section 1932(a)(1)(B), the 
responsibility to pay the clinic at least the rate 
determined under the preceding subparagraphs (or 
paragraph (4), as applicable), provided that the State 
shall meet all requirements described in paragraph (4), 
and shall use oversight processes to ensure that each 
clinic is paid at least the amounts required under the 
preceding paragraphs of this subsection.
``(4) Alternative payment methodologies.--Notwithstanding 
any other provision of this subsection, the State plan may 
provide for payment in any fiscal year to a certified community 
behavioral health clinic for services described in paragraph 
(31) of section 1905(a) in an amount which is determined under 
an alternative payment methodology that--
``(A) is agreed to by the State and the clinic; and
``(B) results in payment to the clinic of an amount 
which is not less than the amount otherwise required to 
be paid to the clinic under this subsection.''.
(b) Requirement To Use Prospective Payment System Under Benchmark 
or Benchmark Equivalent Coverage.--Section 1937(b)(4) of the Social 
Security Act (42 U.S.C. 1396u-7(b)(4)) is amended--
(1) in the paragraph heading, by inserting ``; coverage of 
ccbhc services'' after ``FQHC services'';
(2) by redesignating subparagraphs (A) and (B) as clauses 
(i) and (ii), respectively, and adjusting the margins 
accordingly;
(3) by striking ``this section, a State'' and inserting: 
``this section--
``(A) a State''; and
(4) by adding at the end the following new subparagraph:
``(B) in the case that a State provides for medical 
assistance for certified community behavioral health 
clinic services (as defined in section 1905(jj)(1)) 
through enrollment of an individual with benchmark 
coverage or benchmark equivalent coverage under this 
section, payment for such services shall be made in 
accordance with the requirements of section 
1902(yy).''.

SEC. 103. EXPANDING CCBHC SERVICES WITHIN MEDICAID DEMONSTRATION 
PROGRAM.

(a) Additional Services Within Demonstration Program.--Section 223 
of the Protecting Access to Medicare Act of 2014 (42 U.S.C. 1396a note) 
is amended--
(1) in section (a)(2)(D)--
(A) by redesignating clauses (i) through (ix) as 
subclauses (I) through (IX), respectively, and 
adjusting the margins accordingly;
(B) by striking ``Provision'' and all that follows 
through ``relationships with other providers:'' and 
inserting:
``(i) In general.--Provision (in a manner 
reflecting person-centered care) of--
``(I) the required CCBHC services 
(as defined in clause (ii)); and
``(II) the additional CCBHC 
services (as defined in clause (iii)).
``(ii) Required ccbhc services.--For 
purposes of clause (i), the term `required 
CCBHC services' means any of the following 
services which, if not available directly 
through the certified community behavioral 
health clinic, are provided or referred through 
formal relationships with other providers:''; 
and
(C) by adding at the end the following new clause:
``(iii) Additional ccbhc services.--For 
purposes of clause (i), the term `additional 
CCBHC services' means services available 
directly through the certified community 
behavioral health clinic--
``(I) that are not required CCBHC 
services (as defined in clause (ii));
``(II) that are appropriate to meet 
the health needs of the population 
served; and
``(III) which may include any of 
the primary health services defined in 
section 330 (b)(1)(A) of the Public 
Health Service Act.'';
(2) in subsection (b)(1), by striking ``mental health 
services'' and inserting ``certified community behavioral 
health clinic services''; and
(3) in subsection (e)--
(A) by redesignating paragraphs (1) through (4) as 
paragraphs (2) through (5), respectively; and
(B) by inserting before paragraph (2), as so 
redesignated, the following new paragraph:
``(1) Certified community behavioral health clinic 
services.--The term `certified community behavioral health 
clinic services' means--
``(A) required CCBHC services (as defined in 
subsection (a)(2)(D)(ii)); and
``(B) additional CCBHC services (as defined in 
subsection (a)(2)(D)(iii)), to the extent that a 
certified community behavioral health clinic elects to 
furnish any such services.''.
(b) Effective Date.--The amendments made by this section shall 
apply with respect to services furnished on or after October 1, 2026.

SEC. 104. EXPANDING SCOPE OF CCBHC SERVICES COVERED UNDER THE MEDICAID 
PROGRAM.

(a) Additional Services Within CCBHC Benefit.--Section 1905(jj) of 
the Social Security Act (42 U.S.C. 1396d(jj)) is amended--
(1) in the subsection heading, by inserting ``; Certified 
Community Behavioral Health Clinic'' after ``Certified 
Community Behavioral Health Clinic Services''; and
(2) in paragraph (1)--
(A) in the paragraph heading, by striking ``In 
general'' and inserting ``Certified community 
behavioral health clinic services'';
(B) by redesignating subparagraphs (A) through (I) 
as clauses (i) through (ix), respectively, and 
adjusting the margins accordingly;
(C) by striking ``The term'' and all that follows 
through ``relationships with other providers:'' and 
inserting:
``(A) In general.--The term `certified community 
behavioral health clinic services' means--
``(i) the required CCBHC services (as 
defined in subparagraph (B)); and
``(ii) the additional CCBHC services (as 
defined in subparagraph (C)).
``(B) Required ccbhc services.--For purposes of 
subparagraph (A), the term `required CCBHC services' 
means any of the following services when furnished to 
an individual as a patient of a certified community 
behavioral health clinic (as defined in paragraph (2)), 
in a manner reflecting person-centered care and which, 
if not available directly through a certified community 
behavioral health clinic, may be provided or referred 
through formal relationships with other providers:''; 
and
(D) by adding at the end the following new 
subparagraph:
``(C) Additional ccbhc services.--For purposes of 
subparagraph (A), the term `additional CCBHC services' 
means services furnished to an individual as a patient 
of a certified community behavioral health clinic (as 
defined in paragraph (2)), in a manner reflecting 
person-centered care--
``(i) that are not required CCBHC services 
under subparagraph (B);
``(ii) that are appropriate to meet the 
health needs of the population served; and
``(iii) which may include any of the 
primary health services defined in section 
330(b)(1) of the Public Health Service Act.''.
(b) Effective Date.--The amendments made by this section shall 
apply with respect to services furnished on or after October 1, 2026.

TITLE II--COVERAGE OF CERTIFIED COMMUNITY BEHAVIORAL HEALTH CLINIC 
SERVICES UNDER THE MEDICARE PROGRAM

SEC. 201. COVERAGE OF CERTIFIED COMMUNITY BEHAVIORAL HEALTH CLINIC 
SERVICES UNDER THE MEDICARE PROGRAM.

(a) Coverage.--Section 1861(s)(2) of the Social Security Act (42 
U.S.C. 1395x(s)(2)) is amended--
(1) in subparagraph (JJ), by adding ``and'' at the end; and
(2) by adding at the end the following new subparagraph:
``(KK) certified community behavioral health clinic 
services (as defined in subsection (aa)(8)) furnished on or 
after January 1, 2027.''.
(b) Definitions.--Section 1861(aa) of the Social Security Act (42 
U.S.C. 1395x) is amended--
(1) in the heading, by striking ``and Federally Qualified 
Health Center Services'' and inserting ``, Federally Qualified 
Health Center Services, and Certified Community Behavioral 
Health Clinic Services''; and
(2) by adding at the end the following new paragraph:
``(8) The terms `certified community behavioral health clinic 
services' and `certified community behavioral health clinic' have the 
meaning given each such term in section 1905(jj).''.

SEC. 202. PAYMENT FOR CERTIFIED COMMUNITY BEHAVIORAL HEALTH CLINIC 
SERVICES UNDER THE MEDICARE PROGRAM.

(a) In General.--Section 1833(a)(1) of the Social Security Act (42 
U.S.C. 1395l(a)(1)) is amended--
(1) by striking ``and (HH)'' and inserting ``(HH)''; and
(2) by inserting before the semicolon at the end the 
following: ``, and (II) with respect to certified community 
behavioral health clinic services (as defined in section 
1861(aa)(8)), the amounts paid shall be equal to 80 percent of 
the lesser of the actual charge or the amount determined under 
section 1834(aa)''.
(b) Development and Implementation of Prospective Payment System.--
Section 1834 of the Social Security Act (42 U.S.C. 1395m) is amended by 
adding at the end the following new subsection:
``(aa) Development and Implementation of Prospective Payment System 
for Certified Community Behavioral Health Clinics.--
``(1) In general.--The Secretary shall develop a 
prospective payment system for payment to certified community 
behavioral health clinic services (as defined in section 
1861(aa)(8)) furnished by certified community behavioral health 
clinics (as defined in such section) under this title. In 
establishing such system, the Secretary--
``(A) shall take into account the type, intensity, 
and duration of services furnished by certified 
community behavioral health clinics; and
``(B) may incorporate such adjustments, including 
geographic adjustments, as the Secretary determines 
appropriate.
``(2) Unit of payment.--In establishing a prospective 
payment amount under the system under this subsection, the 
Secretary shall consider an appropriate unit of service and a 
general system design that provides for continued access to 
quality services.
``(3) Payment basis.--Under the system under this 
subsection, the Secretary shall provide for computation of a 
prospective payment amount for services furnished during a year 
as follows:
``(A) For 2027, such amount shall be based on the 
average costs of such clinics which are reasonable (as 
determined without the application of a per visit 
payment limit or productivity screen and prior to the 
application of section 1866(a)(2)(A)(ii)) and related 
to the furnishing of the services described in section 
1905(jj)(1)(B), as determined on the basis of the most 
current audited cost report data for 2 consecutive 
fiscal years available to the Secretary. In the absence 
of complete actual cost data representing the provision 
of such services during the relevant fiscal years, 
certified community behavioral health clinics may, at 
the Secretary's discretion, submit estimated or 
projected data relating to specific services.
``(B) For 2028, such amount shall be equal to the 
amount determined under subparagraph (A), increased by 
the percentage increase in the MEI (as defined in 
section 1842(i)(3)) for the year involved.
``(C) For 2029 and each subsequent year, such 
amount shall be equal to the amount determined under 
this paragraph for the preceding year, increased by the 
percentage increase in a market basket of certified 
community behavioral health clinic services designed by 
the Secretary (or, if such an index is not available, 
by the percentage increase in the federally-qualified 
health center market basket (as described in section 
1834(o)(2)(B)(ii)(II))) for the year involved.
``(4) Periodic reevaluation of rates.--The Secretary may, 
from time to time, adjust the amounts that would otherwise be 
applicable under paragraph (3) for a year by a percentage 
determined appropriate by the Secretary to reflect such factors 
as changes in the intensity of services furnished within a unit 
of service, the average cost of providing care per unit of 
service, and other factors that the Secretary considers to be 
relevant. Such adjustment shall be made before the update under 
paragraph (2)(C) has been applied for the year.''.

SEC. 203. NON-APPLICATION OF MEDICARE PART B DEDUCTIBLE FOR CCBHC 
SERVICES.

Section 1833(b)(4) of the Social Security Act (42 U.S.C. 
1395l(b)(4)) is amended by inserting ``or certified community 
behavioral health clinic services'' after ``such deductible shall not 
apply to Federally qualified health center services''.

SEC. 204. RIGHT TO SEEK REVIEW OF COST REPORTS FROM PROVIDER 
REIMBURSEMENT REVIEW BOARD.

Section 1878(j) of the Social Security Act (42 U.S.C. 1395oo(j)) is 
amended by striking ``and a Federally qualified health center'' and 
inserting ``, a Federally qualified health center, and a certified 
community behavioral health clinic''.

SEC. 205. EXTENDING SAFE HARBOR UNDER ANTI-KICKBACK STATUTE TO WAIVERS 
OF CCBHC COINSURANCE.

Section 1128B(b)(3)(D) of the Social Security Act (42 U.S.C. 1320a-
7b(b)(3)(D)) is amended by inserting ``or a certified community 
behavioral health clinic'' after ``Federally qualified health care 
center''.

SEC. 206. EFFECTIVE DATE.

The amendments made by this title shall apply with respect to 
services furnished on or after January 1, 2026.

TITLE III--COMMUNITY BEHAVIORAL HEALTH CLINIC GRANTS

SEC. 301. OPERATING GRANTS, TECHNICAL ASSISTANCE, DATA INFRASTRUCTURE, 
AND ACCREDITATION FOR COMMUNITY BEHAVIORAL HEALTH 
CLINICS.

Part D of title III of the Public Health Service Act (42 U.S.C. 
254b et seq.) is amended by adding at the end the following new 
subpart:

``Subpart XIII--Community Behavioral Health Clinics

``SEC. 340J. DEFINITIONS.

``In this subpart:
``(1) Certified community behavioral health clinic.--The 
term `certified community behavioral health clinic' has the 
meaning given such term in section 1905(jj)(2) of the Social 
Security Act.
``(2) Certified community behavioral health clinic 
services.--The term `certified community behavioral health 
clinic services' has the meaning given such term in section 
1905(jj)(1) of the Social Security Act.

``SEC. 340J-1. OPERATING GRANTS FOR COMMUNITY BEHAVIORAL HEALTH 
CLINICS.

``(a) In General.--The Secretary shall establish a grant program 
under which the Secretary shall award grants to eligible community 
behavioral health clinics to provide (in a manner reflecting person-
centered care) certified community behavioral health clinic services 
that are required CCBHC services (as defined in section 1905(jj)(1)(B) 
of the Social Security Act).
``(b) Eligibility; Selection.--
``(1) Eligibility.--An entity is eligible to receive a 
grant under subsection (a) if such entity is--
``(A) a certified community behavioral health 
clinic; or
``(B) a community behavioral health clinic that 
indicates in the grant application that the clinic will 
use the grant funds to meet the criteria established by 
the Secretary under section 223(a) of the Protecting 
Access to Medicare Act of 2014 as of March 2023, and 
any subsequent updates to such criteria.
``(2) Selection.--In selecting eligible entities to receive 
a grant under subsection (a), the Secretary--
``(A) may elect to impose as a condition for the 
receipt of a grant under this section that the entity 
be accredited, per section 340J-4(a);
``(B) may award a grant to an entity described in 
paragraph (1)(B) that specializes in providing services 
to children, youth, or veterans, if such entity 
demonstrates to the satisfaction of the Secretary that 
the entity can ensure access to care for all 
individuals in the relevant community served by the 
entity through referral or other formal arrangements 
with other providers of services; and
``(C) may establish additional conditions for the 
receipt of a grant under this section to--
``(i) ensure improved geographic 
distribution of community behavioral health 
clinics;
``(ii) prioritize the awarding of grants to 
eligible entities that serve communities with 
elevated behavioral health needs;
``(iii) prioritize eligible entities that 
are prepared to offer all required CCBHC 
services (as defined in section 1905(jj)(1)(B) 
of the Social Security Act); and
``(iv) ensure consistency in planning with 
State CCBHC programs.
``(c) Use of Funds.--An eligible entity that receives a grant under 
subsection (a)--
``(1) shall use the grant funds--
``(A) to provide certified community behavioral 
health clinic services; and
``(B) in the case of an entity described in 
subparagraph (B) of subsection (b)(1), to meet the 
criteria described in such subparagraph; and
``(2) may use the grant funds--
``(A) to carry out other activities that--
``(i) reduce costs associated with the 
provision of certified community behavioral 
health clinic services;
``(ii) improve access to, and availability 
of, certified community behavioral health 
clinic services provided to individuals in the 
relevant community served by the community 
behavioral health clinic;
``(iii) enhance the quality and 
coordination of certified community behavioral 
health clinic services; or
``(iv) otherwise improve the health status 
of communities; and
``(B) to pay for--
``(i) the costs of acquiring and leasing 
buildings and equipment (including the costs of 
amortizing the principal of, and paying 
interest on, loans);
``(ii) costs relating to the purchase or 
lease of equipment, including data and 
information systems and behavioral health 
information technology to facilitate data 
reporting and other purposes;
``(iii) the costs of in-service staff 
training and other operational or 
infrastructure costs as the Secretary 
determines appropriate; or
``(iv) costs associated with expanding and 
modernizing existing buildings or constructing 
new buildings (including the costs of 
amortizing the principal of, and paying the 
interest on, loans), if such costs are 
specifically allowed for in the grant 
opportunity published by the Secretary.
``(d) Use of Nongrant Funds.--Amounts described in subsection 
(g)(1)(B), including any such funds in excess of those estimated under 
such subsection, shall be used as permitted under this section, and may 
be used for such other purposes as are not specifically prohibited 
under this section if such use furthers the objectives of the grant.
``(e) Term.--Grants awarded under subsection (a) shall be for a 
period of not more than 5 years.
``(f) Condition on Receipt of Funds.--The Secretary may not award a 
grant to an eligible entity under subsection (a) unless the entity 
provides assurances to the Secretary that, not later than 120 days 
after receiving notice that the entity has been selected under 
subsection (b)(2) to receive a grant, the entity will submit to the 
Secretary for approval an implementation plan that describes how the 
entity will--
``(1) provide certified community behavioral health clinic 
services; and
``(2) in the case of an entity described in subparagraph 
(B) of subsection (b)(1), to meet the criteria described in 
such subparagraph.
``(g) Amount of Grant.--
``(1) In general.--Subject to paragraph (2), in determining 
the amount of a grant made in any fiscal year to an eligible 
entity under subsection (a), the Secretary shall take into 
account information provided by the entity with respect to the 
following:
``(A) The total State, local, and other operational 
funding provided to the entity for such fiscal year.
``(B) The fees, premiums, and third-party 
reimbursements that the entity reasonably expects to 
receive for items and services furnished during such 
fiscal year.
``(C) The costs to the entity of meeting the 
purposes and requirements of the grant program under 
this section during such fiscal year, as estimated by 
the Secretary based upon the anticipated costs to the 
entity of--
``(i) providing certified community 
behavioral health clinic services, including 
the anticipated costs of providing any 
individual certified community behavioral 
health service that the entity does not have 
experience providing at the time of submitting 
an application for such grant; and
``(ii) in the case of an entity described 
in subparagraph (B) of subsection (b)(1), 
meeting the criteria described in such 
subparagraph.
``(2) Payments.--The Secretary may award grants under 
subsection (a) in such form and manner as the Secretary 
determines appropriate (including by making grant amounts 
available in advance or through reimbursement, and including by 
making such amounts available in installments), and may adjust 
grant amounts to account for overpayments or underpayments.
``(h) Use of Accreditation in Monitoring Grant Progress.--
Regardless of whether the Secretary elects under subsection (b) to use 
accreditation under section 340J-4(a) as a condition for the award of a 
grant under subsection (a), the Secretary may take such accreditation 
into account in determining whether an entity receiving such a grant is 
providing the services described in subsection (a) and, if applicable, 
meeting such criteria as are described in subsection (b)(2).
``(i) Authorization of Appropriations.--
``(1) In general.--There is authorized to be appropriated 
to carry out this section $552,500,000 for each of fiscal years 
2026 through 2030.
``(2) Maintenance of funding.--The amount made available 
under paragraph (1) shall supplement (and not supplant) any 
other Federal funding made available for certified community 
behavioral health clinics.
``(j) Guidance for Clinics Serving Specialized Populations.--Not 
later than 1 year after the date of enactment of this section, the 
Secretary shall publish guidance clarifying how certified community 
behavioral health clinics that focus on distinct populations, such as 
children, youth, or veterans, may meet any relevant requirement to 
furnish appropriate treatment to all individuals. Such guidance shall 
not affect such clinics' qualification to participate in the 
demonstration program under section 223(d) of the Protecting Access to 
Medicare Act of 2014 or to furnish the services described under section 
1905(a)(31) of the Social Security Act.

``SEC. 340J-2. TECHNICAL ASSISTANCE.

``(a) In General.--Not later than 180 days after the date of 
enactment of the Ensuring Excellence in Mental Health Act, the 
Secretary shall establish a program or programs through which the 
Secretary shall provide (either through the Department of Health and 
Human Services or by grant or contract) technical assistance, and such 
other assistance as the Secretary determines appropriate, to any of the 
following:
``(1) Entities receiving a grant under section 340J-1.
``(2) Entities participating in a demonstration program 
under section 223(d) of the Protecting Access to Medicare Act 
of 2014.
``(3) Certified community behavioral health clinics (as 
defined in sections 1861(aa)(8) and 1905(jj)(2) of the Social 
Security Act) furnishing services under title XVIII or title 
XIX of such Act.
``(4) Health or social service provider organizations 
pursuing or considering certified community behavioral health 
clinic status or partnering with certified community behavioral 
health clinics.
``(5) States and territories, for the purpose of assisting 
in the consideration of demonstration programs carried out 
under section 223(d) of the Protecting Access to Medicare Act 
of 2014, the planning and development of new State certified 
community behavioral health clinic programs, or the ongoing 
implementation and improvement of established State certified 
community behavioral health clinic programs.
``(6) Other stakeholders, for the purpose of facilitating 
the successful implementation of the certified community 
behavioral health clinic model.
``(b) Inclusions.--Assistance provided by the Secretary under 
subsection (a) may include technical and nonfinancial assistance, 
including, but not limited to--
``(1) fiscal and program management assistance;
``(2) operational and administrative support; and
``(3) the provision of information to the entities about 
the variety of resources available under this part and how 
those resources can be best used to meet the health and 
behavioral health needs of the communities served by the 
entities.
``(c) Authorization of Appropriations.--There is authorized to be 
appropriated to carry out this section $8,000,000 for each of fiscal 
years 2026 through 2030.

``SEC. 340J-3. DATA INFRASTRUCTURE FOR COMMUNITY BEHAVIORAL HEALTH 
CLINIC REPORTING.

``(a) In General.--Not later than 180 days after the date of 
enactment of the Ensuring Excellence in Mental Health Act, the 
Secretary shall establish a system under which the Secretary shall 
collect and analyze data on community behavioral health clinics.
``(b) Scope of Data Collection.--The system established under 
subsection (a) shall be used by the Secretary to collect and analyze 
data from--
``(1) entities that receive a grant under section 340J-1; 
and
``(2) certified community behavioral health clinics (as 
defined in sections 1861(aa)(8) and 1905(jj)(2) of the Social 
Security Act) furnishing services under title XVIII or title 
XIX of such Act.
``(c) Authorization of Appropriations.--There is authorized to be 
appropriated to carry out this section $51,000,000 for each of fiscal 
years 2026 through 2030.

``SEC. 340J-4. CERTIFIED COMMUNITY BEHAVIORAL HEALTH CLINIC 
ACCREDITATION.

``(a) Accreditation Standards.--A clinic is accredited as a 
certified community behavioral health clinic under this section if the 
clinic--
``(1) is accredited by an accreditation body approved by 
the Secretary under subsection (b); and
``(2) authorizes the accreditation body to submit to the 
Secretary (or such agency as the Secretary may designate) such 
records or other information as the Secretary may require.
``(b) Approval of Accreditation Bodies.--The Secretary may approve 
a private nonprofit organization to be an accreditation body for the 
accreditation of certified community behavioral health clinics under 
subsection (a) if--
``(1) the accreditation body agrees to inspect the clinic, 
using inspectors qualified to evaluate quality of care in a 
behavioral health service setting, with such frequency the 
Secretary determines appropriate;
``(2) the Secretary determines that the standards applied 
by the accreditation body in determining whether or not to 
accredit a clinic correspond to (and are not less restrictive 
than) the criteria described in section 340J-1(b)(1)(B);
``(3) the accreditation body has made adequate assurances 
that the standards of the accreditation body continue to be met 
by each clinic that it accredited;
``(4) the accreditation body agrees that, for the 3-year 
period following accreditation of a clinic, in the case that 
the accreditation body suspends, withdraws, or revokes such 
accreditation, denies an application to renew such 
accreditation, or takes any other disciplinary action with 
respect to such clinic, the accreditation body shall submit to 
the Secretary the name of such clinic not later than 30 days 
after such action is taken;
``(5) the accreditation body agrees that, in the case that 
its approval is withdrawn by the Secretary, the body will 
notify each clinic accredited by the body of the withdrawal 
within 10 days of the withdrawal; and
``(6) the accreditation body complies with such other 
requirements as the Secretary determines appropriate.
``(c) Oversight of Accreditation Bodies.--The Secretary may provide 
ongoing oversight of accrediting bodies approved under subsection (b). 
Such ongoing oversight may include the following actions:
``(1) Providing continual oversight and review of approved 
accreditation processes through regular communication with such 
bodies.
``(2) Providing additional review of individual certified 
community behavioral health clinic accreditations to assure 
alignment with the criteria established by the Secretary under 
section 223(a) of the Protecting Access to Medicare Act of 2014 
and, in cases where potential issues are identified with 
individual certified community behavioral health clinic 
accreditations, to provide review of such issues.
``(3) Mediating disputes between providers seeking 
certified community behavioral health clinic accreditation and 
approved accreditation bodies.
``(4) Providing ongoing support and coordination across 
approved accreditation bodies.
``(5) In cases where an approved accreditation body is 
found to not provide accreditation in alignment with the 
criteria established by the Secretary under section 223(a) of 
the Protecting Access to Medicare Act of 2014, developing a 
process to terminate the approval provided under subsection (b) 
with respect to such body.
``(6) Periodically reviewing accreditation body processes 
and renewing the approval provided under subsection (b) with 
respect to such bodies.
``(7) Such other activities as the Secretary determines 
necessary for the oversight of accreditation bodies approved 
under subsection (b).''.

TITLE IV--LIABILITY PROTECTION FOR CERTIFIED COMMUNITY BEHAVIORAL 
HEALTH CLINIC CLINICIANS

SEC. 401. CONFERRING PROTECTION UNDER THE FEDERAL TORT CLAIMS ACT TO 
CLINICIANS IN CERTIFIED COMMUNITY BEHAVIORAL HEALTH 
CLINICS.

Section 224(g)(4) of the Public Health Service Act (42 U.S.C. 
233(g)(4)) is amended by inserting ``or a certified community 
behavioral health clinic (as defined in section 1905(jj)(2) of the 
Social Security Act)'' before the period at the end.
<all>