Behavioral Health Information Technology Act of 2013 - Amends the Public Health Service Act to include as a health care provider behavioral and mental health professionals, substance abuse professionals, psychiatric hospitals, certain community mental health centers (including one operated by a county behavioral health agency), and residential or outpatient mental health or substance abuse treatment facilities.
Amends title XVIII (Medicare) of the Social Security Act (SSA), with respect to incentives for meaningful use of certified electronic health records (EHR) technology under the pay schedule for physician's services, to include as additional eligible professionals clinical psychologists providing qualified psychologist services and clinical social workers. Subjects any additional eligible professionals, including those under a MedicareAdvantage (MA) plan, to reductions in incentive payments after a certain date for failure to be a meaningful EHR user.
Amends SSA title XIX (Medicaid) to treat as Medicaid providers the following additional Medicaid providers: (1) public and certain private hospitals that are principally psychiatric hospitals, (2) certain community mental health centers, and (3) certain residential or outpatient mental health or substance abuse treatment facilities.
Makes eligible professionals under the Medicaid program certain clinical psychologists providing qualified psychologist services and certain clinical social workers.
[Congressional Bills 113th Congress]
[From the U.S. Government Publishing Office]
[S. 1517 Introduced in Senate (IS)]
113th CONGRESS
1st Session
S. 1517
To amend the Public Health Services Act and the Social Security Act to
extend health information technology assistance eligibility to
behavioral health, mental health, and substance abuse professionals and
facilities, and for other purposes.
_______________________________________________________________________
IN THE SENATE OF THE UNITED STATES
September 18, 2013
Mr. Whitehouse introduced the following bill; which was read twice and
referred to the Committee on Finance
_______________________________________________________________________
A BILL
To amend the Public Health Services Act and the Social Security Act to
extend health information technology assistance eligibility to
behavioral health, mental health, and substance abuse professionals and
facilities, 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 ``Behavioral Health Information
Technology Act of 2013''.
SEC. 2. EXTENSION OF HEALTH INFORMATION TECHNOLOGY ASSISTANCE FOR
BEHAVIORAL HEALTH AND MENTAL HEALTH AND SUBSTANCE ABUSE.
Section 3000(3) of the Public Health Services Act (42 U.S.C.
300jj(3)) is amended by inserting ``a behavioral or mental health
professional (as defined in section 331(a)(3)(E)(i)), a substance abuse
professional, a psychiatric hospital (as defined in section 1861(f) of
the Social Security Act), a community mental health center that meets
the criteria specified in section 1913(c) (including community mental
health centers that are operated by county behavioral health agencies),
a residential or outpatient mental health or substance abuse treatment
facility,'' before ``and any other category''.
SEC. 3. EXTENSION OF ELIGIBILITY FOR MEDICARE AND MEDICAID HEALTH
INFORMATION TECHNOLOGY IMPLEMENTATION ASSISTANCE.
(a) Payment Incentives for Eligible Professionals Under the
Medicare Program.--Section 1848 of the Social Security Act (42 U.S.C.
1395w-4) is amended--
(1) in subsection (a)(7)--
(A) in subparagraph (E), by adding at the end the
following new clause:
``(iv) Additional eligible professional.--
The term `additional eligible professional'
means either of the following:
``(I) A clinical psychologist
providing qualified psychologist
services (as defined in section
1861(ii)).
``(II) A clinical social worker (as
defined in section 1861(hh)(1)).''; and
(B) by adding at the end the following new
subparagraph:
``(F) Application to additional eligible
professionals.--The Secretary shall apply the
provisions of this paragraph with respect to an
additional eligible professional in the same manner as
such provisions apply to an eligible professional,
except in applying subparagraph (A)--
``(i) in clause (i), the reference to 2015
shall be deemed a reference to 2019;
``(ii) in clause (ii), the references to
2015, 2016, and 2017 shall be deemed references
to 2019, 2020, and 2021, respectively; and
``(iii) in clause (iii), the reference to
2018 shall be deemed a reference to 2022.'';
and
(2) in subsection (o)--
(A) in paragraph (5), by adding at the end the
following new subparagraph:
``(D) Additional eligible professional.--The term
`additional eligible professional' means either of the
following:
``(i) A clinical psychologist providing
qualified psychologist services (as defined in
section 1861(ii)).
``(ii) A clinical social worker (as defined
in section 1861(hh)(1)).''; and
(B) by adding at the end the following new
paragraph:
``(6) Application to additional eligible professionals.--
The Secretary shall apply the provisions of this subsection
with respect to an additional eligible professional in the same
manner as such provisions apply to an eligible professional,
except in applying--
``(A) paragraph (1)(A)(ii), the reference to 2016
shall be deemed a reference to 2020;
``(B) paragraph (1)(B)(ii), the references to 2011
and 2012 shall be deemed references to 2015 and 2016,
respectively;
``(C) paragraph (1)(B)(iii), the references to 2013
shall be deemed references to 2017;
``(D) paragraph (1)(B)(v), the references to 2014
shall be deemed references to 2018; and
``(E) paragraph (1)(E), the reference to 2011 shall
be deemed a reference to 2015.''.
(b) Eligible Hospitals.--Section 1886 of the Social Security Act
(42 U.S.C. 1395ww) is amended--
(1) in subsection (b)(3)(B)(ix), by adding at the end the
following new subclause:
``(V) The Secretary shall apply the
provisions of this subsection with
respect to an additional eligible
hospital (as defined in subsection
(n)(6)(C)) in the same manner as such
provisions apply to an eligible
hospital except in applying--
``(aa) subclause (I), the
references to 2015, 2016, and
2017 shall be deemed references
to 2019, 2020, and 2021,
respectively; and
``(bb) subclause (III), the
reference to 2015 shall be
deemed a reference to 2019.'';
and
(2) in subsection (n)--
(A) in paragraph (6), by adding at the end the
following new subparagraph:
``(C) Additional eligible hospital.--The term
`additional eligible hospital' means an inpatient
hospital that is a psychiatric hospital (as defined in
section 1861(f)).''; and
(B) by adding at the end the following new
paragraph:
``(7) Application to additional eligible hospitals.--The
Secretary shall apply the provisions of this subsection with
respect to an additional eligible hospital in the same manner
as such provisions apply to an eligible hospital, except in
applying--
``(A) paragraph (2)(E)(ii), the references to 2013
and 2015 shall be deemed references to 2017 and 2019,
respectively; and
``(B) paragraph (2)(G)(i), the reference to 2011
shall be deemed a reference to 2015.''.
(c) Medicaid Providers.--Section 1903(t) of the Social Security Act
(42 U.S.C. 1396b(t)) is amended--
(1) in paragraph (2)(B)--
(A) in clause (i), by striking ``, or'' and
inserting a semicolon;
(B) in clause (ii), by striking the period at the
end and inserting ``; or''; and
(C) by adding at the end the following new clause:
``(iii) an additional Medicaid provider.'';
(2) in paragraph (3)--
(A) in subparagraph (B), by inserting after and
below clause (v) the following new sentence: ``Such
term includes an additional eligible professional.'';
and
(B) by adding at the end the following new
subparagraphs:
``(G) The term `additional eligible professional'
means--
``(i) a clinical psychologist providing
qualified psychologist services (as defined in
section 1861(ii)), if such clinical
psychologist is practicing in an outpatient
setting that--
``(I) is led by a clinical
psychologist; and
``(II) is not otherwise receiving
payment under paragraph (1) as a
Medicaid provider described in
paragraph (2)(B); and
``(ii) a clinical social worker (as defined
in section 1861(hh)(1)), if such clinical
social worker is practicing in an outpatient
clinic that--
``(I) is led by a clinical social
worker; and
``(II) is not otherwise receiving
payment under paragraph (1) as a
Medicaid provider described in
paragraph (2)(B).
``(H) The term `additional Medicaid provider'
means--
``(i) a public hospital that is principally
a psychiatric hospital (as defined in section
1861(f));
``(ii) a private hospital that is
principally a psychiatric hospital (as defined
in section 1861(f)) and that has at least 10
percent of its patient volume (as estimated in
accordance with a methodology established by
the Secretary) attributable to individuals who
are receiving medical assistance under this
title;
``(iii) a community mental health center
meeting the criteria specified in section
1913(c) of the Public Health Service Act; or
``(iv) a residential or outpatient mental
health or substance abuse treatment facility
that--
``(I) is accredited by the Joint
Commission on Accreditation of
Healthcare Organizations, the
Commission on Accreditation of
Rehabilitation Facilities, the Council
on Accreditation, or any other national
accrediting agency recognized by the
Secretary; and
``(II) has at least 10 percent of
its patient volume (as estimated in
accordance with a methodology
established by the Secretary)
attributable to individuals who are
receiving medical assistance under this
title.''; and
(3) by adding at the end the following new paragraph:
``(11)(A) The Secretary shall apply the provisions of this
subsection and subsection (a)(3)(F) with respect to an
additional eligible professional who is a Medicaid provider
described in paragraph (2)(A) in the same manner as such
provisions apply to any other eligible professional who is a
Medicaid provider described in paragraph (2)(A), except in
applying--
``(i) paragraph (4)(A)(i), the reference to 2016
shall be deemed a reference to 2020; and
``(ii) paragraph (4)(A)(iii), the reference to 2021
shall be deemed a reference to 2025.
``(B) The Secretary shall apply the provisions of this
subsection and subsection (a)(3)(F) with respect to an
additional Medicaid provider in the same manner as such
provisions apply to any other Medicaid provider described in
paragraph (2)(B), except in applying paragraph (4)(D)(i), the
reference to 2016 shall be deemed a reference to 2020.''.
(d) Medicare Advantage Organizations.--Section 1853 of the Social
Security Act (42 U.S.C. 1395w-23) is amended--
(1) in subsection (l)--
(A) in paragraph (1)--
(i) by inserting ``or additional eligible
professionals (as described in paragraph (9))''
after ``paragraph (2)''; and
(ii) by inserting ``and additional eligible
professionals'' before ``under such sections'';
(B) in paragraph (3)(B)--
(i) in clause (i) in the matter preceding
subclause (I), by inserting ``or an additional
eligible professional described in paragraph
(9)'' after ``paragraph (2)''; and
(ii) in clause (ii)--
(I) in the matter preceding
subclause (I), by inserting ``or an
additional eligible professional
described in paragraph (9)'' after
``paragraph (2)''; and
(II) in subclause (I), by inserting
``or an additional eligible
professional, respectively,'' after
``eligible professional'';
(C) in paragraph (3)(C), by inserting ``and
additional eligible professionals'' after ``all
eligible professionals'';
(D) in paragraph (4)(D), by adding at the end the
following new sentence: ``In the case that a qualifying
MA organization attests that not all additional
eligible professionals of the organization are
meaningful EHR users with respect to an applicable
year, the Secretary shall apply the payment adjustment
under this paragraph based on the proportion of all
such additional eligible professionals of the
organization that are not meaningful EHR users for such
year.'';
(E) in paragraph (6)(A), by inserting ``and, as
applicable, each additional eligible professional
described in paragraph (9)'' after ``paragraph (2)'';
(F) in paragraph (6)(B), by inserting ``and, as
applicable, each additional eligible hospital described
in paragraph (9)'' after ``subsection (m)(1)'';
(G) in paragraph (7)(A), by inserting ``and, as
applicable, additional eligible professionals'' after
``eligible professionals'';
(H) in paragraph (7)(B), by inserting ``and, as
applicable, additional eligible professionals'' after
``eligible professionals'';
(I) in paragraph (8)(B), by inserting ``and
additional eligible professionals described in
paragraph (9)'' after ``paragraph (2)''; and
(J) by adding at the end the following new
paragraph:
``(9) Additional eligible professional described.--With
respect to a qualifying MA organization, an additional eligible
professional described in this paragraph is an additional
eligible professional (as defined for purposes of section
1848(o)) who--
``(A)(i) is employed by the organization; or
``(ii)(I) is employed by, or is a partner of, an
entity that through contract with the organization
furnishes at least 80 percent of the entity's Medicare
patient care services to enrollees of such
organization; and
``(II) furnishes at least 80 percent of the
professional services of the additional eligible
professional covered under this title to enrollees of
the organization; and
``(B) furnishes, on average, at least 20 hours per
week of patient care services.''; and
(2) in subsection (m)--
(A) in paragraph (1)--
(i) by inserting ``or additional eligible
hospitals (as described in paragraph (7))''
after ``paragraph (2)''; and
(ii) by inserting ``and additional eligible
hospitals'' before ``under such sections'';
(B) in paragraph (3)(A)(i), by inserting ``or
additional eligible hospital'' after ``eligible
hospital'';
(C) in paragraph (3)(A)(ii), by inserting ``or an
additional eligible hospital'' after ``eligible
hospital'' in each place it occurs;
(D) in paragraph (3)(B)--
(i) in clause (i), by inserting ``or an
additional eligible hospital described in
paragraph (7)'' after ``paragraph (2)''; and
(ii) in clause (ii)--
(I) in the matter preceding
subclause (I), by inserting ``or an
additional eligible hospital described
in paragraph (7)'' after ``paragraph
(2)''; and
(II) in subclause (I), by inserting
``or an additional eligible hospital,
respectively,'' after ``eligible
hospital'';
(E) in paragraph (4)(A), by inserting ``or one or
more additional eligible hospitals (as defined in
section 1886(n)), as appropriate,'' after ``section
1886(n)(6)(A))'';
(F) in paragraph (4)(D), by adding at the end the
following new sentence: ``In the case that a qualifying
MA organization attests that not all additional
eligible hospitals of the organization are meaningful
EHR users with respect to an applicable period, the
Secretary shall apply the payment adjustment under this
paragraph based on the methodology specified by the
Secretary, taking into account the proportion of such
additional eligible hospitals, or discharges from such
hospitals, that are not meaningful EHR users for such
period.'';
(G) in paragraph (5)(A), by inserting ``and, as
applicable, each additional eligible hospital described
in paragraph (7)'' after ``paragraph (2)'';
(H) in paragraph (5)(B), by inserting ``and
additional eligible hospitals, as applicable,'' after
``eligible hospitals'';
(I) in paragraph (6)(B), by inserting ``and
additional eligible hospitals described in paragraph
(7)'' after ``paragraph (2)''; and
(J) by adding at the end the following new
paragraph:
``(7) Additional eligible hospital described.--With respect
to a qualifying MA organization, an additional eligible
hospital described in this paragraph is an additional eligible
hospital (as defined in section 1886(n)(6)(C)) that is under
common corporate governance with such organization and serves
individuals enrolled under an MA plan offered by such
organization.''.
<all>
Introduced in Senate
Read twice and referred to the Committee on Finance.
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