House Renews Several Medicaid Programs, Including Payment Pilot for Mental Health Clinics

June 2019 ~

The House recently passed legislation to renew several Medicaid programs, including an eight state pilot that pays higher reimbursement rates to mental health clinics that offer comprehensive mental health services regardless of ability to pay, offering assistance to patients move out of assisted living facilities, covering costs for individuals whose spouses are in long-term care, and preventing Medicaid fraud.

On June 18, the House voted (371-46) to pass the “Empowering Beneficiaries, Ensuring Access, and Strengthening Accountability Act of 2019 (H.R. 3253),” which would extend funding for certain Medicaid programs.

The Empowering Beneficiaries, Ensuring Access, and Strengthening Accountability Act of 2019 alters several Medicaid programs and funding mechanisms. Specifically, H.R. 3253

• makes appropriations through FY2024 for, and otherwise revises, the Money Follows the Person Rebalancing Demonstration Program;
• allows state Medicaid fraud control units to review complaints regarding patients who are in non-institutional or other settings;
• temporarily extends the applicability of Medicaid eligibility criteria that protect against spousal impoverishment for recipients of home and community-based services;
• temporarily extends the Medicaid demonstration program for certified community behavioral health clinics;
• repeals the requirement, under the Medicaid Drug Rebate Program, that drug manufacturers include the prices of certain authorized generic drugs when determining the average manufacturer price (AMP) of brand name drugs (also known as a “blended AMP”), and excludes manufacturers from the definition of “wholesalers” for purposes of rebate calculations; and
• increases funding available to the Medicaid Improvement Fund beginning in FY2021.

Under the provision, funding for the eight-state Certified Community Behavioral Health Clinic (CCBHC) demonstration program would be extended for another two and a half years until December 21, 2021.

The bill must now go to the Senate for a vote before the CCBHC demonstration program expires on June 30, 2019.

Source(s): CQ Health; The National Council; Gov Track; Congressional Budget Office;