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Congress·In Committee·3 months ago

Senate Bill Would Expand Medicaid and Medicare Coverage for Community Mental Health Clinics

Also known as: Ensuring Excellence in Mental Health Act

Legislative Progress

✓ Filed
Review
Senate
House
President

Impacts

Positive Impacts(9)
Medicaid
Helps
Mental Health
Helps
Retiree
Helps
Medicare
Helps
Chronic Illness
Helps
Military Active
Helps
Military Veteran
Helps
Veterans Benefits
Helps
Cognitive Developmental
Helps

Key Points

  • Lets states pay certified community mental health clinics in Medicaid using a set payment system tied to real clinic costs, starting Jan. 1, 2026.
  • Expands what these clinics can cover in Medicaid (like crisis help, screening, outpatient care, peer support, and some veteran-focused care), starting Oct. 1, 2026.
  • Adds Medicare coverage for these clinic services starting Jan. 1, 2027, and sets up a Medicare payment system so clinics can be paid in a more predictable way.
  • Lowers some out-of-pocket costs for Medicare patients by waiving the Part B deductible for these clinic services, and allows clinics to appeal certain payment decisions.
  • Creates federal grants to help clinics operate and improve, and gives liability protection to clinic clinicians similar to other federally protected providers.
HealthcareMedicare MedicaidPrescription DrugsVeterans

Milestones

2 milestones2 actions
Dec 9, 2025Senate

Read twice and referred to the Committee on Finance.

Dec 9, 2025

Introduced in Senate

What Happens Next

Projected impacts based on AI analysis

2026-01-01

States may start requiring accreditation for certain Medicaid-certified clinics

In states that choose this option, clinics may need to get approved accreditation to keep or gain certified status, which can affect which clinics stay in-network for this benefit.

2026-01-01

New Medicaid payment method begins for certified community behavioral health clinics in state plans that elect the benefit

If your state covers CCBHC services in its Medicaid plan, clinics should be paid based on reasonable costs (with inflation updates), which can help clinics expand hours, hire staff, and keep crisis services running.

During fiscal year 2026, after funding is appropriated and the program opens

Federal grant program for community behavioral health clinics can start once funded

Clinics could apply for up to 5-year operating grants to expand services, upgrade buildings and technology, and build capacity—potentially increasing appointment availability in your community.

Related News

1 article
Becker's Behavioral Health·3 months ago

Bill aims to solidify Medicare mental health clinic funding

Bipartisan legislation introduced in the Senate would establish a permanent funding structure under Medicare for Certified Community Behavioral Health Clinics (CCBHCs). The Ensuring Excellence in Mental Health Act would formally authorize coverage and create a designated payment model.

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Source Information

Document Type

Congressional Bill

Official Title

Ensuring Excellence in Mental Health Act

Bill NumberS 3402
Congress119th Congress
ChamberSenate
Latest ActionRead twice and referred to the Committee on Finance.

Sponsor

Cosponsors

(3)
D: 2R: 1

Analysis generated by AI. While we strive for accuracy, this should not be considered legal or professional advice. Always verify information with official government sources.