| 1 | | - | Substitute For HOUSE BILL NO. 5371 A bill to amend 1939 PA 280, entitled "The social welfare act," (MCL 400.1 to 400.119b) by adding section 109w. the people of the state of michigan enact: Sec. 109w. (1) The department, in accordance with federal law and regulations, must develop a prospective payment system under the medical assistance program for funding certified community behavioral health clinics. (2) The payment system developed under subsection (1) must fully comply with all federal payment methodologies. The department shall apply for any necessary waivers and approvals from the federal Centers for Medicare and Medicaid Services. (3) Subject to approval, the prospective payment system must be implemented before October 1, 2027. (4) The department shall promulgate policies to implement this section, including, but not limited to, policies that do all of the following: (a) Ensure continuing compliance with the department's licensing and certification requirements. (b) Mitigate conflicts of interest between certified community behavioral clinics and prepaid inpatient health plans to ensure individuals experience no barriers in obtaining access to community mental health services programs. (c) Clearly define retaliatory actions and ensure fair enforcement as provided under subsection (5). (d) Outline the process for dispute resolution, including, but not limited to, the appointment of an independent adjudicator, a timeline for filing of disputes, and standards for selecting and compensating an independent adjudicator. (5) The department shall establish penalties for a violation of the rules, including, but not limited to, imposition of fines, suspension of contracts, or loss of certification as a certified community behavioral health clinic. The department shall enforce the penalties established under this subsection. (6) The department is not required to comply with this section unless the legislature appropriates sufficient funds to administer this section. (7) As used in this section and section 109p: (a) "Certified community behavioral health clinic" means an entity that has been certified by the department in accordance with federal criteria and the protecting access to Medicare act of 2014, Public Law 113-93, or an appropriate change or waiver to the Medicaid state plan, and includes all of the following: (i) A nonprofit or part of a local government behavioral health authority, agency, or organization. (ii) An outpatient health program or facility operated under the authority of the Indian Health Service, an Indian tribe, or a tribal organization that is under a contract, grant, cooperative agreement, or compact with the Indian Health Service under the Indian self-determination act, 25 USC 5321 to 5332, or an urban Indian organization receiving funds under title V of the Indian health care improvement act, 25 USC 1651 to 1660h. (b) "Prospective payment system" means a payment methodology that funds, in advance, a certified community behavioral health clinic for the anticipated costs of carrying out the direct and indirect clinical and administrative activities required of certified community behavioral health clinics. Enacting section 1. This amendatory act does not take effect unless House Bill No. 5372 of the 102nd Legislature is enacted into law. |
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| 1 | + | HOUSE BILL NO. 5371 A bill to amend 1939 PA 280, entitled "The social welfare act," (MCL 400.1 to 400.119b) by adding section 109o. the people of the state of michigan enact: Sec. 109o. (1) The department must develop a prospective payment system under the medical assistance program for funding certified community behavioral health clinics. The payment system must fully comply with all federal payment methodologies. The department must submit to the federal Centers for Medicare and Medicaid Services any approval request necessary for a Medicaid 1115 waiver. (2) The department must certify as a certified community behavioral health clinic a community mental health center licensed by the department that adheres to all federal certified community behavioral health clinic requirements. (3) Subject to approval, the prospective payment system must be implemented before January 1, 2028. (4) The department shall promulgate rules to implement this section. (5) As used in this section and section 109p: (a) "Certified community behavioral health clinic" means an entity that has been certified by the department in accordance with federal criteria and the protecting access to Medicare act of 2014, Public Law 113-93, or an appropriate change or waiver to the Medicaid state plan. (b) "Prospective payment system" means a payment methodology that funds, in advance, a certified community behavioral health clinic for the anticipated costs of carrying out the direct and indirect clinical and administrative activities required of certified community behavioral health clinics. Enacting section 1. This amendatory act does not take effect unless Senate Bill No.____ or House Bill No. 5372 (request no. 04673'23) of the 102nd Legislature is enacted into law. |
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