Connecting Our Medical Providers with Links to Expand Tailored and Effective Care Act
The bill proposes several amendments to existing Medicare statutes, specifically related to payment rates and quality measurements for services code-defined under behavioral health integration. For the years 2025 to 2027, services that fulfill specific criteria will see payment increases of 175%, 150%, and 125%, respectively. Additionally, the bill facilitates the implementation of quality measurement requirements that healthcare providers will need to adhere to, ensuring that the integration of behavioral health services is not only incentivized but also continuously monitored for efficacy. This is expected to widen the net of mental health services available to underserved populations within the Medicare demographic.
House Bill 5819, titled the Connecting Our Medical Providers with Links to Expand Tailored and Effective Care Act (COMPLETE Care Act), aims to amend Title XVIII of the Social Security Act by providing financial incentives for the integration of behavioral health into primary care settings. The bill focuses on enhancing access to mental health services under the Medicare program and aims to address the growing need for behavioral health care by ensuring that primary care practices incorporate these essential services effectively. It establishes a framework for incentive payments to healthcare providers who adopt integration models, thereby expanding the scope of care available to Medicare beneficiaries.
While the bill has garnered support for its focus on improving behavioral health access, there are points of contention regarding the funding mechanisms and the potential for oversight issues. Critics worry about the implications of expanding Medicare’s role in behavioral health without sufficient regulatory frameworks in place, which may lead to inconsistencies in care quality across various regions. The structure for technical assistance to primary care practices to adopt these models is also crucial and will require careful planning to ensure that providers are adequately supported in this transition. There are concerns that without robust support systems, the bill could inadvertently widen the gap in access and care efficacy.