Sponsors (4)
The bill expands coverage and stable, cost‑based payments to certified community behavioral health clinics—improving access and clinic viability—while increasing federal/state costs, administrative complexity, and risks of uneven implementation, patient cost‑sharing, workforce strain, and changes to legal remedies for malpractice.
Medicaid and Medicare enrollees (including veterans and people in rural areas) gain much greater access to comprehensive community behavioral health services because CCBHCs will be authorized, funded under prospective payment systems, and covered by Medicaid (from Jan 1, 2026) and Medicare (from Jan 1, 2027).
Certified community behavioral health clinics (CCBHCs) get more predictable, cost‑based reimbursement under new prospective payment systems (initial payments tied to audited/base‑year costs), improving clinic financial stability and planning.
Requirement to include 24/7 crisis services (mobile crisis teams and stabilization) expands round‑the‑clock crisis care in communities.
Taxpayers and state budgets face materially higher costs from mandatory Medicaid payments, new Medicare coverage, potential recurring federal grants/authorities, and increased federal liability exposure under FTCA.
Medicare beneficiaries may still face significant out‑of‑pocket costs because CCBHC services remain subject to 20% coinsurance even if the Part B deductible is waived.
Creating and operating new prospective payment systems, certification/accreditation pathways, appeals processes, and FTCA administration increases administrative complexity and compliance costs for HHS, states, and clinics — disproportionately burdening smaller or newer providers.
Based on analysis of 5 sections of legislative text.
Establishes Medicaid and Medicare prospective payment systems and accreditation options for certified community behavioral health clinics, and extends FTCA protection to clinicians.
Official title: Amend titles XVIII and XIX of the Social Security Act and the Public Health Service Act to improve the certified community behavioral health clinic program, and for other purposes.
Introduced December 9, 2025 by John Cornyn · Last progress December 9, 2025
Creates a statutory framework to expand and pay for certified community behavioral health clinics (CCBHCs). It lets states use an approved accreditation pathway and requires Medicaid payment under a new prospective payment framework starting January 1, 2026, establishes a Medicare prospective payment system for CCBHC services effective January 1, 2027, creates a statutory placement for community behavioral health clinics in the Public Health Service Act, and extends Federal Tort Claims Act (FTCA) liability protection to clinicians at CCBHCs.