H.R. 10876: Behavioral Healthcare Deregulation Act

This bill would change Medicare rules related to mental health and behavioral health care, with the stated goal of making it easier for people to get treatment and for providers to deliver it.

What the bill would do

• Expand Medicare coverage limits for inpatient psychiatric care. The bill would remove the current 190-day lifetime limit on Medicare coverage for inpatient psychiatric hospital services. In effect, people enrolled in Medicare would no longer face that specific lifetime cap for psychiatric hospital stays.
• Protect certain patients from reduced Medicare payments. If a person is admitted to a psychiatric hospital under an involuntary commitment order under state law, the bill would prevent Medicare payment reductions that otherwise could apply to that hospital stay.
• Reduce some behavioral health-related Medicare payment rules. The bill would repeal certain Medicare provisions affecting how some behavioral health facilities and services are classified or paid under the program.
• Increase payment rates for certain behavioral health integration services. For services that combine mental health care with primary care, Medicare payments would be temporarily increased for 2027 through 2029. The increase would be highest in 2027 and then gradually phase down over the next two years.
• Prevent those higher payments from triggering offsets elsewhere. The bill says the higher payments for these integration services would not count against certain Medicare payment update calculations for those years.
• Require technical assistance for primary care practices. By January 1, 2027, the Department of Health and Human Services would have to arrange technical assistance for primary care practices that want to adopt behavioral health integration models.
• Provide federal funding for implementation. The bill would appropriate whatever funds are needed for this technical assistance program for fiscal years 2027 through 2031.

Practical effect

In plain terms, the bill would make Medicare more supportive of mental health treatment, especially for inpatient psychiatric care and for efforts to combine mental health services with regular medical care. It would also direct federal agencies to help primary care practices add behavioral health services and would increase Medicare payment for certain integrated care services for a limited period.

Relevant Companies

• None found