COMPLETE Care Act
Officially: “COMPLETE Care Act” Read the full text
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1Short title
This section would state that the Act may be cited as the Connecting Our Medical Providers with Links to Expand Tailored and Effective Care or the COMPLETE Care Act.
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1. Short title This Act may be cited as the Connecting Our Medical Providers with Links to Expand Tailored and Effective Care or the COMPLETE Care Act .
2Medicare incentives for behavioral health integration with primary care
This section would amend title XVIII of the Social Security Act (Medicare) to raise payment for behavioral health integration services in primary care and to fund technical assistance for practices adopting these services. For behavioral health integration services furnished during 2027, 2028, or 2029, specifically the services identified as of January 1, 2024 by HCPCS codes 99484, 99492, 99493, 99494, G2214, and G0323, or any successor or similar codes the Secretary of Health and Human Services determines appropriate, Medicare would pay a percentage of the payment amount that would otherwise be determined under the physician fee schedule for that year, instead of that regular amount. That percentage would be 175 percent for services furnished in 2027, 150 percent for services furnished in 2028, and 125 percent for services furnished in 2029. The section would also provide that the increase in payment amounts resulting from this incentive would not be counted when the physician fee schedule's budget-neutrality adjustment is calculated for 2027, 2028, or 2029, so the extra payments for these services would not trigger offsetting reductions to other payment amounts under the fee schedule in those years. Separately, the section would require the Secretary, not later than January 1, 2026, to enter into contracts or agreements with appropriate entities to offer technical assistance to primary care practices seeking to adopt behavioral health integration models. These models would include the Collaborative Care Model, identified by HCPCS codes 99492, 99493, 99494, and G2214 (and any successor codes) as of January 1, 2024, the Primary Care Behavioral Health model, identified by HCPCS codes 99484 and G0323 (and any successor code) as of January 1, 2024, and any other models the Secretary identifies. Notwithstanding any other provision of law, the Secretary could carry out this technical assistance requirement by program instruction or other means. The section would appropriate, in addition to amounts otherwise available, such sums as necessary for each of fiscal years 2025 through 2029, to remain available until expended, to carry out this technical assistance requirement.
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2. Medicare incentives for behavioral health integration with primary care (a) Incentives (1) In general Section 1848(b) of the Social Security Act ( 42 U.S.C. 1395w–4(b) ) is amended by adding at the end the following new paragraph: (13) Incentives for behavioral health integration (A) In general For services described in subparagraph (B) that are furnished during 2027, 2028, or 2029, instead of the payment amount that would otherwise be determined under this section for such year, the payment amount shall be equal to the applicable percent (as defined in subparagraph (C)) of such payment amount for such year. (B) Services described The services described in this subparagraph are services identified, as of January 1, 2024, by HCPCS codes 99484, 99492, 99493, 99494, G2214, and G0323 (and any successor or similar codes as determined appropriate by the Secretary). (C) Applicable percent In this paragraph, the term applicable percent means, with respect to a service described in subparagraph (A), the following: (i) For services furnished during 2027, 175 percent. (ii) For services furnished during 2028, 150 percent. (iii) For services furnished during 2029, 125 percent. . (2) Waiver of budget neutrality Section 1848(c)(2)(B)(iv) of such Act ( 42 U.S.C. 1395w–4(c)(2)(B)(iv) ) is amended— (A) in subclause (V), by striking and at the end; (B) in subclause (VI), by striking the period at the end and inserting ; and and (C) by adding at the end the following new subclause: (VII) the increase in payment amounts as a result of the application of subsection (b)(13) shall not be taken into account in applying clause (ii)(II) for 2027, 2028, or 2029. . (b) Technical assistance for the adoption of behavioral health integration (1) In general Not later than January 1, 2026, the Secretary of Health and Human Services (in this subsection referred to as the Secretary ) shall enter into contracts or agreements with appropriate entities to offer technical assistance to primary care practices that are seeking to adopt behavioral health integration models in such practices. (2) Behavioral health integration models For purposes of paragraph (1), behavioral health integration models include the Collaborative Care Model (with services identified as of January 1, 2024, by HCPCS codes 99492, 99493, 99494, and G2214 (and any successor codes)), the Primary Care Behavioral Health model (with services identified as of January 1, 2024, by HCPCS codes 99484 and G0323 (and any successor code)), and other models identified by the Secretary. (3) Implementation Notwithstanding any other provision of law, the Secretary may implement the provisions of this subsection by program instruction or otherwise. (4) Funding In addition to amounts otherwise available, there is appropriated to the Secretary for each of fiscal years 2025 through 2029, out of any money in the Treasury not otherwise appropriated, such sums as are necessary, to remain available until expended, for purposes of carrying out this subsection.
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In the House.