Medicaid Bump Act
The Medicaid Bump Act would create a substantial federal funding incentive to grow behavioral health services (including mental health and substance use services) provided under Medicaid. It would amend title XIX so that states receive a 90% federal matching rate for the portion of their increased expenditures on behavioral health services above a defined baseline. The baseline is defined as the amount spent during the same quarter in the 4-quarter period ending March 31, 2019, for BH services under the state plan or waivers. The new funds must be used to supplement (not replace) state funding and to improve delivery of services (increasing capacity, efficiency, quality, and reducing staff turnover), including through higher provider payments. The act also requires a definition of what counts as behavioral health services, issued by the federal Secretary within 180 days, and an annual reporting requirement to track BH service payments, rates, and utilization. The changes would apply to calendar quarters beginning after January 1 of the year that starts one year after enactment.
Key Points
- 1Higher FMAP for increased behavioral health spending: For the portion by which a state’s quarterly BH expenditures exceed the 2019 baseline, the federal government would pay 90% of that increment (subject to other provisions in the bill).
- 2Baseline and measurement: The baseline is the sum of BH-related expenditures in the same quarter of the 4-quarter period ending March 31, 2019, for services offered under the state plan or waivers.
- 3Accountability and maintenance of effort: States must use the additional federal funds to supplement, not supplant, state BH funding in effect as of April 1, 2021, and must use funds to improve delivery (capacity, efficiency, quality) and reduce staff turnover, including higher provider payment rates.
- 4Sub-regulatory guidance on BH services: Within 180 days after enactment, HHS must issue guidance defining which services count as behavioral health services for purposes of the increased funding.
- 5Effective date: The amendments apply to calendar quarters beginning on or after January 1 of the year that starts one year after enactment.
- 6Reporting requirement: Not later than one year after enactment, and annually thereafter, HHS must report to Congress on BH services under title XIX, including payment rates, rationale, and utilization by state.