Pass the Medicaid Bump Act

Parity, Coverage, & Equitable Access
Topics
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social determinants of health
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Population
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Coverage & Standards
Network Adequacy/Timely Access
Medicaid
Federal department
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house committees
House Energy and Commerce Committee
senate committees
Senate Finance Committee

Recommendation

Congress should require that the Centers for Medicare and Medicaid Services (CMS) reimburse evidence-based mental health and substance use disorder (MH/SUD) treatments at their true cost.[1] Specifically, federal lawmakers should pass the Medicaid Bump Act.[2]

Background/summary

Insufficient reimbursement has led to in-network provider shortages for Medicaid beneficiaries seeking mental health and substance use disorder (MH/SUD) treatment.[3][4] Medicaid is the single largest payer of MH/SUD services. However, 35 percent of beneficiaries report not being able to access treatment.[5] Congress should mandate that evidence-based MH/SUD treatments are reimbursed at their true cost to incentivize providers to accept Medicaid.[1] To facilitate increased access to treatment, the Medicaid Bump Act would increase the Federal Medical Assistance Percentage (FMAP) to provide states with additional financial resources to improve access to MH/SUD providers.[6] It would also require the Department of Health and Human Services to report on how the increased FMAP impacts access to MH/SUD services.[6] Congress should pass this important legislation.[2]

citations

1. Rand Corporation. Transforming Mental Health Care in the United States. Last Updated 2021.

2. The Kennedy Forum. Recommendations of Congressman Patrick J. Kennedy to the President’s Commission on Combating Drug Addiction and the Opioid Crisis. Last Updated October, 2017.

3. Government Accountability Office. Mental Health Care: Access Challenges for Covered Consumers and Relevant Federal Efforts. Last Updated March 30, 2022.

4. Mental Health America. Fix the foundation: Unfair rate setting leads to inaccessible mental health care. Last Updated February 10, 2023.

5. Kaiser Family Foundation. How do States Deliver, Administer, and Integrate Behavioral Health Care? Findings from a Survey of State Medicaid Programs. Last Updated May 25, 2023.

6. Medicaid Bump Act. S.1727 (Smith-Stabenow) and H.R. 3450 (Tonko-Trone), 117th Congress (2021-2022). Last Accessed August 1, 2023.