COMPLETE Care Act
- Bill Number
- H.R. 2509
- Origin Chamber
- House
- Congress
- 119th Congress, Session 1
- Policy Area
- Health
- Status
- Introduced
- Latest Action
- 2025-03-31: Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
- Last Updated
- 2026-07-10T08:06:24Z
AI-Generated Summary
Purpose
The COMPLETE Care Act (H.R. 2509) aims to encourage the integration of behavioral health services—such as mental health and substance use treatment—into primary care settings under Medicare. By offering financial incentives and support, the bill seeks to improve access to coordinated care for patients with behavioral health needs.
Key Provisions
- Payment Incentives: For services furnished in 2027, 2028, and 2029, Medicare will pay 175%, 150%, and 125% respectively of the standard fee-for-service rate for specific behavioral health integration services. These services are identified by Healthcare Common Procedure Coding System (HCPCS) codes like 99484 (principal care management for behavioral health), 99492–99494 (collaborative care models), G2214 (complex care visits), and G0323 (behavioral health counseling), including any future similar codes.
- Budget Neutrality Waiver: The increased payments will not be offset by reducing payments elsewhere in Medicare during these years, allowing for higher overall spending on these services.
- Technical Assistance Program: Starting January 1, 2026, the Secretary of Health and Human Services (HHS) must contract with organizations to provide training and support to primary care practices adopting behavioral health integration models. These models include:
- Collaborative Care Model (team-based approach involving psychiatrists and primary care providers).
- Primary Care Behavioral Health Model (on-site behavioral health consultants).
- Other models as determined by HHS.
- Implementation and Funding: HHS can implement the technical assistance via guidance or instructions without new rulemaking. Funding is appropriated for fiscal years 2025–2029 from general Treasury funds, with amounts as needed (no specific dollar figure set).
Significant Changes to Existing Law
- Amends Section 1848 of the Social Security Act (which governs Medicare physician payments) by adding a new paragraph for the temporary payment boosts and explicitly excluding them from budget neutrality calculations (under Section 1848(c)(2)(B)(iv)).
- Introduces new HHS authority and dedicated funding for technical assistance, which was not previously specified in law for this purpose. This shifts from standard Medicare payment structures to targeted incentives for behavioral health integration, without requiring broader regulatory changes.
Potential Impacts
- On Government Agencies: HHS will need to administer the incentives, identify successor codes, and manage technical assistance contracts, potentially increasing administrative workload but supported by new funding. This could raise short-term Medicare expenditures (estimated impacts not specified in the bill) without affecting the program's overall budget neutrality.
- On Citizens: Medicare beneficiaries, especially those with mental health or substance use issues, may gain better access to integrated care in primary settings, reducing fragmented treatment and improving health outcomes. However, benefits are limited to three years and specific services.
- On International Relations: No direct impacts, as the bill focuses on domestic Medicare policy.
Main Stakeholders Affected
- Primary Care Providers and Practices: Receive higher reimbursements and technical support to integrate behavioral health, potentially easing adoption barriers.
- Behavioral Health Providers: Benefit from collaborative models that expand their role in primary care settings.
- Medicare Beneficiaries: Older adults and disabled individuals enrolled in Medicare Part B, who may see improved care coordination for behavioral health needs.
- HHS and Contractors: Responsible for program rollout, including selecting entities for technical assistance.
- Taxpayers: Bear the cost through appropriated funds and increased Medicare spending.
Notable Legal, Constitutional, or Political Implications
- Legal: The bill uses existing HCPCS codes for clarity but grants HHS flexibility to update them, which could lead to administrative challenges if not managed well. The waiver of budget neutrality is a targeted exception, avoiding broader Medicare payment cuts but potentially setting a precedent for future incentive programs.
- Constitutional: No apparent issues; the legislation falls within Congress's authority over federal spending and health programs under the Spending Clause.
- Political: Promotes bipartisan mental health priorities (introduced by a diverse group of representatives) amid growing focus on the behavioral health crisis. The temporary nature (2027–2029) may encourage future extensions, while the funding mechanism bypasses annual appropriations debates, streamlining implementation but raising concerns about unchecked spending in a fiscally constrained environment.
This summary was generated by AI and may contain inaccuracies. Refer to the official source document for the authoritative text.
Sponsor
Rep. Malliotakis, Nicole [R-NY-11]
Cosponsors (31)
Rep. Fletcher, Lizzie [D-TX-7], Rep. Pfluger, August [R-TX-11], Rep. Horsford, Steven [D-NV-4], Rep. Carey, Mike [R-OH-15], Rep. Suozzi, Thomas R. [D-NY-3], Rep. Bacon, Don [R-NE-2], Rep. Sewell, Terri A. [D-AL-7], Rep. Balint, Becca [D-VT-At Large], Rep. Tonko, Paul [D-NY-20], Rep. Fitzpatrick, Brian K. [R-PA-1], Rep. Obernolte, Jay [R-CA-23], Rep. Evans, Gabe [R-CO-8], Rep. Van Drew, Jefferson [R-NJ-2], Rep. Joyce, John [R-PA-13], Rep. Conaway, Herbert C. [D-NJ-3], Rep. Ross, Deborah K. [D-NC-2], Rep. Harder, Josh [D-CA-9], Rep. Miller, Carol D. [R-WV-1], Rep. Budzinski, Nikki [D-IL-13], Rep. Bilirakis, Gus M. [R-FL-12], Rep. Balderson, Troy [R-OH-12], Rep. Soto, Darren [D-FL-9], Rep. Vindman, Eugene Simon [D-VA-7], Rep. Gillen, Laura [D-NY-4], Rep. Vasquez, Gabe [D-NM-2], Del. Norton, Eleanor Holmes [D-DC-At Large], Rep. Raskin, Jamie [D-MD-8], Rep. Pettersen, Brittany [D-CO-7], Rep. Moran, Nathaniel [R-TX-1], Rep. Tenney, Claudia [R-NY-24], Rep. Langworthy, Nicholas A. [R-NY-23]
Recent Actions
- 2025-03-31: Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
- 2025-03-31: Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
- 2025-03-31: Introduced in House
- 2025-03-31: Introduced in House
Bill Versions
- Connecting Our Medical Providers with Links to Expand Tailored and Effective Care — issued 2025-03-31 — PDF (5 pages)