More Behavioral Health Providers Act of 2026
- Bill Number
- H.R. 7324
- Origin Chamber
- House
- Congress
- 119th Congress, Session 2
- Policy Area
- Health
- Status
- Introduced
- Latest Action
- 2026-02-03: 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
- 2026-04-23T08:07:09Z
AI-Generated Summary
Purpose
The "More Behavioral Health Providers Act of 2026" (H.R. 7324) aims to increase access to mental health and substance use disorder services under Medicare by expanding financial incentives for healthcare providers in shortage areas. It targets areas lacking sufficient professionals to meet community needs, encouraging more providers to serve Medicare patients in these regions.
Key Provisions
- Bonus Payments for General Services: Physicians providing non-mental health services in designated health professional shortage areas (HPSAs) receive a 10% bonus on Medicare payments for those services.
- Enhanced Bonus for Mental Health Services: Physicians and certain other practitioners ("applicable practitioners") providing "specified health services" in mental health professional shortage areas receive a 15% bonus on Medicare payments. These services start being eligible from January 1, 2027.
- Definition of Specified Health Services: Includes Medicare-covered services for diagnosing, evaluating, or treating mental health disorders or substance use disorders (including co-occurring conditions), as determined by the Secretary of Health and Human Services.
- Definition of Applicable Practitioners: Expands eligibility beyond physicians to include:
- Physician assistants, nurse practitioners, and clinical nurse specialists.
- Clinical social workers.
- Clinical psychologists.
- Marriage and family therapists.
- Mental health counselors.
- Payment Administration: Bonuses are paid monthly or quarterly from the Federal Supplementary Medical Insurance Trust Fund (Medicare Part B fund) to the provider, employer, or facility.
- Technical Updates: The bill amends existing law to reference the new categories consistently, ensuring the bonus applies broadly without unintended exclusions.
Significant Changes to Existing Law
- Previously, the Medicare HPSA bonus program (under Section 1833(m) of the Social Security Act) provided only a 10% incentive for physicians' services in general HPSAs, with limited scope for mental health.
- This bill restructures the program to create a separate track for mental health and substance use services, raising the bonus to 15% and including non-physician practitioners who were previously ineligible.
- It introduces new designations for "mental health professional shortage areas" and specific definitions for behavioral health services, broadening the program's reach without altering core eligibility rules for non-mental health services.
Potential Impacts
- On Government Agencies: The Centers for Medicare & Medicaid Services (CMS) will need to identify mental health shortage areas, process expanded claims, and monitor payments, potentially increasing administrative workload. It may raise Medicare expenditures from the trust fund, though aimed at long-term cost savings by improving preventive care.
- On Citizens: Medicare beneficiaries (primarily those 65+ or with disabilities) in shortage areas gain better access to mental health and addiction treatment, addressing gaps in behavioral health care. Rural and underserved communities could see more providers, reducing wait times and travel burdens.
- On International Relations: No direct impact, as this is a domestic healthcare policy focused on U.S. Medicare.
Main Stakeholders Affected
- Healthcare Providers: Physicians and applicable practitioners (e.g., therapists, social workers) benefit from higher incentives, potentially attracting them to shortage areas.
- Medicare Beneficiaries: Elderly and disabled individuals needing mental health or substance use services, especially in rural or low-resource areas.
- Government and Payers: CMS and the Medicare trust fund, which fund the bonuses; could influence federal budgeting for health programs.
- Communities: Underserved populations facing mental health shortages, including those with substance use disorders.
Notable Legal, Constitutional, or Political Implications
- Legal: Strengthens Medicare's role in behavioral health without requiring new regulations, relying on existing shortage area designations under the Public Health Service Act. The Secretary of Health and Human Services gains discretion in defining disorders and services, which could lead to future guidance or challenges if interpretations vary.
- Constitutional: No apparent issues; it aligns with Congress's authority to regulate interstate commerce and spend for the general welfare, similar to other Medicare expansions.
- Political: Supports bipartisan efforts to tackle the national mental health and opioid crises by incentivizing workforce growth in high-need areas. It could face debate over added costs to Medicare (estimated in billions over time) versus benefits in reducing emergency care reliance, but promotes equity in healthcare access without mandating provider participation.
This summary was generated by AI and may contain inaccuracies. Refer to the official source document for the authoritative text.
Sponsor
Rep. Budzinski, Nikki [D-IL-13]
Cosponsors (2)
Rep. Mann, Tracey [R-KS-1], Del. Norton, Eleanor Holmes [D-DC-At Large]
Recent Actions
- 2026-02-03: 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.
- 2026-02-03: 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.
- 2026-02-03: Introduced in House
- 2026-02-03: Introduced in House
Bill Versions
- More Behavioral Health Providers Act of 2026 — issued 2026-02-03 — PDF (5 pages)