H.R. 4745 — Medicaid Bump Act

This section establishes a 90% federal matching payment under Medicaid for state expenditures on behavioral health services (i.e., mental health and substance use services provided under the state plan or waiver) that exceed amounts expended during the corresponding quarter of the four-quarter baseline period ending March 31, 2019. As a condition for such payments, states must (1) use them to supplement, not supplant, state funds expended for such services through programs in effect as of April 1, 2021; and (2) direct them to activities increasing capacity, efficiency, and quality of service delivery (e.g., higher provider payment rates to reduce staff turnover). The Secretary of HHS must issue sub-regulatory guidance defining behavioral health services within 180 days of enactment. Applies to calendar quarters beginning on or after January 1 of the year one year after enactment.

This section directs the Secretary of Health and Human Services to submit to the House Committee on Energy and Commerce and the Senate Committee on Finance, not later than one year after enactment and annually thereafter, a report on behavioral health services (including mental health and substance use disorder services) provided under Medicaid (title XIX of the Social Security Act) in each state. The report must specify payment rates for such services, the rationale for deriving those rates, and service utilization, to the extent data are available.