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SENATE BILL NO. 1000
A bill to amend 1939 PA 280, entitled
"The social welfare act,"
(MCL 400.1 to 400.119b) by adding sections 109w and 109x.
THE PEOPLE OF THE STATE OF MICHIGAN ENACT:
Sec. 109w. (1) The department must, in accordance with federal 1
law and regulations, develop a prospective payment system under the 2
medical assistance program for funding certified community 3
behavioral health clinics. 4
(2) The payment system developed under subsection (1) must 5
May 21, 2026, Introduced by Senators BAYER, DAMOOSE, SHINK, GEISS, CHANG,
CAVANAGH, POLEHANKI and CHERRY and referred to Committee on Housing and
Human Services.
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fully comply with all federal payment methodologies. The department 1
shall apply for any necessary waivers and approvals from the 2
federal Centers for Medicare and Medicaid Services. 3
(3) Subject to approval, the prospective payment system must 4
be implemented before October 1, 2027. 5
(4) The department shall promulgate, or rely on existing, 6
relevant policies and guidance to administer this section, 7
including, but not limited to, policies that do all of the 8
following: 9
(a) Ensure continuing compliance with the department's 10
licensing and certification requirements. 11
(b) Mitigate conflicts of interest between certified community 12
behavioral clinics and prepaid inpatient health plans or managed 13
care entities to ensure that individuals experience no barriers in 14
obtaining access to community mental health services programs. 15
(c) Clearly define retaliatory actions and ensure fair 16
enforcement as provided under subsection (6). 17
(d) Outline the process for dispute resolution, including, but 18
not limited to, the appointment of an independent adjudicator, a 19
timeline for filing of disputes, and standards for selecting and 20
compensating an independent adjudicator. 21
(5) The department shall review and establish a new base level 22
for prospective payment system rates in accordance with federal 23
guidance and must use actuarial sound methodologies to develop the 24
rates described under this subsection. The department may develop 25
and implement alternative payment structures to reward service 26
effectiveness and quality improvement. The department has the 27
discretion to pay the prospective payment system rates directly to 28
certified community behavioral health clinics or through managed 29
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care, following federal guidance. 1
(6) The department shall establish penalties for a violation 2
of the rules, including, but not limited to, imposition of fines, 3
suspension of contracts, or loss of certification as a certified 4
community behavioral health clinic. The department shall enforce 5
the penalties established under this subsection. 6
(7) The department is not required to comply with this section 7
unless the legislature appropriates sufficient funds to administer 8
this section. 9
(8) As used in this section and sections 109v and 109x: 10
(a) "Certified community behavioral health clinic" means an 11
entity that has been certified by the department in accordance with 12
federal criteria and the protecting access to Medicare act of 2014, 13
Public Law 113-93, or an appropriate change or waiver to the 14
Medicaid state plan, and includes all of the following: 15
(i) A nonprofit or part of a local government behavioral health 16
authority, agency, or organization. 17
(ii) An outpatient health program or facility operated under 18
the authority of the Indian Health Service, an Indian tribe, or a 19
tribal organization that is under a contract, grant, cooperative 20
agreement, or compact with the Indian Health Service under the 21
Indian self-determination act, 25 USC 5321 to 5332, or an urban 22
Indian organization receiving funds under title V of the Indian 23
health care improvement act, 25 USC 1651 to 1660i. 24
(b) "Prospective payment system" means a payment methodology 25
that funds, in advance, a certified community behavioral health 26
clinic for the anticipated costs of carrying out the direct and 27
indirect clinical and administrative activities required of 28
certified community behavioral health clinics. 29
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Sec. 109x. (1) Beginning January 1, 2028, a new certified 1
community behavioral health clinic site must not be established, 2
operated, or designated within this state unless approved by the 3
department in accordance with this section. 4
(2) The department shall develop and implement a certified 5
community behavioral health clinic site review and approval process 6
that must function in a manner substantially similar to a 7
certificate of need program to ensure the appropriate distribution 8
of certified community behavioral health clinic services and to 9
prevent unnecessary duplication of services. 10
(3) In reviewing an application for a new certified community 11
behavioral health clinic site, the department shall consider all of 12
the following factors: 13
(a) The demonstrated need for additional behavioral health 14
services in the proposed service area, including, but not limited 15
to, all of the following factors: 16
(i) Population size. 17
(ii) Behavioral health prevalence rates. 18
(iii) Access disparities. 19
(b) The existing capacity and geographic distribution of 20
currently certified community behavioral health clinic and 21
community mental health service providers. 22
(c) Whether approval of the proposed site would result in an 23
oversaturation of certified community behavioral health clinic 24
providers in a geographic area, including, but not limited to, all 25
of the following factors: 26
(i) Fragmentation of care. 27
(ii) Workforce dilution. 28
(iii) Financial instability among safety-net providers. 29
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(4) The department shall give priority consideration to 1
applications submitted by, or on behalf of, a community mental 2
health services program. Any newly approved certified community 3
behavioral health clinic site must be operated directly by a 4
community mental health services program or under the authority and 5
governance of a community mental health services program through a 6
formal agreement approved by the department. 7
Enacting section 1. This amendatory act does not take effect 8
unless Senate Bill No. 1001 of the 103rd Legislature is enacted 9
into law. 10