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69th Legislature 2025 HB 574
- 1 - Authorized Print Version – HB 574
ENROLLED BILL
AN ACT AUTHORIZING IMPLEMENTATION OF THE CERTIFIED COMMUNITY BEHAVIORAL HEALTH
CLINIC MODEL; ESTABLISHING DUTIES OF THE DEPARTMENT OF PUBLIC HEALTH AND HUMAN
SERVICES; ESTABLISHING REQUIREMENTS AND PERFORMANCE MEASURES FOR CERTIFIED
COMMUNITY BEHAVIORAL HEALTH CLINIC SERVICES; ESTABLISHING REPORTING REQUIREMENTS;
DIRECTING THE DEPARTMENT TO DEVELOP AN INCENTIVE PROGRAM FOR CERTIFIED COMMUNITY
BEHAVIORAL HEALTH CLINICS THAT DEMONSTRATE EXCEPTIONAL OUTCOMES; PROVIDING
RULEMAKING AUTHORITY; AND PROVIDING AN IMMEDIATE EFFECTIVE DATE.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MONTANA:
Section 1. Certified community behavioral health clinics -- department duties -- reporting
requirement. (1) Subject to available funding, the department shall establish a program no later than October
1, 2026, for the implementation of certified community behavioral health clinics that meet the requirements of
Public Law 113-93 and related federal regulations and guidance.
(2) In determining the reimbursement rate for a certified community behavioral health clinic under
the healthy Montana kids plan provided for under Title 53, chapter 4, part 11, and the medical assistance
program provided for in Title 53, chapter 6, the department shall:
(a) establish and execute clear criteria of the costs that are allowed and disallowed in the
development of the encounter rate to be paid to a certified community behavioral health clinic under a
prospective payment system;
(b) establish and execute a detailed plan for analyzing cost reports submitted by providers seeking
to become certified community behavioral health clinics to ensure that the encounter rate developed for the
provider accurately reflects the actual costs of providing care and that disallowed costs are not included in the
rate; and
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(c) rebase the rate in accordance with federal guidance, but no less frequently than every 2 years.
(3) The department shall monitor and evaluate certified community behavioral health clinic
services, outcomes, and impacts. Monitoring and evaluation efforts include:
(a) developing and implementing a plan to reduce duplicative billing of services, fraud, waste, and
abuse;
(b) establishing quality measures for certified community behavioral health clinics and reviewing
data on quality measures reported by each certified community behavioral health clinic;
(c) establishing the circumstances under which a certified community behavioral health clinic
would lose its certification; and
(d) determining the costs to the medicaid program or other state-funded programs of providing
behavioral health care services in a community or region before implementation of the certified community
behavioral health clinic program and the costs, including any cost reductions, or providing those services after
implementation of the certified community behavioral health clinic program. The costs must include payment for
hospitalizations and emergency department visits.
(4) The department shall provide quarterly updates in accordance with 5-11-210 to the children,
families, health, and human services interim committee and the health and human services interim budget
committee on:
(a) the status of implementation of certified community behavioral health clinics;
(b) the impacts of implementation on services for individuals with behavioral health needs;
(c) patient-centered, quality health outcomes;
(d) the percentage of high users of medicaid services who have reduced use of medicaid-funded
services;
(e) the community-level and state-level costs and cost savings related to certified community
behavioral health clinics; and
(f) any additional evaluation metrics required by the centers for medicare and medicaid services.
Section 2. Certified community behavioral health clinic requirements -- billing practices --
performance measurements. (1) In addition to the services required under federal law and regulation, a
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certified community behavioral health clinic shall directly provide the following services:
(a) targeted case management;
(b) peer and family caregiver services and supports; and
(c) outreach and education as specified in subsection (5).
(2) A certified community behavioral health clinic may directly provide or contract with a third party
to provide the following services:
(a) primary care screening and monitoring;
(b) services for veterans and members of the armed forces; and
(c) outpatient psychiatric rehabilitation services.
(3) A certified community behavioral health clinic shall coordinate with other community-based
service providers to prevent duplication of services and develop a continuum of services within the community.
(4) (a) If a screening indicates that a person is in urgent need of services, a certified community
behavioral health clinic shall provide clinical services and an initial evaluation within 1 business day of the first
contact with the patient.
(b) A certified community behavioral health clinic shall provide a new patient with a comprehensive
person-centered and family-centered diagnostic and treatment planning evaluation. The evaluation must be
completed within 30 calendar days of the patient's first request for services.
(5) A certified community behavioral health clinic shall provide outreach and education by:
(a) establishing an outreach team to work in partnership with hospitals and critical access hospitals
to encourage individuals presenting with behavioral health needs at an emergency department to obtain
ongoing behavioral health treatment through the clinic to reduce the need for emergency department care;
(b) working with local law enforcement agencies by:
(i) providing opportunities for training to, or attending training with, law enforcement officers in
methods for responding to individuals with behavioral health needs; and
(ii) responding directly to individuals who have come into contact with law enforcement because of
behavioral health issues; and
(c) designating staff members to encourage the use of the clinic's services by individuals who use
a high volume of medicaid resources but who have not been actively receiving behavioral health treatment.
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(6) The billing practices of a certified community behavioral health clinic must:
(a) provide that private insurance plans are billed first and that medicaid is billed as a payer of last
resort;
(b) include a publicly available, income-based sliding fee scale; and
(c) establish that the certified community behavioral health clinic may not refuse services to a
person who is unable to pay.
(7) In addition to any federally required reporting, each certified community behavioral health clinic
shall collect and report to the department, in a deidentified manner, data on the following quality measures:
(a) changes in the functional assessment scores of patients; and
(b) baseline and subsequent changes in a patient's:
(i) status as housed or unhoused;
(ii) engagement in work; and
(iii) law enforcement involvement.
(8) A certified community behavioral health clinic that contracts with another provider for services
as allowed under federal law and regulations and this section is responsible for:
(a) collecting and reporting on the data required under subsection (7) and any other information
required by the department; and
(b) ensuring that the contracted provider follows all applicable state and federal laws and
regulations.
Section 3. Incentive program. (1) The department shall develop an incentive program to provide
additional financial support to certified community behavioral health clinics that demonstrate exceptional quality
outcome measures.
(2) The department shall adopt rules to implement this section.
Section 4. Codification instruction. [Sections 1 through 3] are intended to be codified as an integral
part of Title 53, chapter 21, part 10, and the provisions of Title 53, chapter 21, part 10, apply to [sections 1
through 3].
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Section 5. Effective date. [This act] is effective on passage and approval.
- END -
I hereby certify that the within bill,
HB 574, originated in the House.
___________________________________________
Chief Clerk of the House
___________________________________________
Speaker of the House
Signed this _______________________________day
of____________________________________, 2025.
___________________________________________
President of the Senate
Signed this _______________________________day
of____________________________________, 2025.
HOUSE BILL NO. 574
INTRODUCED BY J. GILLETTE
AN ACT AUTHORIZING IMPLEMENTATION OF THE CERTIFIED COMMUNITY BEHAVIORAL HEALTH
CLINIC MODEL; ESTABLISHING DUTIES OF THE DEPARTMENT OF PUBLIC HEALTH AND HUMAN
SERVICES; ESTABLISHING REQUIREMENTS AND PERFORMANCE MEASURES FOR CERTIFIED
COMMUNITY BEHAVIORAL HEALTH CLINIC SERVICES; ESTABLISHING REPORTING REQUIREMENTS;
DIRECTING THE DEPARTMENT TO DEVELOP AN INCENTIVE PROGRAM FOR CERTIFIED COMMUNITY
BEHAVIORAL HEALTH CLINICS THAT DEMONSTRATE EXCEPTIONAL OUTCOMES; PROVIDING
RULEMAKING AUTHORITY; AND PROVIDING AN IMMEDIATE EFFECTIVE DATE.