Bill > HB595

This bill proposes to integrate behavioral health and physical health services within Pennsylvania's medical assistance (Medicaid) managed care program, known as HealthChoices. Specifically, the bill requires the state department to combine mental health, addiction services, physical health services, and medication benefits into a unified managed care program. The integration aims to ensure recipients receive comprehensive, high-quality healthcare in their local community, with strategies to address social determinants of health and support whole-person care. The bill mandates that managed care organizations develop approaches that balance quality healthcare, patient satisfaction, and cost-effectiveness, while helping recipients achieve independence or self-care. The department is required to submit a waiver proposal to federal Medicare and Medicaid services by October 1, 2025, and will mandate participation in a capitated managed care program for all medical assistance eligible individuals. The bill defines behavioral health services as covering mental disorders and substance-related and addictive disorders, explicitly excluding intellectual developmental disorders. The integration is intended to create a more sustainable, uniform healthcare delivery system across state departments and agencies, with improved information exchange and administrative efficiency.

Health and Social Services

https://www.legis.state.pa.us/cfdocs/billinfo/bill_history.cfm?syear=2025&sind=0&body=H&type=B&bn=595