summary
Introduced
02/02/2026
02/02/2026
In Committee
03/04/2026
03/04/2026
Crossed Over
Passed
Dead
Introduced Session
104th General Assembly
Bill Summary
Creates the Preventing Crisis Cost Shifting to Medicaid Act. Provides that the General Assembly finds that (i) behavioral health crisis services, including crisis call centers, mobile crisis response, and crisis stabilization and receiving services, function as essential public health infrastructure and must be available statewide without regard to insurance status; and (ii) commercial health insurance policies issued or administered in the State generally do not provide comprehensive coverage for the full continuum of behavioral health crisis services, resulting in the cost of such services being disproportionately borne by Medicaid, local governments, and taxpayers. Requires specified entities (surcharge payors) that are authorized to issue or administer a policy or contract of accident and health insurance or a health maintenance organization contract in the State to pay a behavioral health crisis assessment to the Department of Human Services for deposit into the Statewide 9-8-8 Trust Fund. Exempts Medicaid managed care organizations from paying the behavioral health crisis assessment. Permits the Department to update the total behavioral health crisis assessment amount as necessary to ensure the continued availability, quality, or geographic equity of the statewide behavioral health crisis system. Requires the Department to establish an appropriate mechanism for enforcing a surcharge payor's liability, which may include accrued interest on unpaid liabilities at a rate not to exceed 18% per annum and late fees or penalties at a rate not to exceed 5% per month. Provides that the enforcement mechanism may also include notification to the Department of Healthcare and Family Services to offset payments on the surcharge payor's claims. Provides that the Department of Human Services shall not direct the Department of Healthcare and Family Services to offset claims payments unless the surcharge payor has maintained an outstanding liability to the Statewide 9-8-8 Trust Fund for a period longer than 45 days and has received proper notice of pending enforcement.
AI Summary
This bill, titled the Preventing Crisis Cost Shifting to Medicaid Act, aims to ensure the availability of behavioral health crisis services, such as crisis call centers and mobile response teams, by establishing a new funding mechanism. It recognizes that these services are crucial public health infrastructure but are often not fully covered by commercial health insurance, leading to costs being unfairly placed on Medicaid, local governments, and taxpayers. To address this, the bill requires certain insurance companies and health maintenance organizations (HMOs) that issue or administer policies in the state, and that have significant payment volumes, to pay a behavioral health crisis assessment. This assessment will be deposited into the Statewide 9-8-8 Trust Fund, which supports these vital crisis services. Medicaid managed care organizations are exempt from this assessment. The Department of Human Services is authorized to adjust the total assessment amount over time to maintain the quality and accessibility of the statewide crisis system and is empowered to enforce payment by imposing interest and penalties, and by notifying the Department of Healthcare and Family Services to withhold payments from claims submitted by non-compliant entities, provided certain conditions are met, including a 45-day delinquency and proper notice.
Committee Categories
Health and Social Services
Sponsors (1)
Last Action
Assigned to Human Services Committee (on 03/04/2026)
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