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Representatives Dan Kildee (D-MI) and Brad Wenstrup (R-OH) introduce the Rural Behavioral Health Access Act

Today, Representatives Dan Kildee (D-MI) and Brad Wenstrup (R-OH) announced the introduction of their bipartisan bill: The Rural Behavioral Health Access Act. This legislation would ensure that Critical Access Hospitals (CAH) retain important flexibility to provide behavioral health services through telehealth after the end of the COVID-19 pandemic.

CAH is a rural hospital designation established by Congress to improve access to essential health care services in rural communities, which often lack access to healthcare providers. As more Medicare patients seek care from home and behavioral health demands in rural areas expand, it is critical that CAHs can utilize and bill for telehealth services.

Congress acted rapidly to expand access to telehealth during the COVID-19 pandemic, but behavioral health challenges in rural areas will continue long after the pandemic recedes. According to results from the 2019 National Survey on Drug Use and Health: Detailed Tables, one in five rural Americans reported having a mental illness in 2019, and December 2020 polling by the American Farm Bureau Federation found that more than half of rural Americans say they are personally experiencing more mental health challenges than they were a year ago. Empowering critical access hospitals to continue providing necessary behavioral therapy services is an important, logical step to addressing the growing national behavior health crisis.

Key provisions of the Rural Behavioral Health Access Act Include:
  • Allow Medicare to provide payment for outpatient critical access hospital services consisting of behavioral therapy services when the individual is not located at the hospital.
  • Allow the initiation of a new patient relationship via telehealth, but only when a plan of care has been established that includes in-person care.
  • Allow the provision of behavioral therapy services through an audio-only interaction, but only if audio-visual capability is not available.
You can find the bill one-pager here and the full legislative text here. You can also view NRHA's press release and a recording of the webinar announcing the bill's introduction

The quotes below are what NRHA and others are saying about the bill:

“NRHA applauds Representatives Kildee and Wenstrup for their work to introduce the Rural Behavioral Health Access Act. This important legislation would allow critical access hospitals to continue providing behavioral health services via telehealth beyond the duration of the public health emergency. Mental health needs have spiked in rural communities since the beginning of the pandemic. Allowing continued access via telehealth in these communities will save lives.” – Alan Morgan, Chief Executive Officer of the National Rural Health Association

“The Alliance for Connected Care is pleased to join the National Rural Health Association in applauding this important legislation which shines a light on the need for critical access hospitals to be able to flexibly provide telehealth services to their patients. The Rural Behavioral Health Access Act should be included alongside other important telehealth changes Congress must pass before the end of the public health emergency.” – Krista Drobac, Executive Director, Alliance for Connected Care

"New telehealth flexibilities afforded to county behavioral health and I/DD services have been essential during the past year. These flexibilities have permitted us to serve a larger number of county citizens in a much more effective manner. Now that we also are in the midst of a US behavioral health pandemic, we will need these flexibilities even more going forward." – Ron Manderscheid, PhD, President/CEO, National Association of County Behavioral Health and Developmental Disability Directors

“The Rural Behavioral Health Access Act is timely and important, and we share the goal of ensuring that behavioral health patients in underserved areas do not lose access to virtual care services. This is a population that has especially relied on advances in virtual care during the pandemic, and Congress must act to allow these services to continue. In addition, we believe it is critically important that Congress enact broader changes to the current virtual care legal framework.” – Peter M. Leibold, Executive Vice President, Chief Advocacy Officer, Ascension

Psychiatric Medical Care was founded around the need for highly collaborative partnerships to support quality of life for older adults in rural communities. We applaud Representatives Kildee and Wenstrup for introducing this legislation – which will help to ensure Medicare beneficiaries are able to access the same behavioral therapy services either in a local Critical Access Hospital or through virtual care. – J.R. Greene, FACHE, Chief Executive Officer, Psychiatric Medical Care

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