,i  #aadth ,,congress  #b;d ,session    
,h4 ,r4 #defi  ,,in ,,the ,,house ,,of  
,,representatives  ,february #ab1 #bjaf 
,ms4 ,matsui 7for herself and ,mr4      
,lance7 introduced the following bill2  
which was referred to the ,committee on 
,energy and ,commerce  ,a ,,bill  ,to   
amend the ,protecting ,access to        
,medicare ,act of #bjad 7,,pama7 to     
extend and expand the ,medicaid         
community mental health services        
demonstration program4  #a4 ,short title
 ,this ,act may be cited as the ,extend 
,excellence in ,mental ,health ,act of  
#bjaf4  #b4 ,extension and expansion of 
,medicaid community mental health       
services demonstration program  7a7 ,in 
general ,paragraph 7#c7 of section      
#bbc7;d7 of the ,protecting ,access to  
,medicare ,act of #bjad 7,public ,law   
#aac-ic2 #db ,u4,s4,c4 #acif;a note7 is 
amended to read as follows3  7#c7       
,number and length of demonstration     
programs  7,a7 ,in general ,except as   
provided in subparagraphs 7,b7 and 7,c71

 not more than #h ,states shall be      
selected for #b-year demonstration      
programs under this subsection4  7,b7   
,three-year extension ,a ,state selected
 to participate in the demonstration    
project under this subsection shall1    
upon the request of the ,state1 be      
permitted to continue to participate in 
the demonstration project for an        
additional #c-year period1 if the       
,secretary makes the determination      
specified in subparagraph 7,d7 with     
respect to the ,state4 ,the ,secretary  
shall provide each such ,state with     
notice of that determination4  7,c7     
,expansion to additional ,states  7i7   
,in general ,the ,secretary may expand  
the number of eligible ,states          
participating in the demonstration      
project1 if1 with respect to any such   
,state1 the ,secretary makes the        
determination specified in subparagraph 
7,d74 ,the period of the participation  
of any such eligible ,state in the      
demonstration project shall end on      

,december #ca1 #bjbb1 regardless of the 
date on which the ,state begins         
participating in the demonstration      
project4  7ii7 ,notification ,the       
,secretary shall provide each ,state    
that applies to be added to the         
demonstration project under this        
subsection with notice of the           
determination under subparagraph 7,d7   
and the standards used to make such     
determination4  7,d7 ,determination ,the
 determination specified in this        
subparagraph is that the ,secretary     
determines that1 in the case of a       
request under subparagraph 7,b7 or an   
expansion of the demonstration project  
under subparagraph 7,c7--  7i7 the      
continued participation of a ,state in  
the demonstration project under this    
subsection or an expansion of the       
project to any additional ,state 7as    
applicable7 will measurably improve     
access to1 and participation in1        
services described in subsection        
7a77#b77;,d7 by individuals eligible for

 medical assistance under the ,state    
,medicaid program2 and  7ii7 any such   
,state is in full compliance with the   
reporting requirements under paragraph  
7#g7 and any quality reporting          
requirements established by the         
,secretary4  4  7b7 ,clarification      
concerning coverage of clinical visits  
,section #bbc7;b7 of the ,protecting    
,access to ,medicare ,act of #bjad is   
amended by adding at the end the        
following new paragraph3  7#c7 ,services
 included in clinical visits ,for       
purposes of implementing the guidance   
under paragraph 7#a71 a clinical visit  
shall include-- 7,a7 behavioral health  
services provided on-site2  7,b7        
services authorized under subsection    
7a77#b77;,d7 furnished outside the      
clinic in a community setting1 including
 a homeless shelter1 penal facility1 or 
other community setting 7as identified  
by the ,secretary72 and  7,c7 telehealth
 services4  4