SB1673 - Mental Health Modernization and Access Improvement Act

• Requires Department of Healthcare and Family Services to apply for a Medicaid waiver or State Plan amendment within 6 months to develop a regulatory framework allowing payment reform models for community mental health services, shifting from fee-for-service to value-based payment with incentives linked to quality and outcomes metrics.

• Establishes quality metrics in four categories: claims-based quality metrics (year 1), health outcomes metrics (year 2), patient experience metrics (year 2), and social determinants of health metrics (year 3), with no more than 6 payment-for-performance metrics to determine annual incentive payments starting in year 3.

• Provides annual incentive payments equal to a 6 percentage point increase in base Medicaid reimbursement rates for providers scoring above median on quality metrics and meeting performance benchmarks; providers failing to meet minimum quality thresholds for 3 consecutive years become ineligible for 3 years.

• Increases Medicaid reimbursement rates by 7% annually for 3 years starting July 1, 2019 for community mental health services; creates psychiatry encounter-based rates equal to federally qualified health clinic averages phased in over 4 years; increases Family Support Program rates by 7% annually for 3 years.

• Requires compliance with federal Mental Health Parity and Addiction Equity Act and state parity requirements; allows workforce flexibility for mental health professionals to practice at full scope of licensure; mandates stakeholder involvement and provider education before implementation.