The US Senate Finance Committee has released a bipartisan discussion draft of provisions to expand and support the mental health and substance use-related workforce. The discussion draft proposes adding 400 Medicare-supported graduate medical education (GME) positions to psychiatry residency programs.
GNYHA has long advocated for strengthening Federal support for GME, and we were extremely pleased to see GME expansions in the mental health workforce discussion draft. Since the Committee announced its work on the bill earlier this year, we have been advocating for workforce expansions and circulated on Capitol Hill an advocacy paper requesting additional Medicare GME positions.
The discussion draft adds 400 new Medicare-supported residency positions over 10 years, specifically for psychiatry and psychiatry subspecialty residencies, beginning in fiscal year 2025. The aggregate number of slots made available in a fiscal year would be no more than 200, with the first set of slots to be awarded as of July 1, 2025. It would direct the Centers for Medicare & Medicaid Services to establish an application process for distributing positions and solicits stakeholder feedback on a provision that designates a certain percentage of awarded positions to the following priority categories: hospitals located in a rural area or treated as being located in a rural area; hospitals training residents above their direct GME and indirect medical education caps; hospitals located in states with new medical schools or locations/branch campuses; hospitals that serve areas designated as Federal health professional shortage areas; and hospitals located in states with less than 27 residents per 100,000 people.
The discussion draft also proposes increasing Medicare health professional shortage area bonus payments to psychiatrists and expanding the program to other behavioral health workers who practice in shortage areas. It would allow hospitals and other health care providers to provide evidence-based programs for physicians to improve their mental health and increase resiliency. The discussion draft would also allow states to receive additional Federal Medicaid funding to expand or improve the capacity of mental health and substance use disorder providers. Lastly, it would establish Medicare coverage for mental health services provided by marriage and family therapists and licensed professional counselors.
The discussion draft is part of the Committee’s larger bipartisan mental health legislation. The Committee introduced draft legislation earlier this year to increase access to telemental health services and improve pediatric mental health.