This bill amends the Human Services Code of Pennsylvania to establish a new section focused on the integration of behavioral health and physical health services within the HealthChoices medical assistance managed care program. The new section, Section 443.16, mandates the integration of various services for individuals eligible for medical assistance, including behavioral health services (mental health and addiction services), physical health services, and medication and specialty pharmacy drug benefits. The Department of Human Services is tasked with implementing this integrated program by contracting with managed care organizations to ensure high-quality, comprehensive healthcare services that address social determinants of health and promote patient satisfaction while maintaining budget stability.

Additionally, the bill outlines specific requirements for the Department, including the submission of a waiver proposal to the Centers for Medicare and Medicaid Services to amend the existing PA 67 waiver for the integration of these services by October 1, 2025. It emphasizes the need for mandatory participation in the capitated managed care program for all eligible individuals and the use of the Commonwealth Procurement Code for the program's procurement process. The bill defines "behavioral health services" as encompassing mental disorders and substance-related and addictive disorders, explicitly excluding intellectual developmental disorders. The act is set to take effect immediately upon passage.

Statutes/Laws affected:
Printer's No. 603 (Feb 12, 2025): P.L.31, No.21
Printer's No. 0603: P.L.31, No.21