Community mental health centers (CMHCs) may yet benefit from a push to change the federal definition under which they operate now that President Obama has revived a measure previously passed by the House but not included in the Senate version of health care reform.

Obama included a change in the definition of CMHCs in the health care overhaul proposal he offered in February. The changed definition could allow the CMHCs to qualify for more Medicare reimbursements in the future.

The current CMHC definition, according to members of Congress pushing for the change, restricts billing rates and coverage for their services, limits what Medicaid will pay for, and keeps the centers from addressing the physical health needs of people with severe mental illness being treated there.

"Getting federally qualified behavioral health center language into the health care reform legislation will lay the foundation for positioning community mental health providers to have access to many of the same benefits in federal law and programs as federally qualified health centers do," said Rusty Selix, executive director of the California Council of Community Mental Health Agencies, in a written statement.

Specifically, the change would replace references in federal law to "community mental health centers" with "federally qualified behavioral health centers" (FQBHC) and specify how a facility can meet that definition.

The change was added as an amendment to the House-passed health care reform bill but was not included in the Senate bill, which will likely be the final measure considered by Congress. Passage of the Senate bill will probably depend on addressing outstanding concerns of members of the House through a companion reconciliation measure. That measure will include the changes sought by Obama, including the CMHC language.

"Our amendment begins the process of establishing national standards of care for persons with serious mental illness and addiction disorders and will bring new reporting and accountability standards to mental health care in an effort to better integrate these providers and services within the larger health care system," said Rep. Eliot Engel (D-N.Y.), a sponsor of the amendment, in a written statement.

The measure also will require the centers to use evidence-based and recovery-focused services and will establish nationwide accountability and reporting requirements.

The new standards and federal definition should help reduce fraudulent use of mental health center designations to bilk Medicare through its partial hospitalization benefit, a situation that has occurred under the current definition, according to the National Council for Community Behavioral Healthcare. The fraud controls would come from the first-time use of specific definitions and requirements that a facility would have to meet to receive reimbursements as a FQBHC.

The change could eventually affect the more than 6 million patients of CMHCs, because Medicare officials balked at increasing the facilities' funding until clear definitions were established to delineate which mental health facilities could qualify for federal funding.

"By broadening the definition of federally qualified behavioral health centers, the Sacramento center—in addition to centers across the country—finally will have a baseline [from] which they can start rebuilding the community-based mental health system and help millions of people with mental illness or substance abuse disorders all across the country," said Rep. Doris Matsui (D-Calif.), another sponsor of the House language, in a statement.

Information on the CMHC proposal is posted at <www.thenationalcouncil.org/cs/federal_status_for_community_mental_health_and_addictions_treatment>.