Committee hears House File 958 to make collaborative care a Medicaid benefit

Representative Nadeau presented House File 958, which would make collaborative care — a team-based, primary-care–embedded approach to treating common mental health and substance-use conditions — a reimbursable Medicaid benefit in Minnesota.

Nut graf: The bill sponsor and clinical testifiers said collaborative care has evidence of improved outcomes and broad reimbursement nationally; the proposal would allow specified providers to bill Medicaid using collaborative-care codes, set reimbursement rates, and provide one-time startup funds for training. The committee adopted an author amendment (DE1) and referred the bill to the Committee on Human Services Finance and Policy as amended.

What the bill would do: Representative Nadeau said House File 958 would allow specified providers to bill Medicaid using collaborative-care procedure codes, establish a sustainable reimbursement rate, and allocate one-time funding for startup and training. Sponsor materials and testifiers noted that Medicare and most commercial insurers reimburse collaborative care and that 37 states have recognized it as a Medicaid benefit; the sponsor said the goal was to make Minnesota the 38th state to do so.

Testimony: Frank Chadwin, a clinical social worker at Hennepin Healthcare, testified that collaborative care is team-based, integrates behavioral health into primary care, and uses a registry, measurement-based care, a behavioral health care manager, and psychiatric consultation. Chadwin said the model is “twice as effective as usual care” in trials and highlighted the registry and measurement components.

Kyle Darnell, a psychologist and executive director for behavioral health at CentraCare, described workforce shortages in Greater Minnesota and said collaborative care is a necessary approach to extend psychiatric expertise into underserved regions. He cited federal workforce projections and regional psychiatrist-to-population ratios in his testimony.

Michael Trangle, a psychiatrist with experience in collaborative care, described how a psychiatric consultant can review many cases in an hour of weekly consultation, substantially increasing specialty reach and clinical leverage. He also described financial barriers when Medicaid (Medical Assistance, MA) does not reimburse collaborative-care services: clinics risk providing services without payment and losing sustainability.

Questions and concerns: Committee members raised budget and implementation questions, including whether there are enough providers to staff teams in rural areas and how the bill defines credentialing for behavioral health care managers. Testifiers said credentialing would follow existing Minnesota statute definitions for licensed mental health professionals (including psychologists, clinical social workers, marriage and family therapists and professional counselors) and allow supervised trainees in certain circumstances; registered nurses were identified as appropriate for substance-use disorder services when medication-assisted treatment is involved.

Action: The committee adopted the DE1 author’s amendment by voice vote and referred House File 958 to the Committee on Human Services Finance and Policy as amended. The chair renewed the motion and the referral carried by voice vote; roll-call tallies were not recorded in the hearing transcript.

Next steps and fiscal notes: The sponsor requested a fiscal note and said she hoped it would be at a reasonable level to extend the benefit to Minnesota’s MA population. Several members said a fiscal analysis would be an important next step. No final fiscal figure was recorded in the hearing.