Comment on CMS-2026-1916-0001
Washington Council for Behavioral HealthOpposeTrade association
Summary: The Washington Council for Behavioral Health, representing over forty community behavioral health agencies, opposes the proposed rule because it would impose payment caps on mental health and substance use services that exceed the provisions of H.R.1. They argue that these caps would undermine congressional intent, fail to reflect the actual costs of care, and exacerbate workforce shortages.
On behalf of the Washington Council for Behavioral Health (WA Council), thank you for the opportunity to comment on the Centers for Medicare & Medicaid Services (CMS) proposed rule addressing Medicaid managed care State directed payments (SDPs) and Medicaid fee-for-service (FFS) targeted Medicaid practitioner payments (the Proposed Rule), published at 91 Federal Register 30400 (May 22, 2026). The WA Council is the professional association of licensed community behavioral health agencies, representing over forty agencies across the state.
The WA Council strongly recommends that CMS exclude mental health and substance use care services from any caps that go beyond the provisions enacted in H.R.1. Such an exemption should include services furnished by CCBHCs, CMHCs, and OTPs, consistent with the mental health and substance use protections Congress included in Public Law 119-21, including sections 71120 and 71401. Medicare and Medicaid rates often do not reflect the actual cost of providing mental health and substance use services, which contributes to workforce shortages and limits access to appropriate, high-quality care. Including this exemption would align with congressional intent and further the Administration’s stated efforts to improve mental health and substance use care nationwide. Please see the attached file for more details.