Comment on CMS-2026-1916-0001

7/21/26 Centers for Medicare & Medicaid Services Department of Health and Human Services Attention: RIN 0938-AV69 Submitted via regulations.gov RE: Medicaid Program; Medicaid Managed Care State Directed Payments and Medicaid Fee-for-Service Targeted Medicaid Practitioner Payments (RIN 0938-AV69) On behalf of WellPower, Colorado’s largest community mental health center and a nonprofit behavioral health safety-net provider serving the City and County of Denver, thank you for the opportunity to comment on this proposed rule. Like other Colorado behavioral health providers, our organization's Medicaid financing could be affected by this rule. The Proposed Rule would apply Medicare-based payment limits to that financing beginning in 2028–2029. This is concerning because Medicare does not adequately recognize many of the community-based behavioral health services we are required to provide, including crisis response, peer support and care coordination. Each year, WellPower provides treatment, prevention and crisis services to more than 22,000 children, teens, adults and families, including more than 17,000 people covered by Medicaid. We operate more than 30 sites and provide services at nearly 200 community locations throughout Denver, including schools, hospitals, assisted living facilities and other community settings. Medicaid is the foundation that makes this safety-net system possible. If this rule is finalized as proposed, we would expect significant operational pressure on WellPower’s ability to maintain the workforce and access points required to serve Denver’s Medicaid members. Specifically, we would expect: ☒Freeze hiring ☐Reduce crisis capacity ☒Longer wait times for care ☐Reduced access in rural or frontier areas ☐Reduce outpatient services ☐Other: We urge CMS to exclude behavioral health services — including services provided by Certified Community Behavioral Health Clinics, Community Mental Health Centers, Opioid Treatment Programs, and other providers operating under Colorado’s Comprehensive Safety Net Provider (CSNP) designation — from the expanded payment limits proposed in this rule. H.R. 1 (Pub. L. 119-21) did not extend these caps to behavioral health services, and CMS should not do so by regulation. We appreciate your consideration. Sincerely, James Greer CEO WellPower