H.R. 9877

Health Equity and Accountability Act of 2026

Sponsor: Raul Ruiz

26 cosponsors
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I Data collection and reporting

II Culturally and linguistically appropriate health and health care

III Health workforce diversity

A Diversifying the health care workplace

B Substance Use Disorder Treatment and Behavioral and Mental Health Workforce

C ACCESS in Mental Health Act

D Developing the Community Health Workforce Act

IV Improving Health Care Access and Quality

A Reducing Barriers to Accessing Care

B Improvement of Coverage

C Expansion of Access

1 General Provisions

2 Rural

3 Indian Communities

4 Providers

5 Dental

D Advancing Health Equity Through Payment and Delivery Reform

E Health Empowerment Zones

F Equitable Health Care for All

G Investing in Equity

H Miscellaneous

I Territories Health Equity

1 Medicare

A Part A

B Part B

C Medicare Advantage (Part C)

D Part D

2 Miscellaneous

V Improving health outcomes for women, gender-diverse people, children, and families

A Underserved communities

B Pregnancy screening

C Pregnancy-Related care

D Federal agency coordination on maternal health

E Reproductive and Sexual Health

F Children’s Health

G Elder Care

H Miscellaneous provisions

VI Mental health and substance use disorders

A Access to care and funding streams

Sec. 6101. Coverage of substance use disorder counselor services and peer support specialist services under part B of the Medicare program

(a) Coverage of Services

(1) In general. Section 1861(s)(2) of the Social Security Act (42 U.S.C. 1395x(s)(2)), as amended by section 4251(c)(1), is amended—

(A) in subparagraph (KK), by striking and at the end;

(B) by inserting and at the end of subparagraph (LL); and

(C) by adding at the end the following new subparagraph:

Text this section adds to the law

(MM) substance use disorder counselor services (as defined in subsection (rrr)(1)), and peer support specialist services (as defined in subsection (rrr)(3));

(2) Definitions. Section 1861 of the Social Security Act (42 U.S.C. 1395x), as amended by sections 2007(b), 4221(a), and 4251(c)(2), is amended by adding at the end the following new subsection:

Text this section adds to the law

(rrr) Substance use disorder counselor services; substance use disorder counselor; peer support specialist services; peer support specialist

(1) The term substance use disorder counselor services means services performed by a substance use disorder counselor (as defined in paragraph (2)) for the diagnosis and treatment of substance use disorder and addiction that the substance use disorder counselor is legally authorized to perform under State law (or the State regulatory mechanism provided by the State law) of the State in which such services are performed, as would otherwise be covered if furnished by a physician or as incident to a physician’s professional service, but only if no facility or other provider charges or is paid any amounts with respect to the furnishing of such services.

(2) The term substance use disorder counselor means an individual who—

(A) has performed at least 2 years of supervised substance use disorder counselor practice;

(B) in the case of an individual performing services in a State that provides for licensure or certification of substance use disorder counselors or professional counselors, is licensed or certified as a substance use disorder counselor or professional counselor in such State; or

(C) is a drug and alcohol counselor as described in section 40.281(a)(6) of title 49, Code of Federal Regulations.

(3) The term peer support specialist services means services performed by a peer support specialist (as defined in paragraph (4)) for the well-being of individuals needing mental health support that the peer support specialist is legally authorized to perform under State law (or the State regulatory mechanism provided by the State law) of the State in which such services are performed, as would otherwise be covered if furnished by a physician or as incident to a physician’s professional service, but only if no facility or other provider charges or is paid any amounts with respect to the furnishing of such services.

(4) The term peer support specialist means an individual who—

(A) is an individual living in recovery with mental illness, addiction, or justice system involvement;

(B) has skills learned in formal training;

(C) uses assets-based framing in speaking about mental health, recovery, and well-being; and

(D) delivers services in behavioral health settings to promote mind-body recovery and resiliency.

(3) Provision for payment under part B. Section 1832(a)(2)(B) of the Social Security Act (42 U.S.C. 1395k(a)(2)(B)) is amended by adding at the end the following new clause:

Text this section adds to the law

(v) substance use disorder counselor services and peer support specialist services;

(4) Amount of payment. Section 1833(a)(1) of the Social Security Act (42 U.S.C. 1395l(a)(1)), as amended by section 4251(c)(3), is amended—

(A) by striking and before (II); and

(B) by inserting before the semicolon at the end the following: , and (JJ) with respect to substance use disorder counselor services and peer support specialist services under section 1861(s)(2)(MM), the amounts paid shall be 80 percent of the lesser of the actual charge for the services or 75 percent of the amount determined for payment of a psychologist under subparagraph (L).

(5) Exclusion of peer support specialist services from skilled nursing facility prospective payment system. Section 1888(e)(2)(A)(ii) of the Social Security Act (42 U.S.C. 1395yy(e)(2)(A)(ii)) is amended by inserting peer support specialist services (as defined in section 1861(rrr)(3)), after mental health counselor services (as defined in section 1861(lll)(3)).

(6) Inclusion of substance use disorder counselors as practitioners for assignment of claims. Section 1842(b)(18)(C) of the Social Security Act (42 U.S.C. 1395u(b)(18)(C)) is amended by adding at the end the following new clauses:

Text this section adds to the law

(ix) A substance use disorder counselor (as defined in section 1861(rrr)(2)).

(x) A peer support specialist (as defined in section 1861(rrr)(4)).

(b) Coverage of Certain Mental Health Services Provided in Rural Health Clinics and Federally Qualified Health Centers. Section 1861(aa)(1)(B) of the Social Security Act (42 U.S.C. 1395x(aa)(1)(B)) is amended by striking or by a mental health counselor (as defined in subsection (lll)(4)) and inserting by a mental health counselor (as defined in subsection (lll)(4)), by a substance use disorder counselor (as defined in subsection (rrr)(2)), or by a peer support specialist (as defined in subsection (rrr)(4)).

(c) Effective Date. The amendments made by this section shall apply with respect to services furnished on or after January 1, 2027.

B Interprofessional care

C Workforce development

D Children’s mental health

E Community-Based care

F Reports

G Miscellaneous provisions

VII Addressing high-impact minority diseases

A Cancer

B Viral hepatitis and liver cancer control and prevention

C Acquired bone marrow failure diseases

D Cardiovascular disease, chronic disease, obesity, and other disease issues

E HIV/AIDS

F Diabetes

G Lung disease

H Tuberculosis

I Osteoarthritis and Musculoskeletal Diseases

J Sleep and circadian rhythm disorders

K Kidney disease research, surveillance, prevention, and treatment

L Diversity in clinical trials

M Additional provisions addressing high-impact minority diseases

N Health Equity and Rare Disease Act

O Asunción Valdivia Heat Illness, Injury, and Fatality Prevention

P New Era of Preventing End-Stage Kidney Disease

VIII Health Information Technology

A Reducing Health Disparities Through Health IT

B Modifications To Achieve Parity in Existing Programs

C Additional Research and Studies

D Closing Gaps in Funding To Adopt Certified EHRs

E Expanding Access to Telehealth Services

IX Accountability and Evaluation

X Addressing Social Determinants and Improving Environmental Justice

A In General

B Gun Violence

C Nutrition for women, children, families

1 Senior hunger prevention

2 Closing the meal gap

D Universal school meals

1 School breakfast program

2 School lunch program

3 Elementary and secondary education data

4 Amendments to other programs and laws

XI Protections to combat regulatory harm to health equity