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This bill makes wide-ranging changes to Medicare and Medicaid focused on three main areas: mental health care, prescription drug costs, and expiring program provisions. On mental health, it boosts payments to providers in mental health shortage areas, expands coverage for clinical social workers and behavioral health integration with primary care, promotes telehealth for mental health services, requires more accurate provider directories in Medicare Advantage plans, and directs new federal guidance to help states expand mental health and substance use disorder services under Medicaid and CHIP, including for children in foster care. On drug costs, it protects patients' access to a wide choice of pharmacies under Medicare, sets new rules ensuring independent and rural pharmacies are fairly reimbursed, requires more accurate drug pricing surveys under Medicaid, and ties senior cost-sharing more closely to the actual discounted price of certain expensive drugs starting in 2028. The bill also extends a number of expiring Medicare and Medicaid provisions, such as protections for safety-net hospitals, incentive payments for doctors in value-based care models, telehealth flexibilities, and funding for programs that help low-income seniors navigate Medicare. Key changes are phased in starting as early as 2024 and continuing through 2033, with implementation deadlines set throughout for federal agencies to issue guidance, conduct studies, or launch new payment systems. To help pay for these changes, the bill reduces funding in the Medicaid and Medicare Improvement Funds. Overall, the legislation affects Medicare and Medica

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