CEO Update | 17
CMS Proposes Payment Increases for PHPs and CMHCs in 2019
The Centers for Medicare and Medicaid Services (CMS) has proposed a hospital-based partial hospitalization program (PHP) payment rate of $216.55 for 2019, up from the 2018 rate of $205.36, in the Hospital Outpatient Prospective Payment System and Ambulatory Surgical Center Payment System (OPPS/ASC) proposed rule the agency released on July 25.
CMS also proposed an increase for community mental health centers (CMHCs), which could see a payment rate of $123.84 in 2019 if the rule is made final. By comparison, CMHCs received a payment rate of $117.35 in 2018.
The 2019 OPPS/ASC proposed rule updates Medicare payment rates for PHP services provided in hospital outpatient departments and CMHCs. The PHPs are structured, intensive outpatient programs that consist of a group of mental health services paid on a per diem basis under the OPPS, based on the PHP per-diem costs.
In its rule for Calendar Year (CY) 2018, CMS considered changing its long-standing policy on 20 hours per week of programming for patients in PHPs. The existing policy requires patient care plans to include 20 hours of programing per week. CMS wanted to change this by placing provider reimbursement at risk if a healthcare provider’s patient did not participate in all 20 hours of programing.
NABH sent CMS a comment letter in September 2017 that highlighted the flaws with this approach and the negative consequences that would likely result from it. Based on public comments, CMS decided not to pursue this change for CY 2019.
CMS will accept comments on the CY 2019 proposed rule until September 24.
House Passes National Suicide Hotline Improvement Act
The U.S. House this week passed the National Suicide Hotline Prevention Act, the same bill that the Senate approved unanimously in October 2017.
If signed into law, this legislation would call for a study that would evaluate: a) the feasibility of designating a three-digit dialing code for a national suicide prevention and mental health crisis hotline system, and b) the effectiveness of the current National Suicide Prevention Lifeline (1-800-273-TALK), including how well it addresses veterans’ issues.
NABH joined more than three dozen groups in February to sign a letter from the Mental Health Liaison Group to Congress that expressed strong support for this legislation.
Aligning for Health Coalition Establishes Advisory Board
Aligning for Health—a coalition focused on the need for efficient, integrated, and coordinated programs to better improve health outcomes for all Americans—has established an Advisory Board of experts on social determinants and groups representing states and counties, consumers, and housing, nutrition, public health, and mental health programs.
The Advisory Board will provide advice and recommendations to the coalition as it works to advance policy proposals that “test the idea that the health and well-being of vulnerable populations can be improved by better aligning programs and services addressing the social determinants of health,” the coalition noted in an announcement.
Andrew Sperling of the National Alliance on Mental Illness (NAMI) is a member of the new Advisory Board, which also includes representatives from Trust for America’s Health, the National Academy for State Health Policy, Tufts University and the University of Illinois, the National Coalition on Health Care, and the American Public Human Services Association.
“In order to advance the health and well-being of all people, we must work together to influence modern approaches to sound policy,” said Tracy Wareing-Evans, president and CEO of the American Public Human Services Association, said in the announcement. “Utilizing frameworks like social determinants of health can help us move the health and human services systems upstream to focus on prevention and early interventions that enable all families to live healthy lives and thrive in their communities.”
Federal Officials Tour Wisconsin School to Explore Behavioral Health Integration in Schools
HHS Secretary Alex Azar, Assistant Secretary for Mental Health and Substance Use Elinore McCance-Katz, and Education Secretary Betsy DeVos this week joined representatives from the Federal Commission on School Safety on a field visit to examine behavioral health integration in schools.
The visit to Friendship Middle School in Adams County, Wis., focused on the state’s mental health framework, which allows local school districts to provide integrated behavioral health best practices to students.
After the tour, the visit included two panel discussions so commission members and administration officials could hear from state officials about Wisconsin’s School Mental Health Initiative’s efforts to enhance behavioral health components in day-to-day school activities. Click here to watch a video from the event.
President Trump Issues Declaration on Anniversary of the Americans with Disabilities Act
President Trump this week issued a declaration that proclaimed July 26, 2018 as a day to celebrate the 28th anniversary of the Americans with Disabilities Act (ADA) that President George H.W. Bush signed on July 26, 1990.
In the nearly three decades since the ADA passed, the law has promoted equal access to employment, government services, public accommodations, commercial facilities, and public transportation for millions of Americans living with disabilities.
“Our nation must continue to build upon this foundation and continue to further the participation of the more than 56 million Americans living with disabilities,” the president said in the declaration. “My Administration continues to encourage research that will lead to advancements in technology, medicine, and other fields and better enable independent living.”
Politico-Harvard T.H. Chan School of Public Health Conduct Poll on Opioid Crisis
A new poll from Politico and the Harvard T.H. Chan School of Public Health found that only 26 percent of Americans are satisfied with federal spending on addiction treatment.
Meanwhile, 37 percent of Americans say opioid addiction is a “personal weakness” despite efforts to reduce stigma around addiction. And only one-third of Americans said they considered medication assisted treatment, or MAT, to be effective.
The poll was conducted months after Congress appropriated $4 billion in funding to address the deadly crisis. Click here to read the findings.
Morning Consult Survey Examines Women’s Perspectives and Experiences with Opioids
A new Morning Consult poll of more than 1,000 women between the ages of 25-59 found that few women are screened for substance use disorder, and yet many are prescribed opioids.
According to the findings, this combination happens frequently around surgical procedures, “with the operating room having become an unintentional gateway to the opioid epidemic.” In 2016, the results found, 3 million patients transitioned to persistent opioid use after surgery, which mean they were still taking opioids three to six months after their surgical procedure.
The survey also found that only 20 percent of women who underwent surgery and required pain medication after the procedure said they were screened for substance use disorder through a consultation of their patient history. Click here to learn more results from the study.
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