CEO Update 99
CMS Announces Additional Medicare Coverage Flexibility for Behavioral Healthcare Services
The Centers for Medicare & Medicaid Services (CMS) on Thursday announced additional flexibility in Medicare coverage for several behavioral healthcare services during the Covid-19 pandemic, including partial hospitalization.
CMS said it will allow payment for certain partial hospitalization services—namely, individual psychotherapy, patient education, and group psychotherapy—that are delivered in temporary expansion locations, including patients’ homes.
In addition, hospitals may bill for services provided remotely by hospital-based practitioners to Medicare patients registered as hospital outpatients, including when the patient is at home when the home is serving as a temporary provider-based department of the hospital. Examples of this include counseling and educational service as well as therapy services. This change expands the types of healthcare providers that can provide using telehealth technology.
CMS said hospitals may also bill as the originating site for telehealth services that hospital-based practitioners provide to Medicare patients registered as hospital outpatients, including when the patient is located at home. And while CMS announced previously that Medicare would pay for certain services conducted by audio-only telephone between beneficiaries and their doctors and other clinicians, the agency on Thursday broadened that list to include many behavioral health and patient education services.
CMS is also increasing payments for these telephone visits to match payments for similar office and outpatient visits. This would increase payments for these services to about $46-$110 from a range of about $14-$41. The payments are retroactive to March 1, 2020.
The changes will also allow Opioid Treatment Programs (OTPs) to perform periodic assessments through two-way audio-visual technology and through audio-only telephone calls. This change builds on CMS’ March 31st guidance, in which the agency said audio-only telephone calls were permitted for therapy, counseling, and counseling add-on codes.
In addition, CMS said pharmacists may perform medication management in accordance with state scopes of practice and laws. This modification does not, however, apply to the dispensing of methadone. Thursday’s rule reaffirmed the continuation of methadone dispensing by certified and accredited OTPs, under the supervision of clinicians who have received appropriate training and as required by the Controlled Substances Act.
Until now, CMS only added new services to the list of Medicare services that may be provided via telehealth using its rulemaking process. CMS is changing its process during the Covid-19 pandemic and will add new telehealth services on a sub-regulatory basis as it considers practitioner requests.
CMS also announced that teaching hospitals, including inpatient psychiatric facilities, can increase temporary beds and admit more patients to alleviate pressure on acute-care hospital bed capacity without facing reduced teaching status payments and reduced payments for indirect medical education.
May is Mental Health Month
May 1 kicks off Mental Health Month, and Mental Health America (MHA) has created a 2020 Mental Health Month Toolkit to commemorate the national observance.
MHA and its affiliates nationwide have led this monthly observance since 1949, and this year will promote a “Tools 2 Thrive” theme to provide practical tools to improve mental health.
According to MHA, which reports that one in five people will experience a mental illness during their lifetime, some of the tools may need to be adapted due to social-distancing restrictions during the global pandemic.
HRSA Seeks Public Comment on Bureau of Health Workforce Substance Use Evaluation
HHS’ Health Resources and Services Administration (HRSA) announced it is seeking public comment for the next 30 days on its Bureau of Health Workforce Substance Use Evaluation.
In September 2017, HRSA’s Bureau of Health Workforce launched a multi-pronged effort to increase the U.S. healthcare system’s workforce capacity to prevent and treat the nation’s deadly opioid crisis. HRSA developed or expanded activities under five programs as part of this effort—including programs such as the National Health Service Corps Loan Repayment Program and the Behavioral Health Workforce Education and Training Program—and is now seeking feedback to assess these program changes.
Click here to learn more about the comment submission process.
AHA to Host Webinar Next Week on Outpatient Services Featuring Sheppard Pratt Leaders
The American Hospital Association (AHA) will host a webinar about outpatient behavioral health services during the Covid-19 pandemic featuring leaders from NABH member Sheppard Pratt Health System on Monday, May 4.
Harsh Trivedi, M.D., M.B.A., an NABH board member and AHA trustee, along with Sheppard Pratt’s chief medical officer, chief operating officer, and medical director for outpatient services, will discuss the system’s efforts to redesign and adapt innovative treatment programs across the full continuum of outpatient services. This event follows a webinar that AHA hosted last month on Sheppard Pratt’s processes and protocols in the system’s inpatient psychiatric settings during the pandemic.
The hourlong webinar will begin on Monday at 3 p.m. ET. Click here to register.
Brookings to Host May 6 Webinar on Telehealth Before and After Covid-19
Research organization Brookings will host an hourlong webinar about telehealth services before and after Covid-19 next Wednesday, May 6 at 2 p.m. ET.
In its announcement, Brookings noted that before the global pandemic, federal and state regulations around reimbursement and licensure requirements limited telehealth use, while private insurance programs and Medicaid have historically excluded telehealth services from coverage.
“Whether through remote clinical health management or real-time patient monitoring, telehealth will increasingly become a necessity in health care, especially in assessing treatment options prior to any hospital visits,” the webinar announcement said.
The Center for Technology at Brookings and the John Locke Foundation will host the webinar to discuss the findings of a forthcoming paper on this issue, as well as the status of regulations and how to support telehealth services in the future. Click here to register.
SAMHSA to Host May 7 Webinar on Combatting Social Isolation for Seniors During Covid-19
The Substance Abuse and Mental Health Services Administration (SAMHSA), the Administration for Community Living, the Veterans Health Administration, and the National Coalition on Mental Health and Aging will host a webinar about combatting social isolation for seniors during the pandemic to commemorate National Older Adult Mental Health Awareness Day on Thursday, May 7.
The discussion will include practical ideas to promote connection and recovery for older adults with serious mental illness and substance use disorders during the global pandemic.
Click here for more information about the 90-minute webinar, which will begin at 1 p.m. ET.
Fact of the Week
According to the Kaiser Family Foundation, 56% of U.S. adults report that worry or stress related to the coronavirus outbreak has caused them to experience at least one negative effect on their mental health and wellbeing, such as problems with sleeping or eating, increased alcohol use, or worsening chronic conditions.
For questions or comments about this CEO Update, please contact Jessica Zigmond.