Mental Health Awareness Month Begins Saturday, May 1
Mental Health Awareness Month, also referred to as Mental Health Month, kicks off Saturday, May 1 to recognize the millions of Americans living with a mental illness.
Please be sure to follow NABH on
Twitter and
LinkedIn to help promote Mental Health Month, and visit the websites for the
National Alliance on Mental Illness (NAMI) and
Mental Health America for more information and toolkits.
HHS Provides Exemptions for Buprenorphine Prescribers for Fewer Than 30 Patients
The U.S. Department of Health and Human Services (HHS) announced this week that practitioners prescribing buprenorphine, a controlled substance, for opioid use disorder to fewer than 30 patients are exempt from certain regulatory requirements codified under 21 U.S.C. 823(g)(2)(B)(i)-(ii).
Under the new
guidance, physicians, physician assistants, nurse practitioners, clinical nurse specialists, certified registered nurse anesthetists, and certified nurse midwives are exempt from having to make certain training related certifications and certifying their capacity to provide counseling and other ancillary services. The guideline does not remove the DATA 2000 Waiver, otherwise known as the ‘X-Waiver.’
Providers are still required to file a Notice of Intent with the Substance Abuse and Mental Health Services Administration. The exemption applies to practitioners who are state-licensed and DEA-registered. It also generally limits prescribing to patients who are located in states where the practitioner is licensed.
Practicing under this exemption does not count toward the time requirements for prescribing to a higher patient limit under 21 U.S.C. 823(g)(2)(B)(iii). This exemption also applies to other Schedule III, IV, and V drugs.
Tuesday’s guidance encourages practitioners to provide access to psychosocial services to improve treatment retention and outcomes. In addition, medical education institutions are strongly encouraged to implement comprehensive training in substance use disorder diagnosis and management.
In late January, the Biden administration placed a freeze on Trump administration guidelines that intended to exempt physicians from the X-Waiver. That notice cited clinical concerns and stated the Executive Branch did not have the legal authority to make the change.
GAO Releases Behavioral Health Study on Access, Claims Payments, and Covid-19 Effects
In a
report released Friday, the Government Accountability Office (GAO) said evidence collected during the Covid-19 pandemic suggests the prevalence of behavioral health conditions has increased, while access to in-person behavioral health services has decreased.
The report noted that Centers for Disease Control and Prevention (CDC) surveys found about 38% of respondents reported symptoms of anxiety or depression from April 2020 through February 2021, reflecting an increase of 11% since 2019. Meanwhile, U.S. emergency department visits for overdoses and suicide attempts from mid-March to mid-October 2020 were up 36% and 26%, respectively, since 2019. The study also highlighted issues related to payment for services.
“Officials GAO interviewed from provider organizations offered anecdotal examples of problems with payments for behavioral health services, including examples suggesting that denials and delays were more common for these services than they were for medical/surgical services,” the report said. “However, most officials were not aware of published data that could confirm their concerns, and data from reports from two states on claims denials either did not support their concerns or were inconclusive,” it continued. “In addition, a report in one state that examined mental health parity—requirements that behavioral health benefits are not more restrictive than medical/surgical benefits—found that the rate of complaints associated with behavioral health services was notably lower than those for medical/surgical services.”
CMS Launches Behavioral Health Follow-up Care Learning Collaborative
The Centers for Medicare & Medicaid Services (CMS) has launched the “Improving Behavioral Health Follow-up Care Learning Collaborative” to support state Medicaid and Children’s Health Insurance Program (CHIP) agencies’ efforts to improve access, coordination, and follow-up care for beneficiaries who visit an emergency department or who are hospitalized for a mental health or substance use condition.
In an announcement, CMS said state behavioral health agencies, managed care plans, and providers will learn about evidence-based interventions to improve access to timely follow-up behavioral healthcare during the global pandemic recovery period and beyond.
The new learning collaborative includes a four-part webinar series beginning next month and an “affinity group” starting in July. According to CMS, states interested in acting on the concepts and strategies introduced in the webinar series will have an opportunity to participate in an action-oriented affinity group that will facilitate state-to-state learning and support state teams in designing, implementing, and scaling up quality-improvement projects in their state.
Click
here for more details about the webinar series and affinity group and
here to register for the webinars.
NABH Welcomes Comments on Federal Privacy Regulations
Earlier this year, HHS issued a
notice of proposed rulemaking (NPRM) that outlined significant changes to federal privacy regulations. The Biden administration’s freeze on certain regulations issued during the prior administration does not apply to this proposed rule, and the current administration has extended the deadline for comments on this NPRM to May 6, 2021.
Notably, the NPRM includes a section entitled “Encouraging Disclosures of PHI [Personal Health Information] when Needed to Help Individuals Experiencing Substance Use Disorder (Including Opioid Use Disorder), Serious Mental Illness, and in Emergency Circumstances.” This
link to that section discusses the following proposed changes to federal privacy regulations:
- Revising the standard for determining when a disclosure or use of PHI is in the best interests of the individual to be based on a “good faith belief” instead of “exercise professional judgment”; and
- Changing the standard for use or disclosure of PHI to prevent or lessen a “serious or imminent threat” to the health or safety of a person or the public to instead be allowable based on a “serious and reasonably foreseeable threat” to a person or the public.
This section of the proposed rule also includes
scenarios illustrating how the proposed changes to the privacy rules would help improve care for patients.
NABH welcomes comments about these changes and requests that members send any comments to
Kirsten Beronio, NABH’s director of policy and regulatory affairs, by next
Tuesday, May 4.
NIDA Director Says Addiction Should be Treated, Not Penalized in Health Affairs Blog
People with substance use disorders need treatment, not punishment, and drug use disorders should be approached with a demand for high-quality care and compassion for those affected.
Those are the words of Nora Volkow, M.D., director of the National Institute on Drug Abuse, or NIDA, in a
Health Affairs blog post this week. Volkow also noted that the Covid-19 pandemic has highlighted the large racial health disparities in America, and that Black Americans have experienced worse outcomes during the pandemic, continue to die at a greater rate than White Americans, and also suffer disproportionately from a wide range of other acute and chronic illnesses.
“We have known for decades that addiction is a medical condition—a treatable brain disorder—not a character flaw or a form of social deviance,” Volkow wrote. “Yet, despite the overwhelming evidence supporting that position, drug addiction continues to be criminalized,” she continued. “The U.S. must take a public health approach to drug addiction now, in the interest of both population well-being and health equity.
Separately this week, an
opinion piece in
Stat from former Office of National Drug Control Policy (ONDCP) Deputy Director Tom McLellan, Ph.D. and Jacob Crothers, M.D., an addiction medicine physician, proposed that the United States should engage in a rapid response similar to “Operation Warp Speed” (for the Covid-19 vaccine development and rollout) to address the nation’s ongoing opioid crisis.
In their observations, McLellan and Crothers wrote the U.S. Drug Enforcement Administration surveillance of providers sends a confusing message about encouraging the use of U.S. Food and Drug Administration-approved addiction medications. They also warned against discharging patients for positive drug tests and prohibitive prior authorization policies, and they suggested extending the Medicare opioid treatment bundle to Medicaid.
NCOA to Host Older Adult Mental Health Awareness Day Symposium on May 6
The National Council on Aging (NCOA), along with the U.S. Administration for Community Living and the Substance Abuse and Mental Health Services Administration (SAMHSA) will host the 4
th Annual Older Adult Mental Health Awareness Day Symposium as a virtual event on Thursday, May 6.
Registration is free, and the all-day event for public health practitioners, professionals in the aging networks, mental health providers, healthcare professionals, and others interested in the mental health of older adults will address topics such as access to behavioral health in diverse older adults, latest interventions related to SUDs, and socialization and engagement.
Learn more from the program’s
agenda and click
here to register.
Save the Date: NABH 2021 Annual Meeting
NABH will host its 2021 Annual Meeting from Wednesday, Oct. 6 – Friday, Oct. 8, 2021 at the Mandarin Oriental Washington, DC.
The association re-scheduled for this later date in 2021 due to the ongoing Covid-19 pandemic. We hope you can join us!
After 2021, NABH will host its subsequent Annual Meetings in June. Please save the date for these future NABH Annual Meetings:
We look forward to seeing you again in Washington!
Fact of the Week
Nearly a quarter of all child and adolescent admissions to psychiatric hospitals are involuntary, according to a new
study in
The Lancet. The report also showed children admitted against their will more often had a diagnosis of psychosis, substance misuse, or intellectual disability.
For questions or comments about this CEO Update, please contact Jessica Zigmond.