President Biden Signs Debt Ceiling Increase, Staving Off Medicare Provider Cuts
President Biden on Thursday signed legislation that permits a federal debt ceiling increase and also forestalls expected Medicare payment cuts to providers.
Passed by Congress this week, the bill to raise the federal government’s borrowing limit by about $2.5 trillion—and cover its obligations into 2023—also delays through March 2022 the 2% Medicare sequestration cuts that were to take effect in January.
After the first quarter of 2022, a phased-in, 1% cut will take effect for the second quarter, followed by the full 2% cut for the third and fourth quarters of the year.
Under the legislation, the sequestration will be increased to 2.25% for the first two quarters of 2030, increasing to 3% in quarters three and four of 2030. The bill would also extend the Medicare conversion factor through calendar year 2022 at a rate of 3%, marking a reduction in provider reimbursement by 0.75 percent from the 3.75 conversion factor in 2021.
Senate Majority Leader Schumer Says More Time Needed for ‘Build Back Better Act’
Senate Majority Leader Charles Schumer (D-N.Y.) on Friday signaled that the Biden administration’s
Build Back Better Act will be delayed as discussions continue about the $1.7 trillion climate and social spending plan.
Reports have noted that Democrats are continuing to push for action on the legislation before Christmas, but that ongoing conversations between the White House and Sens. Joe Manchin (D-W.Va.) and Kyrsten Sinema (D-Ariz.)—both of whom have expressed concern about passing another trillion-dollar spending bill—will push the legislation into 2022.
“The president requested more time to continue his negotiations, and so we will keep working with him, hand in hand, to bring this bill over the finish line and deliver on these much-needed provisions,” Schumer said on the Senate floor.” Schumer did not say when the Senate will consider the measure.
HHS Releases 2022 Regulatory Priorities
The U.S. Health and Human Services Department (HHS) has included behavioral health in the department’s recently released
Statement of Regulatory Priorities for 2022.
Beginning on page 5 of the 15-page document, HHS noted it will propose two rules intended to extend telehealth flexibilities for substance use disorder treatments granted during the Covid-19 public health emergency.
One rule will propose revisions to the Substance Abuse and Mental Health Services Administration’s (SAMHSA) regulations that would make permanent regulatory flexibilities for opioid treatment programs to provide extended take-home doses of methadone to patients when it is safe to do so.
In the other telehealth rule, HHS will propose revisions to SAMHSA regulations to permanently allow opioid treatment programs to provide buprenorphine via telehealth services.
The document also describes HHS’ plans to work with the U.S. Labor Department on a rule related to the
Mental Health Parity and Addiction Treatment Equity Act and the
Consolidated Appropriations Act, 2021 related to compliance. Finally, the HHS plan said it will work on revisions related to Part 2 requirements to align rules about the confidentiality of SUD treatment records with rules that the
Health Insurance Portability and Accountability Act of 1996 and the
Coronavirus Aid, Relief, and Economic Security Act of 2020 require.
CMS Adds Mental Health and SUD Measures to Children’s Core Healthcare Quality Measurement Set
The Centers for Medicare & Medicaid Services (CMS) has added two measures to the 2022 updates to the core set of children’s healthcare quality measures.
In
Follow-Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence: Ages 13-17, the measure assesses the percentage of emergency department (ED) visits for beneficiaries aged13 and older with a principal diagnosis of alcohol or other drug (AOD) abuse or dependence who had a follow-up visit for AOD abuse or dependence.
The other measure,
Follow-Up After Emergency Department Visit for Mental Illness: Ages 6-17, assesses the percentage of ED visits for beneficiaries aged 6 and older with a principal diagnosis of mental illness or intentional self-harm and who had a follow-up visit for mental illness.
CDC Data Show Drug Overdose Deaths Involving Fentanyl Increasing
A new report from the Centers for Disease Control and Prevention (CDC) shows that in 2019 and 2020, deaths involving illegal fentanyl increased 94% in the West, 65% in the South, and 33% in the Midwest.
“Pressed into counterfeit pills made to look like oxycodone or other painkillers, illegally made fentanyl has been showing up east of the Mississippi where heroin is sold and in two-thirds of drug overdose deaths charted by CDC through April,” the report noted.
Meanwhile, HHS’ Office of the Inspector General (OIG) this week released a data
brief that reported many Medicare beneficiaries are not receiving medication to treat their opioid use disorder.
“About 1 million Medicare beneficiaries were diagnosed with opioid use disorder in 2020. Yet less than 16 percent of these beneficiaries received medication to treat their opioid use disorder, raising concerns that beneficiaries face challenges accessing treatment,” the OIG’s data brief noted. “Furthermore, less than half of the beneficiaries who received medication to treat their opioid use disorder also received behavioral therapy. These services may be provided in-person or via telehealth; however, the full extent to which beneficiaries use telehealth for behavioral therapy is unknown as Medicare does not require opioid treatment programs to report this information.”
SAMHSA Releases New Prescribing Tools for Buprenorphine in Primary Care Settings
SAMHSA has published a new
resource to provide primary care providers with information on how to implement opioid use disorder treatment using buprenorphine.
The publication highlights common barriers and identifies strategies to address them and also includes specific tactics to support buprenorphine implementation.
SAMHSA to Host Webinar on Harm Reduction Grant Program on Monday
SAMHSA is accepting applications for its first harm-reduction program and will host a webinar Monday, Dec. 20 to review the program’s requirements.
The agency said it expects to award about $30 million in grants with funding from the
American Rescue Plan for programs intended to increase access to a range of community harm-reduction services and to support harm-reduction providers as they work to prevent overdose deaths.
The webinar will be held on Monday at 2 p.m. ET. Click
here to register.
Reminder: NABH Denial-of-Care Portal is Open to Members
NABH’s Denial-of-Care Portal is available for members to provide information about their experiences with managed care organizations that impose barriers to care through insurance-claim denials.
NABH’s Managed Care Committee worked for more than a year to develop the Denial-of-Care Portal as a way to collect specific data on insurers who deny care—often without regard for parity or the effects on patients.
This NABH member-only, survey-like tool allows users to add the name of a managed care organization, type of plan, level of care, type of care (mental health or substance use disorder), duration of approved treatment, duration of unapproved treatment, criteria used to deny a claim, and more.
The portal allows members to submit individual examples of claim denials or upload multiple entries via Excel. It also includes sections on appeals and physician participation. In time, the tool could be a valuable resource for the NABH team’s advocacy efforts.
Please e-mail
Emily Wilkins, NABH’s administrative coordinator, if you have questions about the portal.
Fact of the Week
From August 2019 to April 2021, only 7.4% of people in an emergency department for an opioid overdose received a prescription for naloxone within 30 days of the visit, according to a new
study in
Open Minds.
Happy Holidays from NABH!
NABH will not publish
CEO Update for the next two weeks and will resume on Friday, Jan. 7, 2022. The entire NABH team wishes you, your families, and your teams a very happy, healthy, and safe holiday season!
For questions or comments about this CEO Update, please contact Jessica Zigmond.