CMS Proposes to Modernize Coverage for Behavioral Health Services in 2023 Physician Fee Schedule Rule
The Centers for Medicare & Medicaid Services (CMS) on Thursday proposed new policies to update coverage for behavioral health services in the agency’s physician fee schedule proposed rule for 2023.
In the rule, CMS proposes to address the behavioral healthcare workforce shortage by allowing licensed professional counselors (LPCs), marriage and family therapists (LMFTs), and other types of behavioral health practitioners to provide behavioral health services under general, rather than direct, supervision. CMS also proposes to pay for clinical psychologists and licensed clinical social workers to provide integrated behavioral health services as part of a patient’s primary care team.
In addition, the rule proposes to bundle certain chronic pain management and treatment services into new monthly payments to help improve patient access to team-based, comprehensive, chronic pain treatment. And the agency is proposing to cover opioid treatment and recovery services from mobile units, such as vans, to increase access to services for people who are homeless or live in rural areas.
Meena Seshamani, M.D., Ph.D., director for the Center for Medicare at CMS, and Douglas Jacobs, M.D., M.P.H., chief transformation officer at the Center for Medicare, co-authored a blog
post Thursday about the behavioral health changes in the proposed rule.
Federal Health Officials Recommend ‘Preaddiction’ to Treat SUDs
Directors at the National Institutes of Health and the founder of the Treatment Research Institute this week recommended that the
DSM-5 diagnostic categories “mild to moderate SUD” be a starting definition for the term
preaddiction, a term they said could generate greater attention to the risks associated with early state substance use disorder (SUD) and help direct policies and resources to support preventive and early intervention measures.
Nora Volkow, M.D., director of the National Institute on Drug Abuse, George Koob, Ph.D., director of the National Institute on Alcohol and Abuse and Alcoholism, and Tom McClellan, founder of the Treatment Institute wrote a commentary in
JAMA Psychiatry this week that pushed for using the term preaddiction and highlighted lessons learned from Type 2 Diabetes and the role of “prediabetes” in their argument.
As the authors explained, the American Diabetes Association in 2001 suggested the term prediabetes (defined by elevated scores on two laboratory tests: impaired glucose tolerance and impaired fasting glucose) to leverage public motivation to avoid serious diabetes.
“Intervening early is not a new concept, nor is it easy to implement,” the authors wrote. “The diabetes field likely succeeded owing to a broad, well-organized, and sustained strategy applied concurrently at the clinical, public, and policy levels,” they said, adding that if an analogous approach is to be effective in the SUD field, it will require similarly integrated efforts in three areas: measures to define and detect preaddiction; engaging, effective interventions for preaddiction; and public and clinical advocacy.
“The diabetes example illustrates why a similar strategy has not yet happened in the SUD field: poor integration into the rest of mainstream healthcare, lack of a prominent advocacy group demanding clinical and policy changes, and little reimbursement for interventions with less severe SUDs,
” the authors noted. “Nonetheless, the diabetes example shows that an early intervention approach can work given a comprehensive, sustained effort. That example also suggests the potential impact from a parallel strategy to reduce addiction problems by more aggressive efforts to identify and reverse preaddiction.”
Volkow discussed the issue further in her
blog on July 6.
HUD Announces $365 Million Package to Address Unsheltered Homelessness and Homeless Encampments
The U.S. Housing and Urban Development Department (HUD) recently announced $322 million for permanent housing, supportive services, and other costs, and $43 million to fund about 4,000 new incremental housing choice vouchers.
The
Initiative for Unsheltered and Rural Homelessness through HUD promotes partnerships with healthcare organizations, public housing authorities and mainstream housing providers, and people with lived experience and expertise of homelessness.
“President Biden is following through on his promise to unite our country by delivering funding for healthcare and services that support individuals who are unhoused,” Rahul Gupta, M.D., director of the White House Office of National Drug Control Policy, said in an announcement. “As a physician I have seen firsthand how important it is to address the social and economic conditions of a person’s life in order for them to realize the health and well-being every American deserves.”
Click
here to learn more in the full HUD announcement.
SAMHSA Releases Advisory on Peer Supports Services in Crisis Care
The Substance Abuse and Mental Health Services Administration (SAMHSA) has released an
advisory that discusses the role of peer support workers and models that are available to help individuals in crisis.
The 17-page resource includes information about the evidence base for peer support services in crisis care, what peer support workers should do, how the recovery process looks different for everyone, and more.
Reminder: National Academies’ Forum on Mental Health and SUD to Host Workshop Next Week
The National Academies’ Forum on Mental Health and Substance Use Disorders will host a public workshop that focuses on early intervention for psychosis, current data on the epidemiology and outcomes for people at high risk for psychosis and those who have experienced a first psychosis, and ways to improve care for these patients.
Sessions will provide an overview of the epidemiology for people with psychosis, discuss what services are available and highlight successful models of care, and examine policy solutions and strategies that the most effective for coordinated specialty services.
The workshop will be held on Monday, July 11 from 11 a.m. to 5 p.m. ET. Click
here to register.
Reminder: 2022 Annual Meeting Evaluation
If you attended the 2022 Annual Meeting in Washington, please take a few moments to complete this
evaluation via Survey Monkey. Your feedback will help inform our future programs. Thank you.
Fact of the Week
Comparing the Public Health Emergency (PHE) period (March 2020 to January 2022) with the pre-PHE period, mental health services for children covered by Medicaid has declined about 23%, according to preliminary
data from CMS.
For questions or comments about this CEO Update, please contact Jessica Zigmond