NABH Submits Comment Letter on Federal and State Health Exchange Proposed Rule for 2024
Today, NABH submitted
comments on the Contract Year 2024 proposed rule related to the federal and state health exchange marketplace. NABH expressed support for the generally positive rule, including its multiple proposals to assist consumers seeking to enroll in exchange-based health plans and, ultimately, to access mental health and substance use disorder treatments. Our comments also called for the Centers for Medicare & Medicaid Services (CMS) to, rather than merely requiring a minimal contracting attempt, as proposed, require health plans to meet a minimum contracting level based on a percentage of available mental health facilities and substance use disorder treatment centers. In addition, the letter urged CMS to evaluate the current level of actual coverage for mental health services being provided by plans on the federal and state marketplace. We also called on CMS to study the impact of insurer network expansion practices that result in some behavioral health sites and services being unilaterally added to, or “deemed” members of, health plan networks and paid an in-network rate that was already rejected by the provider.
The comment deadline for this
proposed rule is Monday, January 30.
CMS Approves California’s Medicaid 1115 Demonstration Amendment to Support Care for Justice-Involved Individuals and Contingency Management
The Centers for Medicare & Medicaid Services (CMS)
approved a first-of-its-kind demonstration amendment in California which will provide a set of critical pre-release services and improve access to needed care for people returning home from jails and prisons. This approval marks the first time Medicaid will pay for pre-release services to incarcerated individuals. As part of the approval, California will also increase and sustain provider payment rates and Medicaid managed care payment rates in behavioral health and select other services.
In another first for the country, the
waiver also includes approval for the use of contingency management for individuals with stimulant use disorders (StUDs). The waiver outlines procedures and protocols for using financial incentives in a 24-week program to reinforce the non-use of stimulants. The protocol is followed by six or more months of additional recovery support services. Importantly, the protocols integrate measures to protect against fraud and abuse, first identified by the Motivational Incentives Policy Group, of which NABH is a member. The waiver introduced Medicaid reimbursable services provided by a Contingency Management Coordinator, a new job classification. It is believed that this pilot will serve as a template for other states that are seeking to integrate treatment for individuals with StUD.
SAMHSA Announces Funding Opportunity for Community Programs to Help Youth and Young Adults at High Risk for Psychosis
The Substance Abuse and Mental Health Services Administration (SAMHSA) announced that applications are open for a program to provide trauma-informed, evidence-based interventions to youth and young adults who are at clinical high risk for psychosis.
Award recipients are expected to use evidence-based intervention to improve symptomatic and behavioral functioning; enable youth and young adults to resume age-appropriate social, academic, and/or vocational activities; delay or prevent the onset of psychosis; and minimize the duration of untreated psychosis for those who develop psychotic symptoms.
The deadline for applications is Tuesday, March 14. Click
here to learn more and to apply.
CDC Study Shows that Treating Substance Use Disorders Costs Employer-sponsored Health Insurance over $35 Billion per Year
This week, the Centers for Disease Control and Prevention (CDC) released a
study assessing the medical cost of substance use disorders for US employers, employees, and health insurance plans. The study assessed 162 million non-Medicare eligible enrollees with employer-sponsored health insurance in 2018. The study determined that the total annual medical cost in that population was $35.3 billion and alcohol-related disorders and opioid-related disorders were the most costly. It should be noted that this amount is a fraction of the $1.1 trillion of the total personal health care expenditures paid by private insurance in the US in 2018.
NABH Mourns Behavioral Healthcare Industry Leader Joey Jacobs
NABH mourns the passing of retired behavioral healthcare executive and leader
Joey J. Jacobs, 69, who died Jan. 14 in Nashville following an extended illness.
Jacobs held various roles at Nashville, Tenn.-based HCA Healthcare and co-founded Psychiatric Solutions before he sold the company 13 years ago. Jacobs was also the chair and CEO of Franklin, Tenn.-based Acadia Healthcare, all NABH system members. A former member, Jacobs served on the NABH Board from 2005 through 2009 when NABH was the National Association of Psychiatric Health Systems.
In addition to his wife, Debbie Hammer Jacobs, Jacobs is survived by two sons, Brent and Scott; three grandchildren; and other family members. Services were held on Jan. 20.
Reminder: Please Submit Data to Enhance NABH’s Managed-Care Advocacy Efforts
Thank you to all members who have submitted data to NABH’s denial-of-care portal. Your data will help NABH highlight problems in the field related to health plan denials and timeliness.
Several policymaking entities are interested in these data, which could support advocacy for expanded access to care. For new participants, please e-mail
Emily Wilkins, NABH’s administrative coordinator, for support.
Details Coming Soon for the NABH 2023 Annual Meeting
Please plan to join us in Washington, DC from
June 12-14, 2023 for this year’s NABH Annual Meeting at the Salamander Washington, DC (formerly the Mandarin Oriental hotel). Details coming soon.
Fact of the Week
A new cross-sectional
study including 74,474 opioid-involved deaths, buprenorphine was involved in 2.6% of opioid-involved overdose deaths during July 2019 to June 2021. Although monthly opioid-involved overdose deaths increased, the proportion of involving buprenorphine fluctuated—but did not increase.
For questions or comments about this CEO Update, please contact Jessica Zigmond.
