Senate Finance Committee Advances ‘Better Mental Health Care, Lower-Cost Drugs and Extenders Act’
The Senate Finance Committee on Wednesday advanced the bipartisan
Better Mental Health Care, Lower-Cost Drugs and Extenders Act in a unanimous vote.
The healthcare package partially mitigates Medicare payment cuts for physicians, extends certain expiring Medicare and Medicaid provisions, targets pharmacy benefit manager practices, and extends several substance use disorder (SUD) measures that expired on Oct. 1 as lawmakers missed the deadline to reauthorize the
SUPPORT Act.
Included in the legislation is language from S. 3098, the
Securing Advances and a Variety of Evidence-Based (SAVE) Institutions for Mental Diseases (IMD) Options Act that Sens. John Thune (R-S.D.), Maggie Hassan (D-N.H.), and Marsha Blackburn (R-Tenn.) introduced to make the state plan amendment option permanent, a provision also included in the House Energy & Commerce Committee-passed
SUPPORT Act Reauthorization bill. Some states, including South Dakota and Tennessee, opted into a state plan amendment option authorized under the
SUPPORT Act that allows states to avoid the IMD Exclusion. Without renewal, states avoiding the payment exclusion will be forced to terminate payments to IMD facilities or cover such costs through state funds.
Other provisions in the legislation include prohibiting states from terminating Medicaid coverage for incarcerated individuals and expanding access to mental health and SUD services for Medicaid-eligible individuals 30 days prior to their release from incarceration. The legislation also requires the Centers for Medicare & Medicaid Services (CMS) to collect and publish data from Medicare Advantage plans on the number of prior authorization requests, denials, and appeals for mental health and SUD services at the plan level, including the timelines of prior authorization decisions and justifications for denials.
Senate Finance Committee leaders said the goal is to include the
Better Mental Health Care, Lower-Cost Drugs and Extenders Act legislation into a broader healthcare package, a second Continuing Resolution (CR), or end-of-year omnibus funding package.
CMS Extends MA Coverage to Additional Behavioral Healthcare Practitioners
In a
proposed rule released this week, CMS proposed several changes to increase access to behavioral healthcare services for Medicare Advantage (MA) enrollees.
As required by law, CMS proposed to expand network adequacy standards for MA plans by adding a new category of specialists, “outpatient behavioral health” providers, as a required element of each network. Practitioners in this new category would include marriage and family therapists, mental health counselors, opioid treatment program providers, community mental health centers, addiction-medicine physicians, and other providers already providing traditional Medicare-covered addiction medicine and behavioral health counseling or therapy services.
Also, CMS would extend the existing 10% compensation boost to this new category of practitioners for any MA network that has at least one provider group providing telehealth services.
Comments on this rule are due to CMS by Jan. 25, 2024.
White House, ONDCP, Domestic Policy Council, and 12 Federal Agencies Release Recovery-Ready Workplace Toolkit
The White House, the Office of National Drug Control Policy, the Domestic Policy Council, and a dozen federal departments and independent agencies released their
Recovery-Ready Workplace Toolkit: Guidance and Resources for Private and Public Sector Employers this week.
The 140-page resource supports the fourth pillar of
President Biden’s Unity Agenda for the Nation: beating the opioid and overdose epidemic. Specifically, the toolkit is designed to help businesses and other employers prevent and respond more effectively to substance misuse among employees, build their workforces through hiring of people in recovery, and develop a recovery-supportive workplace culture.
It is also intended to serve as a resource to states, local governments, labor organizations, business groups, and non-profits considering launching multi-employer recovery-ready workforce initiatives at the local or state levels.
HHS Releases ‘Action for Adolescents: A Call to Action for Adolescent Health and Well-Being’
HHS recently released
Action for Adolescents: A Call to Action for Adolescent Health and Well-Being, a new effort to promote collaboration and prompt action to improve the health and well-being of U.S. adolescents nationwide.
Take Action for Adolescents is a research-based resource that outlines a vision, key principles, and eight goals, including: 1) Eliminate disparities to advance health equity, 2) Increase youth agency and youth engagement, 3) Ensure access to safe and supportive environments, 4) Increase coordination and collaboration within and across systems, 5) Expand access to health care and human services, 6) Strengthen training and support for caring adults, 7) Improve health information and health literacy, and 8) Support, translate, and disseminate research. The resource also includes a
Take Action toolkit.
In other HHS news related to the nation’s youth, HHS Secretary Xavier Becerra was recently named Chair of the U.S. Interagency Council on Homelessness and announced $6.1 million in new measures on affordable housing and support for runaway youth. Some of that funding will be used to enhance a variety of supportive services, including mental health services, on-site child care, financial literacy and coaching, GED preparation classes, transportation assistance, and early childhood and youth programs.
Reminder: NABH’s Enhanced Denial-of-Care Portal is Now Available
NABH thanks all members who have submitted data to the association’s
Denial-of-Care Portal. You have provided critical information that expands the portal and helps NABH strengthen its advocacy efforts related to erroneous prior-authorization denials.
With guidance from our members, NABH has improved the portal by adding two elements:
- Time-based data on the number of days between a request for coverage and a plan’s denial, which improves our ability to assess and compare health plan responsiveness.
- The gap between days of provided care versus days of covered care to quantify and compare uncompensated days per health plan.
We strongly encourage all NABH members to submit their denial-of-care data in the portal. If you need help starting, or if you have other questions, please e-mail NABH Associate Manager for Congressional Affairs
Emily Wilkins.
Fact of the Week
For young people between the ages of 15 to 24, time spent in person with friends has reduced by nearly 70% during the last two decades to 40 minutes per day in 2020 from roughly 150 minutes per day in 2003 to 40 minutes per day in 2020, according to
The U.S. Surgeon General’s Advisory on the Healing Effects of Social Connection and Community.
Save the Date for the NABH 2024 Annual Meeting!
Please mark your calendars and plan to join us at the Salamander Washington, DC from
May 13-15, 2024 for next year’s NABH Annual Meeting!
Many Thanks to All Veterans!
This Veterans Day Weekend, NABH thanks its members and their families who have served or are serving in the U.S. military. We appreciate your sacrifice and service.
For questions or comments about this CEO Update, please contact Jessica Zigmond.