NABH Remembers Youth Services Committee Member Mike Lyons, M.S.
NABH remembers with grateful appreciation Mike Lyons, M.S., 54, who died unexpectedly of a brain aneurysm on Sunday, Feb. 11.
Mike served as vice president of specialty education for Universal Health Services’ (UHS) Behavioral Health Division, where he was responsible for implementing UHS’ Best in Class Academic Accountability System throughout the organization’s network of academic programs in acute, partial hospitalization, residential, and day-school settings.
Mike also championed education legislation at the state and federal levels to make certain that children and adolescents with mental illness receive an equitable and quality educational experience.
At the association, Mike was an influential and supportive member of the Youth Services Committee, where his fellow members and NABH team respected him highly for his insights, thoughtful comments, and devotion to helping kids learn. As an example, last year Mike sent his regrets for missing the 2023 Annual Meeting and Youth Services Committee meeting so he could attend the high school graduation ceremony at one of UHS’ facilities. Mike will be missed by all who knew him.
There will be a celebration of Mike’s life at The Casa Bella Club House, 6005 Anello Drive, Melbourne, Florida 32940 from 2 – 5 p.m. on Saturday, Feb. 17. In lieu of flowers, donations can be made to
Camp Marist, 22 Abel Boulevard, Effingham, New Hampshire, 03882. Under the leadership of the Marist Brothers for more than 70 years, Camp Marist is based in New Hampshire’s White Mountain Lakes region and is a place where children learn about character, leadership, and community.
NABH Sends MOTAA Opposition Letter to Congressional Leaders
This week NABH sent a
letter to House and Senate leaders outlining the association’s strong opposition to the
Modernizing Opioid Treatment Access Act (MOTAA).
“The
Modernizing Opioid Treatment Access Act (MOTAA) [H.R. 1359 / S. 644] would permit addiction physicians outside OTPs to prescribe methadone that would be dispensed through pharmacies,” NABH wrote in its letter. “This legislation has not been vetted appropriately with stakeholders, the House has not held a hearing to examine it, and the Senate has given it only a cursory review,” the letter continued. “The bill’s goal is to provide greater access to methadone; however, patient safety concerns with such an untested approach warrants further review and attention before further congressional consideration.”
NABH cautioned that MOTAA would significantly introduce more danger of overdose given the safety profile of methadone (versus buprenorphine, for example). Instead, NABH wrote that implementing the Substance Abuse and Mental Health Services Administration’s (SAMHSA) regulations released on Feb. 2 would be a more effective approach to providing greater access.
“They will allow greater access to individuals of all ages, provide greater convenience for patients, bolster the workforce, ease expansion to broader settings of care (medication units and mobile units), and more,” NABH wrote. “The regulations also recognize that methadone has a more dangerous pharmacological profile than other medications for OUD.”
CMS Clarifies Parameters on Using AI in Coverage Decisions for MA Plans
In a recent
memo, the Centers for Medicare & Medicaid Services (CMS) clarified that Medicare Advantage (MA) plans cannot use artificial intelligence (AI) and algorithms to deny prior authorization requests but may use the technology to assist in coverage decisions.
This clarification – published in the memo as frequently asked questions (FAQ) – is based on the agency’s April 2023
rule, which took effect on Jan. 1, 2024. In the FAQ, the agency responds to concerns about inappropriate coverage denials based on algorithms.
“An algorithm or software tool can be used to assist MA plans in making coverage determinations, but it is the responsibility of the MA organization to ensure that the algorithm or artificial intelligence complies with all applicable rules for how coverage determinations by MA organizations are made,” the agency noted in its FAQ.
This scrutiny aligns with recent lawsuits against UnitedHealth Group, Humana, and Cigna’s MA plans, as well as a 2022 HHS Office of the Inspector General
report about the erroneous algorithm coverage decisions.
Kaiser Family Foundation to Examine Prior Authorization in Webinar Next Week
The Kaiser Family Foundation (KFF) will host a webinar on Feb. 22 featuring a panel of four experts who will explore why insurers use prior authorization, its effect on patients and providers, and how new regulations may change current practices.
Larry Levitt, KFF’s executive vice president for health policy, will moderate the 45-minute discussion that will include Troyen Brennan, M.D., adjunct professor of health policy and management at the Harvard T.H. Chan School of Public Health and former CVS Care executive; Fumiko Chino, M.D., radiation oncologist at Memorial Sloan Kettering Cancer Center; Anna Schwamlein Howard, principal, policy development at the American Cancer Society Action Network; and Kaye Pestaina, KFF’s vice president and director of the Program on Patient and Consumer Protection.
Click
here to register for the webinar, which is scheduled for Thursday, Feb. 22 at noon ET.
SAMHSA Releases Resource on Medicaid Coverage of Medications for Alcohol and Opioid Use Disorders
SAMHSA has released a
report that provides an update on the present state of coverage, availability of, and access to medications within state Medicaid plans for treating ongoing alcohol use disorder (AUD) and opioid use disorder (OUD) and reversing an opioid overdose.
The new resource also includes examples of efforts to increase access to medications for treating SUD. SAMHSA also developed an hourlong
webinar and
slides in conjunction with the report.
SAMHSA Announces New SUD-Related Funding Opportunities
SAMHSA this week released two separate notices of funding opportunities focused on SUD.
In the first funding
notice, SAMHSA will distribute up to 10 awards totaling $9.95 million to implement the screening, brief intervention, and referral to treatment public health model for children, adolescents, and/or adults in primary care and community health settings, HMOs, PPOs, health plans, federally qualified health centers, children’s hospitals, and more with a focus on screening for underage drinking, opioid use, and other substance use.
The other funding
notice will distribute up to 18 awards totaling $5.4 million to expand and assure that graduate-level healthcare students receive SUD education early in their academic careers and prepare them to identify and treat UD in mainstream healthcare after they graduate.
Now Open: 2024 NABH Annual Meeting Registration
Registration is now open for the 2024 NABH Annual Meeting,
The Future of Behavioral Healthcare.
Please join us at the Salamander Washington, DC from
May 13-15, 2024 for this year’s Annual Meeting to examine and discuss critical issues that behavioral healthcare providers manage today and will continue to address tomorrow, including access to care, parity, technology, workforce, the political environment, and more.
Click
here to register for the meeting and reserve your hotel room. We look forward to seeing you in Washington!
Join Us for Hill Day 2024!
Please remember to sign up for Hill Day 2024 on
Tuesday, May 14, the second day of this year’s Annual Meeting. Hill Day is an excellent opportunity to meet one-on-one with legislators to discuss the issues that matter most to behavioral healthcare providers.
After you
register for the NABH Annual Meeting, the NABH Congressional Affairs team will match you with legislators who represent you or your facility footprint. Closer to the day of the meeting, we will send you a meeting schedule, materials, and talking points to guide your conversations with Members of Congress and their staff.
Please indicate in your Annual Meeting registration form that you are interested in Hill Day, and be sure to include all the states where your system has a footprint. If you have an existing relationship with a legislator, please let us know!
Reminder: Please Submit Data to NABH’ Denial-of-Care Portal
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
Behavioral healthcare jobs made three of the top seven and five of the top 20 jobs in Indeed’s
Best Jobs of 2024, which focused on jobs w/ a minimum salary of $75,000 and w/ at least 10% of postings that included remote or hybrid work.
For questions or comments about this CEO Update, please contact Jessica Zigmond.