Author: Administrator

NABH 2023 Annual Meeting is Approaching: Be Sure You’re Registered!

NABH’s 2023 Annual Meeting—Securing the Promise of Parity—is a little more than two weeks away! Please review our online preliminary program, learn about this year’s speakers, view the list of exhibitors and sponsors, register for the meeting, and reserve your hotel room, if you haven’t done so yet. We look forward to seeing you in Washington!

U.S. Surgeon General Releases Advisory on Social Media and Youth Mental Health

U.S. Surgeon General Vivek Murthy, M.D. this week released Social Media and Youth Mental Health, a new advisory that shows while social media may offer some benefits, there are “ample indicators” that social media can pose a risk of harm to the mental health and well-being of children and adolescents. The advisory notes that social-media use by young people is nearly universal, with up to 95% of young people ages 13-17 reporting using a social media platform and more than a third saying they use social media “almost constantly.” “The most common question parents ask me is, ‘Is social media safe for my kids?’” Murthy said in a news release about the advisory. “The answer is that we don’t have enough evidence to say it’s safe, and in fact, there is growing evidence that social media use is associated with harm to young people’s mental health,” he continued. “Children are exposed to harmful content on social media, ranging from violent and sexual content, to bullying and harassment. And for too many children, social media use is compromising their sleep and valuable in-person time with family and friends,” he added. “We are in the middle of a national youth mental health crisis, and I am concerned that social media is an important driver of that crisis – one that we must urgently address.” Murthy’s office reported that adolescents spending more than three hours per day on social media face double the risk of experiencing poor mental health outcomes, such as symptoms of depression and anxiety; yet one 2021 survey of teenagers found that, on average, they spend 3.5 hours a day on social media.

NIMH Finds Youth Suicide Rates Increased During the COVID-19 Pandemic

The National Institute of Mental Health this week released research that shows 5,568 youth died by suicide during the first 10 months of the COVID-19 pandemic, which was higher than the expected number of deaths had the pandemic not occurred. Higher-than-expected suicide rates were found a few months into the pandemic, starting in July 2020. According to the research, the increase in suicide deaths varied significantly by sex, age, race and ethnicity, and suicide method. For this period, researchers also found higher-than-expected suicide deaths among males, preteens aged 5–12 years, young adults aged 18–24 years, non-Hispanic American Indian or Alaskan Native youth, and non-Hispanic Black youth as compared with before the pandemic. Suicide deaths involving firearms were also higher than expected, the study showed.

CMS Reports to Congress on SUD Planning Grant Implementation

The Centers for Medicare & Medicaid Services (CMS) has released the Initial Report to Congress that the SUPPORT Act requires. The 2018 law directs CMS to release three reports to Congress, and the one released this week provides details on states awarded planning grants under the SUPPORT Act, the criteria used to select these states, and initial activities proposed or carried out under the planning grants. Findings in the report are from the first 13 months of the planning period of the demonstration: Sept. 30, 2019-Oct. 31, 2020.

Now Open: HRSA’s Substance Use Disorder Treatment and Recovery Loan Repayment Program

The Health Resources and Services Administration (HRSA) announced this week that the agency’s Substance Use Disorder Treatment and Recovery Loan Repayment Program (STAR LRP) application is open now through mid-July. Anyone who is a behavioral health clinician or support worker, clinical support staff, or trained in substance use disorders may apply to the STAR LRP and receive up to $250,000 in loan repayment. In exchange, loan recipients must work full time for six years in a STAR LRP-approved facility. The application process ends on Thursday, July 13 at 7:30 p.m. ET. Click here to learn more. Also this week, HRSA announced a grant program for professionals focused on behavioral health workforce education and training for children, adolescents, and transitional-aged youth. The grant’s purpose is to address the behavioral health needs of children, adolescents, and transitional-aged youth by increasing the supply and distribution of behavioral health providers in rural and underserved communities. Click here to view the grant opportunity.

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! We are still seeking data from additional members to support advocacy on health plan denials and prior-authorization timeliness. If you are a new participant, please e-mail NABH Administrative Coordinator Emily Wilkins for support.

Fact of the Week

A new study published in Health Affairs found that although almost all insurance plans covered immediate-release buprenorphine in 2021 (with a general trend of decreasing prior authorization requirements and quantity limits since 2017), only two payers had relatively low coverage of extended-release buprenorphine, with only 46% of commercial plans and only 19% of Medicare Advantage plans covering this formulation. The study authors recommended that policymakers and researchers “concerned with buprenorphine insurance barriers should shift their attention to extended-release buprenorphine.” For questions or comments about this CEO Update, please contact Jessica Zigmond.

Please Meet with NABH’s Exhibitors and Sponsors at the 2023 Annual Meeting Next Month!

NABH appreciates the generous support of our exhibitors and sponsors, whose valuable products and services help NABH members deliver quality behavioral healthcare every day to those who need it! Please make time to visit our exhibitors and sponsors at the Annual Meeting from June 12-14 at the Salamander Washington, DC. Before then, you can view a complete list of our exhibitors and sponsors on our Annual Meeting homepage. Also, please be sure to register for the Annual Meeting and reserve your hotel room today if you haven’t done so yet. We look forward to seeing you in Washington!

U.S. Labor Department Projects Five Mental Health Jobs Will Grow ‘Much Faster’ than Average from 2021-2031

The U.S. Labor Department’s (DOL) Bureau of Labor Statistics projects these five mental health-related careers will grow “much faster” than average between 2021-2031: mental health and substance abuse social workers; substance abuse, behavioral disorder, and mental health counselors; community health workers; healthcare social workers; and marriage and family therapists. “Together, they employed about 761,000 workers in 2021 —and they are expected to have more than 91,000 openings on average each year through 2031,” DOL reported in its blog. “The education typically required to enter these occupations ranges from a high school diploma to a master’s degree, and they all pay around or more than the $46,310 median for all occupations in 2022.” Click here to learn more about growth projection for each position.

CMS Releases Guide for Medicaid School-based Services

The Centers for Medicare & Medicaid Services (CMS) this week released a guide for Medicaid school-based services to make it easier for schools to deliver and receive payment for healthcare services to millions of eligible students. CMS worked with the U.S. Department of Education to produce the Comprehensive Guide to Medicaid Services and Administrative Claiming, which is a result of the Bipartisan Safer Communities Act. “With this guide, we are helping states and schools bring health care to kids where they are, rather than the other way around,” CMS Administrator Chiquita Brooks-LaSure said in a statement. “Children spend most of their waking hours in school. We also know that children have suffered serious declines in access to mental and behavioral healthcare services during the COVID-19 pandemic. We’re making it easier for states and schools to maximize Medicaid coverage to grow connections to care.” Medicaid and CHIP cover more than half of all U.S. children, or more than 41 million children, according to CMS. The guide is intended to help states and schools leverage Medicaid and CHIP, and it maps out how they can build a bridge between education and healthcare, including mental healthcare, to support children enrolled in these programs and help them thrive.

House and Senate Committees Press Insurers for Information on Claims

Two congressional oversight committees this week pressed the nation’s insurers for information regarding denial of claims in one instance and denial of care in Medicare Advantage in the second. Republicans from the House Energy and Commerce Committee sent a letter to Cigna President and CEO David Cordani asking for clarification after online news source ProPublica released an investigative report that suggested the insurance company’s physicians reject claims without reading them. Meanwhile, the Senate Homeland Security & Governmental Affairs Committee Permanent Subcommittee on Investigations hosted a hearing about delays and denials of care in Medicare Advantage. That hearing follows an April 2022 report from the HHS Office of Inspector General that found Medicare Advantage insurers have denied some coverage or payment for services that would have been covered under traditional Medicare.

Federally Supported Study Finds More than Half of Physicians Ranked Stigma as Highest Barrier to Treating Patients for OUD

A University of Vermont study of more than 450 clinicians and counselors in rural New England found that more than half (55%) ranked stigma as the highest barrier to treating patients for opioid use disorder (OUD) among other factors that included time and staffing, medication diversion, and organizational/clinic barriers. Meanwhile, 60% of physicians and 51% of counselors surveyed disagreed that medications for OUD “replace addiction to one kind of drug with another.” However, among clinicians with the ability to prescribe, there was considerable difference in this belief, depending on whether they were currently treating with medications for OUD, or MOUD. “More than 80% of those currently treating with MOUD believed it is not an addiction replacement; among those not currently treating with OUD, fewer than half felt that way,” the Federal Office of Rural Health Policy (FORHP) announced. FORHP is part of HHS’ Health Resources and Services Administration and supports the Center on Rural Addiction at the University of Vermont, which conducted the study.

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! We are still seeking data from additional members to support advocacy on health plan denials and prior-authorization timeliness. If you are a new participant, please e-mail NABH Administrative Coordinator Emily Wilkins for support.

Fact of the Week

The Centers for Disease Control and Prevention reports that more Black Americans died from fentanyl overdoses than from any other drug in 2021 and at far higher rates than whites or Hispanics. For questions or comments about this CEO Update, please contact Jessica Zigmond.

NABH to Host Parity Panel with DOL Official Lisa Gomez and Former U.S. Rep. Patrick Kennedy on Tuesday, June 13

NABH President and CEO Shawn Coughlin will moderate a parity panel discussion with Lisa Gomez, assistant secretary for employee benefits security at the U.S. Labor Department, and former U.S. Rep. Patrick Kennedy (D-R.I.). on Tuesday, June 13, the second day of the 2023 Annual Meeting. Before she was sworn in last October, Gomez was a partner with the law firm Cohen, Weiss and Simon LLP and chair of the firm’s management committee. She has deep technical and practical experience in the field of employee benefits law and spent almost three decades representing various Taft-Hartley and multiemployer pension and welfare plans, single employer plans, jointly administered training program trust funds, a federal employees health benefit plan, and other plans covering employees in a range of industries. Gomez earned her bachelor’s degree at Hofstra University and her law degree at Fordham. Former Rep. Kennedy is the CEO of The Kennedy Forum, a not-for-profit he founded in 2013 to unite advocates, business leaders, and government agencies to advance evidence-based practices, policies, and programming mental health and addiction. During his time in Congress, Kennedy was the lead author of the Mental Health Parity and Addiction Equity Act. Kennedy is also the founder of Don’tDenyMe.org, an educational campaign that empowers consumers and providers to understand parity rights and connects them to essential appeals guidance and resources, and co-founder of One Mind, an organization that pushes for greater global investment in brain research. The panel will begin at 9:30 a.m. ET in the Salamander’s Grand Ballroom and will discuss the landmark 2008 parity law and the work that remains to secure the law’s promise. Please be sure to register for the Annual Meeting and reserve your hotel room today, if you haven’t done so yet. We look forward to seeing you in Washington!

CMS Coverage for PHP Telehealth Services Ends With COVID-19 PHE’s Conclusion

The Centers for Medicare & Medicaid Services (CMS) has shared with NABH and other stakeholders the agency’s plans to end telehealth coverage for partial hospitalization program (PHP) services implemented during the COVID-19 Public Health Emergency (PHE) when the PHE concluded at the end of Thursday, May 11. In addition, CMS has explained that telehealth coverage will continue through December 2024 for Intensive Outpatient Program (IOP) services that qualify under the outpatient prospective payment system as “remote mental health services.” NABH continues to communicate with key Members of Congress to clarify the legislative intent behind the telehealth coverage extensions that were authorized in the Consolidated Appropriations Act, 2023 last December. The NABH team understands that some Members of Congress intended for the telehealth coverage extension to include PHP services. Given the persistent confusion on these matters, NABH has urged CMS to issue clarification in writing. NABH will keep members apprised of our efforts to extend telehealth coverage for PHP services.  

DEA Rule to Extend Telemedicine Flexibilities for Prescription of Controlled Substances Effective May 11

The U.S. Drug Enforcement Administration’s (DEA) temporary extension of COVID-19 telemedicine flexibilities for prescription of controlled medications took effect Thursday, May 11. Under the DEA’s rule, the agency has extended the full set of telemedicine flexibilities adopted during the PHE for six months through Nov. 11, 2023. For any practitioner-patient telemedicine relationships that have been or will be established up to Nov. 11, 2023, the full set of telemedicine flexibilities regarding prescription of controlled medications established during the PHE will extend for one year through Nov. 11, 2024. In a letter to DEA on March 31, NABH advocated to remove requirements for in-person medical examinations for Schedule II stimulant medications for ADHD and Schedule III-V mental health medications. Please contact Sarah Wattenberg, NABH’s director of quality and addiction services, with questions or comments.

SAMHSA and FDA Officials Release Letter to Practitioners to Promote Medication First Model

Officials from the Substance Abuse and Mental Health Services Administration (SAMHSA) and the U.S. Food and Drug Administration (FDA) this week sent a letter to healthcare practitioners noting that although counseling and other services are important parts of treatment plans, they should not be prerequisites for receiving medication. “An often-cited barrier to prescribing buprenorphine for the treatment of OUD is the perception that patients must engage in counseling and other services in order to start or continue receiving the medication,” wrote Miriam Delphin-Rittmon, Ph.D. and Patrizia Cavazzoni, M.D. “This letter serves to clarify the importance of counseling and other services as part of a comprehensive treatment plan, but to also reiterate that the provision of medication should not be made contingent upon participation in such services,” they added. Delphin-Rittmon serves as the assistant secretary for mental health and substance use at SAMHSA and Cavazzoni is the director of the FDA’s Center for Drug Evaluation and Research.

SAMHSA Announces Funding Opportunity for Cooperative Agreements for 988 Suicide and Crisis Lifeline Crisis Center Follow-Up Programs

SAMHSA has announced it anticipates funding a total of $5 million in 10 awards to expand efforts among 988 lifeline centers to support individuals in follow-up programs. Specifically, the money would support individuals post-contact to provide continued support and linkages to decrease suicide risk by 1) ensuring the systematic follow-up of suicidal persons who contact the 988 suicide and crisis lifeline; 2) providing enhanced crisis stabilization coordination, crisis respite, mobile crisis outreach response services, and other services on the crisis continuum of care; 3) reducing unnecessary police engagement; and 4) improving connections for high-risk populations. Click here to learn more.

SAMHSA Distributes Additional Grant Funding for Programs to Combat Overdose and SUD

Also this week, SAMHSA announced awards in four grant programs totaling nearly $11.3 million in additional funding to support the Biden administration’s ongoing efforts nationwide in prevention, treatment, recovery support, and harm reduction. The four grant programs are Screening, Brief Intervention to Referral Treatment (SBIRT) (nearly $6.9 million); Grants to Prevent Prescription Drug/Opioid Overdose-Related Deaths ($2.6 million); Target Capacity to Expansion-Special Projects ($1.1 million); and Provider’s Clinical Support System to universities (more than $725,000). Click here to learn more about the programs

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! We are still seeking data from additional members to support advocacy on health plan denials and prior-authorization timeliness. If you are a new participant, please e-mail NABH Administrative Coordinator Emily Wilkins for support.

Fact of the Week

The Centers for Disease Control and Prevention reports that overdose deaths increased by 279% for drug overdoses involving fentanyl during the five-year study period to 21.6 per 100,000 standard population in 2021 from 5.7 per 100,000 standard population in 2016. For questions or comments about this CEO Update, please contact Jessica Zigmond.

Hill Day Returns to NABH Annual Meeting Program!

NABH is excited to welcome its members and guests back to Hill Day during the 2023 Annual Meeting! This year NABH is working with the firm Advocacy Associates to help schedule Capitol Hill meetings and briefings for interested Annual Meeting attendees during Hill Day on Tuesday, June 13 from 1:30 to 5 p.m. ET. NABH will help prepare interested attendees by providing materials through a mobile app. To take advantage of this free opportunity, please indicate that you want to participate in Hill Day when you register for the 2023 Annual Meeting, or contact NABH Administrative Coordinator Emily Wilkins. Please remember to reserve your hotel room at the Salamander Washington, DC, if you haven’t done so yet. We look forward to seeing you next month!

HHS Launches FindSupport.gov During First Week of Mental Health Awareness Month

HHS on Thursday launched FindSupport.gov, a website designed to help the public identify available resources, explore unbiased information about various treatment options, and learn how to find the support they need for problems related to mental health, drugs, or alcohol. HHS’ Substance Abuse and Mental Health Services Administration (SAMHSA) and the Centers for Medicare & Medicaid Services (CMS) developed the concept for FindSupport.gov as a response to research that people were looking for an unbiased, trustworthy source of information to receive support for mental health and substance use issues. The department also developed a brief video to highlight the new website. Also Thursday, HHS hosted its Support is Here to Strengthen Mental Health summit, where HHS Secretary Xavier Becerra said the Biden administration is saying to all who are struggling with mental health that support is here. “I am proud that we are changing the way mental health is viewed in this country because mental health is health, period.” Becerra tweeted. The summit and new website coincide with the first week of Mental Health Awareness Month, which the United States has observed since 1949. The month-long observance is meant to fight stigma, provide support, educate the public, and advocate for policies that support the millions of Americans affected by mental illness. Click here to learn more, and please remember to follow us @NABHbehavioral and on LinkedIn at the National Association for Behavioral Healthcare.

DEA Extends COVID-19 Telehealth Flexibilities for Prescription of Controlled Medications for Now

The U.S. Drug Enforcement Administration (DEA) on Wednesday said it will extend its COVID-19 telemedicine flexibilities for prescription of controlled medications as the agency works to determine how to move forward in a way that gives Americans access to needed medicine with the appropriate safeguards. An announcement from DEA noted the agency received a record number of comments on its proposed telemedicine rules, which prompted DEA and the U.S. Health and Human Services Department (HHS) to submit a draft temporary rule to the Office of Management and Budget requesting an extension. NABH submitted comments on this matter (see CEO Update, April 28, 2023). “Further details about the rule will become public after its full publication in the Federal Register,” the announcement said.

CMS’ Recent Proposed Rule Would Establish Network Adequacy Requirements and Payment Transparency in Medicaid MCOs

CMS’ recent Medicaid managed care proposed rule aims to strengthen standards for more timely access to care for Medicaid and Children’s Health Insurance Program (CHIP) managed care enrollees and establish new payment transparency requirements in fee-for-service and managed care programs. As NABH reported in last week’s CEO Update, CMS is proposing to establish maximum appointment wait-time standards for outpatient mental health and substance use disorder—adult and pediatric—and other services, including routine primary care. News reports offered details of a call that CHIP Services Director Daniel Tsai had with reporters, in which Tsai said, “The standards we established are what we call a national floor so a state is welcome to set a standard that is higher than that, [but] they must meet at least the standard that we outlined proposed in the proposed rule,” according to an article in Inside Health Policy, which noted the administration wants to align Medicaid wait-time standards with the two-week requirement for commercial plans.   The proposed rule would also require states to employ an independent company to conduct yearly “secret shopper surveys” that confirm a managed care plan is complying with appointment wait-time standards and the insurer’s provider directory is up-to-date. Regarding payment rates, Tsai was reported as saying that, historically, CMS, advocates, and providers do not have a good way of understanding and benchmarking where Medicaid payment rates are across different state programs. “So what we do propose is that every state has to make their base rates of payments transparently available and easily accessible, and every state has to benchmark their base rates for Medicaid relative to Medicare payment rates, which is a national standard that allows for comparison and easy benchmarking across states,” Tsai said.

Joint Commission Seeks Feedback on Proposed Workplace Violence Prevention Requirements for BHC Program

The Joint Commission this week opened its field review to gather feedback from behavioral healthcare organizations about their experiences with workplace violence to help provide the most evidence-based and relevant requirements for its Behavioral Health Care and Human Services (BHC) accreditation program. In its announcement, the Joint Commission said its field review will ask for comments on the potential new requirements and the larger context of how behavioral healthcare organizations are currently experiencing, preventing, and monitoring workplace violence. The field review is open through June 9 and takes about 15 to 20 minutes to complete. Click here to complete the questionnaire.   HRSA Payment Program for Rural Health Clinic Buprenorphine-Trained Providers Still Active HHS’ Health Services and Resources Administration (HRSA) has announced that Rural Health Clinics (RHCs) are still eligible to apply for a $3,000 payment on behalf of each provider trained to prescribe buprenorphine between Jan. 1, 2019 and Jan. 25, 2023. SAMHSA announced in January 2023 that clinicians no longer need a DATA 2000 Waiver to prescribe buprenorphine; however, the payment program to defray earlier training cost is still active. Launched in 2021, the program pays for providers who previously trained for the waiver to prescribe buprenorphine. HRSA said about $900,000 in program funding remains available for RHCs, which will be paid on a first-come, first-served basis until funds are exhausted. Send question to DATA2000WaiverPayments@hrsa.gov.

NIDA Study Finds Association Between Cannabis Use Disorder and Schizophrenia

A new National Institute of Drug Abuse (NIDA) study has found that young men between 21-30 years of age with a cannabis (marijuana) use disorder have an increased risk of developing schizophrenia. The findings are notable because they emphasize that cannabis use disorder appears to be a major modifiable risk factor for schizophrenia at the population level. After evaluating more than 6 million people in Denmark for more than five decades, researchers estimated that the percentage of cases of schizophrenia that may have been avoided by preventing cannabis use disorder was as high as 30% among men aged 21-30; 15% among men aged 16-49; and 4% among women aged 16-49. The study was a collaboration between authors at the Mental Health Services in the Capital Region of Denmark and NIDA at the National Institutes of Health.

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! We still seek data from additional members to support advocacy on health plan denials and prior-authorization timeliness. If you are a new participant, please e-mail NABH Administrative Coordinator Emily Wilkins for support.

Fact of the Week

A new study reports three in 10 Americans say they know someone affected by opioid addiction; within that group, more than half say they know someone who has died from opioid use.   For questions or comments about this CEO Update, please contact Jessica Zigmond.

NABH Pleased to Welcome HHS Secretary Xavier Becerra at 2023 Annual Meeting

U.S. Health and Human Services Department (HHS) Secretary Xavier Becerra, J.D. will address attendees at the 2023 NABH Annual Meeting on Monday, June 12 from 2:15 p.m. to 2:45 p.m. Secretary Becerra is the 25th secretary of HHS and the first Latino in U.S. history to hold the office. Previously Secretary Becerra was California’s attorney general and before that served for 12 terms in the U.S. House of Representatives, where he was the first Latino to serve as a member of the powerful House Ways and Means Committee. Secretary Becerra also served as chairman of his party’s caucus and as the ranking member of both the Ways and Means Subcommittee on Health and the Ways and Means Subcommittee on Social Security. Born in Sacramento, Secretary Becerra is the son of working-class parents. He was the first in his family to receive a four-year degree, earning his bachelor’s degree in economics from Stanford University. He earned his law degree from Stanford Law School. Please register for the Annual Meeting and reserve your hotel room today, if you haven’t done so yet. We look forward to seeing you in Washington!

CMS Releases FAQs About Transition Period Following End of Covid-19 PHE

The Centers for Medicare & Medicaid Services (CMS) has released a fact sheet of frequently asked questions to help providers prepare for the transition period after the Covid-19 public health emergency (PHE) ends on May 11. Although certain waivers and flexibilities CMS granted during the pandemic are set to expire, others will be permanent or extended due to congressional action. For instance, the Consolidated Appropriations Act, 2023 extended many telehealth flexibilities through Dec. 31, 2024, including: people with Medicare can access telehealth services in any geographic area in the United States, rather than only those in rural areas; people with Medicare can stay in their homes for telehealth visits that Medicare pays for rather than traveling to a healthcare facility; and certain telehealth visits can be delivered audio-only (such as a telephone) if someone is unable to use both audio and video, such as a smartphone or computer. The fact sheet also noted that Medicare Advantage plans may offer additional telehealth benefits and that individuals should check with their plan about coverage. “For Medicaid and CHIP, telehealth flexibilities are not tied to the end of the PHE and have been offered by many state Medicaid programs long before the pandemic,” CMS noted in the fact sheet. “Coverage will ultimately vary by state. CMS encourages states to continue to cover Medicaid and CHIP services when they are delivered via telehealth.

DEA Requests Extension on Agency’s Final Rule on Telehealth Prescribing of Controlled Substances

The Drug Enforcement Administration (DEA) has asked the White House for an extension on the release of the DEA’s final rule on telehealth prescribing of controlled substances. The extra time would permit telehealth services to continue under COVID-19 policies temporarily. NABH’s letter to DEA in late March was among the more than 18,000 comments that DEA received about telehealth services; the agency likely needs additional time to finalize the rule and avert disrupting current telehealth practices after the PHE ends on May 11.

CMS Releases Proposed Rules on Access and Quality in Medicaid & CHIP

CMS late Thursday released notices of proposed rulemaking (NPRMs)—Ensuring Access to Medicaid Services (Access NPRM) and Managed Care Access, Finance, and Quality (Managed Care NPRM) that NABH is reviewing. To improve access to care, the Managed Care NPRM proposes to establish maximum appointment wait-time standards for outpatient mental health and substance use disorder—adult and pediatric—and other services, including routine primary care (also adult and pediatric). CMS will accept comments on the proposed rules until Monday, July 3.

NIH Seeks to Expand Peer Reviewer Pool to Ensure Review Committees are Diverse and Inclusive

The National Institutes of Mental Health (NIMH) is seeking to expand its pool of peer reviewers with mental health researchers who can offer diverse perspectives in the peer-review process. The NIMH peer-review process aims to make certain that scientific experts evaluate grant applications in a manner free from what the National Institutes of Health deems as inappropriate incidences. Peer reviewers provide feedback on the scientific merit of those applications. Click here to learn more about eligibility requirements for peer reviewers and here to submit an application.

SAMHSA Announces Funding Opportunity to Promote Physical-Behavioral Healthcare Integration

The Substance Abuse and Mental Health Services Administration (SAMHSA) announced it will award a total of about $29 million in a new grant funding opportunity intended to integrate physical healthcare and behavioral healthcare. The opportunity is not open directly to healthcare providers, but rather to the states. Specifically, states and state agencies—such as the state mental health authority, the single state agency for substance use services, the state’s Medicaid agency, and the state health department—are eligible to apply. SAMHSA’s announcement said it anticipates awarding 14 grants and the length of the project is five years. Click here to learn more.

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! We are still seeking data from additional members to support advocacy on health plan denials and prior authorization timelines. If you are a new participant, please e-mail NABH Administrative Coordinator Emily Wilkins for support.

Fact of the Week

A recent study in JAMA Psychiatry suggests that estimates of long-term exposure to multiple air pollutants were associated with increased risk of depression and anxiety. Researchers concluded that the non-linear associations may have important implications for policymaking in air pollution control. An article this week in Kaiser Health News also explored the connection between anxiety and pollution.   For questions or comments about this CEO Update, please contact Jessica Zigmond.

Former DOL Assistant Secretary for Employment and Training John Pallasch to Kick Off 2023 Annual Meeting

NABH is pleased to announce John Pallasch, former Senate-confirmed assistant secretary for employment and training at the U.S. Labor Department (DOL), will kick off the association’s 2023 Annual Meeting with his presentation on Monday, June 12 at the Salamander Washington, DC.   Currently Pallasch is the founder and CEO of One Workforce, a workforce consultancy in Aiken, S.C. He served previously as executive director of Kentucky’s Office of Employment and Training, and—in his first stint at DOL—as deputy assistant secretary in the department’s Mine Safety and Health Administration.   Pallasch has spent more than 20 years influencing organizational personnel, efficiency, and productivity in the public and private sectors. He will draw from those experiences to help NABH members think more critically about their workforce challenges and more creatively about how to solve them.   Pallasch graduated from Ohio State and later earned a law degree from Pepperdine University School of Law. Please help us welcome him in the Salamander’s Grand Ballroom on Monday, June 12 at 2:45 p.m. ET.   If you haven’t done so yet, please register for the Annual Meeting and reserve your hotel room today.  We look forward to seeing you in Washington!

CMS Final Rule Establishes Mental Health Facilities and SUD Treatment Centers as Essential Community Providers

In a final rule this week, the Centers for Medicare & Medicaid Services (CMS) expanded access to care for low-income and medically underserved communities by establishing two new essential community provider (ECP) categories for mental health facilities and SUD treatment centers. The changes came in the Patient Protection and Affordable Care Act (ACA) notice of benefit and payment parameters (NBPP) for 2024. This annual notice administers policy changes for plans on the ACA exchanges and sets rates and risk-model specifications. The decision to categorize mental health facilities and SUD treatment centers as ECPs is a win for NABH; in late January, NABH advocated for these ECP categories in its comment letter to CMS about the agency’s proposed NBPP rule for 2024. “NABH strongly supports CMS’ proposal to expand its network adequacy criteria by creating two distinct essential community provider categories for mental health facilities and substance use disorder (SUD) treatment centers,” NABH President and CEO Shawn Coughlin wrote in the association’s letter. “To construct each county-level network, the rule would require insurers on the health exchanges to attempt to contract with at least one SUD Treatment Center and at least one Mental Health Facility.” The final rule takes effect 60 days after it appears in the Federal Register.

CMS Announces Opportunities to Increase Care Access, Including SUD Treatment, for Incarcerated Individuals

CMS this week announced a new opportunity for states to help increase care for individuals who are incarcerated in the period immediately before their release to help them thrive as they re-enter communities. The new Medicaid Reentry Section 1115 Demonstration Opportunity would allow state Medicaid programs to cover services that address various health concerns, including substance use disorders and other chronic health conditions. In an announcement Monday, CMS Administrator Chiquita Brooks-LaSure said the agency reached a milestone in expanding access through Medicaid. “This guidance outlines a pathway to implement historic changes for individuals who are incarcerated and eligible for Medicaid, she said. “By improving care and coordination prior to release from the justice system, we can help build a bridge back to the community and enhance individual and collective public health and public safety outcomes.” Click here to read the letter from Daniel Tsai, deputy administrator and director at the Center for Medicaid and CHIP Services, to state Medicaid directors.

NIH Study Shows Prevalence of Stimulant Therapy for ADHD Associated with Higher Rates of Prescription Stimulant Misuse in Teens

Researchers have found a strong link between the prevalence of prescription stimulant therapy for attention-deficit/hyperactivity disorder (ADHD) and rates of prescription stimulant misuse—taken in a way other than directed by a clinician— by students in middle schools and high schools. The study this week in JAMA Network Open emphasized the need for assessments and education in both schools and communities to prevent medication-sharing among teens. “This is especially important considering non-medical use of prescription stimulants among teens remains more prevalent than misuse of any other prescription drug, including opioids and benzodiazepine,” NIH noted in a news release about the study. The National Institutes of Health’s National Institute on Drug Abuse (NIDA) and the U.S. Food and Drug Administration supported the study, which used data between 2005 and 2020 by the Monitoring the Future (MTF) study. The MTF is a large, multicohort survey of legal and illicit drug use among American adolescents in eighth, 10^th, and 12^th grades. NIDA also funds the MTF.

Reminder: Public Comments on SAMHSA’s 2023-2026 Draft Strategic Plan Due April 27

The Substance Abuse and Mental Health Services Administration (SAMHSA) is seeking public comment on the agency’s draft 2023-2026 SAMHSA Strategic Plan that presents a person-centered mission and mission highlighting SAMHSA’s priorities and principles. SAMHSA’s five priority areas include preventing overdose; enhancing access to suicide prevention and crisis care; promoting resilience and emotional health for children, youth, and families; integrating behavioral and physical healthcare; and strengthening the behavioral healthcare workforce. The agency’s four core principles are equity, trauma-informed approaches, recovery, and commitment to data and evidence. Comments on the draft plan are due by 5 p.m. ET next Thursday, April 27. Click here to submit comments.

Reminder: 2023 NABH Exhibitor and Sponsor Guide Ad Deadline is Today, April 21

NABH will distribute the 2023 NABH Exhibitor and Sponsor Guide to all registrants at the 2023 NABH Annual Meeting from June 12-14, 2023 at the Salamander Washington, DC. Be sure your organization is included in it!   All ads are due today, Friday, April 21, 2023. Please click here for details about advertising options, requirements, payment, and more. The association also will send the guide to all NABH members after the meeting and post it on the NABH Annual Meeting webpage.

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.

Fact of the Week

The U.S. Drug Enforcement Administration’s (DEA) National Prescription Drug Take Back Day is tomorrow, Saturday, April 22. DEA reflects the agency’s commitment to health and safety, encouraging the public to remove unneeded medications from their homes as a measure of preventing medication misuse and opioid addiction from starting.   For questions or comments about this CEO Update, please contact Jessica Zigmond.

CMS Proposes 3% Increase in Payment Rates to Inpatient Psychiatric Facilities for 2024

The Centers for Medicare & Medicaid Services (CMS) is proposing to update Inpatient Psychiatric Facility Prospective Payment System (IPF PPS) payment rates by 1.9% in fiscal year (FY) 2024, or $55 million, relative to current rates. This update includes a 3.2% market basket increase, a 0.2 percentage point productivity cut, and a 1.0% decrease to outlier payments. Other notable components of the agency’s proposed IPF PPS rule this week include: Proposed Modification to the Regulation on Excluded Units Paid Under the IPF PPS: Responding to increased mental health needs—including the need for available inpatient psychiatric beds—CMS is proposing greater flexibility for hospitals to open and bill Medicare for a new IPF distinct part unit. Specifically, beginning in FY 2024, CMS would allow hospitals to open a new unit at any time during the cost reporting period, with 30-day advance notice to the CMS regional office and Medicare administrative contractor. An announcement about the proposed rule said “CMS believes this proposal would alleviate unnecessary burden and administrative complexity placed upon hospitals when opening new psychiatric units, helping to expand access to behavioral healthcare” in line with the agency’s behavioral healthcare strategy. Proposed Updates to the IPFQR Program The rule also proposes to adopt three quality measures focused on health equity for the IPFQR Program. First, beginning in FY 2026, a Facility Commitment to Health Equity measure would ask IPFs to attest to its efforts to address health equity across five domains: (1) Equity is a Strategic Priority; (2) Data Collection; (3) Data Analysis; (4) Quality Improvement; and (5) Leadership Engagement. Second, a Screening for Social Drivers of Health (SDOH) measure would assess the percentage of patients over 17 who are screened for five specific health-related social needs (HRSNs) — food insecurity, housing instability, transportation needs, utility difficulties, and interpersonal safety. Voluntary reporting would begin in the calendar year 2025, with payments affected beginning in FY 2027. Finally, CMS would adopt a Screen Positive Rate for SDOH measure beginning with voluntary reporting in CY 2024 and payment impact in FY 2027. This process measure assesses the percentage of patients who screen positive for each of the noted HRSNs in this quality measure. Request for Information (RFI) to Inform the Revisions to the IPF PPS Required by the Consolidated Appropriations Act, 2023 (CAA, 2023): Meanwhile, CMS noted in the rule that it has continued to analyze more recent IPF cost and claim information in an ongoing effort to refine the IPF PPS. In its FY 2023 IPF PPS proposed rule, CMS issued a technical report and sought comments on the results of the latest refinement analysis in preparation to propose IPF PPS patient-level and non-regression-derived refinements to be effective in FY 2024. Subsequently, new provisions in the CAA, 2023 require CMS to revise payments under the IPF PPS for Rate Year 2025 (or FY 2025 under the IPF PPS) as the U.S. Health and Human Services secretary determines appropriate. Consequently, CMS has included a request for information (RFI) that will be used to inform future payment revisions. Also in the proposed rule, CMS has addressed the specific types of data and information that the CAA, 2023 suggests CMS may collect, as well as soliciting comments on additional data and information that could be collected to inform future payment revisions. CMS will accept public comments on the proposed rule through Monday, June 5.

Final Medicare Advantage Rule for 2024 Addresses Many NABH Priorities

Earlier this week, the Centers for Medicare & Medicaid Services (CMS) issued its contract year 2024 final rule related to the Medicare Advantage (MA) program, which addresses multiple, long-standing concerns of the NABH. In particular, we are pleased with the rule’s extensive improvements related to prior authorization, network adequacy, and quality of care, including measures that:

• Require MA plans to comply with the general coverage and benefit conditions of the Traditional Medicare program, along with national and local coverage determinations (LCD), and related regulations;
• Apply prior authorization approvals to a patient’s full course of treatment for medically reasonable and necessary care, as determined by the treating physician;
• Codify appointment wait time standards for behavioral healthcare and other services;
• Add a 10 percentage point credit to insurers’ network adequacy assessment for the inclusion of clinical psychologists and licensed clinical social workers;
• Exempt emergency behavioral health services from the prior authorization process;
• Require MA organizations to:
  • include behavioral health services in their care coordination programs;
  • base medical necessity determinations on the individual circumstances of a specific patient, rather than on a proprietary algorithm or software;
  • create a utilization management committee that annually reviews coverage policies to ensure that coverage is “no more restrictive than traditional Medicare coverage criteria;’ and
  • include in their advertisements a specific Medicare Advantage plan name and ban the use words or imagery that is “misleading, confusing, or misrepresents the plan.”
• Clarify that insurers may deny care using proprietary criteria, only if traditional Medicare coverage rules are not fully established and the in-house coverage standards are based on “current evidence in widely used treatment guidelines or clinical literature made publicly available to CMS, enrollees, and providers.”

Of concern, is CMS’ exclusion of providers of medication for opioid use disorder from its network adequacy criteria. This proposal was not finalized because the elimination of the x-waiver requirement for buprenorphine providers removed the data source necessary for CMS to track those providers. The rule also explained that there are too few opioid treatment programs (OTPs) to establish access standards, and reminded MA organizations that they are required to include OTPs as part of their Part B coverage for OTP services or arrange out-of-network care at in-network cost sharing.

New Resource: ‘Using Contingency Management To Combat Stimulant Use Disorder’ Fact Sheet

NABH has produced Using Contingency Management To Combat Stimulant Use Disorder, a brief fact sheet that explains contingency management (CM) and highlights the association’s legislative request for Congress to direct federal agencies to replace the current $75 CM incentive payment limitation with scientifically proven incentive levels. “Decades of research and peer-reviewed literature validate the effective use of CM, which uses positive reinforcement to encourage abstinence from stimulant use,” NABH’s fact sheet explains. “Positive behavior reinforcement takes the form of predictable and meaningful financial incentives, such as gift cards (with restricted purchase guidelines) or prizes, which can be earned only when specific ‘target behaviors’ are achieved, such as drug-free urine samples.” The new resource is available on NABH’s homepage under “Latest Content” and also posted on NABH’s “Be an Advocate” page.

Reminder: Please Submit NABH’s Behavioral Health Information Technology Survey by April 12

NABH is seeking feedback from all system members about their experiences with behavioral health information technology as the association urges Congress and the Biden administration to extend incentives to behavioral healthcare organizations for adopting electronic health records. Please submit this brief survey by Wednesday, April 12. Your responses will help NABH in its advocacy efforts to urge Congress and the Biden administration to extend these incentives to behavioral healthcare organizations. Please e-mail Rochelle Archuleta if you have questions.

2023 Exhibitor and Sponsor Guide Advertising Deadline is Approaching!

NABH will distribute the 2023 NABH Exhibitor and Sponsor Guide to all registrants at the 2023 NABH Annual Meeting from June 12-14, 2023 at the Salamander Washington, DC. Be sure your organization is included in it!   All ads for the guide are due by April 21, 2023. Please click here for details about advertising options, requirements, payment, and more. The association also will send the guide to all NABH members after the meeting and post it on the NABH Annual Meeting webpage.

2023 ExNABH Annual Meeting Hotel Cut-Off Date is May 11!hibitor and Sponsor Guide Advertising Deadline is Approaching!

Please reserve your hotel room today at the Salamander Washington, DC (formerly the Mandarin Oriental hotel) for the 2023 NABH Annual Meeting from June 12-14, 2023! The hotel’s cut-off date is Thursday, May 11, 2023. And please visit our Annual Meeting webpage to register for the meeting, if you have not done so yet. We look forward to seeing you in Washington!

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.

Fact of the Week

A recent Health Affairs study found that the proportion of adult primary care visits that addressed mental health concerns increased to 15.9% by 2016 and 2018 from 10.7% of visits in 2006–07. For questions or comments about this CEO Update, please contact Jessica Zigmond

NABH Releases 2023 Advocacy Priorities

NABH this week released its 2023 advocacy priorities, which reflect the association’s mission and outline the actions NABH will take to achieve its goals. Categorized under the headings “Mental Health” and “The Addiction Crisis,” NABH’s 2023 advocacy priorities include securing the promise of parity; persuading lawmakers to provide incentives for behavioral healthcare providers to establish and implement a solid behavioral health information technology infrastructure; advocating Congress to repeal the Institutions for Mental Diseases (IMD) exclusion; pushing the Centers for Medicare & Medicaid Services to ensure payment rates provide adequate and appropriate reimbursement for opioid treatment program services; maintaining tele-behavioral healthcare services, and more.   Please review this document and share it with others. If you have questions, please contact nabh@nabh.org.

FDA Approves First Over-the-Counter Naloxone Spray

The U.S. Food and Drug Administration (FDA) on Tuesday approved Narcan, 4 mg. naloxone hydrochloride nasal spray for over-the-counter (OTC), non-prescription use, making it the first naloxone product approved to use without a prescription. Naloxone is a medication that reverses the effects of opioid overdose rapidly and is the standard treatment for opioid overdose. The FDA’s action clears the way for this life-saving medication to be sold directly to consumers in drug stores, convenience stores, grocery stores, gas stations, and online. The move comes at a time when the Centers for Disease Control and Prevention released provisional data earlier this month that showed 101,750 reported U.S. fatal overdoses in the 12-month period ending in October 2022, while the predicted number of fatal doses for that period is even higher at 107,669. “As a physician, I have used Naloxone on people to reverse an opioid overdose hundreds of times and have witnessed firsthand its life-saving effects,” Rahul Gupta, M.D., director of the White House Office of National Drug Control Policy, said in a statement this week. “FDA’s announcement to make Narcan available over-the-counter is an important step to make this medicine accessible to more people at a time when the majority of overdose deaths are being driven by illicit opioids like fentanyl,” he added. “This move will also build on the progress made under the Biden-Harris administration to get more Naloxone into communities, expand access to treatment for substance use disorder, and reduce the supply of illicit drugs, which has resulted in a decline or flattening of overdose deaths for seven months in a row.” According to the FDA, the manufacturer determines the timeline for availability and price of this OTC product. Click here to learn more.

SAMHSA Warns Providers and Grantees About Xylazine Risks

In a letter this week, the Substance Abuse and Mental Health Services Administration (SAMHSA) alerted providers to the risks of xylazine, a non-opioid agent increasingly found in combination with opioids such as fentanyl. The letter said xylazine—which the FDA has not approved for use in humans—can cause severe circulatory changes with devastating effects on human tissue, leading to painful open lesions, necrosis, and potentially limb loss. “Practitioners must be aware of risks posed by xylazine and prepare to manage patients accordingly, Miriam Delphin-Rittmon, Ph.D., assistant secretary for mental health and substance use, wrote to providers. “SAMHSA’s goal with this alert is to provide information about the consequences of xylazine exposure, what practitioners can do to mitigate harm, and how SAMHSA is responding to this emerging public health challenge.” Known as “tranq” or “tranq dope” in the illicit drug market, xylazine can cause drowsiness, lethargy, and, in rare instances, apnea and death. SAMHSA encourages healthcare professionals and patients to report adverse events resulting from possible xylazine exposure to their local health department, poison center, or the American Association of Poison Control Centers at 1-800-222-1222. FDA’s MedWatch Adverse Event reporting may be completed online at www.fda.gov/medwatch.

SAMHSA Announces Three Recovery-Related Funding Opportunities

SAMHSA this week announced it will accept applications through May for three separate funding opportunities to implement and strengthen recovery services in communities. The programs include the Treatment, Recovery, and Workforce Support grant to implement evidence-based programs to support individuals in substance use disorder (SUD) treatment and recovery to live independently and participate in the workforce; the Recovery Community Services Program-Statewide Network, intended to strengthen community-based recovery organizations, their statewide networks of recovery stakeholders, and specialty and general healthcare systems as key partners in delivering state and local recovery support services; and the Recovery Community Services Program, which would provide peer recovery support services to individuals with SUD or co-occurring substance use and mental disorders, including those in recovery from these disorders. SAMHSA will accept applications for all three funding opportunities until May 30.

Reminder: SAMHSA Funding Opportunity to Establish or Implement Opioid Recovery Centers

SAMHSA has announced it will grant up to $1.4 million in two awards to establish or implement comprehensive treatment and recovery centers that provide a spectrum of treatment, harm reduction, and recovery support services to address America’s opioid crisis. Applications are due Tuesday, May 16. Click here to learn more and apply.

Advertise in the 2023 NABH Exhibitor and Sponsor Guide!

NABH will distribute the 2023 NABH Exhibitor and Sponsor Guide to all registrants at the 2023 NABH Annual Meeting from June 12-14, 2023 at the Salamander Washington, DC. Be sure your organization is included in it!   All ads are due by April 21, 2023. Please click here for details about advertising options, requirements, payment, and more. The association also will send the guide to all NABH members after the meeting and post it on the NABH Annual Meeting webpage.

Register and Reserve Your Hotel Room Today for the 2023 NABH Annual Meeting!

Please 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). NABH’s theme this year is Securing the Promise of Parity, which recognizes the Mental Health Parity and Addiction Equity Act’s (MPAEA) 15^th anniversary and that we have more work to do to ensure the landmark law is implemented fully. Our preliminary program will be available soon. Meanwhile, please visit our Annual Meeting homepage to register, reserve your hotel room, and view our Annual Meeting At-a-Glance. We look forward to seeing you in Washington!

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.

Fact of the Week

Between 2009 and 2019, the number of pediatric mental health hospitalizations increased by 25.8%, and these hospitalizations accounted for a significantly higher proportion of pediatric hospitalizations, according to a study published in JAMA this week. For questions or comments about this CEO Update, please contact Jessica Zigmond.

NABH Responds to Senate HELP Committee RFI About U.S. Healthcare Workforce Shortage

NABH thanks its many members who submitted comments detailing their workforce challenges and potential solutions, which helped form the association’s response to the Senate Health, Education, Labor & Pensions (HELP) Committee’s request for information earlier this week. In its six-page letter, NABH noted that America’s behavioral healthcare workforce shortage has reached a crisis point, with nearly 58 million adults reporting any mental illness, about 61 million people using illicit drugs, and more than 150 million people living in federally designated mental health professional shortage areas at a time when the U.S. psychiatrist workforce will contract through 2024 to a projected low of 38,821, equal to a shortage of between 14,280 and 31,091 psychiatrists. A diminished candidate pool, a limited employee pipeline, workplace violence, employee satisfaction in a post-pandemic environment, a highly competitive workforce, over-regulation, and an extremely limited health information technology infrastructure were the leading drivers of the segment’s workforce shortage, the association noted, based on NABH system member responses. The letter then summarized a range of solutions under the categories of reimbursement at parity, additional funding for training programs, and deregulation. NABH will discuss how to address the behavioral healthcare workforce shortage in two sessions at the 2023 NABH Annual Meeting on Monday, June 12.

NABH Addresses Federal Lawmakers’ Stigmatizing Comments about OTPs

NABH this week sent a letter to federal lawmakers expressing deep disappointment with the congressional leaders’ recent comments that compared the nation’s opioid treatment programs (OTPs) with drug cartels and characterized this behavioral healthcare segment as an industry protecting its profits. “These comments are highly stigmatizing to the approximately 18,000 staff who work in OTPs and have dedicated their careers to delivering life-saving services to individuals with opioid use disorders (OUD),” NABH wrote in a letter to Rep. Donald Norcross (D-N.J.) and Sen. Edward Markey (D-Mass.) “Your comments also perpetuate the ongoing stigma against medication-assisted treatment (MAT) that plagues our society,” the letter continued. “This stigma is one of the primary reasons that people with OUD do not seek, nor receive, MAT, even though it is the evidence-based, gold standard of care for patients suffering from OUD. We are confident you both agree that with our nation facing an overdose epidemic with one death every five minutes, we cannot afford to lose ground in the battle against stigmatization in addiction care.” The letter highlights strengths and weaknesses of recent regulatory reforms and current legislation. It also provides a series of recommendations for lawmakers, such as examining the effects of recent efforts to expand access, with a specific focus on understanding the root causes behind incremental overdoses as well as the disproportionate harm that marginalized populations suffer; addressing significant barriers to treatment; and studying the potential impact of leveraging community-based pharmacies in the United States to dispense methadone widely to patients while ensuring that adequate regulatory controls can be established, given the concerning behaviors by pharmacies that recent court proceedings have documented.

NABH Files Amicus Brief on Behalf of Nine Organizations in Wit v. UBH Ruling

NABH has filed an amicus brief that supports a petition for rehearing the ongoing Wit v. United Behavioral Health (UBH) case. A three-judge panel in the 9^th U.S. Circuit Court of Appeals on Jan. 26 replaced its March 2022 ruling in the Wit v. UBH case with a new opinion that was a major disappointment to both mental health patients and providers. NABH asserts the latest opinion will materially reduce the benefit of insurance because it does not protect medically necessary treatment based on generally accepted standards of care.

NIH Study Reveals Shared Genetic Markers Underlying SUD

Scientists have identified genes commonly inherited across addiction disorders, regardless of the substance used, according to a study published in Nature Mental Health. With support from the National Institute on Drug Abuse, the National Institute on Alcohol and Alcoholism, the National Institute of Mental Health, the Eunice Kennedy Shriver National Institute of Child Health and Human Development, and the National Institute on Aging, researchers at Washington University in St. Louis, along with more than 150 coauthors worldwide, analyzed genomic data from more than 1 million people. Their findings also reinforce the role of the dopamine system in addiction, by showing that the combination of genes underlying addiction disorders was also associated with regulation of dopamine signaling. Click here to learn more.

SAMHSA Announces Funding Opportunity to Establish or Implement Opioid Recovery Centers

The Substance Abuse and Mental Health Services Administration (SAMHSA) announced it will grant up to $1.4 million in two awards to establish or implement comprehensive treatment and recovery centers that provide a spectrum of treatment, harm reduction, and recovery support services to address America’s opioid crisis. Applications are due Tuesday, May 16. Click here to learn more and apply.

Advertise in the 2023 NABH Exhibitor and Sponsor Guide!

NABH will distribute the 2023 NABH Exhibitor and Sponsor Guide to all registrants at the 2023 NABH Annual Meeting from June 12-14, 2023 at the Salamander Washington, DC. Be sure your organization is included in it! All ads are due by April 21, 2023. Please click here for details about advertising options, requirements, payment, and more. The association also will send the guide to all NABH members after the meeting and post it on the NABH Annual Meeting webpage.

Register and Reserve Your Hotel Room Today for the 2023 NABH Annual Meeting!

Please 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). NABH’s theme this year is Securing the Promise of Parity, which recognizes the Mental Health Parity and Addiction Equity Act’s (MPAEA) 15^th anniversary and that we have more work to do to ensure the landmark law is implemented fully. Please visit our Annual Meeting homepage to register, reserve your hotel room, and view our Annual Meeting At-a-Glance. We look forward to seeing you in Washington!

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.

Fact of the Week

The National Alliance on Mental Illness (NAMI) reports that research shows the effects of solitary confinement on mental health are often fatal, both during and after incarceration. A recent showed individuals were overall 24% more likely to die in the first year after release, including from suicide (78% more likely) and homicide (54% more likely). They were also 127% more likely to die of an opioid overdose in the first two weeks after release. For questions or comments about this CEO Update, please contact Jessica Zigmond.

NABH Remembers Former Board Member Frank Fortunati, Jr., J.D., M.D.

NABH remembers with grateful appreciation Frank Fortunati, Jr., J.D., M.D., 58, who died March 5 after a protracted, courageous battle against prostate cancer. A psychiatrist, attorney, and pharmacist, Fortunati had served as assistant professor of psychiatry and deputy chair for Yale-New Haven Health System. Since 2016, he was the vice chief and medical director of psychiatry and behavioral health for Yale-New Haven Hospital, where he was also active in the department’s COVID Healthcare Worker Support Task Force and Anti-racism Task Force. Referred to as a true Renaissance Man, Fortunati was an accomplished musician who played saxophone, guitar, piano, and flute. His obituary noted that one of his great joys was performing with his friends and fellow psychiatrists in their band “Schedule II.” In the car, he enjoyed listening to jazz or classic Rock. He was also an avid gardener, spending hours growing and harvesting tomatoes, peppers, eggplants, grapes, and figs.   Fortunati served as a member of the NABH Board of Trustees from 2018-2020 and was also an engaged member of NABH’s Quality Committee, Workplace Violence Prevention Workgroup, and COVID-19 Task Force. His fellow board members and the Washington-based NABH team will remember how he always listened well and offered thoughtful, practical solutions to any topic—and proposed solutions that made life better for patients and the healthcare teams who cared for them. “Fortunati led by example, often serving in multiple roles (vice chief, section head, inpatient medical director),” the Yale School of Medicine wrote in an announcement about his death. “He earned the respect of everyone who worked with him. His credibility enabled him to drive change and improve quality. He put others ahead of his personal needs, repeatedly declining to complete the paperwork necessary for his own promotion in the service of looking out for others.” Fortunati is survived by his wife, Karen; children Jenna and Frankie; other family members; and the Fortunati family’s three cherished dogs. Funeral services were held at Saint Mary Church (Precious Blood Parish) in Milford, Conn. on March 11.

NABH Raises Information System Limitations and Prior Authorization Concerns with CMS

NABH this week submitted comments to the Centers for Medicare & Medicaid Services (CMS) about the agency’s electronic prior authorization proposed rule as it pertains to behavioral healthcare patients and providers. Under the direction of the NABH Managed Care Committee, the association raised concerns that the current limitations of the behavioral healthcare sector’s information system infrastructure are such that, without federal investment in compliant information technology to enable behavioral healthcare connectivity, most behavioral healthcare providers will remain shut out of 1) the interoperable exchange of patient health information, and 2) the electronic prior authorization processes that the rule proposes. NABH’s letter also strongly supports modifying existing regulation to treat prior authorization approvals as a promise of payment that cannot be retracted, in addition to a determination of whether an item or service is medically necessary.

NABH Opposes Proposed FTC Ban on Non-Compete Clauses

In comments submitted today, NABH asked the Federal Trade Commission (FTC) to withdraw its proposed rule that would ban non-compete clauses. NABH’s opposition to this proposal was based on three distinct concerns: the rule proposes an overly simplified, one-size-fits-all approach for all employees across all industries; given the workforce disruptions related to the COVID-19 pandemic, now is not the time to upend the healthcare labor markets; and, finally, the FTC lacks the statutory authority to promulgate this wide-reaching regulation.

Members of Congress Request Telehealth Parity Guidance from DOL

A bipartisan group of Members of Congress have sent a letter to the U.S. Labor Department (DOL) urging the department to provide guidance regarding parity enforcement for mental health and substance use disorder (SUD) services delivered via telehealth. In the letter, House members expressed concern that health plans may be less motivated to cover behavioral healthcare telehealth services after the COVID-19 public health emergency is scheduled to end on May 11. “Since the onset of the pandemic, telehealth use has risen dramatically, with 41% of MH/SUD care delivered via telehealth by October 2020,” the letter noted. “Mental health conditions continue to be the top claims diagnosis in the commercial market rising from 30% in January 2020 to roughly 65% in November 2022,” it continued. “Given the immense need for MH/SUD services combined with acute behavioral health workforce shortages, we want to ensure insurance plans and issuers understand their responsibility under federal parity law as it relates to behavioral health services delivered via telehealth.” Click here to read the full letter.

SAMHSA Announces National Strategy for Suicide Prevention Funding Opportunity

The Substance Abuse and Mental Health Services Administration (SAMHSA) this week announced it will grant five awards totaling $2 million to implement suicide prevention and intervention programs for adults that help implement the 2021 Surgeon General’s Call to Action to Implement the National Strategy for Suicide Prevention.   With an emphasis on older adults, adults in rural areas, and American Indian and Alaskan native adults, the program is meant to address the Call to Action’s broad-based public health approach to suicide prevention through enhancing collaboration among stakeholders such as county health departments, workplace settings, criminal justice setting, senior-serving organizations, and community firearm stakeholders. Applications are due Monday, May 15. Click here for more information.

Advertise in the 2023 NABH Exhibitor and Sponsor Guide! 

NABH will distribute the 2023 NABH Exhibitor and Sponsor Guide to all registrants at the 2023 NABH Annual Meeting from June 12-14, 2023 at the Salamander Washington, DC. Be sure your organization is included in it! All ads are due by April 21, 2023. Please click here for details about advertising options, requirements, payment, and more. The association also will send the guide to all NABH members after the meeting and post it on the NABH Annual Meeting webpage. Registration is Open for the 2023 NABH Annual Meeting: Securing the Promise of Parity! Please 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). NABH’s theme this year is Securing the Promise of Parity, which recognizes the Mental Health Parity and Addiction Equity Act’s (MPAEA) 15^th anniversary and that we have more work to do to ensure the landmark law is implemented fully. Please visit our Annual Meeting homepage to register, reserve your hotel room, and view our Annual Meeting At-a-Glance. We look forward to seeing you in Washington!

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.

Fact of the Week

Black and Hispanic adults with co-occurring disorders were less likely to receive mental health or substance use treatment (47% and 43%, respectively) than White adults (64%), according to research from The Pew Charitable Trusts.  For questions or comments about this CEO Update, please contact Jessica Zigmond.

President Biden’s FY 2024 Budget Proposal Includes Strong Focus on Behavioral Healthcare Needs

Yesterday, President Biden issued his Fiscal Year 2024 budget proposal, which now goes to Congress for consideration. Key provisions include:   Elimination of the 190-day Lifetime Limit on Psychiatric Hospital Services. The proposed budget would rescind the current law limiting Medicare enrollees to a lifetime limit of 190-days inpatient psychiatric care. The purpose of this provision is to increase access to hospital-level care and advance parity between mental health and physical health coverage for patients with serious mental illness. The budget estimates that this item would generate a $2.4 billion cost to Medicare over 10 years. Greater Psychiatric Hospital Flexibility when Restoring Compliance with Conditions of Participation. In cases where a psychiatric hospital is non-compliant with the Medicare conditions of participation for a deficiency that does not jeopardize patient health and well-being, the proposed budget would give CMS flexibility to continue issuing Medicare payments if the facility is actively working to correct the deficiency, rather than terminate Medicare participation. Workforce. The proposed budget also includes a $2 billion mandatory Mental Health System Transformation Fund for workforce development and service expansion. In part, this workforce development effort would augment FY 2023 funding already enacted in law to train about 18,000 behavioral health providers— including clinicians, peer support specialists, and others—and increase the number of providers practicing in areas of high demand throughout the country. Parity. The proposed budget would apply to Medicare Advantage the 2008 Mental Health Parity and Addiction Equity Act, requiring health plans to offer mental health and substance use disorder benefits that are no more restrictive than the medical and surgical benefits they offer. It also requires health plans to use medical necessity criteria for behavioral health developed by nonprofit medical specialty associations, as well as regulation of behavioral health network adequacy, and the creation of a standard for parity in reimbursement. The budget estimates a $760 million cost over 10 years for these parity items. Learn more about the Biden administration’s FY 2024 budget proposal here.

Study Shows Opioids Cause Half of All Poisonings in U.S. Kids Aged 5 and Under

About 52% of poisoning deaths of U.S. children aged 5 and under in 2018 involved the ingestion of an opioid, according to a study published online this week in the journal Pediatrics. Researchers also found that opioids accounted for a progressively greater proportion of the substances contributing to poisoning-related deaths during the study period, from 24% in 2005 to 52% in 2018.   “As the types of opioids circulating during the current epidemic continue to evolve, policy and programmatic initiatives should focus on children in addition to adults,” the study’s authors wrote.  “Regulatory changes have improved the safety of OTC medications, but a substantial proportion of pediatric fatalities are still associated with this medication class.”

Thank You to Members Who Submitted Comments on Workforce Challenges & Solutions

NABH thanks all members who responded to our request for feedback about their system’s most critical workforce challenges and potential solutions. The NABH Research and Education Foundation is seeking comments in these two areas to help NABH respond to a request for information (RFI) that the Senate Health, Education, Labor & Pensions (HELP) Committee announced last week. The RFI follows a Feb. 16 hearing the Senate HELP Committee held to examine the root causes of America’s current healthcare workforce shortages and explore potential solutions.   If you haven’t sent comments and would like to contribute, please send your feedback as an attachment to foundation@nabh.org by the close of business on Monday, March 13.

Registration is Open for the 2023 NABH Annual Meeting: Securing the Promise of Parity!

Please 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). NABH’s theme this year is Securing the Promise of Parity, which recognizes the Mental Health Parity and Addiction Equity Act’s (MPAEA) 15^th anniversary and that we have more work to do to ensure the landmark law is implemented fully. Please visit our Annual Meeting homepage to register, reserve your hotel room, and view our Annual Meeting At-a-Glance. We look forward to seeing you in Washington!

Manatt Telehealth Webinar Recording Now Available

NABH thanks its members who helped the NABH Education and Research Foundation and Manatt produce a joint issue brief, Telehealth is Effectively Augmenting Traditional Partial Hospitalization and Intensive Outpatient Programs last month. In case you missed it, Manatt led a webinar on March 1 that highlighted the telehealth issue brief’s findings. Click here to submit a brief form to watch the recorded webinar. NABH is grateful to Abhi Pardeshi from UHS, Dylan Ross from Rogers Behavioral Health, and T.J. Vlavianos from Northwell Health’s Zucker Hillside Hospital for joining NABH President and CEO Shawn Coughlin as the webinar’s panelists.

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.

Fact of the Week

Males make up 25% of people with anorexia. Because they are often diagnosed later than females, they are at higher risk of dying, according to the Center for Discovery. For questions or comments about this CEO Update, please contact Jessica Zigmond.

Registration is Open for the 2023 NABH Annual Meeting: Securing the Promise of Parity!

Please 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). NABH’s theme this year is Securing the Promise of Parity, which recognizes the Mental Health Parity and Addiction Equity Act’s (MPAEA) 15^th anniversary and that we have more work to do to ensure the landmark law is implemented fully. Please visit our Annual Meeting homepage to register, reserve your hotel room, and view our Annual Meeting At-a-Glance. We look forward to seeing you in Washington!

Please Send Us Your Feedback on Workforce Challenges & Solutions

The NABH Research and Education Foundation is seeking comments from NABH members on 1) the main drivers of your system’s workforce shortages, and 2) your ideas for solutions. NABH will gather this collective feedback and respond to the request for information (RFI) that the Senate Health, Education, Labor & Pensions (HELP) Committee announced thursday. The RFI follows a Feb. 16 hearing the Senate HELP Committee held to examine the root causes of America’s current healthcare workforce shortages and explore potential solutions. Please send your comments as an attachment to foundation@nabh.org by the close of business on Monday, March 13. Thank you for your help with this critical issue!

DEA Proposes Two Telemedicine Regulations

The Drug Enforcement Administration (DEA) recently published two telemedicine rules that, taken together, largely revert to pre-COVID requirements for an in-person medical evaluation prior to prescribing controlled substances. DEA’s Notices of Proposed Rulemaking (NPRM) for buprenorphine and telemedicine without an in-person medical evaluation propose permitting the following two scenarios under which a telemedicine prescription can take place: Scenario A: Permitting a virtual first prescription by the prescribing practitioner without an in-person medical evaluation for an initial 30-days of non-narcotic Schedule III-V or buprenorphine-controlled substances. The NPRM proposes specific processes and documentation requirements for this scenario, such as checking the PDMP and noting ‘telemedicine’ on the face of the prescription. Scenario B: Permitting a qualified telemedicine referral in which a second DEA-registered practitioner performs an in-person exam and makes a referral to the prescribing practitioner. Under this scenario, Schedule II-V and narcotic substances can be prescribed. The NPRM proposes processes and documentation for these referrals, such as a written referral and transfer of medical records prior to prescribing. To continue prescribing after 30-days under Scenario A, a one-time in-person medical evaluation is required. The in-person evaluation requirement can be satisfied in three ways:

• Through an evaluation by the telemedicine prescribing practitioner;

• Through an evaluation conducted as a three-way audio-visual exam in which the prescribing practitioner, another DEA-registered referring provider, and the patient participate;

• Through a ‘qualified telemedicine referral’ by another DEA-registered practitioner who has seen the patient in-person and who adheres to specific procedures and documentation for the referral.

Meanwhile, if a telemedicine prescription for a controlled substance was initiated during the public health emergency (PHE), the NPRM proposes a 180-day transition period during which time an in-person medical evaluation must take place. If the NPRM is finalized by May 11, 2023 (the designated end of the PHE), an individual inducted during the PHE would have to have an in-person medical evaluation by November 2023. This extends to all prescriptions for controlled substances II-V initiated during the PHE. The NPRM do not include the long-awaited special registration rule, which would have allowed certain clinicians to prescribe controlled substances via telemedicine without an in-person evaluation. Moreover, DEA said this NPRM satisfies its obligation to propose rules for a special registration. In addition, the revisions align with the Centers for Medicare & Medicaid Services’ updated definition of telehealth to include audio-only telemedicine of controlled substances for mental health where states permit it. These instances are both limited and situational. NABH will provide comments to DEA by the agency’s March 31 deadline. Please send any comments to Sarah Wattenberg at sarah@nabh.org by Friday, March 17.

SAMHSA Releases Report on Long COVID’s Effects on Behavioral Health

A meta-analysis of studies around the world showed that the overall prevalence of depression, anxiety, and sleep disturbances among COVID-19 survivors was 45%, 47%, and 34%, respectively, according to a report released this week from the Substance Abuse and Mental Health Services Administration (SAMHSA). The Centers for Disease Control and Prevention (CDC) defines Long COVID as “new, returning, or ongoing symptoms that last four or more weeks following acute COVID-19 diagnosis.” SAMHSA’s report, Overview of the Impacts of Long COVID on Behavioral Health, examines the effects of the deadly virus in a variety of areas, including cognitive and psychiatric symptoms associated with Long COVID, a widening of health disparity gaps, potential long-term implications, and future directions for Long COVID recovery. “Among the most common symptoms of Long COVID is a gradient of cognitive and psychiatric sequelae (e.g., depression, anxiety, PTSD), which may portend significant consequences for patient functioning and quality of life,” the report noted. The study also said that in comparison with those not affected, COVID-19 survivors show increased rates of mental health and cognitive problems.

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.

Fact of the Week

Research has shown that, regardless of COVID-19 status, 53% of healthcare workers reported symptoms of at least one mental health condition, including depression (32%), anxiety (30%), PTSD (37%), and suicidal ideation (8%), according to SAMHSA’s Overview of the Impacts of Long COVID on Behavioral Health. For questions or comments about this CEO Update, please contact Jessica Zigmond.

Registration is Open for the 2023 NABH Annual Meeting: Securing the Promise of Parity!

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). NABH’s theme this year is Securing the Promise of Parity, which recognizes the Mental Health Parity and Addiction Equity Act’s (MPAEA) 15^th anniversary and that we have more work to do to ensure the landmark law is implemented fully. Please visit our Annual Meeting homepage to register, reserve your hotel room, and view our Annual Meeting At-a-Glance. We look forward to seeing you in Washington!

Reminder: NABH-Manatt Telehealth Issue Brief Webinar on Wednesday, March 1

Manatt will host a webinar featuring NABH President and CEO Shawn Coughlin and NABH members as panelists on Wednesday, March 1 at noon ET to highlight findings from the telehealth issue brief that the NABH Education and Research Foundation and Manatt released this month. The telehealth issue brief is the first resource from the NABH Education and Research Foundation, which worked with NABH members and Manatt to compile and evaluate data to measure the impact that telehealth services have had on access and outcomes. The study showed how telehealth services effectively augment traditional partial hospitalization programs (PHP) and intensive outpatient programs (IOP). NABH urges its members to read the issue brief and share it with others. The association has also created a social media toolkit with shareable graphics that highlight key research from the study. Members can access the issue brief and social media toolkit on the NABH Education and Research Foundation’s Resources page. Click here to register for next week’s free webinar.

Biden Administration Will Allow States to Use Medicaid to Cover SUD for Incarcerated Persons

The Biden administration will allow states to use Medicaid funding to cover substance use disorder (SUD) treatment for incarcerated persons at state jails and prisons, news outlets reported this week. According to Politico, Rahul Gupta, M.D., director of the Office of National Drug Control Policy, said Tuesday that the Centers for Medicare & Medicaid Services (CMS) plans to release guidance this spring that outlines how states could use the program and federal dollars to pay for treatments before people are released. The story also quoted Gupta as saying the guidance is a “smart move” and that all 112 of the nation’s federal prisons will offer medication-assisted treatment for SUD by this summer.

NIH Trial to Compare Effects of Prescribed Buprenorphine or Methadone in Office Settings

The National Institutes of Health (NIH) will conduct a hybrid effectiveness/implementation trial to compare patients’ ability to remain in treatment when they’re prescribed buprenorphine or methadone in an office-based setting, STAT News reported today. According to the story, the clinical trial, scheduled for this year, is the first of its kind in the “fentanyl era.” “While we do have hints from the scientific literature that methadone has better outcomes with respect to retention in treatment and decreases in illicit drug use, we actually don’t have that literature in patients who are primarily using fentanyl,” David Fiellin, M.D., director of Yale Medical School’s Program in Addiction Medicine and the researcher overseeing the trial, said in the story. Click here for details about the NIH study.

CMS Releases Preliminary Medicaid and CHIP Data Snapshot

CMS this week released Medicaid and CHIP and the Covid-19 Public Health Emergency, a data snapshot that compares healthcare service utilization patterns, including behavioral healthcare services, in Medicaid and the Children’s Health Insurance Program (CHIP) during the Covid-19 pandemic from March 2020 through July 2022. Section five of the report presents the behavioral healthcare content, including services delivered via telehealth and a breakdown of services for adults and children enrolled in these programs. More than 137 million Americans—including children, pregnant women, parents, seniors, and individuals with disabilities—were enrolled across each state’s Medicaid or CHIP for at least one day during the public health emergency.

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.

Fact of the Week

Black patients are 1.6 times more likely to experience an involuntary psychiatric hospital admission than non-Black patients, according to a study about racial and ethnic inequities published in Psychiatric Services.   For questions or comments about this CEO Update, please contact Jessica Zigmond.

FDA Advisors Recommend Over-the-Counter Use of Narcan

A U.S. Food and Drug Administration (FDA) advisory panel this week voted 19-0 to recommend the agency approve the anti-opioid overdose drug Narcan be made available as an over-the-counter drug. Narcan is currently available by prescription only, and the change would make it the first opioid overdose reversal drug to be made available over the counter. News reports noted the FDA advisors also asked that the manufacturer make it more clear to users how to administer the product. The FDA is expected to make a final decision by March 29.

CDC Releases Youth Risk Behavior Survey Data Summary & Trends Report: 2011-2021

Female students were nearly twice as likely to attempt suicide during the past year compared with their male peers, with nearly six in 10 feeling persistently sad or hopeless and more than one in 10 attempting suicide, the Centers for Disease Control and Prevention (CDC) reported in its Youth Risk Behavior Survey Data Summary & Trends Report: 2011-2021 this week. The data provide a critical view of U.S. adolescent health and well-being related to sexual behavior, substance use, experiences of violence, mental health, and suicidal thoughts and behaviors. This year’s report also includes data on students’ experiences of unstable housing, school connectedness, and parental monitoring to expand understanding of young people’s environments and opportunities to improve them. In the CDC’s words, the findings “tell a distressing story” about the health and well-being of our country’s young people. According to the report, female students experienced more violence, mental health challenges, suicidal thoughts and behaviors, and substance use than their male peers. For instance, the percentage of female students who had ever experienced forced sex increased for the first time in 10 years, with 14% of female students having this experience. Meanwhile, attempted suicide was higher among Black students than students from other groups and increased among Black and White students from 2011 to 2021. And LGBQ+ students were nearly four times as likely as their heterosexual peers to attempt suicide during the past year, with more than two in 10 reporting this experience.

CDC Provisional Data Show U.S. Drug Overdose Deaths High but Declining

Provisional data from the CDC this week show the number of U.S. drug overdose deaths, while still high, has declined. The CDC predicts there were 106,840 drug overdose deaths for the 12-month period ended September 2022 compared with 107,937 predicted drug overdose deaths for the 12-month period ended August 2021. And when comparing month-over-month statistics in 2022, the numbers show a steady decline, starting with 110,317 predicted overdose deaths in March 2022. In a statement last month, Office of National Drug Control Policy (ONDCP) Director Rahul Gupta, M.D. attributed the progress to the Biden administration’s efforts to remove barriers to treatment and disrupting the supply of illicit drugs.

SAMHSA Releases National Substance Use and Mental Health Services Survey, 2021

More than two-thirds of substance use treatment facilities (69.5%) offered pharmacotherapies as part of their treatment services, with a higher percentage of substance use facilities reporting they used medication-assisted treatment (MAT) for treating opioid use disorder (55.3%) than for treating alcohol use disorder (37.9%). Those were among the findings of the Substance Abuse and Mental Health Services Administration’s (SAMHSA) National Substance Use and Mental Health Services Survey, 2021 released this week.   Researchers gathered data from April 30, 2021 through January 10, 2022 for the 35-page report, which is the most comprehensive national source of data on substance use and mental health treatment facilities, its territories, and Washington, D.C.

NABH Submits Comments to SAMHSA on Opioid Treatment Program Regulations

This week NABH submitted a comment letter to SAMHSA on the Opioid Treatment Program (OTP) regulations 42 CFR part 8. In it, NABH wrote that the association appreciates SAMHSA’s flexibility to OTPs, including new authority to provide methadone induction via telehealth. NABH was the first organization to advocate for this change when COVID-19 social-distancing measures made it hard for individuals to access methadone treatment. NABH expressed concerns and called for SAMHSA to remove changes to accreditation standards that would prematurely trigger one-year or non-accreditation status. Click here to read NABH’s letter.

NABH Submits Comments to CMS on Medicare Advantage

Also this week, NABH submitted comments to the Centers for Medicare & Medicaid Services (CMS) about policy and technical changes to Medicare Advantage (MA) for calendar year 2024. NABH noted that the association appreciates the proposed rule’s focus on improving access to and quality of care through increasing both the oversight and transparency of insurers. In particular, NABH supports the rule’s proposed improvements related to prior authorization, network adequacy, and quality of care, many of which NABH and its partners have long pursued. The association outlined a series of recommendations to CMS on topics such as clarifying “Original Medicare” standards as minimum requirements for MA; improving medical necessity; streamlining prior authorization requirements; and, regarding the rule’s proposed reduction of the overpayment window, allowing a reasonable time of about six months for providers to conduct investigations, and, when necessary, process a refund. Click here to read NABH’s letter.

Reminder: NABH-Manatt Telehealth Issue Brief Webinar on Wednesday, March 1

Manatt will host a webinar featuring NABH President and CEO Shawn Coughlin and some NABH members as panelists on Wednesday, March 1 at noon ET to highlight findings from the telehealth issue brief that the NABH Education and Research Foundation and Manatt released this month. The telehealth issue brief is the first resource from the NABH Education and Research Foundation, which worked with NABH members and Manatt to compile and evaluate data to measure the impact that telehealth services have had on access and outcomes. The study showed how telehealth services effectively augment traditional partial hospitalization programs (PHP) and intensive outpatient programs (IOP). NABH urges its members to read the issue brief and share it with others. The association has also created a social media toolkit with shareable graphics that highlight key research from the study. Members can access the issue brief and social media toolkit on the NABH Education and Research Foundation’s Resources page. Click here to register for next month’s free webinar.

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

Some data brokers are marketing highly sensitive data on individuals’ mental health conditions on the open market, with seemingly minimal vetting of customers and seemingly few controls on using purchased data, according to a study from Duke University’s Sanford School of Public Policy. For questions or comments about this CEO Update, please contact Jessica Zigmond.

Becerra Renews COVID-19 Public Health Emergency Through May 11

U.S. Health and Human Services Department (HHS) Secretary Xavier Becerra on Thursday renewed the nation’s COVID-19 public health emergency (PHE) status for another 90 days through May 11. “Based on current trends regarding COVID-19, the U.S. Department of Health and Human Services is planning for this to be the final renewal and for the COVID-19 PHE to end on May 11, 2023,” Becerra wrote to the nation’s governors on Feb. 9. “Rather than 60 days’ notice, I am providing 90 days’ notice before the COVID-19 PHE ends to give you and your communities ample time to transition.” Becerra’s letter also noted that the Biden administration’s whole-of-government approach to combatting the deadly virus has helped transition the country away from the emergency phase. Since Omicron peaked at the end of January 2022, daily COVID-19 reported cases are down 92%; COVID-19 deaths have declined by more than 80%; and new COVID-19 hospitalizations are down nearly 80%, Becerra’s letter noted.

NIMH to Host Webinar Next Week on the Opioid Crisis and HEALing Communities Study

The National Institute on Mental Health (NIMH) will host a webinar next Tuesday to discuss how the HEALing Communities Study (HCS) is testing the prevention and treatment of opioid misuse in communities that the nation’s opioid crisis has hit hardest. Sharon L. Walsh, Ph.D., professor of behavioral science, psychiatry, pharmacology and pharmaceutical sciences at the University of Kentucky’s Colleges of Medicine and Pharmacy, will describe how the HCS has begun to expand access to evidence-based care, improve data availability and timeliness, address social determinants of health, reduce stigma through public health communications campaigns, and modify relevant policies. Walsh also serves as director of the Center on Drug and Alcohol Research and the Substance Use Disorder Priority Research Area. She is the principal investigator of the HCS at the University of Kentucky. The HCS tests the integration of prevention, overdose treatment, and medication-based treatment in select communities. Click here to register for the free webinar, which will begin at 2 p.m. ET on Tuesday, Feb. 14.

SAMHSA Announces Funding Opportunity for Assertive Community Treatment Programs for Youth and Adults with SMI

The Substance Abuse and Mental Health Services Administration (SAMHSA) this week announced it will award more than $5 million to establish or expand and maintain Assertive Community Treatment (ACT) programs for transition-aged youth and adults with serious mental illness (SMI).   The program’s purpose is to improve behavioral health outcomes for individuals by reducing rates of hospitalization, mortality, substance use, homelessness, and involvement with the criminal justice system. Click here to learn more about the opportunity. Applications are due by Monday, April 10.

NIDA Reports Increased Activity in ‘Blue Lotus’ Drug

The National Institute on Drug Abuse (NIDA) reported this week that, in response to mentions of blue lotus for the first time from a Rapid Street Reporting (RSR) site visit in Austin, the substance has experienced steady activity in the past three years, with activity peaking in early and late 2022. Also known as Nymphae caerulea, blue lotus is a water lily primarily found in East Africa and the Arabian Peninsula. The flower contains aphorphine, a dopamine agonist, and is sold primarily as tea extracts or incense. Click here to learn more about blue lotus and the RSR team’s other recent findings in NIDA’s Feb. 10 newsletter.

In Case You Missed It: NABH Education and Research Foundation and Manatt Produce Issue Brief on Telehealth Services in PHP and IOP

The NABH Education and Research Foundation on Feb. 1 released an issue brief that shows how telehealth services effectively augment traditional partial hospitalization programs (PHP) and intensive outpatient programs (IOP). The telehealth issue brief is the first resource from the NABH Education and Research Foundation, which worked with NABH members and Manatt to compile and evaluate data to measure the impact that telehealth services have had on access and outcomes. NABH urges its members to read the issue brief and share it with others. The association has also created a social media toolkit with shareable graphics that highlight key research from the study. Members can access the issue brief and social media toolkit on the NABH Education and Research Foundation’s Resources page. Manatt will host a webinar about the issue brief’s findings on Wednesday, March 1 at noon ET. Click here to learn more and register for the free webinar. The NABH Education & Research Foundation fields independent studies and partners with other organizations to identify and develop best practices and improve NABH members’ ability to support the country’s behavioral health needs.

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

Medicare Advantage (MA) enrollment increased by 22.2 million beneficiaries, or 337%, from 2006 through 2022, while traditional Medicare enrollment declined by 1.0 million, or −2.9% during that period, according to a study published this week in the journal Health Affairs. The increase in MA enrollment and penetration “indicates that beneficiaries are reforming Medicare with their feet,” the study’s authors wrote. For questions or comments about this CEO Update, please contact Jessica Zigmond.

NABH Education and Research Foundation Partners with Manatt to Produce Issue Brief on Telehealth Services in PHP and IOP

The NABH Education and Research Foundation this week released an issue brief that shows how telehealth services effectively augment traditional partial hospitalization programs (PHP) and intensive outpatient programs (IOP). The telehealth issue brief is the first resource from the NABH Education and Research Foundation, which worked with NABH members and Manatt to compile and evaluate data to measure the impact that telehealth services have had on access and outcomes. Results from the study show that using telehealth services improved access to care and optimized the reach of existing personnel. The initial findings from several NABH members also indicated that, relative to in-person services, telehealth delivery-of-care produced similar or better outcomes for PHP and IOP patients. The telehealth issue brief’s key findings also include: During the COVID-19 crisis, regulatory flexibilities enabled traditional in-person PHPs and IOP programs to implement telehealth services rapidly. Using telehealth to deliver PHP and IOP services has improved access to care for remote patients and those facing other access obstacles. Emerging research is showing that, relative to in-person care, the use of telehealth in PHPs and IOPs generally is improving the quality of clinical care, patient satisfaction and the overall efficiency of the healthcare system. NABH urges its members to read the issue brief and share it with others. The association has also created a social media toolkit with shareable graphics that highlight key research from the study. Members can access the issue brief and social media toolkit on the NABH Education and Research Foundation’s Resources page. Manatt will host a webinar about the issue brief’s findings on Wednesday, March 1 at noon ET. Click here to learn more and register for the free webinar. The NABH Education & Research Foundation fields independent studies and partners with other organizations to identify and develop best practices and improve NABH members’ ability to support the country’s behavioral health needs.

New 9th Circuit Court of Appeals Ruling Threatens Behavioral Healthcare Coverage

A three-judge panel in the 9^th U.S. Circuit Court of Appeals on Jan. 26 replaced its March 2022 ruling in the Wit v. United Behavioral Health (UBH) case with a new opinion that is a major disappointment to both mental health patients and providers. NABH asserts the latest opinion will materially reduce the benefit of insurance because it does not protect medically necessary treatment based on generally accepted standards of care. NABH refuses to allow insurers to deny medically appropriate care to those who need it and will file a new amicus brief and request that the 9^th Circuit rehear the case. The U.S. District Court for the Northern District of California’s initial ruling on this class action case in 2019 affects more than 100 million health insurance enrollees. The ruling, considered one of the most significant of the last decade, found that UBH’s reimbursement guidelines for psychiatric conditions were non-compliant with generally accepted standards of care and treatment. In its ruling, the District Court articulated a series of clinical standards for behavioral healthcare treatment that emphasized the need for treatment to sustain improvement, rather than only address an immediate clinical crisis. The District Court also applied a holistic approach that required treatment for both primary and comorbid impairments, such as the combination of depression and a substance use disorder. A year after this finding, the District Court ordered UBH to reprocess more than 50,000 claims it had initially denied. The 9^th Circuit Court of Appeals subsequently undid this ruling with its 2022 memorandum. While the latest ruling in this case is a disappointment, NABH and other behavioral healthcare groups found both positive and negative elements in it. These include: Positive Factors:

• The 9^th U.S. Circuit Court of Appeals found that UBH violated its fiduciary duty to all class members by using medical necessity criteria that were infected by UBH’s financial conflict of interest.
• The 9^th U.S. Circuit Court of Appeals upheld the U.S. District Court’s finding that UBH broke the laws of four states, which required UBH to apply specific substance use criteria to evaluate medical necessity.

Negative Factors:

• The 9^th U.S. Circuit Court of Appeals held that UBH does not have to reprocess over 60,000 claims for class members denied coverage under UBH’s flawed guidelines, contrary to longstanding precedent on reprocessing as an ERISA remedy.
• The 9^th U.S. Circuit Court of Appeals held that all ERISA class action members must first exhaust their administrative remedies, even if doing so would be futile, as the U.S. District Court found was the case here.
• The 9^th U.S. Circuit Court of Appeals held that insurers may use medical necessity criteria that are inconsistent with generally accepted standards of care.

CMS Updates Audit Protocol for Medicare Advantage Payments

The Centers for Medicare and Medicaid Services (CMS) on Jan. 30 issued a final rule related to using risk adjustment to ensure accurate payment for services provided under Medicare Advantage (MA). Modifications to the risk adjustment audit protocol, called risk adjustment data validation (RADV), and the related overpayment refund process were initially issued in a 2018 proposed rule. Final action was delayed until now, in part, due to the COVID-19 pandemic. The final rule reflects estimates from the HHS Office of the Inspector General of more than $15 billion in MA overpayments in fiscal year 2019, or about 7% of total payments. The final rule takes effect April 3, 2023 and has an estimated recovery amount of $4.7 billion in over 10 years. NABH supports this final rule’s objective to increase oversight of payment accuracy under MA and improve the alignment between payments and medically necessary services for enrollees. To align MA payments with the clinical needs of enrollees, CMS risk-adjusts payments based on patients’ health status and key characteristics. The goal of risk adjustment is to pay less for healthier enrollees and more for more medically complex enrollees. To identify any inaccuracies in MA risk-adjustment’s impact on payments, CMS conducts retrospective RADV audits of a sample of each plan’s enrollees—typically about 200 per plan— to review their medical records to quantify any gaps between medically necessary care and reimbursed services. Extrapolation: Beginning with payment year (PY) 2018, rather than PY 2011, as proposed, the overpayments quantified through RADV audits will be extrapolated to the full MA contract. While not articulated in the final rule, CMS’ extrapolation methodology will be disclosed to MA insurers and be focused on insurers identified as being at highest risk for improper payments. CMS stated that its use of extrapolation is intended to incentivize meaningful steps by its contractors to reduce improper MA risk-adjusted payments. Overpayments identified for PYs 2011 through 2017 will be refunded to CMS without the application of extrapolation. FFS Adjuster: In addition, as proposed, the final rule will not apply an adjustment factor (known as an FFS Adjuster) to RADV audit findings, which is a form of risk adjustment. This final position is based on recent case law, which found that the FFS adjuster must be applied to MA payments but not refunded overpayments, including those identified during a RADV audit.

Congressional Research Services Releases Parity Report

The Congressional Research Service (CRS)—the public policy research institute of the U.S. Congress—this week released a report that explains mental health/substance use disorder benefit coverage and parity requirements and the types of private health insurance plans subject to those requirements. The report includes a brief review of relevant legislative history, including changes enacted in December 2022, and a discussion and examples of required federal agency activities. The CRS focused on federal private insurance requirements; it does not compare state requirements or actual plan variation in coverage. It also does not examine mental health benefits in Medicare and Medicaid. Click here to read the report.

National Institute of Mental Health Develops Strategic Framework to Address Youth Mental Health Disparities

The National Institute of Mental Health (NIMH) has developed the National Institute of Mental Health (NIMH) Strategic Framework for Addressing Youth Mental Health Disparities for fiscal years 2022–2031, a resource intended to provide a conceptual approach to help guide NIMH activities, including research funding, stakeholder engagement, and workforce development related to research on the mental health needs of youth affected by racial and ethnic health disparities. “Our country is in the midst of a youth mental health crisis, including alarming increases in youth suicide in recent years,” Christina P.C. Borba, Ph.D., M.P.H., wrote in the framework’s foreword message. “We also know that youth exposed to racism, discrimination, and other adverse experiences, as well as those from disadvantaged and underserved communities, are disproportionately impacted by mental illnesses, and frequently experience reduced access to high-quality, evidence-based mental health services and receive fewer follow-ups in a variety of provider settings,” Borba continued. “Addressing these challenges will require sustained attention, effort, and resources – all built on a foundation of high-quality research.”

News Report Shows How States are Responding to Synthetic Opioid Nitazene

The news outlet Axios recently examined how nitazene, a synthetic opioid thought to be 40 times more powerful than fentayl, is complicating the public health response to the opioid crisis in various states. Nitazene comes in powder, pill, and liquid form and requires significant lab work to trace. “Often laced into substances that users think is fentanyl or heroin, it’s potentially lethal or can cause a more severe onset of withdrawal symptoms,” the story noted. The Centers for Disease Control and Prevention (CDC) last September published a study on nitazene-related deaths in Tennessee from 2019-2021 and reported that nitazenes are an emerging group of highly potent psychoactive substances for which tests are not often included in standard toxicology panels. “Given their potency, raising awareness about nitazenes and implementing strategies to reduce harm through increased testing, surveillance, and linkage to treatment for substance use disorders are of vital importance,” the CDC study said. “More data are required to better understand this emerging group of psychoactive substances in the United States.”

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 Pew Research Center study shows that 40% of parents report they are “extremely/very” worried that their children might struggle with anxiety or depression at some point. For questions or comments about this CEO Update, please contact Jessica Zigmond.

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.

SAMHSA Announces Monica Johnson as 988 & Behavioral Health Crisis Coordinating Office Director

The Substance Abuse and Mental Health Services Administration (SAMHSA) announced this week that Monica Johnson, M.A., LPC is the new director of the 988 & Behavioral Health Crisis Coordinating Office. Johnson has worked in the behavioral health field for 26 years and most recently served as the interim commissioner for the Georgia Department of Behavioral Health & Developmental Disabilities. SAMHSA’s announcement noted that Johnson has overseen and implemented successfully several programs funded through SAMHSA, the Bureau of Justice Assistance, the Office of Juvenile Justice Delinquency Prevention, and the U.S. Education Department. Johnson earned an undergraduate degree in psychology from Kennesaw State University in Georgia and a graduate degree in professional counseling and psychology at Argosy University in Virginia. She is the recipient of the Intensive Cognitive Behavior Therapy for Schizophrenia Certification at the Aaron T. Beck Institute for Cognitive Behavior Therapy in Philadelphia.

CMS to Host Call About Administration Simplification Proposed Rule on Jan. 25

The Centers for Medicare & Medicaid Services (CMS) National Standards Group will host a call to discuss the Administrative Simplification: Adoption of Standards for Health Care Attachments Transactions and Electronic Signatures, and Modification to Referral Certification and Authorization Transaction proposed rule next Wednesday, Jan. 25 from 2 p.m. to 3:30 p.m. ET. The agency will use the 90-minutes session to provide an overview of the proposed rule and also offer background on the current standards, expectations of what the proposed rule is meant to do, and information about how to submit comments. Click here to register.

CMS to Host Educational Session on Advancing Interoperability and Improving Prior Authorization Processes Proposed Rule

The CMS Office of Burden Reduction and Health Informatics will host a virtual education about the Advancing Interoperability and Improving Prior Authorization Processes proposed rule on Thursday, Feb. 9 from noon to 1 p.m. ET. On Dec. 6, CMS issued the prior authorization proposed rule, which aims to improve patient and provider access to health information and streamline processes. Click here to read the agency’s fact sheet.     Next month’s educational session is intended to help participants learn about the rule’s provisions and hear how the proposed rule builds on current CMS interoperability policies. Participants will be permitted to ask questions. Click here to register by Feb. 8.

ASAM to Release Training Module on Level of Care Certification Next Month

The American Society of Addiction Medicine (ASAM) and CARF International announced that a training module to introduce updated rating elements to the ASAM Level of Care Certification (LOCC) will be available on Feb. 15. ASAM and CARF International announced the LOCC’s updated rating elements in July 2022, and residential treatment programs that are applying for the ASAM LOCC for levels 3.1, 3.5, and 3.7 will be responsible for meeting the updated elements as part of their certification survey. These facilities will also be responsible for meeting the existing rating elements listed in the ASAM LOCC manual.

Joint Commission Releases Sentinel Event Alert About Eliminating Racial & Ethnic Disparities in Pregnant and Postpartum Patients

The Joint Commission this week released a Sentinel Event Alert about eliminating barriers and racial disparities causing mortality and morbidity in pregnant and postpartum women. Along with the announcement, the Joint Commission released a Quick Safety that addresses mental health conditions and their role in maternal death.

SAMHSA Publishes Guide on Expanding Access to Behavioral Healthcare Services for People Experiencing Homelessness

SAMHSA this week released a guide that highlights strategies for behavioral healthcare and housing providers to conduct outreach and engage with individuals experiencing homelessness. The new resource also includes strategies for how to initiate behavioral healthcare treatment as individuals wait to receive housing and retain them in their recovery efforts after they find housing.

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 recent study found that those on medical addiction therapy had a 63% lower likelihood of an alcohol-related liver disease diagnosis. For questions or comments about this CEO Update, please contact Jessica Zigmond.

HHS Awards Nearly $245 Million to Support Youth Mental Health and the Healthcare Workforce

The U.S. Health and Human Services Administration (HHS) announced this week it awarded nearly $245 million in funding from the Bipartisan Safer Communities Act to support youth mental health and help the healthcare workforce address mental health needs.   The funding—released through the Substance Abuse and Mental Health Services Administration (SAMHSA) and Health Resources and Services Administration (HRSA)—is for a variety of programs and grants, including Project Advancing Wellness and Resiliency in Education (Project AWARE) to help develop and support school-based mental health programs and services; Mental Health Awareness Training grants to prepare and train school personnel, emergency first responders, law enforcement, and others to recognize the signs and symptoms of mental health challenges to enable early intervention; the National Child Traumatic Stress Initiative to improve treatment for children, adolescents, and families who have experienced traumatic events, and more.   In its announcement, HHS noted that the Bipartisan Safer Communities Act included nearly $60 million to support the integration of mental health training into the training of primary care clinicians, with a specific focus on preparing primary care providers to treat the mental health needs of children and adolescents. “Often the first person you turn to when you or your kids need mental health support is your trusted primary care provider—yet for too long, we haven’t given those primary care providers the mental health training they need to help, HRSA Administrator Carole Johnson said in the announcement. “With funding from the Bipartisan Safer Communities Act, the Health Resources and Services Administration is investing in making mental health a part of primary care training so that there is no wrong door when your family needs support.”

National Academies to Host Virtual Webinars About 988 Implementation on Jan. 20 and 23

The National Academies Forum on Mental Health and Substance Use Disorders will host two virtual webinars about the challenges and opportunities related to the implementation of the 988 behavioral health crisis hotline at the state and local levels. The discussions will provide an overview of how 988 has been implemented and will also feature best practices. The two-hour webinars will be held on Friday, Jan. 20 and Monday, Jan. 23; both will begin at 12:30 p.m. ET. Click here to register.

CMS to Host National Stakeholder Call with Administrator Brooks-LaSure on Jan. 24

The Centers for Medicare & Medicaid Services (CMS) will host a national stakeholder call featuring CMS Administrator Chiquita Brooks-LaSure and her leadership team to discuss the agency’s accomplishments in 2022 and priorities for 2023. Click here to register.

Register Today for the 2023 Rx and Illicit Drug Summit in Atlanta

The 2023 Rx and Illicit Drug Summit will be held in Atlanta from April 10-13 and will include nearly 100 educational sessions organized in nine different tracks to highlight the most effective strategies for prevention, treatment, and recovery. The meeting’s advanced rate ends on Jan. 27. Click here to register.

NABH’s 2023 Priorities Featured in Mental Health Weekly & Alcohol and Drug Abuse Weekly

In case you missed it, NABH President & CEO Shawn Coughlin discussed the association’s priorities for 2023 and NABH Director of Quality and Addiction Services Sarah Wattenberg reflected on accomplishments of 2022 and hopes for the New Year in Mental Health Weekly and Alcohol and Drug Abuse Weekly, respectively.

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.

Save the Date for the NABH 2023 Annual Meeting!

Please mark your calendars and plan to join us in Washington, DC from June 12-14, 2023 for next year’s NABH Annual Meeting! Details coming soon.

Fact of the Week

In a cohort study of 5,142,577 commercially insured adults across all 50 states, the weekly rate of in-person mental health service utilization decreased by more than 50% after the Covid-19 pandemic started; however, concurrent increases in telehealth led to a slight increase in total utilization for anxiety disorders and stability in total volume of service for other disorders, according to a new study published in JAMA Health Forum. For questions or comments about this CEO Update, please contact Jessica Zigmond.

NABH Welcomes Harsh K. Trivedi, M.D., M.B.A as 2023 Board Chair

NABH is pleased to welcome Sheppard Pratt President & CEO Harsh K. Trivedi, M.D., M.B.A as the association’s board chair for 2023. Harsh has served as an NABH board member as well as a member of the association’s workplace violence prevention workgroup and Covid-19 task force. A graduate of the Mount Sinai School of Medicine, Harsh completed his general psychiatry residency at the Zucker Hillside Hospital/Albert Einstein College of Medicine. He completed his child and adolescent psychiatry training at Children’s Hospital Boston/Harvard Medical School. Harsh has served as president and CEO at Sheppard Pratt in Baltimore since 2016. NABH is eager to work with Harsh as the association celebrates its 90^th anniversary in 2023!

SAMHSA Releases National Survey on Drug Use and Health for 2021

About one in four U.S. adults had a mental illness and more than 16% of the population—or more than 46 million people—met the criteria for substance use disorder (SUD) in 2021, according to the Substance Abuse and Mental Health Services Administration’s (SAMHSA) National Survey of Drug Use and Health (NSDUH).   Released annually, the latest report for the 2021 calendar year also found that younger people reported even higher levels of mental illness—one in three for those between the ages of 18 and 25. Meanwhile, nearly 94% of people with SUD didn’t receive any treatment in 2021. “Every year since 1971, this survey has given us a window into our nation’s mental health and substance use challenges and 2021 was no different,” HHS Secretary Xavier Becerra said in an announcement about the survey. “As the findings make clear, millions of Americans young and old faced mental health and substance use challenges – sometimes both at once – during the second year of the pandemic,” he continued. “As we work to improve behavioral health across the nation, HHS is committed to ensuring that all people facing mental health or substance use challenges are connected to appropriate services and supports.” SAMHSA noted that estimates from the 2021 NSDUH should not be compared with estimates from previous years because the Covid-19 pandemic necessitated methodological changes to the data collection process.

CMS Issues Information Bulletin on Medicaid Provisions in Consolidated Appropriations Act, 2023

The Centers for Medicare and Medicaid Services (CMS) on Thursday issued an informational bulletin that highlights provisions in the Consolidated Appropriations Act, 2023 (CAA, 2023) related to the Medicaid continuous enrollment condition. The CAA, 2023 updates certain Medicaid and Children’s Health Insurance Program (CHIP) provisions, including significant changes to the continuous enrollment condition of the Family First Coronavirus Response Act. Under the CAA, 2023, expiration of the continuous enrollment condition will no longer be linked to the Covid-19 public health emergency (PHE); instead, the condition will end on March 31, 2023. After the condition ends, states will have up to 12 months to initiate, and 14 months to complete, a renewal for all individuals enrolled in Medicaid, CHIP, and the Basic Health Program. Click here for more details.

HRSA Urges Nurses to Apply for Nurse Corps Loan Repayment Program

The Health Resources and Services Administration (HRSA) this week announced a reminder that the Nurse Corps Loan Repayment Program opens soon. As part of the program, certain eligible nurses could qualify for up to 85% of unpaid debt. In return, they would be required to serve at least two years in a critical shortage facility in a high need area or accredited school of nursing in a U.S. state or territory. Nurses must work at eligible facilities for this program, which include public or non-profit medical facilities. Click here to learn about eligibility and application requirements.

Bipartisan Policy Center to Host Behavioral Healthcare Workforce Panel Discussion

The Bipartisan Policy Center (BPC) will host a panel discussion about the organization’s federal policy recommendations to address the huge gap between need and care on Tuesday, Jan. 24. The BPC noted that as of March 2021, about 37% of Americans lived in mental health shortage areas. Panelists will highlight findings of a new BPC report, Filling the Gaps in the Behavioral Health Workforce, which recommends ways to bolster the role of behavioral healthcare workers such as peer specialists, community health workers, and paraprofessionals, as well as community members who can help support the licensed workforce. Click here to register for the hourlong webinar that starts at noon ET on Jan. 24.

Reminder: Apply for HRSA Grants to Reduce Neonatal Abstinence Syndrome in Rural Settings

The Health Resources and Services Administration’s (HRSA) Federal Office of Rural Health Policy will invest $20 million in about 40 grants to reduce the incidence of neonatal abstinence syndrome (NAS) in the nation’s rural communities. According to HRSA’s announcement, grant recipients will collaborate with local, state, and regional stakeholders to provide coordinated, trauma-informed, and family centered behavioral and maternal healthcare services—including medication-assisted treatment—to rural pregnant and post-partum women and their families. Applicant organizations may be in either an urban or rural area; however, all activities supported by the program must exclusively occur in HRSA-designated, rural areas. The agency will accept applications through March 8, 2023.

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.

Save the Date for the NABH 2023 Annual Meeting!

Please mark your calendars and plan to join us in Washington, DC from June 12-14, 2023 for next year’s NABH Annual Meeting!

Fact of the Week

While visits to pediatric emergency rooms rose 1.5% from 2015 to 2021, visits for mental health crises increased 8% a year, according to a new study in JAMA Pediatrics. The study also found that 13% of those young patients returned in six months. For questions or comments about this CEO Update, please contact Jessica Zigmond.

Two Proposed Rules Would Improve Prior Authorization and Network Adequacy

The Centers for Medicare & Medicaid Services (CMS) this week released two proposed rules related to longstanding concerns with Medicare Advantage (MA) plans and other insurers that are designed to improve quality of care and plan accountability. These rules respond to the HHS Office of Inspector General’s report earlier this year about inappropriate prior authorization denials by MA plans as well as 4,000 comments in 2022 from stakeholders, including NABH, on related concerns. Contract Year 2024 Proposed Rule on Medicare Advantage: Released Wednesday, this proposed rule includes significant MA refinements related to behavioral healthcare, such as a prior authorization exemption for emergency mental health services needed to evaluate and stabilize patients. It also proposes implementing a 10-percentage point payment add-on for telehealth services provided by clinical psychologists, licensed clinical social workers, and those who prescribe medication for opioid use disorder. To assist patients seeking care, the rule proposes appointment wait-time standards for primary care and behavioral healthcare services. It would also require mid-year notices for enrollees with a behavioral health or primary care provider who dropped from their plan network. Regarding network adequacy, CMS proposes adding clinical psychologists, licensed clinical social workers, and those who prescribe medication for opioid use disorder to the list of specialty types that CMS uses to evaluate MA networks. To improve parity in access, the proposed rule would also require most MA organizations to include behavioral healthcare services in care coordination programs. In addition, the rule clarifies that plans should include both physical and mental conditions in their coverage of emergency medical care. Also, to address stakeholders’ concerns regarding the dramatic increase in opioid overdose deaths during the Covid-19 pandemic, the rule proposes that MA organizations designate in their provider directories those who obtained a waiver from the Substance Abuse and Mental Health Services Administration (SAMHSA) and the Drug Enforcement Administration to treat patients with medications for opioid use disorder and are listed on SAMHSA’s Buprenorphine Practitioner Locator. Comments to CMS are due by Monday, Feb. 13, 2023. Federal Health Exchange Notice of Benefit and Payment Parameters for 2024: On Monday, the agency issued a proposed rule related to all health insurers participating in federal and state health insurance exchanges. Specifically, CMS would categorize mental health facilities and substance use disorder (SUD) treatment centers as essential community providers and require insurers to include at least one of these providers in each network. Previously, mental health facilities and SUD treatment centers had been designated in the “other” category. In addition, the rule would require contract reviews to assess the actual availability of SUD and mental health services. To address concerns about reduced access to care after the Covid-19 public health emergency ends, CMS has proposed extending by 60 to 90 days those who would otherwise lose Medicaid or Children’s Health Insurance Program coverage in January 2024. Comments on this rule will be accepted during the 45-day period after the rule is published in the Federal Register.

SAMHSA’s Proposed Rule Permits Methadone Prescribing for New Patients via Telemedicine

SAMHSA this week proposed updating federal regulations to permit using audio-visual telehealth services for any new patient treated with methadone in an Opioid Treatment Program (OTP) under specific conditions. In a proposed rule, SAMHSA said federal regulations should be updated to allow using audio-visual telehealth services for patients treated with methadone in OTPs only if a program physician, or an authorized healthcare professional under the supervision of a program physician, determines that an adequate evaluation of the patient can be accomplished via an audio-visual telehealth platform. This change is not extended to using audio-only telehealth platforms and applies only to ordering methadone that an OTP dispenses under existing OTP procedures. In addition, SAMHSA’s proposed changes would update 42 CFR Part 8 by removing stigmatizing or outdated language; supporting a more patient-centered approach to treatment; and reducing barriers to receiving care. SAMHSA’s proposed changes also would revise standards to reflect an OTP accreditation and treatment environment that has evolved since Part 8 became effective in 2001. Consequently, SAMHSA said its proposed revisions reflect evidence-based practice, language that aligns with current medical terminology, effective patient engagement approaches, and the workforce providing services in OTPs, including:

• expanding the definition of an OTP treatment practitioner to include any provider who is appropriately licensed to dispense and/or prescribe approved medications. The current Part 8 rule defines a practitioner as being: “a physician who is appropriately licensed by the State to dispense covered medications and who possesses a waiver under 21 U.S.C.823(g)(2).” During the Covid-19 public health emergency, this has been formally expanded to align with broader definitions of a practitioner (nurse practitioners, physician assistants, etc.), and OTPs reported that this change was essential in supporting workflow and access;
• adding evidence-based delivery models of care, such as split dosing, telehealth, and harm-reduction activities;
• removing such outdated terms as “detoxification”;
• updating criteria for provision of take-home doses of methadone;
• strengthening the patient-practitioner relationship through promoting shared and evidence-based decision-making;
• allowing for early access to take-home doses of methadone for all patients, to promote flexibility in creating plans of care that facilitate such every-day needs as employment, while also affording people with unstable access to reliable transportation the opportunity to also receive treatment; likewise, promoting mobile medication units to expand an OTPs geographic reach; and
• reviewing OTP accreditation standards.

According to SAMHSA, the changes– which are part of President Biden’s National Drug Control Strategy – come at a time when fewer than one out of 10 Americans can access treatment for substance use disorder. SAMHSA will accept public comments on the proposed rule until Feb. 14, 2023.

NASHP Brief Highlights State Opioid Spending Plans

The National Academy for State Health Policy has released Understanding Opioid Settlement Spending Plans Across States: Key Components and Approaches, which highlights how states are implementing structures to disburse the more than $50 billion in opioid settlement funds awarded to them. Opioid settlement funds began pouring into states this year, including about $26 billion from a settlement that 46 states agreed to with Johnson & Johnson (J&J), AmerisourceBergen, Cardinal Health, and McKesson in July 2021. To understand common challenges and potential best practices for state leaders, NASHP engaged state leaders nationwide to understand both the structure and status of their current opioid settlement planning activities. NASHP is also analyzing governing materials and entities such as state legislation, opioid settlement agreements and spending plans, advisory committees, and other groups charged with disbursing state funding, which are referenced in NASHP’s tracker.

SAMHSA Releases Resource Highlighting Drug-Related ED Visits in 2021

SAMHSA has released Drug Abuse Warning Network (DAWN): Findings from Drug-Related Emergency Department Visits, 2021, an analysis of DAWN data with a variety of information for drug-related emergency department (ED) visits last year. The report highlights nationally representative weighted estimates, including percent and unadjusted rates per 100,000, for all drug-related ED visits; nationally representative weighted estimates for the top five drugs in drug-related ED visits; an assessment of trends and drugs involved in polysubstance ED visits in a subset of sentinel hospitals; and the identification of drugs new to DAWN’s Drug Reference Vocabulary.

Brookings Institution Releases Papers on Behavioral Health Integration and Youth Services

The Brookings Institution this week released two academic white papers related to behavioral healthcare: Making Progress on Integration of Behavioral Health Care and Other Medical Care and Meeting the Moment Children’s Mental Health: Recommendations for Federal Policy.   The first is a 10-page analysis of recent policy efforts in the nation’s evolving healthcare system, and the second paper seeks to clarify the potential sources of the persistent problems in mental illnesses in children. The 22-page youth services white paper also considers what tools the federal government should employ to address the crisis.

Reminder: Apply for HRSA Grants to Reduce Neonatal Abstinence Syndrome in Rural Settings

The Health Resources and Services Administration’s (HRSA) Federal Office of Rural Health Policy will invest $20 million in about 40 grants to reduce the incidence of neonatal abstinence syndrome (NAS) in the nation’s rural communities. According to HRSA’s announcement, grant recipients will collaborate with local, state, and regional stakeholders to provide coordinated, trauma-informed, and family centered behavioral and maternal healthcare services—including medication-assisted treatment—to rural pregnant and post-partum women and their families. Applicant organizations may be in either an urban or rural area; however, all activities supported by the program must exclusively occur in HRSA-designated, rural areas. HRSA will offer a webinar for applicants on Wednesday, Jan. 4, 2023 from 2 p.m. to 3 p.m. ET; registration is not required. The agency will accept applications through March 8, 2023.

Reminder: NABH 2023 Board Election Ballots Due Friday, Dec. 30 

NABH has e-mailed system members NABH Board of Trustees candidate profiles and a ballot to elect new members to the 2023 Board. If you have not done so, please vote for the open Board Chair-Elect position and one available Board seat; sign the ballot (it is not valid without a signature); and return it to NABH. You can do this by scanning your completed ballot and e-mailing it nabh@nabh.org or maria@nabh.org. NABH must receive all ballots no later than Friday, Dec. 30, 2022. New Board members and the Board Chair-elect will take office in January 2023.

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.

Save the Date for the NABH 2023 Annual Meeting!

Please mark your calendars and plan to join us in Washington, DC from June 12-14, 2023 for next year’s NABH Annual Meeting!

Fact of the Week

Fentanyl is now the leading cause of death for Americans between the ages of 18 and 49, according to a Washington Post analysis of death data for 2021 from the Centers for Disease Control and Prevention. For questions or comments about this CEO Update, please contact Jessica Zigmond.

CMS Proposes Electronic Prior Authorization for Providers and Payers

The Centers for Medicare & Medicaid Services (CMS) this week released a proposed rule that would require certain providers and payers to implement an electronic prior-authorization process, shorten the timeframe for payers to respond to prior-authorization requests, and work to make the prior-authorization process more efficient and transparent. An announcement from CMS said the proposed requirements would apply to Medicare Advantage (MA) organizations, state Medicaid and Children’s Health Insurance Program (CHIP) agencies, Medicaid managed care plans, CHIP managed care entities, and qualified health plan issuers on the federally facilitated exchanges. The agency estimates that these proposed policies could create efficiencies that would save physician practices and hospitals more than $15 billion over a 10-year period. The rule would automate essential prior-authorization functions related to documentation, requests, and decisions. Also, payers would be required to provide a clear reason for denials and to respond to urgent prior-authorization requests within 72 hours and standard requests within seven days. The proposed electronic platform is the already-established “Patient Access API,” which uses the Health Level 7^® format. The rule also would enhance patients’ access to their own information on prior- authorization requests, approvals, and related information by requiring online reporting of certain performance metrics. CMS is seeking information from stakeholders on the following topics:

• How to standardize data on patients’ social risk factors (e.g., housing instability, food insecurity) that influence patient health and health care utilization;
• How to advance electronic data exchange among behavioral health providers;
• How to improve the exchange of medical documentation between and among providers/suppliers and patients (for the purpose of care coordination);
• How to enable the connection of health information networks to advance cross-organization interoperability, such as the prior-authorization improvements in this rule, including incentives for payers; and
• Evidence-based policies that CMS could pursue to leverage health IT, data sharing, and interoperability to improve maternal health outcomes.

NABH will address these and the rule’s other key provisions in the association’s formal comments. CMS will publish the rule in the Federal Register on Dec. 13, 2022 and accept comments through March 13, 2023.

Biden Administration Launches Opioid Overdose Dashboard

The Biden Administration on Thursday unveiled a website featuring the Office of National Drug Control Policy’s (ONDCP) new Opioid Overdose Tracker to monitor non-fatal, opioid overdoses in the pre-hospital setting in an effort to prevent overdose deaths. Non-fatal overdoses are a good predictor of fatal overdoses, Biden administration officials said during a news briefing Wednesday according to Politico. People who experience at least one non-fatal overdose are about two to three times more likely to eventually die from one, they said. Earlier this year, the Centers for Disease Control and Prevention estimated that 80,816 Americans died from opioid overdoses in 2021, increasing from an estimated 70,029 in 2020. Using data submitted to the National Emergency Medical Services Information System (NEMSIS), the new dashboard contains one interactive page with a geo-surveillance view, and its data set includes all de-duplicated Emergency Medical Services (EMS) patient care reports for a rolling time period that meet specific inclusion criteria. In 2022, all 50 states, three territories (the Virgin Islands, Guam, and the Northern Mariana Islands), and Washington, D.C. had submitted data to the national database, according to NEMSIS. The NEMSIS Technical Assistance Center collects data from about 95% of all EMS agencies in the United States that respond to 911 requests for emergency care and transport patients to acute care facilities. According to a National Public Radio story, ONDCP Director Rahul Gupta, M.D. told reporters during a call that “We could see tens of thousands of additional lives saved” with the new tool, which Gupta said he hopes first responders, clinicians, and policymakers will use to connect people to care and also minimize response times and ensure that resources are available. NABH has advocated that the dashboard be updated in 2023 to use numbers at the state and county levels, as well as the national level.

New Report Shows Number of Patients Receiving Medications for Opioid Use Disorders in OTPs

Of the 512,224 patients in Opioid Treatment Programs (OTPs) who reported using medications for opioid use disorders (MOUDs), 476,763 reported using methadone, 33,473 reported buprenorphine, and the remaining 1,988 reported using naltrexone, according to a new report from the National Association of State Alcohol and Drug Abuse Directors (NASADAD). NASADAD partnered with the American Association for the Treatment of Opioid Dependence (AATOD) for the study, which was funded to determine the number of patients who receive MOUDs in OTPs, the types of federally approved medications that patients use in treatment, and the specific formulations of medication used among the patient population. Researchers analyzed data from 1,547 Opioid Treatment Programs (OTPs) nationwide that completed the survey, reflecting an 85-percent response rate. The Substance Abuse and Mental Health Services Administration funded the study through the agency’s Opioid Response Network.

MedPAC Discusses Draft Recommendations for 2024 Physician Payment Increases

The Medicare Payment Advisory Commission (MedPAC) this week discussed draft recommendations to increase the Medicare base payment rate for physician and other health professional services by 1.25% in 2024, a rate that is half of the forecasted increase in the Medicare Economic Index for 2024. Current law calls for no updates to 2024 payment rates relative to 2023 levels. The commission also discussed supporting a payment add-on for services for low-income Medicare beneficiaries (15% for primary care; 5% for non-primary care), which new Medicare spending would fund. The purpose of these items is to help maintain access to physician services for Medicare beneficiaries. Both measures received substantial support from the commissioners, and they are expected to be approved as formal recommendations to Congress when MedPAC convenes in January to vote on these and other Medicare payment adequacy recommendations for 2024.

HHS Highlights Progress to Mark One-Year Anniversary of HHS’ Overdose Prevention Strategy

Since the Biden administration released its Overdose Prevention Strategy a year ago, the number of healthcare providers with waivers to prescribe buprenorphine for opioid use disorder increased by 19% and the number of naloxone prescriptions filled in pharmacies has increased by 37%, HHS announced late last week. The announcements were made in conjunction with a news conference HHS Secretary Xavier Becerra held to mark the first anniversary of the Biden administration’s Overdose Prevention Strategy. During the news conference, Becerra highlighted some of the strategy’s recent actions, including an announcement from the Centers for Disease Control and Prevention (CDC) that state, local, and territorial awardees of the CDC Overdose Data to Action cooperative agreement can use a portion of their funds to purchase naloxone; and the U.S. Food and Drug Administration’s notice last month that certain naloxone products have the potential to be safe and effective for over-the-counter use.

HRSA to Invest $20 Million in Grants to Reduce Neonatal Abstinence Syndrome in Rural Settings

The Health Resources and Services Administration’s (HRSA) Federal Office of Rural Health Policy will invest $20 million in about 40 grants to reduce the incidence of neonatal abstinence syndrome (NAS) in the nation’s rural communities. According to HRSA’s announcement, grant recipients will collaborate with local, state, and regional stakeholders to provide coordinated, trauma-informed, and family centered behavioral and maternal healthcare services—including medication-assisted treatment—to rural pregnant and post-partum women and their families. Applicant organizations may be in either an urban or rural area; however, all activities supported by the program must exclusively occur in HRSA-designated, rural areas. HRSA will offer a webinar for applicants on Wednesday, Jan. 4, 2023 from 2 p.m. to 3 p.m. ET; registration is not required. The agency will accept applications through March 8, 2023.

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.

Save the Date for the NABH 2023 Annual Meeting!

Please mark your calendars and plan to join us in Washington, DC from June 12-14, 2023 for next year’s NABH Annual Meeting!

Fact of the Week

A new study published in The Lancet Psychiatry found that people with severe mental illness have an elevated risk for several chronic health problems even before they receive their first diagnosis of a severe mental illness. For questions or comments about this CEO Update, please contact Jessica Zigmond.

Senate Finance Committee Releases ‘Fifth and Final’ Mental Health Parity Discussion Draft

Senate Finance Committee leaders on Thursday released what they said is their fifth and final legislative mental health parity discussion draft in their effort to place access to behavioral healthcare on par with physical healthcare in Medicare and Medicaid.   Previous iterations of the draft were released in May, June, September, and November this year. Policies in the final draft include: strengthening the accuracy of provider directories in Medicare Advantage plans; strengthening requirements in Medicaid for managed care organizations and states to maintain regularly updated provider directories that include, in part, information on accessing care from behavioral health professionals; directing the Government Accountability Office (GAO) to conduct a study of the differences in enrollee cost-sharing and utilization management between behavioral and non-behavioral health services in Medicare Advantage and compared with traditional Medicare; requiring Medicare to provide guidance to health care providers detailing the extent to which Medicare beneficiaries with substance use disorders can receive partial hospitalization program services; and directing GAO to report on Medicaid payment rates for behavioral health services compared to medical and surgical services across a sample of states. “Too often the notion of mental health parity falls short of reality,” Senate Finance Committee Chairman Ron Wyden (D-Ore.) said in an announcement about the discussion draft. “These policies represent the first step towards addressing the mental health parity and ghost network challenges that I intend to build on in the coming months—especially the challenges I hear about consistently from families at home who aren’t able to find available mental health professionals covered in their insurance networks,” he added.

HHS Releases Proposed Rule to Revise 42 CFR Part 2 Regulations

The U.S. Health and Human Services Department (HHS) this week released a proposed rule to revise regulations known as 42 CFR Part 2, or “Part 2,” which protect the confidentiality of substance use disorder (SUD) treatment records. Specifically, Part 2 protects “records of the identity, diagnosis, prognosis, or treatment of any patient which are maintained in connection with the performance of any program or activity relating to substance abuse education prevention, training, treatment, rehabilitation, or research, which is conducted, regulated, or directly or indirectly assisted by any department or agency of the United States.”  The protections are meant to address concerns that discrimination and fear of prosecution deter people from entering treatment for SUD. The rule proposes a host of revisions, including, but not limited to: permitting Part 2 programs to use and disclose Part 2 records based on a single prior consent signed by the patient for all future uses and disclosures for treatment, payment, and healthcare operations; permitting the redisclosure of Part 2 records as permitted by the Health Insurance Portability and Accountability Act (HIPAA) privacy rule by recipients that are Part 2 programs, HIPAA-covered entities, and business associates, with certain exceptions; and expanding prohibitions on using and disclosing Part 2 records in civil, criminal, administrative, or legislative proceedings conducted by a federal, state, or local authority against a patient, absent a court order or the consent of the patient. HHS released a summary of the proposed rule’s provisions and will accept comments for up to 60 days after the proposed rule is published in the Federal Register.

DEA Lab Testing Reveals 6 out of 10 Fentanyl-Laced, Fake Prescription Pills Contain a Potentially Lethal Dose of Fentanyl

The Drug Enforcement Administration (DEA) this week alerted the public of a sharp rise nationwide in the lethality of fentanyl-laced, fake prescription pills.   In a public safety alert, the agency said the DEA laboratory found that of the fentanyl-laced, fake prescription pills analyzed in 2022, six out of 10 contained a potentially lethal dose of fentanyl. This is an increase from DEA’s previous announcement in 2021 that four out of 10 fentanyl-laced fake prescription pills were found to contain a potentially lethal dose. According to the alert, the pills are largely made by two Mexican drug cartels, the Sinaloa Cartel and the Jalisco (CJNG) Cartel, to look identical to real prescription medications, including OxyContin®, Percocet®, and Xanax®, and they are often deadly. In 2021, the DEA seized more than 20.4 million fake prescription pills, and earlier this year, the DEA conducted a nationwide operational surge to target the trafficking of fentanyl-laced fake prescription pills and, seized 10.2 million fake pills in all 50 states in just more than three months. The DEA’s One Pill Can Kill campaign alerts the American public of the dangers of fake prescription pills.

NIDA Director Volkow Calls for Dismantling Stigma at Intersection of HIV and Meth Use 

In her blog post to commemorate World Aids Day on Thursday, Dec. 1, National Institute on Drug Abuse (NIDA) Director Nora Volkow, M.D. promoted NIDA’s video “Sex, Meth and HIV,” to emphasize that in order to end the HIV epidemic it is important to recognize and respect both the complexity and needs of sexual and gender minorities who use drugs. “Like other drugs, methamphetamine may help individuals cope with mental health challenges like depression, anxiety, and trauma,” Volkow wrote. “Some gay and bisexual men use methamphetamine to enhance sexual experience and sense of connectedness,” she added. “It can also temporarily boost self-confidence among individuals who may experience stigma and shame surrounding sexuality or other aspects of their lives.” Volkow referenced a 2020 study in the Journal of Acquired Immune Deficiency Syndromes (JAIDS), which showed that a third of new HIV transmissions among sexual and gender minorities who have sex with men were in people who regularly use methamphetamine.   On a related note, at a conference in Boston last month, Volkow said American physicians should “absolutely” be allowed to prescribe methadone to their patients. “There’s absolutely no reason why not,” Volkow said, according to a story in STAT. “There are countries where physicians are providing methadone, and the outcomes are actually as good as those they get [at] methadone clinics.”

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.

Save the Date for the NABH 2023 Annual Meeting!

Please mark your calendars and plan to join us in Washington, DC from June 12-14, 2023 for next year’s NABH Annual Meeting! Fact of the Week The likelihood that someone with serious mental illness will be the victim of a violent crime is 11.8 higher when compared with the general public. For questions or comments about this CEO Update, please contact Jessica Zigmond.

HHS Announces $350 Million Initiative to Boost Covid-19 Vaccinations

The U.S. Health and Human Services Department’s (HHS) Health Resources and Services Administration (HRSA) on Tuesday announced a $350 million initiative for HRSA-supported health centers to increase Covid-19 vaccinations in their communities, with a specific focus on underserved populations. The funding will help health centers provide Covid-19 vaccines through mobile, drive-up, walk-up, or community-based vaccination events, including working with community-based organizations and other efforts to increase administering Covid-19 vaccines. According to HHS, health centers have administered more than 22 million vaccines in underserved communities nationwide, of which 70% to patients of racial and ethnic minorities.

Study Shows Shortage of Mental Healthcare Providers Associated with Higher Youth Suicide Rate

Counties with a shortage of mental healthcare providers were connected to higher rates of youth suicide, researchers reported this week in JAMA Pediatrics. The study noted that that while the findings are based on data from 2015 and 2016, the report comes at a time with the number of Americans living in areas with a shortage of mental health professionals is growing. Federal data show more than 150 million people live in such areas. Meanwhile, researchers initially found that counties with provider shortages had a 41% higher youth suicide rate: 5.09 per 100,000 youths compared with 3.62 per 100,000 in counties without shortages. And when the researchers controlled for socioeconomic and other confounding factors—rural and high-poverty areas are known to have higher suicide rates—they still found that living in a county with a shortage of mental health workers was associated with a 16% higher youth suicide rate. “Strategies to ameliorate mental health professional workforce shortages…. may be considered in comprehensive youth suicide prevention programs,” the authors concluded.

NABH and Other Groups Urge Congress to Support Medicare Mobile Crisis Intervention Benefit

NABH is one of more than 50 organizations that sent a letter to House and Senate leaders urging the federal lawmakers to include a mental health crisis intervention benefit in the Medicare program in Congress’ end-of-year legislative package. The organizations represent mental health and substance use treatment providers, crisis centers, family members, advocates, justice-focused organizations, and payers committed to strengthening access to mental healthcare and substance use treatment. The letter explains that in the most recent discussion draft on Integration, Coordination, and Access to Care, the Senate Finance Committee included a key provision of payment for mobile crisis response intervention services under the Physician Fee Schedule, which would add this benefit to the Medicare program. Mobile crisis teams include mental health professionals and individuals who provide peer-support services who are trained to de-escalate a situation and help the individual connect with services and supports.   “Since its launch in July, calls to the 988 Lifeline increased exponentially even more than predicted in SAMHSA’s December 2020 capacity report to Congress. Data from September 2022 vs. September 2021 show calls answered increased by 40%, chats answered increased by 218%, and texts answered increased by 1153%,” the letter said. “While one-time grant funds are helpful to initiate programs, they are not sufficient to sustain them, especially in light of increasing demand,” the letter continued. “In 2021, Congress provided incentives to states to increase Medicaid coverage of mobile crisis teams. Now, it should allow a mobile crisis intervention benefit in Medicare.”

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.

Save the Date for the NABH 2023 Annual Meeting!

Please mark your calendars and plan to join us in Washington, DC from June 12-14, 2023 for next year’s NABH Annual Meeting!

Fact of the Week

Researchers have identified variations in 10 genes that significantly raise the risk for schizophrenia—information that could help identify new treatment targets, according to the National Institutes of Health, which funded one of the largest genetic studies of its kind.

Happy Thanksgiving from NABH!

The NABH staff wishes its members and their families a very happy, healthy, and safe Thanksgiving! For questions or comments about this CEO Update, please contact Jessica Zigmond.

News Reports Signal HHS Will Extend Covid-19 PHE Through April 2023

Several news outlets have reported that the U.S. Health and Human Services Department (HHS) intends to extend the existing Covid-19 Public Health Emergency (PHE) through April 2023. The current PHE—which has been extended many times since 2020—is effective through Jan. 11, 2023.

FDA Announces Preliminary Assessment of Certain Naloxone Products for Over-the-Counter Use

The U.S. Food and Drug Administration (FDA) this week issued a Federal Register notice that includes the agency’s preliminary assessment that certain naloxone drug products—up to 4 milligrams (mg) nasal spray and up to 2 mg autoinjector for intramuscular (IM) or subcutaneous (SC) use—may be approvable as safe and effective for nonprescription use. In its announcement about the notice, FDA said this move is “intended to facilitate both the development and approval of nonprescription naloxone products; however, it is not a final determination that certain naloxone drug products are safe and effective for nonprescription use, and it does not mandate an immediately effective switch to nonprescription/over-the-counter (OTC) availability for naloxone.” The announcement also said the FDA needs additional data, such as product-specific data on the nonprescription user interface design, including packaging and labeling, before it makes its final determination.

CMS Releases Medicaid and CHIP Access Data Brief

The Centers for Medicare & Medicaid Services (CMS) this week released a data brief that includes a snapshot of selected metrics in three essential dimensions of Medicaid and Children’s Health Insurance (CHIP) access. Culling data from various sources, CMS developed the brief to show access to Medicaid and CHIP coverage, measured by enrollment and retention; access to services, with a focus on mental health conditions and substance use disorders; and perceived access, measured by beneficiary experiences in managed care.

SAMHSA’s GAINS Center to Host Webinar About Project ECHO and SUD on Nov. 21

The Substance Abuse and Mental Health Services Administration’s (SAMHSA) GAINS Center on Monday, Nov. 21 will host “Black Robes and White Coats: Using Project ECHO to Increase Judiciary Knowledge about Substance Use Disorder,” a webinar that will provide an overview of the pilot Project ECHO for the Judiciary. The purpose of Project ECHO for the Judiciary is for participating judges to learn about treatments for opioid disorder and develop a better understanding of substance use disorders to help inform their decisions in the courtroom. The webinar will begin at 2:30 p.m. ET on Monday. Click here to register.

FDA to Host Stakeholder Call About Naloxone Access on Nov. 28

The top leaders at FDA and SAMHSA will host a stakeholder call on Monday, Nov. 28 to discuss naloxone access and harm reduction. FDA Commissioner Robert Califf, M.D. and Marta Sokolowska, deputy center director for substance use and behavioral health in FDA’s Center for Drug Evaluation and Research, will lead the call, and SAMHSA Assistant Secretary for Mental Health and Substance Use Miriam Delphin-Rittmon, Ph.D. will participate. “Every person who experiences an opioid overdose, whether it is with prescribed medication or an illicit drug, should have access to naloxone,” FDA said in its announcement about the call. “Entities such as harm-reduction programs help save lives by making naloxone available in underserved communities,” it continued. “The agency intends to stand by these efforts by supporting their ability to acquire FDA-approved naloxone products, and we recently issued the guidance, Exemption and Exclusion from Certain Requirements of the Drug Supply Chain Security Act (DSCSA) for the Distribution of FDA-Approved Naloxone Products During the Opioid Public Health Emergency,” it said, adding that FDA recognizes this action alone is not enough and that there is more work to do. The hourlong Zoom call will begin at 2:30 p.m. ET. Click here to register.

Reminder: Please Submit Data to Enhance NABH’s Managed-Care Advocacy Efforts

Thank you to all members who have already submitted your 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.

Save the Date for the NABH 2023 Annual Meeting!

Please mark your calendars and plan to join us in Washington, DC from June 12-14, 2023 for next year’s NABH Annual Meeting!

Fact of the Week

Demand for anxiety and depression treatment remains high for the third consecutive year, and 60% of practitioners report they no longer have openings for new patients, according to the American Psychological Association’s 2022 Covid19 Practitioner Impact Survey. For questions or comments about this CEO Update, please contact Jessica Zigmond.

CMS Releases Final Physician Fee Schedule and OPPS Rules for 2023 

Telehealth services authorized temporarily during the Covid-19 public health emergency (PHE) will extend through at least 2023 and for at least 151 days after the PHE ends, the Centers for Medicare & Medicaid Services (CMS) announced in the agency’s final 2023 Physician Fee Schedule (PFS) this week. CMS’ decision to extend the telehealth services benefit will allow for additional data collection to evaluate a possible permanent addition as a Medicare benefit. CMS issued the regulation on the same day it released the final Outpatient Prospective Payment System (OPPS) rule for next year. In that regulation, CMS implemented a 4.1% payment increase for outpatient facilities in 2023. Please read below for additional details about the final regulations. 2023 Physician Fee Schedule Final Rule: The PFS final rule directs CMS to implement an approximately 4.5-percent reduction—reflecting a decrease of $1.55— in the conversion factor, which the agency uses to calculate payments for physicians and the other clinicians paid under the PFS. CMS also updated the payment amount for the drug component of the opioid treatment bundle using the Producer Price Index (PPI) for Pharmaceuticals for Human Use and will do so annually to account for inflation. CMS will also modify the payment rate for the non-drug bundle to base the rate on a 45-minute –rather than a 30-minute—session, which better comports with OTP practices. Under the final rule, OTPs may also use audio-visual and audio-only telehealth for buprenorphine intake if the Substance Abuse and Mental Health Services Administration (SAMHSA) and the Drug Enforcement Administration (DEA) grant permission. Also pending authorization from SAMHSA and DEA, OTPs may furnish periodic assessments via audio-only when video is not available for the duration of 2023. CMS also made final billing for mobile units in accordance with SAMHSA and DEA guidance. Locality adjustments will be applied and based on the location of the OTP hub. Meanwhile, the PFS final rule implements an exception to supervision requirements to allow marriage and family therapists, licensed professional counselors, addiction counselors, certified peer recovery specialists, and others to provide behavioral healthcare services while under general supervision, rather than “direct” supervision. This means practitioners now will be able to provide services without requiring that a physician or nurse practitioner be present on site. Responding to comments from the behavioral healthcare field, CMS also made final a new behavioral health integration service that a clinical psychologist or clinical social worker can perform when mental health services are the focal point of care integration, along with allowing a psychiatric diagnostic evaluation to initiate such integration services. CMS also made final several provisions related to accountable care organizations to grow participation in the program, incorporate recent lessons related to episode payment approaches, and advance equity among program participants. Outpatient Prospective Payment System Final Rule: Although the 4.1% payment increase for outpatient services is larger than CMS had proposed, NABH does not consider this payment update adequate to address the intense cost pressures—stemming from considerable increases in labor, supplies, equipment, drugs, and other expenses—that the association had highlighted. Regarding payments for 340B hospitals, the final OPPS rule ends the cuts that the U.S. Supreme Court found to be unlawful. Per the high court’s ruling, 340B payments in 2023 will return to pre-2018 levels: the average sale price plus 6% with an offsetting reduction to make the measure budget neutral, as required by law. The final rule falls short of reimbursing 340B payment cuts from previous years. NABH expects additional 340B rules from CMS by the summer of 2023. Both the PFS and OPPS final rules will take effect Jan. 1, 2023. NABH and Other Organizations Urge Federal Appropriators to Include Behavioral Health Funding in Continuing Resolution NABH and a dozen other behavioral health organizations on Friday send a letter to House and Senate appropriators requesting that federal lawmakers include appropriate funding levels for behavioral health treatment in the upcoming Continuing Resolution (CR) to keep the federal government operating. Specifically, NABH and the other organizations—including the American Psychiatric Association, the American Psychological Association, Mental Health America, the National Association of State Mental Health Program Directors— requested that Congress include $1.42 billion for the Community Mental Health Block Grant (MHGB), including a 10% set-aside for mental health crisis services within the MHGB; $60 million to expand the Mental Health Crisis Response Partnership Pilot Program; $747 million for the 988 behavioral health crisis hotline, including $30 million to provide specialized services for LGBTQ+ youth; $400 million for Certified Community Behavioral Health Clinics; and $10 million for the Behavioral Health Crisis 988 Coordinating Office. “Additional federal investments are needed to strengthen the 988 system to transform how our country responds to people in crisis,” the organizations wrote in the letter. “A continuing resolution of any length threatens our ability to meet the high and growing need for behavioral health treatment and care.”

SAMHSA to Host Webinar About CCBHC Certification Criteria Next Week

SAMHSA will host a webinar open to the public next Wednesday, Nov. 9 regarding updates to the Certified Community Behavioral Health Clinic (CCBHC) certification criteria. SAMHSA will provide a brief overview of CCBHCs, describe key elements of certification criteria and SAMHSA’s process for soliciting feedback from the field, and discuss how the public can provide feedback. The Zoom webinar will begin at 4 p.m. ET. The meeting ID is 160 306 8999 and the passcode is 160547.

SAMHSA Names Jennifer Fan as Director of Center for Substance Abuse Prevention

SAMHSA this week named Capt. Jennifer Fan, Pharm.D., J.D. as the acting director of the agency’s Center for Substance Abuse Prevention (CSAP). A commissioned officer in the U.S. Public Health Service, Fan served in SAMHSA from 2007 through 2021 in several roles, including acting CSAP deputy director, special assistant for the CSAP director, and CSAP’s subject matter expert on opioids and prescription drug misuse. She also served as the senior editor for the Surgeon General’s Spotlight on Opioids Report and helped to create SAMHSA’s Strategic Prevention Framework for Prescription Drugs (SPF Rx) grants and the Grants to Prevent Prescription Drug/Opioid Overdose-Related Deaths (PDO). Fan earned her doctorate in pharmacy from the University of Maryland School of Pharmacy and her law degree from the University of Baltimore School of Law.

SAMHSA Introduces ‘Screen 4 Success’ to Help Parents and Caregivers Understand Wellbeing of Children

SAMHSA recently announced Screen4Success, a new screening tool from the agency’s “Talk. They Hear You.” national prevention campaign that can help parents and caregivers better understand children’s health, wellness, and wellbeing, and find resources to address needs. Parents and caregivers can access the new tool on mobile devices through the Talk. They Hear You. campaign mobile app, which is available for free on the App Store, Google Play, and Microsoft store.

Enhanced NABH Denial-of-Care Portal is Now Available

NABH recently made enhancements to its Denial-of-Care Portal that are intended to make the portal easier for members to use. A year ago, NABH developed the Denial-of-Care Portal to collect specific data on insurers who deny care—often without regard to parity or the effects on patients. Now the association has updated this resource to make it more user-friendly for members and also more aligned with what regulators need to identify parity violations. The updated portal includes fewer questions, which will require less time for members to complete. In addition, all questions are now optional. NABH hopes this will make it more likely for members to share the data they have. Lastly, NABH has added a checklist of “red flags” that were included in the 2022 MHPAEA Report to Congress from the U.S. Health and Human Services, Labor, and Treasury Departments in January. Please e-mail Emily Wilkins, NABH’s administrative coordinator, if you have questions about the portal.

Save the Date for the NABH 2023 Annual Meeting!

Please mark your calendars and plan to join us in Washington, DC from June 12-14, 2023 for next year’s NABH Annual Meeting!

Fact of the Week

Fifty-three percent of those polled said the new 988 behavioral health crisis hotline will be effective to keep people in crisis out of jail, with Black (64%) and Hispanic (54%) adults more optimistic, the American Psychiatric Association reports. For questions or comments about this CEO Update, please contact Jessica Zigmond.

GAO Report Identifies Challenges and Opportunities to Recruit and Retain Behavioral Health Workforce

Financial, educational, and workplace challenges are three categories that pose the greatest challenges to recruiting and retaining behavioral health providers, the Government Accountability Office (GAO) concluded in a new report. The GAO was assigned to review what is known about the behavioral health workforce, offer information regarding both barriers to and incentives for recruiting and retaining providers, and identify what actions various U.S. Health and Human Services department (HHS) agencies are taking to recruit and retain these providers. In its comprehensive review, the GAO interviewed NABH staff as a stakeholder group. “Reimbursement rates and compensation for behavioral health services are low, according to stakeholders from multiple research organizations and behavioral health associations,” the report noted, adding that many programs designed to recruit diverse behavioral health providers only benefit individuals already studying in a behavioral health field and do not address the lack of a pipeline for underserved populations to enter the workforce. The GAO recommended that incentives such as loan repayment and scholarships for students seeking behavioral healthcare professions could help to address some of the barriers to entering the field. Learn more in highlights from the study and the full report.

HHS and U.S. Surgeon General’s Office to Host Mental Health Briefing Monday, Oct. 31

HHS and the U.S. Surgeon General’s office will host a briefing on Monday, Oct. 31 to discuss the Surgeon General’s Framework for Workplace Mental Health & Well-being, which will outline the foundational role that workplaces should play in promoting the health and well-being of workers and communities. The briefing will highlight the five essentials for workplace mental health and is intended to help organizations develop, institutionalize, and update policies, processes, and practices that best support the mental health and well-being of all workers. Click here to register for the 30-minute briefing, which will begin at 1:30 p.m. ET.

Commonwealth Fund Study Examines How Changing Opioid Addiction Treatment Delivery Could Reduce Death and Suffering

A new study from the Commonwealth Fund analyzes how government regulation and inadequate treatment capacity can limit patients’ access to lifesaving care and what policymakers could do to help combat opioid addiction. According to the report’s findings, opioids are involved in almost 75% of overdose deaths in the United States, which claim more than 100,000 lives per year. But while opioid addiction can be treated with effective medications, only 10% to 15% of U.S. residents with opioid use disorder receive them. “During Covid-19, the federal government showed flexibility by allowing OTPs (opioid treatment programs) to provide more take-home methadone doses, allowing buprenorphine treatment initiation via telehealth, and removing buprenorphine waiver training requirements for providers treating 30 or fewer patients,” the report noted. “Data indicate that methadone take-home flexibilities have not been associated with worse outcomes or significant misuse, and telehealth services have been associated with improved medication retention and lower overdose risk,” it continued. “Some of these provisions are temporary and could sunset or change after the COVID-19 public health emergency ends.”

CMS Administrator Brooks-LaSure to Host Webinar Next Week on CMS’ Strategic Plan

Centers for Medicare & Medicaid Services (CMS) Administrator Chiquita Brooks-LaSure and her leadership team will provide an update on the agency’s strategic plan next Tuesday, Nov. 1. This is the agency’s fourth national stakeholder call with the administrator this year, and it’s intended to provide an opportunity for stakeholders to learn how they can partner with CMS to implement the agency’s strategic plan. The hourlong call will begin next Tuesday at 3 p.m. ET. Click here to register.

SAMHSA to Host Behavioral Health Services Information Virtual Workshop on Nov. 2

SAMHSA will host a virtual workshop next week to help providers learn how to access the agency’s available data on Behavioral Health Services Information System (BHSIS) and online treatment locator. Herman Alvarado, a supervisory social science analyst at SAMHSA’s Center for Behavioral Health Statistics and Quality, will provide an overview for participants. The event is intended to provide technical assistance to National Network to Eliminate in Behavioral Health (NNED) members and minority-service and under-resourced community-based organizations. The 90-minute virtual workshop will begin at 3 p.m. next Wednesday, Nov. 2. Click here to register.

NIH’s HEAL Initiative Highlights Examples of Successful Programs to Prevent and Treatment Opioid Misuse and Addiction

The National Institutes of Health’s (NIH) Helping to End Addiction Long-term, or HEAL, initiative— a trans-NIH research effort focused on improving prevention and treatment for opioid misuse and addiction and enhancing pain management—recently released examples of programs that have helped some of the youngest patients battling opioid misuse or addiction. HEAL funds more than 1,000 research projects in every U.S. state and is a $2.5 billion effort that has grown substantially this year, adding 10 new programs and more than 200 new projects that are seeking scientific solutions to prevent overdose and connect people to treatment for pain and addiction. Click here to learn about some innovative programs related to mobile apps.

Enhanced NABH Denial-of-Care Portal is Now Available

NABH recently made enhancements to its Denial-of-Care Portal that are intended to make the portal easier for members to use. A year ago, NABH developed the Denial-of-Care Portal to collect specific data on insurers who deny care—often without regard to parity or the effects on patients. Now the association has updated this resource to make it more user-friendly for members and also more aligned with what regulators need to identify parity violations. The updated portal includes fewer questions, which will require less time for members to complete. In addition, all questions are now optional. NABH hopes this will make it more likely for members to share the data they have. Lastly, NABH has added a checklist of “red flags” that were included in the 2022 MHPAEA Report to Congress from the U.S. Health and Human Services, Labor, and Treasury Departments in January. Please e-mail Emily Wilkins, NABH’s administrative coordinator, if you have questions about the portal. Save the Date for the NABH 2023 Annual Meeting!  Please mark your calendars and plan to join us in Washington, DC from June 12-14, 2023 for next year’s NABH Annual Meeting!

Fact of the Week

By 2030, HHS’ Health Resources and Services Administration (HRSA) estimates a 20% decrease in the supply of adult psychiatrists to 27,020, while the agency estimates a 22% increase in the supply of child and adolescent psychiatrists to 9,830. For questions or comments about this CEO Update, please contact Jessica Zigmond.

MHA Releases ‘State of Mental Health in America’ Report for 2023

More than 50 million Americans experienced a mental illness between 2019 and 2020, while more than one in 10 youth in the United States experience depression that is severely impairing their ability to function at school or work, at home, with family, or in their social life, according to a new report from Mental Health America (MHA). The State of Mental Health in America is a nearly 40-page chartbook that provides a baseline to answer some questions about how many people in America need and have access to mental health services. The report is a companion piece to interactive data available on MHA’s website. Using publicly available data from the 50 states and Washington, D.C., MHA used a set of 15 measures, such as adults with any mental illness, adults with thoughts of suicide, and youth with substance use disorder in the last year. MHA noted that the Covid-19 pandemic negatively affected the ability to collect data for national surveillance in 2020; consequently, the indicators in this year’s report cannot be compared with previous years. The findings also reported that the majority of individuals with a substance use disorder in the U.S. are not receiving treatment, and that there are about 350 individuals for every one mental healthcare provider in the United States.

SAMHSA Announces $15 Million in Early 2023 for CCBHCs

The Substance Abuse and Mental Health Services Administration (SAMHSA) this week announced it will award $15 million early next year to expand access to planning grants for certified community behavioral health clinics (CCBHCs) to all 50 states. This funding—along with the $300 million that SAMHSA awarded in September for both new and existing CCBHCs—comes from the Bipartisan Safer Communities Act that President Biden signed in June.

CMS Releases FAQs About Medicaid and CHIP Determinations and Renewals After PHE Ends

The Centers for Medicare & Medicaid Services on Oct. 17 answers to frequently asked questions about the agency’s March 2022 guidance to states regarding planning efforts to resume Medicaid and Children’s Health Insurance Program (CHIP) eligibility determinations and renewals after the Covid-19 public health emergency ends. The FAQs address the unwinding period, renewals and changes in circumstances, non-MAGI ex parte renewals, section 1902(e)(14)(A) waivers, premiums, fraud, and more.

New Reports Examine Telehealth Laws & Medicaid Policies and Trauma & Recovery for Youth

The Center for Connected Health Policy (CCHP) this week released its Fall 2022 summary of telehealth laws and Medicaid program policies, which allows users to export data for each state into a PDF document. CCHP provides bi-annual summary reports to provide a snapshot of the progress made in the past six months. Also this week, the National Child Traumatic Stress Network released A Trauma-Informed Guide for Working with Youth in Multiple Settings, which is intended for people who work with youth involved in multiple systems (YIMS) and their families to use a traumatic stress perspective and provide trauma-informed care. The report defines YIMS as children and adolescents who are under the care or supervision of multiple child and family-serving systems. They include “crossover youth” or “dually involved youth” who are involved in child welfare (CW) and in the juvenile justice (JJ) system. In addition to CW and JJ involvement, YIMS are also often simultaneously involved in an array of other service systems including immigration, legal, education, family services, physical and behavioral health systems and systems designed to serve those with developmental disabilities or who experience homelessness.

Register Today for Oct. 27 Webinar on CPT Coding and Billing Changes for Mental Health in 2023

The Association for Behavioral Health and Wellness, the American Psychological Association, and the American Psychiatric Association will host a webinar about what to expect in CPT coding and billing changes for mental health in 2023 on Thursday, Oct. 27. Stephen Gillaspy, Ph.D., senior director of health and healthcare financing at the American Psychological Association, will lead the presentation about the Centers for Medicare and Medicaid Services’ (CMS) proposed changes outlined in the agency’s 2023 physician fee schedule proposed rule. The webinar will focus on new CPT codes and changes to existing codes, expanding the outpatient Evaluation and Management (E/M) documentation guidelines to the facility setting, and other CMS proposals, such as “incident to” billing that, if implemented, will have a significant effect on mental and behavioral clinicians beginning Jan.  1, 2023. The hourlong webinar will begin at 12:30 p.m. ET. Click here to register.

Enhanced NABH Denial-of-Care Portal is Now Available

NABH recently made enhancements to its Denial-of-Care Portal that are intended to make the portal easier for members to use. A year ago, NABH developed the Denial-of-Care Portal to collect specific data on insurers who deny care—often without regard to parity or the effects on patients. Now the association has updated this resource to make it more user-friendly for members and also more aligned with what regulators need to identify parity violations. The updated portal includes fewer questions, which will require less time for members to complete. In addition, all questions are now optional. NABH hopes this will make it more likely for members to share the data they have. Lastly, NABH has added a checklist of “red flags” that were included in the 2022 MHPAEA Report to Congress from the U.S. Health and Human Services, Labor, and Treasury Departments in January. Please e-mail Emily Wilkins, NABH’s administrative coordinator, if you have questions about the portal.

Save the Date for the NABH 2023 Annual Meeting!

Please mark your calendars and plan to join us in Washington, DC from June 12-14, 2023 for next year’s NABH Annual Meeting!

Fact of the Week

More seniors in 2022 (28%) than in 2021 (20%) said the cost of care affected their ability to seek treatment for a mental health condition, according to a survey of seniors that the Pan Foundation conducted in May 2022. For questions or comments about this CEO Update, please contact Jessica Zigmond.

NABH 2023 Board Position Nominations Due Today!

The deadline to submit nominations for the 2023 NABH Board Chair-Elect and two available NABH Board seats is today, Friday, Oct. 14. The NABH Selection Committee is seeking senior managers who represent the association’s diverse membership related to levels of care, organizational structures, and size. Please download a nomination form to recommend individuals for the single-slate ballot in 2023. Also, please attach a curriculum vitae (CV) for every individual you recommend. This will help the Selection Committee in its deliberations. All NABH members are welcome to suggest themselves. Please return this form and candidates’ curricula vitae by Friday, Oct. 14, 2022, to maria@nabh.org.

Becerra Extends Covid-19 PHE for Another 90 Days

HHS Secretary Xavier Becerra on Thursday renewed the Covid-19 public health emergency (PHE) for an additional 90 days. Former HHS Secretary Alex Azar declared the Covid-19 PHE for the first time in January 2020 Since then, it has been renewed—either by Azar or Becerra— 10 times, making this week’s announcement the 11^th renewal.

Bipartisan Policy Center Recommends Extending Medicare Telehealth Benefits for Two Years Post Pandemic

Congress and the Biden administration should extend most of the Medicare program’s telehealth flexibilities for beneficiaries for two years after the Covid-19 pandemic ends and then evaluate the effects, the Bipartisan Policy Center (BPC) recommended in a report released this week. And that’s for a start. The report—totaling more than 80 pages—also concluded that researchers should evaluate the benefits of hybrid (both in-person and virtual) care models for primary and specialty care, including for which conditions and specialties it is most effective; further evaluate full telehealth flexibilities in the context of value-based payment models; and assess rigorously the quality of audio-only care. “Throughout this report, BPC recommends targeted adjustments to the current telehealth flexibilities; all recommended changes are in response to emerging evidence on benefits versus risks and to stakeholder concerns,” the researchers noted. “This approach would enable beneficiaries to maintain their access to telehealth services while minimizing risks to patients and the Medicare program, as well as provide time for policymakers to continue to review and assess the evidence.”

ONDCP to Host Webinar About Low-Threshold Buprenorphine on Monday, Oct. 17

The White Office of National Drug Control Policy (ONDCP) will host a webinar on Monday, Oct. 17 to examine low-threshold buprenorphine programs, which seek to reduce barriers that often limit access or reduce retention in care. ONDCP Director Rahul Gupta, M.D. will welcome participants to the webinar, which will feature evidence from experts in the field and include a panel discussion about policy and practice. The webinar will be held from 1 p.m. – 3 p.m. ET. Click here to register.

Register Today for Webinar on CPT Coding and Billing Changes for Mental Health in 2023

The Association for Behavioral Health and Wellness, the American Psychological Association, and the American Psychiatric Association will host a webinar about what to expect in CPT coding and billing changes for mental health in 2023 on Thursday, Oct. 27. Stephen Gillaspy, Ph.D., senior director of health and healthcare financing at the American Psychological Association, will lead the presentation about the Centers for Medicare and Medicaid Services’ (CMS) proposed changes outlined in the agency’s 2023 physician fee schedule proposed rule. The webinar will focus on new CPT codes and changes to existing codes, expanding the outpatient Evaluation and Management (E/M) documentation guidelines to the facility setting, and other CMS proposals, such as “incident to” billing that, if implemented, will have a significant effect on mental and behavioral clinicians beginning Jan.  1, 2023. The hourlong webinar will begin at 12:30 p.m. ET. Click here to register.

JAMA Pediatrics Examines Continued Rise of Unintentional Ingestion of Edible Cannabis in Toddlers

An analysis in JAMA Pediatrics this week concluded that immediate action should be taken to alter the current trajectory of unintentional pediatric ingestion of edible cannabis products. The article noted that cannabis is the third most used psychoactive substance worldwide, with use continuously rising in the U.S. adult population. Meanwhile, cannabis products are used commonly and stored in homes in which children are present and education from healthcare professionals about safe storage is lacking, the article continued. Consequently, children are at risk of being drawn to THC (tetrahydrocannabinol, the psychoactive compound of marijuana)-infused products that resemble their favorite snacks or candy. “Children with THC intoxication can present with neurologic impairment, including lethargy, ataxia, tachycardia, mydriasis, seizures, altered mental status, and hypotonia,” the article said. “However, given the unpredictability of the dose ingested, patient presentation can vary. Altered mental status in children results in broad differential diagnoses ranging from traumatic to infectious causes.”

Enhanced NABH Denial-of-Care Portal is Now Available

NABH recently made enhancements to its Denial-of-Care Portal that are intended to make the portal easier for members to use. A year ago, NABH developed the Denial-of-Care Portal to collect specific data on insurers who deny care—often without regard to parity or the effects on patients. Now the association has updated this resource to make it more user-friendly for members and also more aligned with what regulators need to identify parity violations. The updated portal includes fewer questions, which will require less time for members to complete. In addition, all questions are now optional. NABH hopes this will make it more likely for members to share the data they have. Lastly, NABH has added a checklist of “red flags” that were included in the 2022 MHPAEA Report to Congress from the U.S. Health and Human Services, Labor, and Treasury Departments in January. Please e-mail Emily Wilkins, NABH’s administrative coordinator, if you have questions about the portal.

Save the Date for the NABH 2023 Annual Meeting!

Please mark your calendars and plan to join us in Washington, DC from June 12-14, 2023 for next year’s NABH Annual Meeting!

Fact of the Week

A 2016 parent survey shows 64% of children with Attention Deficit/Hyperactivity Disorder (ADHD) had at least one other mental, emotional, or behavioral disorder, the Centers for Disease Control and Prevention reports. October is ADHD Awareness Month. Help the National Institute of Mental Health raise awareness by sharing these resources. For questions or comments about this CEO Update, please contact Jessica Zigmond.

NABH Seeking Candidates for 2023 Board Positions

The NABH Selection Committee is seeking nominations to fill the NABH Board Chair-Elect and two NABH Board seats that will become available in 2023. In particular, the committee wants to identify senior managers who represent the association’s diverse membership related to levels of care, organizational structures, and size. Please download a nomination form to recommend individuals for the single-slate ballot in 2023. Please attach a curriculum vitae (CV) for every individual you recommend. This will help the Selection Committee in its deliberations. All NABH members are welcome to suggest themselves. Please return this form and candidates’ curricula vitae by Friday, Oct. 14, 2022, to maria@nabh.org.

Harris Poll Shows Strong Public Support for Mental Health and Uncertainty on How to Help

Two in three U.S. adults say they believe they don’t have enough knowledge to tell if someone is considering suicide, while eight in 10 adults say they are open to learning how to help someone in need, according to a Harris Poll survey released this week. Since 2015, the American Foundation for Suicide Prevention (AFSP), the National Action Alliance for Suicide Prevention (Action Alliance), and the Suicide Prevention Resource Center (SPRC) have commissioned the Harris Poll to conduct bi-annual, nationally representative survey of adults in the United States to understand the public’s beliefs and attitudes about mental health and suicide. The survey evaluates what the public knows about to support someone who is struggling and their perceptions of barriers to help those at risk for suicide. This latest poll offers an early read on public awareness of 988, the national behavioral health crisis hotline that launched in July. Researchers found that while gains have been made in valuing mental health, there is not consistent societal support for mental healthcare. The findings show that 76% of Americans surveyed said they perceive mental health as equal to physical health, while 51% said they feel that physical health is treated as more important of the two. Meanwhile, 67% of those surveyed said they believe they have had a mental health condition at some point in their lives, up from 60% who said so in 2018 and 57% in 2018. “Overall, the poll indicates that progress has been made, but there is more to do,” the report noted. “We must continue to learn more about suicide and mental health particularly through increased research efforts, teach everyone how to help prevent suicide and strengthen mental health, and advocate for improved access to care and robust crisis services.”

ONDCP to Host Webinar About Low-Threshold Buprenorphine on Oct. 17

The White House Office of National Drug Control Policy (ONDCP) will host a webinar on Monday, Oct. 17 to examine low-threshold buprenorphine programs, which seek to reduce barriers that often limit access or reduce retention in care. ONDCP Director Rahul Gupta, M.D. will welcome participants to the webinar, which will feature evidence from experts in the field and include a panel discussion about policy and practice. The webinar will be held from 1 p.m. – 3 p.m. ET. Click here to register.

HRSA Previews Behavioral Health Training Opportunities for Primary Care Residents

The Health Resources and Services Administration (HRSA) this week announced a funding opportunity totaling nearly $60 million during a five-year period to support training to expand the public health workforce. The new program will train primary care residents in the prevention, identification, diagnosis, treatment, and referral of services for mental and behavioral health conditions. It is intended to benefit pediatric, adolescent, young adult, and other populations who are at-risk or have experienced abuse, trauma, or mental health and/or substance use disorders, including those related to the effects of gun violence. According to HRSA, awards will support both classroom training and clinical rotations that focus on mental and behavioral health conditions. Eligible entities include accredited public or not-for-profit private hospitals; schools of allopathic medicine or osteopathic medicine; residency programs accredited by the Accreditation Council for Graduate Medical Education in family medicine, general internal medicine, general pediatrics or combined internal medicine and pediatrics (“med-peds”); and tribes and tribal organizations, if otherwise eligible. Click here to be notified when this funding opportunity opens.

Enhanced NABH Denial-of-Care Portal is Now Available

NABH recently made enhancements to its Denial-of-Care Portal that are intended to make the portal easier for members to use. A year ago, NABH developed the Denial-of-Care Portal to collect specific data on insurers who deny care—often without regard to parity or the effects on patients. Now the association has updated this resource to make it more user-friendly for members and also more aligned with what regulators need to identify parity violations. The updated portal includes fewer questions, which will require less time for members to complete. In addition, all questions are now optional. NABH hopes this will make it more likely for members to share the data they have. Lastly, NABH has added a checklist of “red flags” that were included in the 2022 MHPAEA Report to Congress from the U.S. Health and Human Services, Labor, and Treasury Departments in January. Please e-mail Emily Wilkins, NABH’s administrative coordinator, if you have questions about the portal.

Save the Date for the NABH 2023 Annual Meeting!

Please mark your calendars and plan to join us in Washington, DC from June 12-14, 2023 for next year’s NABH Annual Meeting!

Fact of the Week

A Harris Poll survey released this week found that more than half of adults in the United States say seeing a mental health professional is a sign of strength. For questions or comments about this CEO Update, please contact Jessica Zigmond.

House to Vote Friday on Senate-Approved Stopgap Spending Measure

The House of Representatives is expected to vote Friday on the short-term spending bill the Senate approved Thursday to avert a federal government shutdown and increase aid to Ukraine. Included in the legislation is a provision to continue funding the national 988 behavioral crisis hotline through Sept. 30, 2023, for which Congress has appropriated $62,000,000.

TODAY: SAMHSA to Moderate Recovery Month Panel at 1:15 p.m. ET

Acting Deputy Assistant Secretary Tom Coderre of the Substance Abuse and Mental Health Services Administration (SAMHSA) will moderate a panel discussion at 1:15 p.m. ET today, Friday, Sept. 30, the last day of National Recovery Month. Titled “Making Small Choices, Every Day,” the event will feature panelists who will discuss their recovery experiences while sharing success stories and providing hope that recovery is possible. The panel will address seeking treatment for mental illness or substance use disorders, overcoming challenges such as stigma, and helping the public understand the importance of helping those in recovery. SAMHSA will livestream the event on the agency’s Facebook page.

House Passes Bill to Bolster Mental Health Parity Protections for Workers

The House earlier this week passed the Mental Health Matters Act of 2022, a bill intended to hold employer-based health plans more accountable for inappropriate denials of mental health and substance use benefits. The legislation would give the U.S. Labor Department more authority to enforce plan requirements under the Mental Health Parity and Addiction Equity Act and the Employee Retirement Income Security Act. It also would ban forced arbitration agreements when plans deny benefits improperly, and ensure a fair standard of review from the courts. Before the bill passed, the White House released a Statement of Administrative Policy supporting the legislation. The White House noted that the Mental Health Matters Act also would improve the well-being of young children in Head Start and K-12 schools by building on President Biden’s efforts to increase the number of school-based mental health services providers, as well as authorizing grants to partnerships between high-need, local educational agencies, and institutions of higher education. NABH will continue to track developments related to this bill.

CMS Releases Latest Enrollment Figures for Medicare, Medicaid, and CHIP

The Centers for Medicare & Medicaid Services (CMS) this week released the agency’s latest enrollment figures for Medicare, Medicaid & the Children’s Health Insurance Program (CHIP), and the health insurance marketplaces, reporting that 156.5 million Americans have coverage in these federal health insurance programs. According to the latest figures, there are 89.4 million enrollees in Medicaid and CHIP, 64.6 million enrollees in Medicare, and 14.5 million people enrolled in state-based and federal health insurance marketplaces. The agency reported a subtotal figure of 168.5 million enrollees, which CMS then adjusted by subtracting 12 million to account for Americans who are dually eligible for both Medicare and Medicaid. Click here for a breakdown of the individual programs.

Former ONDCP Leaders Pen Opinion Piece on Increasing Recovery Services

On this last day of National Recovery Month, two former leaders at the White House Office of National Drug Control Policy wrote an opinion piece in The Hill newspaper to call for more training in addiction science and policymaking. In their blog, former ONDCP Director Michael Botticelli and Regina LaBelle, a former acting director at ONDCP and director of the Addiction and Public Policy Initiative at the Georgetown University Law Center’s O’Neill Institute, recognized the role that people in recovery play by building healthier communities. They also emphasized the need to remove barriers to healthcare, housing, and employment and education, including modifying the regulatory hurdles that reduce access to methadone.

Enhanced NABH Denial-of-Care Portal is Now Available

NABH recently made enhancements to its Denial-of-Care Portal that are intended to make the portal easier for members to use. A year ago, NABH developed the Denial-of-Care Portal to collect specific data on insurers who deny care—often without regard to parity or the effects on patients. Now the association has updated this resource to make it more user-friendly for members and also more aligned with what regulators need to identify parity violations. The updated portal includes fewer questions, which will require less time for members to complete. In addition, all questions are now optional. NABH hopes this will make it more likely for members to share the data they have. Lastly, NABH has added a checklist of “red flags” that were included in the 2022 MHPAEA Report to Congress from the U.S. Health and Human Services, Labor, and Treasury Departments in January. Please e-mail Emily Wilkins, NABH’s administrative coordinator, if you have questions about the portal.

Save the Date for the NABH 2023 Annual Meeting!

Please mark your calendars and plan to join us in Washington, DC from June 12-14, 2023 for next year’s NABH Annual Meeting!

Fact of the Week

Early intervention in psychosis programs contributed to, on average, 3.2 fewer hospitalizations and 2.7 more years employed during the course of patients’ lives compared with individuals with the same diagnosis who received standard care, according to a study published in Psychiatric Services. For questions or comments about this CEO Update, please contact Jessica Zigmond

Biden Administration Announces More Than $1.6 Billion for Communities to Address Addiction & Overdose Crises

The U.S. Health and Human Services Department (HHS) on Friday announced it will award more than $1.6 billion in investments to communities nationwide to address America’s addiction and overdose crises. Funding will come from the Substance Abuse and Mental Health Services Administration’s (SAMHSA) State Opioid Response (SOR) program and Tribal Opioid Response (TOR) grant program and the Health Resources and Services Administration’s (HRSA) rural communities’ opioid response programs.   “I have heard many stories of despair from individuals battling addiction and from families who have lost loved ones to overdose,” HHS Secretary Xavier Becerra said in the grant announcement. “Through these grants, we are investing in evidence-based supports and services for individuals, families, and communities on the road to recovery.” Click here to learn about the four individual grant opportunities.

Covid-19 PHE Will Likely Be Extended Due to Absence of 60-Day Termination Notice from HHS

The Covid-19 public health emergency (PHE) will most likely be extended for another 90 days after the PHE’s current Oct. 13, 2022 expiration date because HHS has not given states 60 days’ notice before termination. In January 2021, HHS’s Administration for Strategic Preparedness & Response (ASPR0 sent a letter to the nation’s governors outlining the commitment to a 60-day, PHE termination notice. HHS Assistant Secretary for Public Affairs Sarah Lovenheim posted a message on Twitter this past Monday, Sept. 19, that assured states and providers there will be at least two months’ notice before the PHE is allowed to expire. NABH will notify members about any updates related to the PHE’s end date.

National Center on Substance Abuse and Child Welfare to Host Sept. 27 Webinar on Contingency Management

SAMHSA announced this week that the National Center on Substance Abuse and Child Welfare will host a webinar on Thursday, Sept. 29 that highlights how contingency management can help families affected by substance use disorders. The webinar will provide an overview of contingency management, including details about implementation with different cultural populations. It will also show how Montefiore Medical Center in New York, a Regional Partnership Grant awardee, has implemented contingency management, and provide practical strategies for implementation. The webinar will begin next Thursday at 1:30 p.m. ET. Click here to register.

NIH-Led Study Shows Heart Medication Could Be Effective for Alcohol Use Disorder

A medication to treat heart problems and high blood pressure may also be effective for treating alcohol use disorder, according to a new study from researchers at the National Institutes of Health (NIH) and published in Molecular Psychiatry. The research shows evidence from experiments in mice and rats—as well as a cohort study in humans—that suggests the medication spironolactone could play a role in reducing alcohol drinking. Researchers from the NIH’s National Institute on Drug Abuse and the National Institute on Alcohol Abuse and Alcoholism, as well as from the Yale School of Medicine, produced the study. “Combining findings across three species and different types of research studies, and then seeing similarities in those data, gives us confidence that we are onto something potentially important scientifically and clinically,” Lorenzo Leggio, M.D., Ph.D., chief of the clinical psychoneuroendocrinology and neuropsychopharmacology section, a joint laboratory of NIDA and NIAAA, and one of the senior authors, said in an announcement about the research. “These findings support further study of spironolactone as a potential treatment for alcohol use disorder, a medical condition that affects millions of people in the U.S.”

Enhanced NABH Denial-of-Care Portal is Now Available

NABH recently made enhancements to its Denial-of-Care Portal that are intended to make the portal easier for members to use. A year ago, NABH developed the Denial-of-Care Portal to collect specific data on insurers who deny care—often without regard to parity or the effects on patients. Now the association has updated this resource to make it more user-friendly for members and also more aligned with what regulators need to identify parity violations. The updated portal includes fewer questions, which will require less time for members to complete. In addition, all questions are now optional. NABH hopes this will make it more likely for members to share the data they have. Lastly, NABH has added a checklist of “red flags” that were included in the 2022 MHPAEA Report to Congress from the U.S. Health and Human Services, Labor, and Treasury Departments in January. Please e-mail Emily Wilkins, NABH’s administrative coordinator, if you have questions about the portal.

Save the Date for the NABH 2023 Annual Meeting!

Please mark your calendars and plan to join us in Washington, DC from June 12-14, 2023 for next year’s NABH Annual Meeting!

Fact of the Week

Prenatal cannabis exposure following the middle of the first trimester is associated with attention, social, and behavioral problems in children that persist into early adolescence, according to a recent study in JAMA Pediatrics based on research funded by the National Institute on Drug Abuse. For questions or comments about this CEO Update, please contact Jessica Zigmond.

NABH Annual Membership Updates Are Due Today, Sept. 16!

Today, Friday, Sept. 16, is the deadline for members to submit changes about their organizations for the online-only NABH 2022 Membership Directory. Last month NABH sent its system members a message with a link to the association’s membership-update tool. To help ensure we have the most accurate information on our members, please use this tool to verify your system’s information. NABH has added several new categories this year. The answers to these questions will help us provide a more accurate description of our diverse membership to policymakers, regulators, partner organizations, and the media. Please be sure to enter information for all your system’s facilities so that we have a better picture of our diverse membership. If you need NABH to re-send the link, please contact Maria Merlie at maria@nabh.org. Thank you for your cooperation!

NABH Submits Comments on CMS’ Proposed Rule for Medicare Hospital Outpatient Prospective Payment System

NABH this week sent comments and recommendations to the Centers for Medicare & Medicaid Services (CMS) regarding the agency’s proposed Medicare Hospital Outpatient Prospective Payment System (OPPS) for calendar year 2023 (CY 2023). In its five-page letter, NABH proposed that CMS examine ways to account for increased costs to ensure that beneficiaries continue to have access to quality outpatient care and offered a range of recommendations, including: reducing the productivity cut for CY 2023; ensuring that non-340B hospitals remain unharmed; expanding telehealth services; and more.

CMS Announces Approval of Nation’s First Medicaid Mobile Crisis Intervention Services Program

The Centers for Medicare & Medicaid Services (CMS) this week announced approval of the Oregon Health Authority’s proposal to cover community-based stabilization services throughout the state. Oregon is the first state to seek and be granted approval for the new Medicaid option that became available to states in April 2022.  The program will provide community-based stabilization services to individuals experiencing mental health and/or substance use crises by connecting them to a behavioral health specialist 24 hours a day, every day of the year.

Sound the Alarm for Kids Virtual Roundtable is Today, Friday, Sept. 16 at 1 p.m. ET

Sound the Alarm for Kids will host “Helping Girls Thrive: A Conversation Examining Trends in Girls’ Mental Health” is today, Friday, Sept. 16 at 1 p.m. ET. The virtual roundtable discussion will examine the national campaign to raise awareness about today’s mental health crisis among children and teens and how to create change. Some of the speakers include Christina Bethell, Ph.D., M.P.H., M.B.A, director of the Child and Adolescent Health Measurement Initiative at Johns Hopkins University and Kelley Haynes-Mendez, Psy.D., senior director of the human rights team at the American Psychological Association. Click here to register.

Enhanced NABH Denial-of-Care Portal is Now Available

NABH recently made enhancements to its Denial-of-Care Portal that are intended to make the portal easier for members to use. A year ago, NABH developed the Denial-of-Care Portal to collect specific data on insurers who deny care—often without regard to parity or the effects on patients. Now the association has updated this resource to make it more user-friendly for members and also more aligned with what regulators need to identify parity violations. The updated portal includes fewer questions, which will require less time for members to complete. In addition, all questions are now optional. NABH hopes this will make it more likely for members to share the data they have. Lastly, NABH has added a checklist of “red flags” that were included in the 2022 MHPAEA Report to Congress from the U.S. Health and Human Services, Labor, and Treasury Departments in January. Please e-mail Emily Wilkins, NABH’s administrative coordinator, if you have questions about the portal.

Save the Date for the NABH 2023 Annual Meeting!

Please mark your calendars and plan to join us in Washington, DC from June 12-14, 2023 for next year’s NABH Annual Meeting!

Fact of the Week

Based on data from 14 state maternal mortality review committees, the Centers for Disease Control and Prevention (CDC) reports that mental health conditions—including suicide—are the 6th leading cause of pregnancy-related death. For questions or comments about this CEO Update, please contact Jessica Zigmond