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CEO Update 199

Reminder: Please Submit Updated Member Information by Next Friday, Sept. 13!

NABH is developing its online-only 2024 Membership Directory, an essential member benefit that helps the association in its advocacy efforts.

Last month NABH e-mailed system members a link to the association’s membership-update tool. To help ensure we have the most accurate information on our members, please use the link to our membership-update tool and verify your system’s information.

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 of your system’s facilities so that we have a better picture of our membership.

The deadline to submit your changes to NABH is next Friday, Sept. 13. If you need assistance, please contact Maria Merlie maria@nabh.org or 202-393-6700, ext. 104.

As always, thank you for your time and for all you do to advance NABH’s Mission and Vision!

Former CDC Directors Caution that Paring Down Agency Could Cost Lives and Damage Economy

Eight former Centers for Disease Control and Prevention (CDC) directors penned an op-ed this week in STAT that warns cutting funding to the Atlanta-based public health agency could endanger lives and the U.S. economy.

“One misguided narrative is that the CDC should focus only on a ‘core mission’ of combatting infectious diseases,” wrote former directors William Foege, William Roper, Jeffrey Koplan, Julie Gerberding, Tom Frieden, Brenda Fitzgerald, Robert Redfield, and Rochelle Walensky, all of whom are physicians. “In fact, the core mission of the CDC is to save lives and protect Americans from all health threats — not only infectious diseases but also cancer, environmental risks, injuries, and the conditions that are the leading causes of death among Americans.”

They added that the CDC has helped save millions of lives through reduced tobacco and alcohol use, diabetes prevention and control, injury prevention including reducing traumatic brain injury, healthier pregnancies with lower maternal mortality, and other health-protection programs.

“Limiting our health defense to just some threats would be like allowing our military to protect us from only some types of attack, telling the National Weather Service to warn people about tornadoes but not hurricanes, or allowing doctors to treat only some diseases,” they continued.

The piece is a response to a Republican bill that would cut funding to the CDC by 22% and also to an op-ed earlier this year from Scott Gottlieb, M.D., former director of the U.S. Food and Drug Administration who now serves on the board of Pfizer.

September Issue of JAMA Pediatrics Includes Several Mental Health-Related Articles

NABH calls members’ attention the September edition of JAMA Pediatrics, which includes a number of articles focused on mental health.

Topics include healthcare needs and costs for children exposed to prenatal substance use, hospital admissions for eating disorders, mental health of transgender youth following gender identity milestones, and more.

September is National Recovery Month and Suicide Prevention Month

September is National Recovery Month, and the Substance Abuse and Mental Health Services Administration (SAMHSA) will commemorate the annual observance with a campaign focused on the four dimensions of recovery: health, home, purpose, and community.

Week One will emphasize health and will highlight choices that support well-being – such as eating a nutritious diet, exercising regularly, developing healthy sleeping habits, and managing other health issues –that can help support people with mental health and substance use conditions in their journey to recovery. Click here to access SAMHSA’s Recovery Month social media toolkit.

September is also Suicide Prevention Month, and SAMHSA has created a separate toolkit with hashtags and posts for the month and also World Suicide Prevention Day on Sept. 10 to remember the lives of those lost to suicide.

Reminder: Join NABH for World Suicide Prevention Day Webinar on Sept. 10

Please join NABH this coming Tuesday, Sept. 10, World Suicide Prevention Day, for a webinar that will feature two experts who will highlight HHS’ 2024 National Strategy for Suicide Prevention, a 10-year, comprehensive, societal approach to suicide prevention that provides concrete recommendations for addressing gaps in the suicide-prevention field.

NABH will welcome Julie Goldstein Grumet, Ph.D., vice president of suicide prevention strategy at the Education Development Center (EDC) and director of the EDC’s Zero Suicide Institute; and Colleen Carr, M.P.H., director of the National Action Alliance for Suicide Prevention.

Grumet and Carr will discuss the core strategic directions of the National Strategy; provide context on how these goals fit into current efforts by health systems, providers, and their partners in the field; highlight opportunities to support National Strategy implementation efforts; and what to expect – as well as how to engage – as the new strategy rolls out.

The discussion will also include an overview of key NABH priorities reflected in the new strategy, including workplace violence prevention and current efforts to protect and advance workforce wellbeing, including suicide prevention.

Please click here to register for this hourlong webinar on Tuesday at 2 p.m. ET.

Join NABH for October Webinar on Using Publicly Available Data in Health Plan Negotiations

Please join NABH for a webinar to learn about using hospital data to improve negotiations with health plans on Wednesday, Oct. 16, 2024.

The webinar will feature Erica K. Fox, M.B.A., vice president of business development and managed care contracting at Perimeter Healthcare. A member of NABH’s Managed Care Committee, Fox will review the use of publicly available data from hospitals, such as payer-specific negotiated rates and standard charges for all payers and plans, to negotiate contracts with health plans.

Fox has more than 25 years of senior leadership experience in the behavioral health sector. Prior to her current role, she served as the business development director at Peachford Hospital, a Universal Health Services facility. Fox earned her undergraduate degree from Michigan State University, where she received a dual degree in Communications and Spanish. She later earned a master’s degree in healthcare administration from Loyola University Chicago.

Please register here for this hourlong webinar on Wednesday, Oct. 16 starting at 2 p.m. ET. We hope you join us!

Please Submit Data to NABH’s Denial-of-Care Portal

We urge all NABH members to join those already submitting data to our Denial-of-Care Portal.

We are beginning to use aggregated portal data to illustrate and compare prior authorization practices for commercial, Medicare Advantage, and Medicaid managed care denials.

Policymakers have expressed particular interest in our aggregate estimate on days of uncompensated charity care, as well as the length of delayed health plan responses to prior-authorization requests.

To support this advocacy push, we strongly encourage all NABH members to submit data to the portal. Please contact NABH Associate Manager for Congressional Affair Emily Wilkins with questions about the data metrics that we are collecting and/or the data-submission process.

Fact of the Week

An analysis of provisional data from the National Institute on Drug Abuse found that between 2015 and 2023, there was a nearly five-fold increase in overdose deaths among non-Hispanic Black men 55 and older.

For questions or comments about this CEO Update, please contact Jessica Zigmond.

CEO Update 198

Reminder: Please Update Your Member Information for the 2024 NABH Membership Directory!

NABH is developing its online-only 2024 Membership Directory, an essential member benefit that helps the association in its advocacy efforts.

NABH has e-mailed system members a link to the association’s membership-update tool. To help ensure we have the most accurate information on our members, please use the link to our membership-update tool and verify your system’s information.

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 of your system’s facilities so that we have a better picture of our membership.

The deadline to submit your changes to NABH is Friday, Sept. 13. If you need assistance, please contact Maria Merlie maria@nabh.org or 202-393-6700, ext. 104.

As always, thank you for your time and for all you do to advance NABH’s Mission and Vision!

Legislative Preview: What to Expect from Congress This Fall 

Following their annual August recess and respective party conventions, federal lawmakers will return to Capitol Hill on Monday, Sept 9 to determine next steps for funding the federal government and provide stop-gap funding for veterans’ benefits.

The House and Senate will continue to attempt to pass appropriations bills funding various federal agencies before the Sept. 30 deadline. Both chambers have passed respective appropriations bills for Labor and HHS with vastly different funding levels, which likely won’t be reconciled before the deadline.

Numerous other agency funding bills are still pending. Congressional leaders are already having conversations about passing a Continuing Resolution (CR) to fund the government, which Congress will need to approve by Sept. 30 to stave off a government shutdown. The length of the CR will likely extend past the election or potentially after the 119 Congress takes office in January.

In addition, Congress will likely consider a $3 billion emergency aid bill that would cover veterans benefits and services as the Veterans Affairs Department (VA) warns of a nearly $14.9 billion shortfall through fiscal year 2025. A bipartisan group of appropriators and other senators intend to introduce legislation that would provide almost $2.3 billion in additional fiscal 2024 funding for the VA to cover compensation and pensions in the near term, along with almost $597 million for readjustment benefits. Without action from Congress by Sept. 20, the VA has warned it won’t be able to pay out roughly $3 billion in disability compensation, pension, and education benefits as early as Oct. 1. Because this is considered “must pass” legislation, Congress could attempt to add additional bills to this action.

Congress is expected to adjourn Sept. 27 after completing these tasks and return after the Nov. 5 elections. At that time, Congress will return to address unfinished business before the end of the year, commonly known as the “lame duck session.” Typically, most work during this session depends on which political party won majorities in the House and Senate during the November elections and whether there is a pending change in majority in either legislative chamber.

The outcome of the U.S. presidential race can also play a role in the level of activity during a lame duck session. Some congressional members might continue to push for an end-of-year health package, which could include reauthorizing the SUPPORT Act and a telehealth extension, among other priorities.

September is National Recovery Month and Suicide Prevention Month 

Next month marks National Recovery Month, and the Substance Abuse and Mental Health Services Administration (SAMHSA) will commemorate the annual observance with a campaign focused on the four dimensions of recovery: health, home, purpose, and community.

Week One will emphasize health and will highlight choices that support well-being – such as eating a nutritious diet, exercising regularly, developing healthy sleeping habits, and managing other health issues –that can help support people with mental health and substance use conditions in their journey to recovery. Click here to access SAMHSA’s Recovery Month social media toolkit.

September is also Suicide Prevention Month, and SAMHSA has created a separate toolkit with hashtags and posts for the month and also World Suicide Prevention Day on Sept. 10 to remember the lives of those lost to suicide.

Reminder: Join NABH for World Suicide Prevention Day Webinar on Sept. 10

Please join NABH on World Suicide Prevention Day, for a webinar that will feature two experts who will highlight HHS’ 2024 National Strategy for Suicide Prevention, a 10-year, comprehensive, societal approach to suicide prevention that provides concrete recommendations for addressing gaps in the suicide-prevention field.

NABH will welcome Julie Goldstein Grumet, Ph.D., vice president of suicide prevention strategy at the Education Development Center (EDC) and director of the EDC’s Zero Suicide Institute; and Colleen Carr, M.P.H., director of the National Action Alliance for Suicide Prevention.

Grumet and Carr will discuss the core strategic directions of the National Strategy; provide context on how these goals fit into current efforts by health systems, providers, and their partners in the field; highlight opportunities to support National Strategy implementation efforts; and what to expect – as well as how to engage – as the new strategy rolls out.

The discussion will also include an overview of key NABH priorities reflected in the new strategy, including workplace violence prevention and current efforts to protect and advance workforce wellbeing, including suicide prevention.

Please click here to register for this hourlong webinar on Tuesday, Sept. 10 at 2 p.m. ET.

HHS and DOJ to Host Webinar on Incarcerated Youth and Medicaid Next Week

HHS and the U.S. Justice Department (DOJ) will host a webinar next Tuesday, Aug. 27 that will highlight policy approaches designed to connect justice-involved youth with Medicaid and CHIP services.

In late July, the Centers for Medicare & Medicaid Services (CMS) sent a letter to state health officials that addressed the statutory requirements in the Consolidated Appropriations Act, 2023 regarding the availability of certain state plan services for incarcerated youth in Medicaid and the Children’s Health Insurance Program (CHIP) and modification of CHIP eligibility requirements for children who become incarcerated in juvenile or adult corrections systems.

During this webinar, HHS and DOJ leadership and subject matter experts will discuss how this opportunity will help advance health equity and build healthier and safer communities.
Click here to register for the webinar that will start at 2 p.m. ET.

SAMHSA Offers On-Demand Module on Motivational Interviewing Strategies for AUD

SAMHSA is offering an on-demand module to help physicians, physician associates, nurses, social workers, and other healthcare professionals learn how to use Motivational Interviewing strategies as a guided approach to clinical interactions and fostering behavior change in patients with alcohol use disorder.

SAMHSA’s PCSS-MAUD Motivational Interviewing for Alcohol Use Disorder Treatment is a self-paced training program that addresses the Accreditation Council for Graduate Medical Education competencies of patient care, medical-based knowledge, and practice-based learning.

National Academies Examines Strategies to Improve Behavioral Healthcare Access in Medicare and Medicaid

The National Academies has released Expanding Behavioral Healthcare Workforce Participation Through Medicare, Medicaid, and Marketplace Plans, a new resource it developed after SAMHSA and CMS asked the not-for-profit institutions t convene a committee that would examine current challenges in ensuring broad access to evidence-based behavioral healthcare services through Medicare, Medicaid, and Marketplace programs—and propose strategies to address those challenges.

“Barriers to obtaining behavioral health treatment are most evident in populations receiving Medicare, Medicaid, and Marketplace plans,” the National Academies wrote in its description of the new resource. “Behavioral healthcare providers serving individuals enrolled in these plans are more likely to experience challenges around reimbursement and training, which disincentivizes participation.”

Join NABH for October Webinar on Using Publicly Available Data in Health Plan Negotiations

Please join NABH for a webinar to learn about using hospital data effectively in your negotiations with health plans on Wednesday, Oct. 16, 2024.

The webinar will feature Erica K. Fox, M.B.A., vice president of business development and managed care contracting at Perimeter Healthcare. A member of NABH’s Managed Care Committee, Fox will review the use of publicly available data from hospitals, such as payer-specific negotiated rates and standard charges for all payers and plans, to negotiate contracts with health plans.

Fox has more than 25 years of senior leadership experience in the behavioral health sector. Prior to her current role, she served as the business development director at Peachford Hospital, a Universal Health Services facility. Fox earned her undergraduate degree from Michigan State University, where she received a dual degree in Communications and Spanish. She later earned a master’s degree in healthcare administration from Loyola University Chicago.

Please register here for this hourlong webinar on Wednesday, Oct. 16 starting at 2 p.m. ET. We hope you join us!

Reminder: Please Submit Data to NABH’s Denial-of-Care Portal

We urge all NABH members to join those already submitting data to our Denial-of-Care Portal.

We are beginning to use aggregated portal data to illustrate and compare prior authorization practices for commercial, Medicare Advantage, and Medicaid managed care denials.

Policymakers have expressed particular interest in our aggregate estimate on days of uncompensated charity care, as well as the length of delayed health plan responses to prior-authorization requests.

To support this advocacy push, we strongly encourage all NABH members to submit data to the portal. Please contact NABH Associate Manager for Congressional Affair Emily Wilkins with questions about the data metrics that we are collecting and/or the data-submission process.

Fact of the Week

The National Institutes of Health announced it has launched a program to advance research that will support Native American communities to lead research to address overdose, substance use, and pain, including factors such as mental health and wellness.

NABH will not publish CEO Update next Friday, Aug. 30. The NABH staff wishes you, your teams, and your families a safe and happy Labor Day weekend next week! CEO Update will resume on Friday, Sept. 6.

For questions or comments about this CEO Update, please contact Jessica Zigmond.

CEO Update 197

Please Update Your Member Information for the 2024 NABH Membership Directory!

NABH is developing its online-only 2024 Membership Directory, an essential member benefit that helps the association in its advocacy efforts.

This week NABH e-mailed system members a link to the association’s membership-update tool. To help ensure we have the most accurate information on our members, please use the link to our membership-update tool and verify your system’s information.

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 of your system’s facilities so that we have a better picture of our membership.

The deadline to submit your changes to NABH is Friday, Sept. 13. If you need assistance, please contact Maria Merlie maria@nabh.org or 202-393-6700, ext. 104.

As always, thank you for your time and for all you do to advance NABH’s Mission and Vision!

HRSA Social Worker Licensure Compact Seeks to Increase Behavioral Healthcare Access and Enhance Telehealth Services

The Health Resources and Services Administration (HRSA) announced recently its first Licensure Portability Grant Program investment in a multi-state social worker licensure compact.

According to HRSA, state licensure compacts allow states to agree on a common approach to licensing health care providers, allowing providers to practice across state lines without having to apply for a license in each state. Streamlining licensure while maintaining quality standards improves access to services both by better facilitating hiring and by easing pathways to utilizing telehealth. HRSA made the announcement at its National Telehealth Conference last month.

“Social workers are essential to expanding access to behavioral health care services, a top priority of the Biden-Harris administration,” HHS Deputy Secretary Andrea Palm said in a statement. “HRSA is leading the way in growing the behavioral health workforce both by training more providers and by breaking down barriers to allow the workforce to make mental health and substance use disorder services more accessible across the country,” she added.

Click here to see the grant program awardees.

Join NABH Sept. 10 for Webinar on the 2024 National Strategy for Suicide Prevention

Please help NABH recognize World Suicide Prevention Day on Tuesday, Sept. 10, 2024 by joining us for a webinar featuring two experts who will highlight HHS’ 2024 National Strategy for Suicide Prevention, a 10-year, comprehensive, societal approach to suicide prevention that provides concrete recommendations for addressing gaps in the suicide-prevention field.

The webinar will feature Julie Goldstein Grumet, Ph.D., vice president of suicide prevention strategy at the Education Development Center (EDC) and director of the EDC’s Zero Suicide Institute; and Colleen Carr, M.P.H., director of the National Action Alliance for Suicide Prevention.

Grumet and Carr will discuss the core strategic directions of the National Strategy; provide context on how these goals fit into current efforts by health systems, providers, and their partners in the field; highlight opportunities to support National Strategy implementation efforts; and what to expect – as well as how to engage – as the new strategy rolls out.

The discussion will also include an overview of key NABH priorities reflected in the new strategy, including workplace violence prevention and current efforts to protect and advance workforce wellbeing, including suicide prevention.

Please register here for this hourlong webinar on Tuesday, Sept. 10 webinar that starts at 2 p.m. ET. I hope you join us!

Reminder: Behavioral Health Business to Examine ‘How AI is Making Healthcare More Human’ in August Webinar

The publication Behavioral Health Business will host a webinar next month to explore how AI could potentially enhance humanity in behavioral health.

The discussion will examine how AI could extend to underserved communities, improve patient outcomes, and increase both clinician and patient satisfaction.

It also promises to highlight new research involving 130,000 patients that shows people are significantly more likely to begin therapy when their experience starts with Limbic, an AI-powered clinical assessment, with the most positive effects observed among minority groups.

The webinar will be held Thursday, Aug. 22 at Noon ET. Click here to register.

 Reminder: Please Submit Data to NABH’s Denial-of-Care Portal

We urge all NABH members to join those already submitting data to our Denial-of-Care Portal.

We are beginning to use aggregated portal data to illustrate and compare prior authorization practices for commercial, Medicare Advantage, and Medicaid managed care denials.

Policymakers have expressed particular interest in our aggregate estimate on days of uncompensated charity care, as well as the length of delayed health plan responses to prior-authorization requests.

To support this advocacy push, we strongly encourage all NABH members to submit data to the portal. Please contact NABH Associate Manager for Congressional Affair Emily Wilkins with questions about the data metrics that we are collecting and/or the data-submission process.

Fact of the Week

According to a Pew Charitable Trusts fact sheet released this week, more than 10.2 million people ages 12 and older misused stimulants – which includes cocaine, prescription stimulants for ADHD and methamphetamine – in 2022. This reflects a nearly 9% increase from 2021.

For questions or comments about this CEO Update, please contact Jessica Zigmond.

CEO Update 196

Contingency Management Battles Ongoing Headwinds

Earlier this week, a STAT news article reviewed the executive branch’s response to advocacy efforts to expand financing for the only evidence-based treatment for stimulant use disorder, contingency management (CM.)  CM provides financial rewards for abstinence from stimulants and has decades of research demonstrating that intervention changes the reward centers of the brain, resulting in behavior change. There are no medications for stimulant use disorders.

Currently, the Substance Abuse and Mental Health Services Administration limits CM rewards to $75, which is too low for effective treatment. In addition, members of Congress have confused CM treatment with harm reduction and made the treatment a highly charged political issue. Speaking on behalf of NABH, Sarah Wattenberg, director of quality and addiction services, stated, “I understand their political concerns, but sometimes you just have to bite the bullet.” She continued, “Too many people are dying, and we need to act now.”

Reminder: Join NABH Sept. 10 for Webinar on the 2024 National Strategy for Suicide Prevention

Please help NABH recognize World Suicide Prevention Day on Tuesday, Sept. 10, 2024 by joining us for a webinar featuring two experts who will highlight HHS’ 2024 National Strategy for Suicide Prevention, a 10-year, comprehensive, societal approach to suicide prevention that provides concrete recommendations for addressing gaps in the suicide-prevention field.

The webinar will feature Julie Goldstein Grumet, Ph.D., vice president of suicide prevention strategy at the Education Development Center (EDC) and director of the EDC’s Zero Suicide Institute; and Colleen Carr, M.P.H., director of the National Action Alliance for Suicide Prevention.

Grumet and Carr will discuss the core strategic directions of the National Strategy; provide context on how these goals fit into current efforts by health systems, providers, and their partners in the field; highlight opportunities to support National Strategy implementation efforts; and what to expect – as well as how to engage – as the new strategy rolls out.

The discussion will also include an overview of key NABH priorities reflected in the new strategy, including workplace violence prevention and current efforts to protect and advance workforce wellbeing, including suicide prevention.

Please register here for this hourlong webinar on Tuesday, Sept. 10 webinar that starts at 2 p.m. ET. I hope you join us!

NABH Seeks Member Feedback on CMS’ 2025 PFS and OPPS Proposed Rules

NABH seeks member feedback on the Centers for Medicare & Medicaid Services (CMS) proposed 2025 Physician Fee Schedule rule and 2024 Outpatient Prospective Payment System  rule.

To weigh in, please begin by reviewing the regulations and NABH’s recent 2025 Physician Fee Schedule and 2025 Outpatient Prospective Payment System alerts to help NABH staff identify the priorities we should address with CMS, such as payment, impact on patients and quality, or operational challenges.

Please email your comments to Rochelle Archuleta by Friday, Aug. 9. Comments for both rules are due to CMS by Monday, Sept. 9.

Reminder: SAMHSA Announces Funding Opportunity to Enhance Capacity of Women’s Behavioral Health Providers

SAMHSA is accepting applications for its Women’s Behavioral Health Technical Assistance Center to enhance capacity of women’s behavioral health providers, general healthcare providers, and others involved in the holistic care of women with or at risk for mental health and substance use conditions—including women who were greatly affected by the COVID-19 pandemic.

The agency said it has a total of $12.5 million for five years and anticipates granting one award. Applications are due by Tuesday, Aug. 20, 2024. Click here to learn more.

Reminder: Behavioral Health Business to Examine ‘How AI is Making Healthcare More Human’ in August Webinar

The publication Behavioral Health Business will host a webinar this month to explore how AI could potentially enhance humanity in behavioral health.

The discussion will examine how AI could extend to underserved communities, improve patient outcomes, and increase both clinician and patient satisfaction.

It also promises to highlight new research involving 130,000 patients that shows people are significantly more likely to begin therapy when their experience starts with Limbic, an AI-powered clinical assessment, with the most positive effects observed among minority groups.

The webinar will be held Thursday, Aug. 22 at Noon ET. Click here to register.

Reminder: Please Submit Data to NABH’s Denial-of-Care Portal

We urge all NABH members to join those already submitting data to our Denial-of-Care Portal.

We are beginning to use aggregated portal data to illustrate and compare prior authorization practices for commercial, Medicare Advantage, and Medicaid managed care denials.

Policymakers have expressed particular interest in our aggregate estimate on days of uncompensated charity care, as well as the length of delayed health plan responses to prior-authorization requests.

To support this advocacy push, we strongly encourage all NABH members to submit data to the portal. Please contact NABH Associate Manager for Congressional Affair Emily Wilkins with questions about the data metrics that we are collecting and/or the data-submission process.

Fact of the Week

A recent JAMA study found that between Jan. 2010 and Dec. 2021, 60% of youth who lost their lives to suicide lacked mental health diagnoses. This study’s findings highlight the importance of “…equitable access to MH screening, diagnosis, and treatment for all youths. “

For questions or comments about this CEO Update, please contact Jessica Zigmond.

CEO Update 195

CMS Finalizes 2.5% IPF Payment Increase and Payment System Reforms

The Centers for Medicare & Medicaid Services’ (CMS) fiscal year (FY) 2025 final rule on the inpatient psychiatric facility prospective payment system (IPF PPS) implements a net increase of 2.5 percentage points. The overall update of $65 million, compared with FY 2024 payment levels, represents a slight decrease from the proposed 2.6 percentage point increase.

This update includes a market basket increase of 3.3 percentage points that is offset by a 0.5 percentage point for productivity. In addition, to maintain the mandated outlier pool of 2.0% of total payments, CMS finalized an outlier payment reduction of 0.3 percentage point to stay within this target, which reduces the number of cases that will qualify for an outlier payment.

CMS also finalized several adjustments to ensure that the PPS design and other changes discussed below are implemented in a budget-neutral manner. Due to these adjustments, the base per diem rate will be reduced to $876.53 from $895.63.

All-Inclusive Reporting
NABH is extremely disappointed that CMS finalized a significant narrowing of its all-inclusive reporting policy, which will take effect for upcoming cost reporting periods. Current policy allows IPFs to use an alternative methodology for reporting ancillary charges on cost reports. The final rule restricts this reporting option for ancillary charges only to Indian Health Service (IHS) hospitals, tribally owned and government-owned psychiatric, and acute care hospitals. CMS overlooked NABH’s strong caution that for many “all-inclusive IPFs,” significant administrative, timing and cost considerations will make impossible a timely transition to this change.

Under the finalized timing framework, CMS contractors will begin assessing compliance with the change through a look-back process that begins following the completion of a provider’s upcoming cost-reporting period that begins on or after Oct. 1, 2024. Specifically, all IPFs will be required to have a charge structure that allows the reporting of ancillary costs and charges on their cost reports for all ancillary services and correlating charges, such as labs and drugs.

With this change, IPFs that are currently in the all-inclusive category now will have their cost reports included in the annual IPF PPS update that CMS calculates. Because CMS calculates the annual update using the sum of routine and ancillary costs, in prior years the agency has removed from the calculation the all-inclusive IPFs, as their cost reports lack data on ancillary services. The final rule notes that in 2018, because of this exclusion, 82,491 (out of 364,080 total stays) were removed from the update calculation. CMS acknowledges that this exclusion has been producing skewed updates that do not represent the costs of the entire IPF field, with approximately 55 percent of stays from freestanding all-inclusive facilities removed in 2018, and 0.3 percent of stays from all-inclusive psychiatric units.

In response to feedback that all-inclusive IPFs are providing full and clinically-appropriate services and that the absence of ancillary charges on cost reports is due to gained cost efficiencies, CMS said it “believe[s that] IPFs are providing these necessary services to patients.” The agency added:  “…maintaining an accurate charge structure would be part of a business’s accounting for reordering and restocking pharmaceuticals at a minimum, as well as more accurate payment for the purposes of outlier payments.”

Payment Increase for Electroconvulsive Therapy
For FY 2025, to achieve some alignment with outpatient rates, CMS finalized the proposed 71 percent increase for ECT payment per treatment from the current rate of $385.58 to $661.52.

IPF PPS Modifications
As mandated by Congress, CMS reviewed key IPF PPS elements with a focus on facility and patient-level adjustments, and in this rule finalizes multiple, relatively modest changes. While the agency is maintaining the rural and teaching facility adjustments, as is, the rule finalizes multiple budget-neutral changes to the structure of the PPS. As shown in Tables 4 and 5 in the rule, CMS finalized these changes:

  • Added DRGs 917 (Poisoning and toxic effects of drugs w MCC) and 918 (Poisoning and toxic effects of drugs w/out MCC).
  • Replaced DRGs 080 (Nontraumatic stupor & coma w MCC) and 081 (Nontraumatic stupor & coma w/o MCC) with DRGs 947 (Signs and Symptoms w MCC) and 948 (Signs and Symptoms w/out MCC.
  • Removed 2 DRGs: DRG 887 (Other mental disorder diagnoses) and DRG 896 (Alcohol, Drug Abuse or Dependence w/out rehab therapy w MCC).
  • Multiple changes to comorbidity payment add-ons were finalized as shown in Table 10.

IPF Quality Reporting Program
As proposed, the final rule implements one new measure: the 30-Day Risk-Standardized All-Cause Emergency Department Visit Following an Inpatient Psychiatric Facility Discharge. In response to concerns raised through public comments that its implementation may not be feasible, CMS did not finalize the proposed requirement for IPFs to submit patient-level quality data every quarter (versus the current annual basis).

Please see CMS’ fact sheet for more information about the rule.

NABH Seeks Member Feedback on CMS’ 2025 PFS and OPPS Proposed Rules

NABH seeks member feedback on the Centers for Medicare & Medicaid Services (CMS) proposed 2025 Physician Fee Schedule rule and 2024 Outpatient Prospective Payment System  rule.

To weigh in, please begin by reviewing the regulations and NABH’s recent 2025 Physician Fee Schedule and 2025 Outpatient Prospective Payment System alerts to help NABH staff identify the priorities we should address with CMS, such as payment, impact on patients and quality, or operational challenges.

Please email your comments to Rochelle Archuleta by Friday, Aug. 9. Comments for both rules are due to CMS by Monday, Sept. 9.

Senate Passes Kids Online Safety and Privacy Act

The Senate on July 30 voted 91-3 to pass the Kids Online Safety and Privacy Act (KOPSA), a combination of the Kids Online Safety Act and the Children and Teens’ Online Privacy Protection Act. The bill would for the first time make social companies such as Facebook and TikTok responsible for the ill effects of design features that recommend content and encourage engagement.

KOPSA prescribes that technology companies must limit the amount of data they collect on children under 17; not target minors with advertising; give children the highest privacy settings by default; offer the ability to opt out of various design features like content recommendations and engagement nudges; and have an independent third party audit their platforms for potential harm to children; among other provisions.

Recent developments have increased pressure on Congress to pass a bill protecting online safety and privacy. Several states have passed social media and privacy laws aimed at mitigating youth harms. And in June, U.S. Surgeon General Vivek Murthy called for social media platforms to come with warning labels.

Technology companies and free speech advocates staunchly oppose the bill, which is expected to face certain legal challenges if it becomes law. Grassroots organizations alarmed by child suicide have pushed for the federal legislation, and have helped to enact laws in California, Colorado, Connecticut, Maryland, and New York meant to regulate social media for minors.

House companion bills are awaiting committee action, with House Energy and Commerce Chair Cathy McMorris Rodgers (R-Wash.) planning a vote this Fall. House Leadership has also signaled interest in the measures and there is bipartisan support for them.

Passing this legislation would be the first major regulation in years to alter how large technology companies interact with children on their platforms.

SAMHSA Releases 2023 National Survey on Drug Use and Health

The Substance Abuse and Mental Health Services Administration (SAMHSA) this week released key findings from the 2023 National Survey on Drug Use and Health (NSDUH).

Conducted by the federal government since 1971, the NSDUH is a primary source of statistical information on self-reported substance use and mental health of the U.S. civilian, noninstitutionalized population 12 or older. Estimates are presented by age group and by race/ethnicity for selected measures.

ASAM Past President Stuart Gitlow Pens Op-Ed on Cannabis Re-Scheduling

Stuart Gitlow, M.D., M.P.H., M.B.A., DFAPA, DFASAM, past president of the American Society of Addiction Medicine, penned an Op-Ed in ASAM Weekly in response to a proposal by the U.S. Justice Department to reschedule marijuana from Schedule I to Schedule III.

Currently, marijuana is illegal at the federal level, while many states have implemented decriminalization and legalization initiatives. This creates a difficult position for physicians (among others, such as dispensaries) who might recommend or fill out state-required forms for medical marijuana.

In his opinion piece, Gitlow argued that this would not change under rescheduling. Additionally, rescheduling would not decriminalize or legalize marijuana use. He also wrote there has not been sufficient research confirming any “true medical utility” of marijuana, whereas there is an understanding that the plant has addictive potential and impacts public health negatively.

Join NABH Sept. 10 for Webinar on the 2024 National Strategy for Suicide Prevention

Please help NABH recognize World Suicide Prevention Day on Tuesday, Sept. 10, 2024 by joining us for a webinar featuring two experts who will highlight HHS’ 2024 National Strategy for Suicide Prevention, a 10-year, comprehensive, societal approach to suicide prevention that provides concrete recommendations for addressing gaps in the suicide-prevention field.

The webinar will feature Julie Goldstein Grumet, Ph.D., vice president of suicide prevention strategy at the Education Development Center (EDC) and director of the EDC’s Zero Suicide Institute; and Colleen Carr, M.P.H., director of the National Action Alliance for Suicide Prevention.

Grumet and Carr will discuss the core strategic directions of the National Strategy; provide context on how these goals fit into current efforts by health systems, providers, and their partners in the field; highlight opportunities to support National Strategy implementation efforts; and what to expect – as well as how to engage – as the new strategy rolls out.

The discussion will also include an overview of key NABH priorities reflected in the new strategy, including workplace violence prevention and current efforts to protect and advance workforce wellbeing, including suicide prevention.

Please register here for this hourlong webinar on Tuesday, Sept. 10 webinar that starts at 2 p.m. ET. I hope you join us!

Reminder: Behavioral Health Business to Examine ‘How AI is Making Healthcare More Human’ in August Webinar

The publication Behavioral Health Business will host a webinar next month to explore how AI could potentially enhance humanity in behavioral health.

The discussion will examine how AI could extend to underserved communities, improve patient outcomes, and increase both clinician and patient satisfaction.

It also promises to highlight new research involving 130,000 patients that shows people are significantly more likely to begin therapy when their experience starts with Limbic, an AI-powered clinical assessment, with the most positive effects observed among minority groups.

The webinar will be held Thursday, Aug. 22 at Noon ET. Click here to register.

ICYMI: CMS Shares Discusses EMTALA and Behavioral Health in ACEP Podcast

CMS participated in the American College of Emergency Physicians’ ACEP Frontline podcast to discuss the Emergency Medical Treatment & Labor Act (EMTALA) and behavioral health.

The podcast describes how behavioral health conditions and physical health conditions are considered similarly from the standpoint of EMTALA.

Reminder: Please Submit Data to NABH’s Denial-of-Care Portal

We urge all NABH members to join those already submitting data to our Denial-of-Care Portal.

We are beginning to use aggregated portal data to illustrate and compare prior authorization practices for commercial, Medicare Advantage, and Medicaid managed care denials.

Policymakers have expressed particular interest in our aggregate estimate on days of uncompensated charity care, as well as the length of delayed health plan responses to prior-authorization requests.

To support this advocacy push, we strongly encourage all NABH members to submit data to the portal. Please contact NABH Associate Manager for Congressional Affair Emily Wilkins with questions about the data metrics that we are collecting and/or the data-submission process.

Fact of the Week

NBC News reported recently that athletes prioritized their mental health ahead of the Summer 2024 Olympic Games that opened in Paris a week ago.

For questions or comments about this CEO Update, please contact Jessica Zigmond.

CEO Update 194

House Passes Bill to Reauthorize Child Welfare Programs Included RTF Provision

The House Ways and Means Committee on Thursday passed unanimously H.R. 9076, the Bipartisan Protecting America’s Children by Strengthening Families Act, to reauthorize and reform the nation’s child welfare programs under Title IV-B of the Social Security Act. Authorization for these programs expired in fiscal year 2021, and there have been no serious reforms since 2008.

Introduced by Reps. Darin LaHood (R-Ill.) and Danny Davis (D-Ill.), H.R. 9076 focuses mainly on America’s child foster care system and also includes a provision titled Improving Data Collection and Reporting for Youth in Residential Treatment Programs.

The language directs HHS and other agencies to update guidance to state agencies in administering state plans approved under parts B and E of title IV of the Social Security Act on a) best practices for federal and state agencies to collect data and share information related to the well-being of youth residing in residential treatment facilities, including those facilities operating in multiple states or serving out-of-state youth; b) best practices on improving state collection and sharing of data related to incidences of maltreatment of youth residing in residential treatment facilities, including with respect to meeting the requirement of section 471(a)(9)(A) of such Act for such youth in foster care; and c) best practices on improving oversight of youth residential programs receiving federal funding and research-based strategies for risk assessment related to the health, safety, and well-being of youth in the facilities.

The House Ways and Means Committee’s passage of this legislation follows the influential panel’s hearing last month about child welfare programs, which included testimony from Paris Hilton, who supported H.R. 2955, The Stop Institutional Child Abuse Act, aspects of which were incorporated into the data collection and reporting Section of H.R. 9076.

The next step would be for H.R. 9076 to move to the House floor for a vote; however, it’s unclear whether the House will consider the legislation. It’ also unknown if the Senate will consider the bill or consider similar legislation.

NABH will continue to monitor any congressional action related to H.R. 9076

HHS Streamlines Technology, Cybersecurity, and AI Functions Under ONC

HHS on Thursday announced a reorganization to streamline and strengthen its technology, cybersecurity, data, and AI strategy and policy functions.

Under the restructured format, the Office of the National Coordinator for Health Information Technology, or ONC, will be renamed the Assistant Secretary for Technology Policy and Office of the National Coordinator for Health Information Technology, or ASTP/ONC. All oversight of technology, data, and AI policy and strategy will move from its current structure under the Assistant Secretary for Administration to ASTP/ONC, including the HHS-wide roles of chief technology officer, chief data officer, and chief AI officer.

In addition, the public-private effort between the health sector and the federal government on cybersecurity (“405(d) Program”) will move from ASA to the Assistant Secretary for Strategic Preparedness and Response, or ASPR, joining the other health sector cybersecurity activities already located in ASPR’s Office of Critical Infrastructure Protection.

Biden Administration Awards $45.1 Million to Expand Mental Health and Substance Use Services

The Biden administration this week announced grant awards totaling $45.1 million – including $15.3 million specifically for children and youth– to expand mental health and substance use services.

The youth funding will go toward supporting their mental health in school settings; serving children and families who have experienced traumatic events and grief; and providing services specific to young people of transitional ages who are at risk for or have serious mental health conditions.

“Be it fostering wellness in young people, caring for the unhoused, facilitating treatment and more, this funding directly supports the needs of our neighbors,” HHS Secretary Xavier Becerra said in an announcement about the funding. “These investments will empower communities to implement effective solutions that promote long-term healing and resilience.”

Click here to read about the various grant awards and access links to apply.

NABH Seeks Member Feedback on CMS’ 2025 PFS and OPPS Proposed Rules

NABH seeks member feedback on the Centers for Medicare & Medicaid Services’ (CMS) proposed 2025 Physician Fee Schedule rule and 2024 Outpatient Prospective Payment System  rule.

To weigh in, please begin by reviewing the regulations and NABH’s recent 2025 Physician Fee Schedule and 2025 Outpatient Prospective Payment System alerts to help NABH staff identify the priorities we should address with CMS, such as payment, impact on patients and quality, or operational challenges.

Please email your comments to Rochelle Archuleta by Friday, Aug. 9. Comments for both rules are due to CMS by Monday, Sept. 9.

Reminder: SAMHSA Announces Funding Opportunity to Enhance Capacity of Women’s Behavioral Health Providers

SAMHSA is accepting applications for its Women’s Behavioral Health Technical Assistance Center to enhance capacity of women’s behavioral health providers, general healthcare providers, and others involved in the holistic care of women with or at risk for mental health and substance use conditions—including women who were greatly affected by the COVID-19 pandemic.

The agency said it has a total of $12.5 million for five years and anticipates granting one award. Applications are due by Tuesday, Aug. 20, 2024. Click here to learn more.

Reminder: Behavioral Health Business to Examine ‘How AI is Making Healthcare More Human’ in August Webinar

The publication Behavioral Health Business will host a webinar next month to explore how AI could potentially enhance humanity in behavioral health.

The discussion will examine how AI could extend to underserved communities, improve patient outcomes, and increase both clinician and patient satisfaction.

It also promises to highlight new research involving 130,000 patients that shows people are significantly more likely to begin therapy when their experience starts with Limbic, an AI-powered clinical assessment, with the most positive effects observed among minority groups.

The webinar will be held Thursday, Aug. 22 at Noon ET. Click here to register.

Reminder: Please Submit Data to NABH’s Denial-of-Care Portal

We urge all NABH members to join those already submitting data to our Denial-of-Care Portal.

We are beginning to use aggregated portal data to illustrate and compare prior authorization practices for commercial, Medicare Advantage, and Medicaid managed care denials.

Policymakers have expressed particular interest in our aggregate estimate on days of uncompensated charity care, as well as the length of delayed health plan responses to prior-authorization requests.

To support this advocacy push, we strongly encourage all NABH members to submit data to the portal. Please contact NABH Associate Manager for Congressional Affair Emily Wilkins with questions about the data metrics that we are collecting and/or the data-submission process.

Fact of the Week

A new poll from the National Alliance on Mental Illness found 82% of Americans are still not familiar with 988, the lifeline that helps people in mental health, substance use, and suicide crises get connected to support services.

For questions or comments about this CEO Update, please contact Jessica Zigmond.

CEO Update 193

FDA & FTC Issue Warnings to Crack Down on Illegal Sales of Food Products with Delta-8 THC

The Food and Drug Administration (FDA) and the Federal Trade Commission this week issued warnings to five companies to crack down on illegal sales of food products containing delta-8 THC.

The products’ packaging resemble familiar snacks and candies, potentially leading to accidental ingestion or overconsumption. The agencies are especially concerned about the appeal to children and potential impurities or unpredictable effects from processes used to synthesize delta-8 THC, the psychoactive cannabinoid from the Cannabis sativa plant.

The companies have 15 working days to submit written responses detailing how they will address these violations and prevent future ones. If the violations are not addressed promptly, the agency may take legal action.

From Jan. 1, 2021, to Dec. 31, 2023, the FDA received more than 300 adverse event reports involving children and adults who consumed delta-8 THC products. In response, the agency issued a warning to customers in June 2022. Meanwhile, between Jan. 1, 2021, and May 31, 2022, national poison control centers handled 10,448 single substance exposure cases involving edible products containing THC, 77% of them for people 19 or younger. 

Adverse effects can include hallucinations, vomiting, tremor, anxiety, dizziness, confusion and loss of consciousness, the agency said.

Joint Commission’s Revised Guidelines for Restraint and Seclusion to Begin Next Year

The Joint Commission has announced new and revised requirements will apply to behavioral healthcare and human services organizations that use restraint and/or seclusion starting on Jan 1, 2025.

The changes include revising the definition of restraint; reducing redundancies; streamlining processes; and removing requirements for physical holding of a child or youth and incorporating this concept into the requirements for restraint and seclusion because physical holding that restricts freedom of movement is a type of restraint.

Click here to learn more.

DEA Rule on Telehealth Slated for September

The Drug Enforcement Administration is expected to issue its highly anticipated telehealth prescribing rule in September, according to an article in Inside Telehealthan Inside Health Policy publication.

“A last-minute title change of the proposed rule may indicate that the registration could allow for prescribing controlled substances across state lines, sources say,” the article noted.

The article also said the rule’s title was updated to “Special Registrations for Telemedicine and Limited State Telemedicine Registration,” according to DEA’s spring regulatory agenda published July 5.

NIH Study: Doctors Reluctant to Treat Addiction Report Lack of Support as Barrier

A new National Institutes of Health study found “instiutional environment” as the most frequently reported reason why physicians are reluctant to intervene in addiction treatment.

“Institutional environment” refers to factors such as lack of support from a physician’s institution or employer; insufficient resources, such as staff and training; challenges in organizational culture; and competing demands. This reason for reluctance was cited in 81% of the studies reviewed, followed by insufficient skill (74%), lack of cognitive capacity to manage a certain level of care (74%), and inadequate knowledge (72%).

Meanwhile, about 66% of studies cited negative social influences – or beliefs about public and community acceptance of addiction care – while 56% of studies cited fear of harming the patient-physician relationship as deterrents for physicians to intervene in addiction.

The study’s findings highlighted the need for institution-wide changes to improve the adoption of evidence-based substance use disorder treatment practices among physicians, such as increasing organizational support, leadership and staff buy-in, and education and training.

Kaiser Family Foundation to Host ‘Beyond Chevron: How the SCOTUS Decision will Affect Healthcare Policy Decisionmaking’ Webinar Next Week

The Kaiser Family Foundation (KFF) will host a webinar next week to discuss the potential challenges stemming from the U.S. Supreme Court’s decision on June 28 to overturn the Chevron precedent that required federal courts to defer to reasonable agency decisions when federal law is unclear.

Moderated by  KFF Executive Vice President for Health Policy Larry Levitt, the discussion will address questions such as: How will the decision change how regulators approach drafting new regulations? What type of health policy regulations are likely to be most vulnerable to future court challenges? How will it alter the legislative process and the ability to pass new laws? And to what extent will Congress be able to provide greater specificity in delegating authority to federal agencies in future legislation?

The 45-minute webinar will be held on Thursday, July 25 at Noon ET. Click here to register.

Behavioral Health Business to Examine ‘How AI is Making Healthcare More Human’ in August Webinar

The publication Behavioral Health Business will host a webinar next month to explore how AI could potentially enhance humanity in behavioral health.

The discussion will examine how AI could extend to underserved communities, improve patient outcomes, and increase both clinician and patient satisfaction.

It also promises to highlight new research involving 130,000 patients that shows people are significantly more likely to begin therapy when their experience starts with Limbic, an AI-powered clinical assessment, with the most positive effects observed among minority groups.

The webinar will be held Thursday, Aug. 22 at Noon ET. Click here to register.

Reminder: SAMHSA Announces Funding Opportunity to Enhance Capacity of Women’s Behavioral Health Providers

SAMHSA is accepting applications for its Women’s Behavioral Health Technical Assistance Center to enhance capacity of women’s behavioral health providers, general healthcare providers, and others involved in the holistic care of women with or at risk for mental health and substance use conditions—including women who were greatly affected by the COVID-19 pandemic.

The agency said it has a total of $12.5 million for five years and anticipates granting one award. Applications are due by Tuesday, Aug. 20, 2024. Click here to learn more.

Reminder: Please Submit Data to NABH’s Denial-of-Care Portal

We urge all NABH members to join those already submitting data to our Denial-of-Care Portal.

We are beginning to use aggregated portal data to illustrate and compare prior authorization practices for commercial, Medicare Advantage, and Medicaid managed care denials.

Policymakers have expressed particular interest in our aggregate estimate on days of uncompensated charity care, as well as the length of delayed health plan responses to prior-authorization requests.

To support this advocacy push, we strongly encourage all NABH members to submit data to the portal. Please contact NABH Associate Manager for Congressional Affair Emily Wilkins with questions about the data metrics that we are collecting and/or the data-submission process.

Fact of the Week

Early population estimates from the Centers for Disease Control and Prevention (CDC) show that around 7% of the entire U.S. adult population reported having Long COVID in 2022. “Some of the most common mental health conditions associated with Long COVID include fatigue, sleep disturbances, depression, anxiety, psychosis, cognitive impairment, obsessive-compulsive disorder, and posttraumatic stress disorder,” the Substance Abuse and Mental Health Services Administration (SAMHSA) reported recently. “Both COVID-19 and Long COVID can result in new onset of behavioral health conditions in those who have not previously reported these conditions, and aggravate complications for those with pre-existing mental health conditions and substance use disorders.”

For questions or comments about this CEO Update, please contact Jessica Zigmond.

CEO Update 192

FDA Releases Guidance on Constructing Effective Clinical Trials for Devices

The FDA on Thursday issued guidance about constructing effective clinical trials to develop medical devices that treat patients who misuse opioids.

The new guidance is intended to improve both the design and development of clinical studies to provide a reasonable assurance of safety and effectiveness for a device intended to treat OUD. Challenges in developing OUD device studies include inaccurate patients report of drug use, high rates of missing data, and confounding effects of concomitant drug treatments.

The guidance is not legally enforceable.

CMS Updates IOP and PHP Payment Rates for 2025

The Centers for Medicare & Medicaid Services (CMS) this week issued its calendar year (CY) 2025 Medicare hospital outpatient prospective payment system (OPPS) proposed rule, which proposes a net increase of 2.3 percentage points, relative to current year rates. The net update reflects a market basket increase of 3.0 percentage points and the statutorily required 0.4 percentage point cut, along with several budget neutrality adjustments and a minor increase in outlier payments.

The proposed update would apply to services paid under the OPPS, intensive outpatient programs (IOP), partial hospitalization programs (PHP), community mental health centers (CMHCs), opioid use disorder (OUD) treatments in an IOP, and other settings.

In addition to other items, the proposed rule addresses the behavioral healthcare provisions summarized below and lists in Table 68 the eight proposed ambulatory payment classification (APC) per diems for IOPs and PHPs that are set according to the number of services provided per day.

IOPs
For the IOP benefit established last year, the current dual-rate, per-diem structure would be maintained: one rate for days with three services and another rate for days with four or more services. In general, the structure of the IOP mirrors the design of the PHP, including provisions on coding, billing, and payment policies.

The rule defines IOPs as distinct and organized outpatient programs of psychiatric services provided for individuals who have an acute mental illness or substance use disorder, consisting of a specified group of behavioral health services paid on a per-diem basis for a minimum of nine hours of IOP services per week, or other payment system.

Opioid Treatment Program (OTP) Payment Add-On
For the new OPPS coverage of OUD treatments that OTPs provide, CMS would maintain the payment add-on of three times the payment rate for APC 5861 (intensive outpatient of three services per day) for hospital-based IOPs.

FQHCs and RHCs
The annual payment update for IOP services provided by federally qualified health centers and rural health clinics will be addressed in the pending physician fee schedule proposed rule for CY 2025.

PHPs
For PHPs, services provided in hospital outpatient departments and CMHCs, CMS proposes to maintain the current payment structure, which sets reimbursements based on whether a patient receives three services versus four or more services per day. PHPs are intensive, structured outpatient programs that are alternatives to psychiatric hospitalization, consisting of a specified group of mental health services paid on a per-diem basis for a minimum of 20 hours of PHP services per week, based on per diem costs.

Access to Non-Opioid Treatments for Pain Relief
As mandated by Congress, CMS is proposing temporary add-on payments for certain non-opioid treatments for pain relief. This complex provision would take effect from Jan. 1, 2025 through Dec. 31, 2027, and would require certain clinical evidence for medical devices and FDA-approved indications for pain management. The payment add-on would be capped at the estimated average of 18% of the full OPPS payment, calculated using the top five procedures by volume for each drug or device. Table 84 in the rule lists the proposed seven injections and other items that would qualify for a payment add-on under this provision.

CMS will accept comments on this rule through Sept 9. See the agency’s related fact sheet for more information.

CMS’ Proposed 2025 PFS Rule Would Cut Overall Payments by 2.8%

In its proposed rule  for the calendar year (CY) 2025 physician fee schedule, the Centers for Medicare & Medicaid Services on Wednesday recommended reducing the conversion factor by 2.8% to $32.36 in CY 2025, compared with $33.29 in CY 2024. This change reflects the expired 2.93% statutory payment increase for CY 2024; a 0.00% conversion factor update under the Medicare Access and Children’s Health Insurance Program Reauthorization Act; and a .05% budget-neutrality adjustment.

Proposed New Behavioral Healthcare Services
The lengthy rule includes these proposals to improve payment for and access to behavioral healthcare services:

  • For people determined to have elevated suicide or overdose risk, a new payment for safety planning interventions and post-discharge follow-up contacts;
  • New digital tools payment for:
    • Post-discharge telephonic follow-up;
    • Software devices that treat a mental health condition in conjunction with ongoing treatment; and
  • Extending evaluation and management services payment to allow clinical psychologists, clinical social workers, marriage and family therapists, and mental health counselors to conduct interprofessional consultations among themselves, as well with psychiatrists and other physicians.

Proposed Payment Updates by Specialty
Table 128 in the proposed rule lists these and other proposed updates by specialty:

  • +3.0% for clinical psychologists;
  • +1.0% for psychiatrists;
  • +4.0% for clinical social workers;
  • +1.0% for family practice physicians;
  • +1.0% for internal medicine physicians; and
  • No change for nurse practitioners.

Opioid Treatment Programs (OTPs)

Telehealth Extended for Methadone Treatment
Regarding methadone treatments, CMS proposes extending current telehealth flexibilities permanently for periodic assessments and initiation of treatment. For beneficiaries lacking permanent access to two-way audio-video communications technology, CMS would allow periodic assessments to be furnished via audio-only communications when applicable requirements are met. To support this proposal, CMS cites evidence that audio-only visits produce many of the same benefits as video-based visits. The rule also notes that this provision would advance the agency’s health equity goals.

For initiation of treatment with methadone for any new patient, audio-visual telehealth may be used if an OTP can conduct an adequate evaluation of the patient. Audio-only telehealth is not permitted. Such telehealth evaluations would use OTP intake add-on code (HCPCS code G2076) and must comply with the Drug Enforcement Administration, the Substance Abuse and Mental Health Services Administration (SAMHSA), and other requirements. These OTP provisions also are intended to align with SAMHSA’s goals for reducing barriers to access.

Payment for Patient Intakes
The rule proposes payment updates for intake activities (HCPCS code G2076) by OTPs, which align with recent SAMHSA reforms to advance patient-centered and evidence-based paradigms of care for Opioid Use Disorder (OUD) treatments such as harm-reduction interventions and recovery support services. Specifically, the rule would implement payment for social determinants of health risk assessments (HCPCS code G0136) to identify unmet health-related social needs or the need for OUD-related harm-reduction interventions and recovery support services. In addition, CMS seeks feedback on how OTPs currently coordinate care and make referrals to community-based organizations that address unmet Health Related Social Needs (HRSNs), provide harm-reduction services, and/or offer recovery support services.

Opioid Agonist and Antagonist Medications
CMS proposes to establish payment for new opioid agonist and antagonist medications that the U.S. Food and Drug Administration approved recently. Specifically, the rule would create a new add-on code to the bundled payment to reflect take-home supplies for nalmefene hydrochloride (nalmefene) nasal spray (Opvee®). The agency also proposes paying for a new extended-release injectable buprenorphine product (Brixadi®), indicated to treat moderate to severe OUD using a new weekly bundled payment code to reflect the weekly formulation of Brixadi®. In addition, the rule would update payment for the existing bundled payment for monthly injectable buprenorphine (HCPCS G2069) in order to reflect payment for the monthly formulation of Brixadi®. CMS’ goals for these changes are to help prevent additional opioid overdose deaths, reduce illicit opioid use, and retain more individuals with an OUD in treatment.

Billing Clarification
The rule also clarifies that for billing, an OUD diagnosis code is required on claims submitted under the Medicare OTP benefit, which helps ensure that payments for Part B OTP services are for the treatment of OUD.

Additional Telehealth Proposals
Permanent Expansion of Audio-only Telehealth
CMS proposes to permanently expand the allowable forms of telehealth “interactive telecommunications systems” to include audio-only communication technology if the patient is not capable of, or does not consent to, the use of video technology.

Temporary Telehealth Expansions
In addition, CMS is proposing temporary changes for the use of audio-visual (not audio-only) telehealth for the purpose of physician/practitioner supervision. Specifically, the rule would expand through CY 2025 the allowance for supervising practitioners to be “immediately available” through audio-visual telehealth. In addition, for CY 2025 only, teaching physicians could continue to supervise audio-visual telehealth services furnished by residents in all teaching settings, such as through a 3-way telehealth visit. Also for CY 2025, the agency will continue to permit physicians to use their currently enrolled practice location instead of their home address when providing telehealth services from home.

The rule also extends through CY 2025 the pandemic-originating coverage of telehealth services provided by federally qualified health centers and rural health clinics. This extension also includes the waiver allowing for reporting of enrolled practice addresses, rather than home addresses, when providers perform services from their home, and the waiver for virtual supervision for residents in all teaching settings when the services are provided virtually.

NABH is displeased that beginning Jan. 1, 2025 – in compliance with federal law – the rule repeals crucial telehealth flexibilities that would subject most digital care to pre-pandemic regulations.

Permanent Audio-visual Telehealth for Low-Risk Services
For services furnished after December 2025, CMS proposes that physician/practitioner oversight via audio-visual telehealth shall be limited to services that are “low risk by their nature, do not often demand in-person supervision, and are typically furnished entirely by the supervised personnel.” CMS’ stated goal for approving remote supervision for these particular low-risk services is that they already are known to balance patient safety concerns with the need to expand access and optimize workforce capacity:

  • Services with the underlying HCPCS code that has been assigned a PC/TC indicator of ‘5’; and
  • Services described by CPT code 99211 (Office or other outpatient visit for the evaluation and management of an established patient that may not require the presence of a physician or other qualified health care professional).

In addition to CMS’ proposed telehealth expansions, Congress is also considering extending telehealth flexibilities beyond this year, most likely through a two-year extension. NABH strongly endorses these flexibilities.

Quality
For reporting in 2025, CMS proposes six new, optional metrics for the quality payment program.
Please see the agency’s news release to read a high-level summary of the rule.

CMS will accept comments on the proposed rule through Sept. 9.

Reminder: SAMHSA Accepting Nominations for First SAMHSA Trailblazers in Advancing Recovery Awards

The Substance Abuse and Mental Health Services Administration (SAMHSA) announced this week it has started accepting nominations for the inaugural SAMHSA Trailblazers in Advancing Recovery (STAR) awards, which honor leaders with lived experience of mental health and/or substance use condition, including family members whose lives have been affected.

The new STAR awards will also recognize organizations that have demonstrated a commitment to promoting equitable and inclusive access to wellness and recovery supports for individuals with mental health and/or substance use conditions.

Last year SAMHSA published Recovery from Substance Use and Mental Health Problems Among Adults in the United States, which reports that more than 70% of people, or about 50 million people, identified as ever having a mental health and/or substance use problem were in recovery.

Nominations opened June 26 and will remain open through July 18. SAMHSA is planning an awards ceremony that it will livestream in September as part of National Recovery Month. Click here to learn about the award categories, eligibility requirements, and nominating process.

Reminder: SAMHSA Announces Funding Opportunity to Enhance Capacity of Women’s Behavioral Health Providers

SAMHSA is accepting applications for its Women’s Behavioral Health Technical Assistance Center to enhance capacity of women’s behavioral health providers, general healthcare providers, and others involved in the holistic care of women with or at risk for mental health and substance use conditions—including women who were greatly affected by the COVID-19 pandemic.

The agency said it has a total of $12.5 million for five years and anticipates granting one award. Applications are due by Tuesday, Aug. 20, 2024. Click here to learn more.

Reminder: ONC Funding Opportunity Seeks to Accelerate BHIT

HHS’ Office of the National Coordinator for Health Information Technology (ONC) last month announced a funding opportunity totaling $2 million for fiscal year 2024 under the Leading Edge Acceleration Projects (LEAP) in Health Information Technology (Health IT).

ONC is seeking applications that address two areas of interest. The first area seeks to develop innovative ways to evaluate and improve the quality of healthcare data used in artificial intelligence (AI) tools in healthcare to improve electronic health record technologies.

The second area is focused on designing, developing, and piloting lightweight health IT solutions that can enhance health IT capabilities in behavioral healthcare settings and improve care coordination between behavioral healthcare and clinical healthcare settings.

“These two areas of interest are a natural extension of ONC’s work,” Steve Posnack, deputy national coordinator for health information technology and an NABH 2024 Annual Meeting speaker, said in a statement. “We look forward to receiving innovative applications and seeing the impacts generated by selected awardees.”

Click here to learn more about the grant opportunity; ONC will accept applications through today, July 12, 2024.

Reminder: Please Submit Data to NABH’s Denial-of-Care Portal

We urge all NABH members to join those already submitting data to our Denial-of-Care Portal.

We are beginning to use aggregated portal data to illustrate and compare prior authorization practices for commercial, Medicare Advantage, and Medicaid managed care denials.

Policymakers have expressed particular interest in our aggregate estimate on days of uncompensated charity care, as well as the length of delayed health plan responses to prior-authorization requests.

To support this advocacy push, we strongly encourage all NABH members to submit data to the portal. Please contact NABH Associate Manager for Congressional Affair Emily Wilkins with questions about the data metrics that we are collecting and/or the data-submission process.

Fact of the Week

Results from a recent national survey showed 61% of Americans are unaware that primary care physicians can prescribe medication for opioid use disorder and 13% incorrectly believed that they could not, according to study published in JAMA.
                                  
For questions or comments about this CEO Update, please contact Jessica Zigmond.

CEO Update 191

House Ways and Means Committee Hearing Examines U.S. Child Welfare System 
and RTFs

The House Ways and Means Committee on Wednesday held a hearing about strengthening America’s child welfare system and protecting America’s children through reauthorizing Title IV-B, a child and youth foster-care program.

Although committee members focused primarily on improving the nation’s child foster care system, they also asked several questions of witness Paris Hilton, who testified about Residential Treatment Facilities (RTFs) and offered support for S.1351/H.R.2955, The Stop Institutional Child Abuse Act. Members and witnesses acknowledged the need for RTFs and also called for greater state and federal oversight, an expanded workforce, additional mental healthcare for children in the youth foster-care system outside RTFs, and more community-based care.

The hearing was one of several this Congress held to explore reauthorizing the Social Security Act’s Title IV-B program, which provides flexible funding for states to support family preservation, reunification, adoption, and permanency for children in foster care. Congress has not reauthorized the program since 2008.

In addition to potentially reauthorizing Title IV-B, several committee members discussed legislation they have drafted related to RTFs, which the committee could examine in a future mark-up session. These bills include:

H.R. 8817, the Promoting Accountability, Reporting, Information Sharing, and Health Act, by Reps. Steube (R-Fla.) and Jimmy Panetta (D-Calif.), which directs the U.S. Health and Human Services Department, the U.S. Education Department, the Administration for Children and Families, the Center for Medicare & Medicaid Services, and the U.S. Justice Department, to develop guidance on best practices for federal agencies and states. The guidance would focus on collecting data collection and sharing information related to youth well-being in RTFs, improving data on maltreatment, and enhancing oversight of youth residential programs receiving federal funding.

H.R. 8643, the Foster Youth Mental Health Support Act, by Rep. Michelle Steel (R-Calif.), which amends subpart 1 of Title IV part B of the Social Security Act to strengthen state plan requirements to include comprehensive mental health and well-being for children and youth in foster care.

Both bills were recently introduced, and NABH will share the bill language with members as soon as it is available. NABH sent the Ways and Means Committee comments about RTFs and our new youth RTF fact sheet, which highlights 10 essential facts about youth RTFs.

NABH Congratulates Board Chair Frank Ghinassi for AHRQ Technical Expert Panel Position

NABH is pleased to announce NABH Board Chair Frank Ghinassi, Ph.D., A.B.P.P., president and CEO of Rutgers University Behavioral Health Care and vice president of the behavioral health and addictions service line at RWJBarnabas Health, is serving on a behavioral health technical expert panel (TEP) that the Office of the Assistant Secretary, or ASPE, convened in partnership with the Agency for Healthcare Research and Quality (AHRQ).

ASPE and AHRQ engaged research firm Mathematica to identify and recommend behavioral health integration measure concepts for further development. In Phase 1 – completed in March 2024 – the team conducted an environmental scan and gathered feedback from key stakeholders about priorities for measures related to the integration of behavioral and physical healthcare.

In Phase 2, the current phase, the team will develop draft measure specifications based on further review of the literature and interviews with key stakeholders. The TEP will provide feedback on the draft measure specifications as well as the face validity of the measures, according to a memo from Mathematica, which said it will use the TEP feedback to refine the measure specifications.

ICYMI: Surgeon General’s Op-Ed on Why Social Media Platforms Should Carry Warning Labels

U.S. Surgeon General Vivek Murthy, M.D., M.B.A., last week penned an op-ed in The New York Times urging social media platforms to carry warning labels.

“The mental health crisis among young people is an emergency— and social media has emerged as an important contributor,” Murthy wrote. “Adolescents who spend more than three hours a day on social media face double the risk of anxiety and depression symptoms, and the average daily use in this age group, as of the summer of 2023, was 4.8 hours. Additionally, nearly half of adolescents say social media makes them feel worse about their bodies,” he continued. “It is time to require a surgeon general’s warning label on social media platforms, stating that social media is associated with significant mental health harms for adolescents.

Murthy added that a surgeon general’s warning label – which requires congressional action – would regularly remind parents and adolescents that social media has not been proved safe. He recognized that a warning label alone will not keep kids safe and added that the advisory he issued last year includes specific recommendations for policymakers, platforms, and the public to make social media safer for kids.

SAMHSA Accepting Nominations for First ‘SAMHSA Trailblazers in Advancing Recovery’ Awards

The Substance Abuse and Mental Health Services Administration (SAMHSA) announced this week it has started accepting nominations for the inaugural SAMHSA Trailblazers in Advancing Recovery (STAR) awards, which honor leaders with lived experience of mental health and/or substance use condition, including family members whose lives have been affected.

The new STAR awards will also recognize organizations that have demonstrated a commitment to promoting equitable and inclusive access to wellness and recovery supports for individuals with mental health and/or substance use conditions.

Last year SAMHSA published Recovery from Substance Use and Mental Health Problems Among Adults in the United States, which reports that more than 70% of people, or about 50 million people, identified as ever having a mental health and/or substance use problem were in recovery.

Nominations opened June 26 and will remain open through July 18. SAMHSA is planning an awards ceremony that it will livestream in September as part of National Recovery Month.

Click here to learn about the award categories, eligibility requirements, and nominating process.

SAMHSA Announces Funding Opportunity to Enhance Capacity of Women’s Behavioral Health Providers

SAMHSA is accepting applications for its Women’s Behavioral Health Technical Assistance Center to enhance capacity of women’s behavioral health providers, general healthcare providers, and others involved in the holistic care of women with or at risk for mental health and substance use conditions—including women who were greatly affected by the COVID-19 pandemic.

The agency said it has a total of $12.5 million for five years and anticipates granting one award. Applications are due by Tuesday, Aug. 20, 2024. Click here to learn more.

Reminder: ONC Funding Opportunity Seeks to Accelerate BHIT

HHS’ Office of the National Coordinator for Health Information Technology (ONC) last month announced a funding opportunity totaling $2 million for fiscal year 2024 under the Leading Edge Acceleration Projects (LEAP) in Health Information Technology (Health IT).

ONC is seeking applications that address two areas of interest. The first area seeks to develop innovative ways to evaluate and improve the quality of healthcare data used in artificial intelligence (AI) tools in healthcare to improve electronic health record technologies.

The second area is focused on designing, developing, and piloting lightweight health IT solutions that can enhance health IT capabilities in behavioral healthcare settings and improve care coordination between behavioral healthcare and clinical healthcare settings.

“These two areas of interest are a natural extension of ONC’s work,” Steve Posnack, deputy national coordinator for health information technology and an NABH 2024 Annual Meeting speaker, said in a statement. “We look forward to receiving innovative applications and seeing the impacts generated by selected awardees.”

Click here to learn more about the grant opportunity; ONC will accept applications through July 12, 2024.

Reminder: Please Submit Data to NABH’s Denial-of-Care Portal

We urge all NABH members to join those already submitting data to our Denial-of-Care Portal.

We are beginning to use aggregated portal data to illustrate and compare prior authorization practices for commercial, Medicare Advantage, and Medicaid managed care denials.

Policymakers have expressed particular interest in our aggregate estimate on days of uncompensated charity care, as well as the length of delayed health plan responses to prior-authorization requests.

To support this advocacy push, we strongly encourage all NABH members to submit data to the portal. Please contact NABH Associate Manager for Congressional Affair Emily Wilkins with questions about the data metrics that we are collecting and/or the data-submission process.

Fact of the Week

study published in JAMA last week found that, despite their known association with reduced risk of a fatal drug overdose, only a small percentage of Medicare beneficiaries (4.1%) received medications for opioid use disorder (MOUD) or filled a naloxone prescription (6.2%) in the 12 months after a nonfatal drug overdose. “Efforts to improve access to behavioral health services; MOUD; and overdose-prevention strategies, such as prescribing naloxone and linking individuals to community-based health care settings for ongoing care, are needed,” the study noted.

Happy Independence Day from NABH!

NABH will not publish CEO Update on Friday, July 5 and will resume on Friday, July 12. The NABH team wishes you, your families, and your teams a happy and safe Independence Day weekend!

For questions or comments about this CEO Update, please contact Jessica Zigmond.

CEO Update 190

House Ways & Means Committee to Host Hearing Next Week on Strengthening 
Child Welfare

The House Ways and Means Committee is scheduled to conduct a hearing next Wednesday, June 26 focused on strengthening child welfare by reauthorizing Title IV-B, a program serving children and youth in foster care. Policymakers are expected to review youth Residential Treatment Facilities (RTFs) during the hearing.

Among witnesses invited to testify is Paris Hilton, who has spoken about her turbulent experience at a youth treatment center and is an advocate for S.1351/H.R.2955, The Stop Institutional Child Abuse Act. The bill establishes an interagency Federal Work Group on Youth Residential Programs to support and implement best practices regarding the health and safety, care, treatment, and appropriate placement of youth in youth residential programs.

The hearing is part of the Committee’s ongoing focus to reauthorize the Social Security Act’s Title IV-B programs. The Committee has previously held several hearings to examine various programs included in Title IV-B. The Title IV-B program provides flexible funding for states to support family preservation, reunification, adoption, and permanency for children in foster care; however, many consider the program outdated, and Congress has not reauthorized it since 2008.

NABH will submit comments to the Ways & Means Committee and will also share our new youth RTF fact sheet, which highlights 10 essential facts about youth RTFs.

The hearing comes on the heels of last week’s Senate Finance Committee hearing about RTFs, “Youth Residential Treatment Facilities: Examining Failures and Evaluating Solutions” and a partisan report, Warehouse of Neglect: How Taxpayers Are Funding Systemic Abuse in Youth Residential Treatment Facilities, which cites limitations and problems at youth RTFs and fails to recognize the critical care, treatment, and educational support these programs provide to America’s youth. NABH sent this letter to the Senate Finance Committee last week in conjunction with the hearing.

CMS Announces Funding Opportunity Application Period for the Innovation in Behavioral Health Model

The Centers for Medicare & Medicaid Services (CMS) this week released its notice of funding opportunity application for the Innovation in Behavioral Health (IBH) model that focuses on improving the behavioral and physical health outcomes and quality of care for Medicare and Medicaid enrollees who experience moderate to severe behavioral health conditions.

The IBH Model is a state-based model that state Medicaid agencies (SMAs) lead with a goal of aligning payment between Medicaid and Medicare for integrated care.

CMS will select up to eight SMAs to participate in the IBH Model, and these agencies will use cooperative agreement funding to develop necessary infrastructure and capacity to implement the IBH Model. The SMAs will recruit “Practice Participants” to deliver care, and they will receive funding to support necessary upgrades to health information technology, electronic health records, practice transformation activities, and staffing to implement the model.

CMS will issue award notices to selected SMAs in mid-December. Learn more from this CMS IBH model overview fact sheet. For additional questions, you can reach the IBH Model team at IBHModel@cms.hhs.gov.

SAMHSA Announces New Way to Order 988 Print Materials

The Substance Abuse and Mental Health Services Administration has announced a new website to order 988 awareness printed materials.

“Over the past two years, we’ve heard your requests to simplify and improve the ordering process for 988 Suicide & Crisis Lifeline print materials,” SAMHSA said in an announcement. “We know that print materials are a critical need for all who are working to raise awareness about 988 across the country, and we have been working behind the scenes to improve this process.”

Providers and other partners will still be able to use the “order print materials” link from SAMHSA’s 988 Partner Toolkit.

CDC Reports 26% Drop in Uninsured Americans Since 2019

New data from the Centers for Disease Control and Prevention’s National Health Interview Survey (NHIS) show 7.6% of Americans did not have health insurance in 2023, compared with 10.3% of Americans without health insurance in 2019, reflecting a 26% decrease in the number of uninsured Americans.

Meanwhile, the NHIS reported that among adults ages 18–64 living in Medicaid expansion states, the percentage with public coverage increased to 25.2% in 2023 from 23.4% in 2019. A similar increase in public coverage was observed among adults living in non-Medicaid expansion states 18.1% in 2023 from 15.1% in 2019.

In a story this week, Behavioral Health Business highlighted how more Americans with health insurance could affect the behavioral healthcare segment.

Reminder: ONC Funding Opportunity Seeks to Accelerate BHIT

HHS’ Office of the National Coordinator for Health Information Technology (ONC) last month announced a funding opportunity totaling $2 million for fiscal year 2024 under the Leading Edge Acceleration Projects (LEAP) in Health Information Technology (Health IT).

ONC is seeking applications that address two areas of interest. The first area seeks to develop innovative ways to evaluate and improve the quality of healthcare data used in artificial intelligence (AI) tools in healthcare to improve electronic health record technologies.

The second area is focused on designing, developing, and piloting lightweight health IT solutions that can enhance health IT capabilities in behavioral healthcare settings and improve care coordination between behavioral healthcare and clinical healthcare settings.

“These two areas of interest are a natural extension of ONC’s work,” Steve Posnack, deputy national coordinator for health information technology and an NABH 2024 Annual Meeting speaker, said in a statement. “We look forward to receiving innovative applications and seeing the impacts generated by selected awardees.”

Click here to learn more about the grant opportunity; ONC will accept applications through July 12, 2024.

Reminder: Please Submit Data to NABH’s Denial-of-Care Portal

We urge all NABH members to join those already submitting data to our Denial-of-Care Portal.

We are beginning to use aggregated portal data to illustrate and compare prior authorization practices for commercial, Medicare Advantage, and Medicaid managed care denials.

Policymakers have expressed particular interest in our aggregate estimate on days of uncompensated charity care, as well as the length of delayed health plan responses to prior-authorization requests.

To support this advocacy push, we strongly encourage all NABH members to submit data to the portal. Please contact NABH Associate Manager for Congressional Affair Emily Wilkins with questions about the data metrics that we are collecting and/or the data-submission process.

Fact of the Week

Hospitals that report using AI to detect patterns of drug diversion – when drugs are stolen from hospitals – nearly doubled to 56% in 2023 from 29% in 2019, according to a Wolters Kluwer survey.

For questions or comments about this CEO Update, please contact Jessica Zigmond.

CEO Update 189

Senate Finance Committee Holds Hearing and Releases Report on Youth RTFs

In conjunction with a hearing Wednesday, the Senate Finance Committee released Warehouse of Neglect: How Taxpayers Are Funding Systemic Abuse in Youth Residential Treatment Facilities, a partisan report that cites limitations and problems at youth RTFs and fails to recognize the critical care, treatment, and educational support these programs provide to America’s youth.

Only members of the Committee’s minority staff developed the report, a two-year effort that focused on four operators of youth residential treatment facilities (RTFs), including three NABH system members.

“NABH is eager to work with federal leaders to develop policies that advance access to quality care in the appropriate settings for U.S. youth who struggle with mental health and substance use disorders,” NABH President and CEO Shawn Coughlin said in a statement Wednesday. “We also want to remind congressional leaders that if public discourse about youth RTFs is to benefit the common good, we need to ensure that policymakers, members of the media, worried parents, concerned teachers, and the general public share the same, clear understanding of the role that regulated, licensed RTFs play in the behavioral healthcare continuum.”

The report recommended three main points: 1) children placed in RTFs must be afforded safety, dignity, and homelike conditions and provided with the treatment and support that they need, 2) government funding should prioritize community-based services and placements to address children’s behavioral health needs, and 3) effective oversight mechanisms of RTFs require substantial investment at all levels of government.

At the hearing, several Democratic members joined Senate Finance Committee Chairman Ron Wyden (D-Ore.) and Ranking Member Mike Crapo (R-Idaho). Several witnesses, including a disabilities-rights advocate and a Government Accountability Office representative, painted an incomplete picture of the care and treatment that RTFs provide. While most acknowledged youth RTFs play a role in the behavioral healthcare continuum, senators and witnesses called for more home and community-based services and better state and federal oversight, among other recommendations.

Meanwhile, there were no statements that reflected the successful treatment in RTF programs and the increasing need for them in the United States today. Since 2010, the number of youth residential treatment programs has declined by 60.9%; the number of youth served has declined by 77%; and the number of beds has declined by 66.2%; according to a May 2024 study from the Manhattan Institute.

Also Wednesday, NABH sent a letter to the Senate Finance Committee and released a new youth RTF fact sheet, which highlights 10 essential facts about youth RTFs. Please share the fact sheet with your teams and engage with NABH’s X and LinkedIn posts to spread the message about these facilities and the critical – and often life-saving – care that NABH members provide in RTFs every day.

Legal Action Center to Host Webinar Next Week on How SUD Providers Can Leverage Medicaid Reentry for People Leaving Prisons and Jails

Medicaid reentry is a new federal policy meant to strengthen access to health coverage and transitional services for people preparing to come home from prison or jail, with a primary goal to prevent overdose among reentering individuals.

The Legal Action Center, an Opioid Response Network training partner, will host Medicaid Reentry: How Substance Use Disorder Service Providers/Stakeholders Can Leverage This New Opportunity to Strengthen Equitable Health Outcomes for People Leaving Prison/Jail, a 75-minute webinar next Thursday, June 20 starting at noon ET.

Click here to add the event to your calendar.

National Academies Releases Publication on Adult ADHD

The National Academies has released Adult Attention-Deficit/Hyperactivity Disorder: Drug Development, Diagnosis, and Treatment, which is based on proceedings from a December 2023 workshop about the topic.

According to the National Academies, evidence suggests adults with ADHD may be more likely to develop an SUD, and there are concerns that non-medical use of prescription stimulants could lead to misuse, overdose, or toxicity.

Reminder: ONC Funding Opportunity Seeks to Accelerate BHIT

HHS’ Office of the National Coordinator for Health Information Technology (ONC) last month announced a funding opportunity totaling $2 million for fiscal year 2024 under the Leading Edge Acceleration Projects (LEAP) in Health Information Technology (Health IT).

ONC is seeking applications that address two areas of interest. The first area seeks to develop innovative ways to evaluate and improve the quality of healthcare data used in artificial intelligence (AI) tools in healthcare to improve electronic health record technologies.

The second area is focused on designing, developing, and piloting lightweight health IT solutions that can enhance health IT capabilities in behavioral healthcare settings and improve care coordination between behavioral healthcare and clinical healthcare settings.

“These two areas of interest are a natural extension of ONC’s work,” Steve Posnack, deputy national coordinator for health information technology and an NABH 2024 Annual Meeting speaker, said in a statement. “We look forward to receiving innovative applications and seeing the impacts generated by selected awardees.”

Click here to learn more about the grant opportunity; ONC will accept applications through July 12, 2024.

Reminder: Please Submit Data to NABH’s Denial-of-Care Portal

NABH thanks all members who have submitted data to the association’s Denial-of-Care Portal. You have provided critical information that expands the portal and helps NABH strengthen its advocacy efforts related to erroneous prior-authorization denials.

With guidance from our members, NABH has improved the portal by adding two elements:

  1. Time-based data on the number of days between a request for coverage and a plan’s denial, which improves our ability to assess and compare health plan responsiveness.
  2. The gap between days of provided care versus days of covered care to quantify and compare uncompensated days per health plan.

We strongly encourage all NABH members to submit their denial-of-care data in the portal. If you need help starting, or if you have other questions, please e-mail NABH Associate Manager for Congressional Affairs Emily Wilkins.

Fact of the Week

The number of individual pills containing fentanyl that law enforcement officer seized was 2,300 times greater in 2023 compared with 2017, with 115,562,603 pills seized in 2023 versus 49,657 in 2017, according to a recent announcementfrom the National Institute on Drug Abuse.

For questions or comments about this CEO Update, please contact Jessica Zigmond.

CEO Update 188

Senate Democrats Pressure Biden Administration to Complete Final Parity Rule

A group of Senate Democrats is pressuring the Biden administration to complete and release its final rule on the Mental Health Parity and Addiction Equity Act’s requirements.

In a letter to the leaders of HHS, the Internal Revenue Service, and the U.S. Labor Department’s Employee Benefits and Security Administration, Sens. Chris Murphy (Conn.), Peter Welch (Vt.), Alex Padilla (Calif.), Ed Markey (Mass.), Amy Klobuchar (Minn.), and Ben Ray Luján (N.M.) urged the Biden administration to stay the course on completing its work to finalize the 2023 proposed rule.

The letter noted: “…these rules will close existing loopholes in the law, expand narrow networks, and prohibit restrictive practices that prevent families from accessing care.”

Particularly important are the rules that combat the nonquantitative treatment limitations that are being used to deny mental health services to patients. These common-sense parity rules will help Americans suffering from mental health conditions or substance use disorder, reduce costs for taxpayers, and save lives.

NABH and leaders of mental health advocacy groups are also strongly urging these agency leaders to oppose efforts from insurance and employer groups to weaken the proposed rule’s strong protections.

Meanwhile, these communications come as a powerful group of employer organizations – the ERISA Industry Committee, the Partnership for Employer-Sponsored Coverage, and the U.S. Chamber of Commerce – have pushed back on the administration and the proposed rule, arguing that the regulations would be “unworkable” and undermine access to care.

Insurers have also slammed the proposed rule, saying it wouldn’t address underlying workforce shortages, which they say limit access to care. The Treasury Department has targeted June to finalize the rules, although it remains uncertain if that will happen.

HRSA Accepting STAR Loan Repayment Program Applications Through June 27

The Health Resources and Services Administration (HRSA) will accept applications from eligible
SUD treatment clinicians and community health workers for its Substance Use Disorder Treatment and Recovery (STAR) Loan Repayment Program through Thursday, June 27.

Click here for guidance about the STAR Loan Repayment program and here for information about the application process.

HRSA Adds Occupations to Guide for Licensure Portability

HRSA has announced that counseling and school psychologists have been added as new disciplines to the Multi-Discipline Licensure Resource Project that HRSA supports with the Association of State and Provincial Psychology Boards.

Previously the site provided guidance for psychology, social work, physical therapy, and occupational therapy. The new disciplines include counseling, dentistry, dieticians, emergency medical services, physician assistants, nursing, advanced practice nursing, and school psychologists.

SAMHSA Releases Issue Brief on Peer Support in Mental Health

The Substance Use and Mental Health Services Administration has released an issue brief for state mental health authorities about the benefits of peer support and inclusion of the peer workforce throughout the behavioral healthcare continuum.

The new resource highlights current standards and best practices for including peer support workers as an essential component of services delivery for mental and co-occurring disorders such as SUD.

Reminder: ONC Funding Opportunity Seeks to Accelerate BHIT

HHS’ Office of the National Coordinator for Health Information Technology (ONC) last month announced a funding opportunity totaling $2 million for fiscal year 2024 under the Leading Edge Acceleration Projects (LEAP) in Health Information Technology (Health IT).

ONC is seeking applications that address two areas of interest. The first area seeks to develop innovative ways to evaluate and improve the quality of healthcare data used in artificial intelligence tools in healthcare to improve electronic health record technologies.

The second area is focused on designing, developing, and piloting lightweight health IT solutions that can enhance health IT capabilities in behavioral healthcare settings and improve care coordination between behavioral healthcare and clinical healthcare settings.

“These two areas of interest are a natural extension of ONC’s work,” Steve Posnack, deputy national coordinator for health information technology and an NABH 2024 Annual Meeting speaker, said in a statement. “We look forward to receiving innovative applications and seeing the impacts generated by selected awardees.”

Click here to learn more about the grant opportunity; ONC will accept applications through July 12, 2024.

Reminder: Please Submit Data to NABH’s Denial-of-Care Portal

NABH thanks all members who have submitted data to the association’s Denial-of-Care Portal. You have provided critical information that expands the portal and helps NABH strengthen its advocacy efforts related to erroneous prior-authorization denials.

With guidance from our members, NABH has improved the portal by adding two elements:

  1. Time-based data on the number of days between a request for coverage and a plan’s denial, which improves our ability to assess and compare health plan responsiveness.
  2. The gap between days of provided care versus days of covered care to quantify and compare uncompensated days per health plan.

We strongly encourage all NABH members to submit their denial-of-care data in the portal. If you need help starting, or if you have other questions, please e-mail NABH Associate Manager for Congressional Affairs Emily Wilkins.

Fact of the Week

Starting people with opioid use disorder on extended-release, injectable naltrexone (XR-naltrexone) within five to seven days of seeking treatment is more effective than the standard treatment method of starting within 10-15 days, but requires closer medical supervision, according to results from a National Institute on Drug Abuse-supported clinical trial.

For questions or comments about this CEO Update, please contact Jessica Zigmond.

CEO Update 187

NABH Comments on Fiscal Year 2025 IPF PPS Final Rule

This week NABH sent its public comment letter to the Centers for Medicare & Medicaid Services (CMS) about the agency’s fiscal year 2025 inpatient psychiatric facility prospective payment system (IPF PPS) rule.

In the letter, NABH emphasized that the proposed net update for FY 2025 – an increase of 2.6% percent relative to FY 2024 rates – does not adequately account for the nationwide cost pressures that IPFs continue to face.

“The update does not reflect the remaining healthcare cost inflation that was sparked by the COVID-19 pandemic and still persists in the form of workforce pressures and shortages and other elevated costs,” NABH wrote. “These include continued head-to-head wage competitions with other employers within and outside of local healthcare marketplaces, which are exacerbated by burnout among clinical and non-clinical personnel, and other factors that continually pressure IPFs to raise compensation levels.”

NABH offered its perspective and suggestions on a range of other topics, including the need for modern behavioral health information technology, a request to delay the requirement for ancillary-services reporting by two years, and proposed quality reporting changes.

“NABH urges CMS to delay implementing its proposed policy restriction on all-inclusive reporting. Given the complexity of transitioning from all-inclusive to traditional reporting of ancillary charges, the proposed effective date of Oct. 1, 2024 is impossible and should be changed to Oct. 1, 2026.”

The association thanks all its members who gave their time and recommendations in the last few months to help NABH prepare the letter to CMS.

FDA Launches ‘Prescribe with Confidence’ Campaign to Help Providers Treat OUD

The U.S. Food and Drug Administration (FDA) has launched Prescribe with Confidence, a campaign to help healthcare providers recognize and treat opioid use disorder (OUD), which the agency says affects 6 million people over the age of 12 in the United States.

“Research shows that OUD treatment is most effective when medications are used,” FDA Commissioner Robert Carliff, M.D. said in a brief video about the campaign.

In its announcement, the FDA noted that many primary care providers have found prescribing medications to treat OUD is easier than they thought it would be. The agency has provided firsthand testimonials, free training, and other resources to help providers. Click here to learn more.

ICYMI: 2024 NABH Annual Meeting Highlights

NABH thanks all who traveled to Washington earlier this month for the association’s 2024 Annual Meeting!

Photos from the meeting are now available. If you choose to use any of these pictures, please credit photographer Chris Ferenzi.

NABH has shared the Annual Meeting slide presentations and learned some attendees had trouble downloading them. We have re-posted the presentations as PDF documents on our 2024 Annual Meeting Speakers & Presentations page. David Wasserman’s presentation will be available until today, Friday, May 31.

We’ve received positive feedback about the NABH Education and Research Foundation’s workforce panel, and we urge you to share NABH’s Workforce Startup Guide with your teams. You can download the guide on NABH’s website homepage.

Reminder: ONC Funding Opportunity Seeks to Accelerate BHIT

HHS’ Office of the National Coordinator for Health Information Technology (ONC) on May 13 announced a funding opportunity totaling $2 million for fiscal year 2024 under the Leading Edge Acceleration Projects (LEAP) in Health Information Technology (Health IT).

ONC is seeking applications that address two areas of interest. The first area seeks to develop innovative ways to evaluate and improve the quality of healthcare data used in artificial intelligence (AI) tools in healthcare to improve electronic health record technologies.

The second area is focused on designing, developing, and piloting lightweight health IT solutions that can enhance health IT capabilities in behavioral healthcare settings and improve care coordination between behavioral healthcare and clinical healthcare settings.

“These two areas of interest are a natural extension of ONC’s work,” Steve Posnack, deputy national coordinator for health information technology and an NABH 2024 Annual Meeting speaker, said in a statement. “We look forward to receiving innovative applications and seeing the impacts generated by selected awardees.”

Click here to learn more about the grant opportunity.

Reminder: Please Submit Data to NABH’s Denial-of-Care Portal

NABH thanks all members who have submitted data to the association’s Denial-of-Care Portal. You have provided critical information that expands the portal and helps NABH strengthen its advocacy efforts related to erroneous prior-authorization denials.

With guidance from our members, NABH has improved the portal by adding two elements:

  1. Time-based data on the number of days between a request for coverage and a plan’s denial, which improves our ability to assess and compare health plan responsiveness.
  2. The gap between days of provided care versus days of covered care to quantify and compare uncompensated days per health plan.

We strongly encourage all NABH members to submit their denial-of-care data in the portal. If you need help starting, or if you have other questions, please e-mail NABH Associate Manager for Congressional Affairs Emily Wilkins.

Fact of the Week

A new analysis in JAMA highlights how a hospital cyberattack can affect neighboring facilities and an entire community’s care: researchers examined emergency department (ED) discharge data from the California Department of Health Care Access and Information between 2014-2020 and found a temporary decrease in ED visits and inpatient admissions at hospitals targeted by ransomware attacks and a temporary increase in ED visits at nearby, unaffected hospitals.

For questions or comments about this CEO Update, please contact Jessica Zigmond.

CEO Update 186

2024 NABH Annual Meeting & Hill Day Highlights

NABH thanks all who traveled to Washington last week for the 2024 Annual Meeting!

Photos from the meeting are now available. If you choose to use any of these pictures, please credit photographer Chris Ferenzi.

Last week NABH shared the Annual Meeting slide presentations and learned some attendees had trouble downloading them. We have re-posted the presentations as PDF documents on our 2024 Annual Meeting Speakers & Presentations page. David Wasserman’s presentation will be available until May 31.

We’ve received positive feedback about the NABH Education and Research Foundation’s workforce panel, and we urge you to share NABH’s Workforce Startup Guide with your teams. You can download the guide on NABH’s website homepage.

NABH also thanks all members who participated in Hill Day in conjunction with #NABH2024! Our members met with policymakers and their staff and highlighted the crucial need to secure the promise of parity between behavioral and physical healthcare, increase the behavioral healthcare workforce, and invest in behavioral health information technology to adopt electronic health records.

NABH members conducted more than 60 congressional meetings and prioritized key offices for policymakers who serve on committees of jurisdiction overseeing behavioral healthcare policy, including the Senate Finance Committee, Senate Health, Education, Labor and Pension Committee, House Energy and Commerce Committee, and House Ways and Means Committee.

Please save the date for next year’s Annual Meeting: May 12-14, 2025 at the Salamander Washington, DC!

House Committees Advance Telehealth Extension Bills

The House Energy & Commerce Health Subcommittee on May 16 unanimously advanced telehealth legislation to the full House Energy & Commerce Committee that would extend for two years key COVID-19 pandemic telehealth waivers scheduled to expire at the end of this year.

The bill that the Subcommittee advanced – similar to the bill the House Ways & Means Committee passed in the previous week – would delay the in-person requirement and originating site restrictions for mental health services and extend the provision for audio-only telehealth services for the next two years. Both bills also include a five-year extension of waivers for the Acute Hospital Care at Home program, allowing patients to receive hospital-level care in their homes until 2029.

The House Energy & Commerce’s bill includes payment parity for federally qualified health centers and rural health clinics, so they can bill the same amount for telehealth and in-person outpatient services. Under the House Ways & Means Committee’s bill, the centers would be reimbursed at lower rates for most virtual services.

Meanwhile, the Energy & Commerce panel also advanced a second telehealth bill that would establish a Medicare incident to modifier for mental health services furnished through telehealth. Both committees’ bills include offsets that impose new transparency requirements on pharmacy benefit managers and delay the upcoming changes to Medicare payment rates for clinical lab tests by one year.

The Senate has yet to take up a telehealth extension bill, although Senate Finance Committee Chair Ron Wyden (D-Ore.) is pushing to extend permanently some of the COVID-19-era telehealth flexibilities set to expire at the end of this calendar year. If Congress passes a short-term telehealth extension, lawmakers will have to restart the process after it expires.

Final Medicaid Rule Reduces Allowed Wait Times for Behavioral Healthcare Outpatient Appointments

The Centers for Medicare & Medicaid Services (CMS) recently published a Medicaid final rule that includes positive changes on several NABH priority issues.

NABH is pleased that beginning in June 2027, wait times for adult and pediatric outpatient mental health and substance use disorder (SUD) services will be subject to a 10-day maximum. Also, starting in 2028, states will be required to conduct annual “secret shopper” surveys to investigate whether managed care plans are meeting wait time requirements and the validity of provider directories.

In July 2027, states must survey Medicaid enrollees to assess their managed care experience. Finally, to help CMS understand and improve payment adequacy, beginning in July 2026, states must annually submit payment data that compare state Medicaid managed care plan rates with Medicare or Medicaid state plan rates, including specific data for mental health and SUD services.

This CMS fact sheet provides additional details about the final rule.

ONC Funding Opportunity Seeks to Accelerate BHIT

HHS’ Office of the National Coordinator for Health Information Technology (ONC) on May 13 announced a funding opportunity totaling $2 million for fiscal year 2024 under the Leading Edge Acceleration Projects (LEAP) in Health Information Technology (Health IT).

ONC is seeking applications that address two areas of interest. The first area seeks to develop innovative ways to evaluate and improve the quality of healthcare data used in artificial intelligence (AI) tools in healthcare to improve electronic health record technologies.

The second area is focused on designing, developing, and piloting lightweight health IT solutions that can enhance health IT capabilities in behavioral healthcare settings and improve care coordination between behavioral healthcare and clinical healthcare settings.

“These two areas of interest are a natural extension of ONC’s work,” Steve Posnack, deputy national coordinator for health information technology and an NABH 2024 Annual Meeting speaker, said in a statement. “We look forward to receiving innovative applications and seeing the impacts generated by selected awardees.”

Click here to learn more about the grant opportunity.

Reminder: Please Submit Data to NABH’s Denial-of-Care Portal

NABH thanks all members who have submitted data to the association’s Denial-of-Care Portal. You have provided critical information that expands the portal and helps NABH strengthen its advocacy efforts related to erroneous prior-authorization denials.

With guidance from our members, NABH has improved the portal by adding two elements:

  1. Time-based data on the number of days between a request for coverage and a plan’s denial, which improves our ability to assess and compare health plan responsiveness.
  2. The gap between days of provided care versus days of covered care to quantify and compare uncompensated days per health plan.

We strongly encourage all NABH members to submit their denial-of-care data in the portal. If you need help starting, or if you have other questions, please e-mail NABH Associate Manager for Congressional Affairs Emily Wilkins.

Fact of the Week

A new study of more than 1.2 million people has identified 95 regions of the genome linked to PTSD, and 80 of those have not been identified previously. Researchers also identified 43 genes that seem to play a role in causing PTSD.

For questions or comments about this CEO Update, please contact Jessica Zigmond.

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2024 NABH Annual Meeting Starts Monday!

We’re pleased to devote this week’s edition of CEO Update to details about the 2024 Annual Meeting that starts Monday, May 13 in Washington, D.C.

This year’s Annual Meeting focuses on The Future of Behavioral Healthcare, and our presenters will explore this theme as it relates to behavioral health information technology, parity, workforce issues, and more.

To prepare for the meeting, please view our preliminary program, learn more about this year’s speakers, and see our list of exhibitors and sponsors attending the meeting.

Be Sure to Access the 2024 NABH Annual Meeting Mobile App!

Again this year, attendees will have access to all Annual Meeting programming and materials through NABH’s web-based app.

Early Monday, NABH will send all attendees an Annual Meeting alert with this link to the app that displays details about sessions, speakers, meeting room locations, NABH’s advocacy priorities, and more. Attendees can also access the link through a QR code near the Registration Desk at the Annual Meeting.

Deputy National Coordinator for Health IT Steven Posnack to Open Monday Sessions

NABH is pleased to welcome Deputy National Coordinator for Health Information Technology Steven Posnack, M.S., M.H.S. as our first 2024 Annual Meeting presenter on Monday, May 13 t 2:45 p.m. ET in the Salamander hotel’s Grand Ballroom.

Posnack advises the national coordinator, leads the execution of the Office of the National Coordinator for Health Information Technology’s (ONC) mission, and represents ONC’s interests at a national and international level.

Together with the national coordinator, Posnack also oversees ONC’s federal coordination, regulatory policy, public-private initiatives, and the overall implementation of statutory authorities and requirements, including those from the 21st Century Cures Act and HITECH Act. He will discuss behavioral health information technology at our Annual Meeting.

NABH Education and Research Foundation to Workforce Panel on Monday at 4 p.m. ET

Building on last year’s success, the NABH Education and Research Foundation will host a panel discussion featuring NABH members and workforce consultants on Monday from 4 p.m. – 5 p.m. ET.

This year’s panel will focus on NABH member best workforce practices, internships, apprenticeships, and other “grow your own” programs.

NABH Education and Research Foundation Vice President Jim Shaheen of New Season, who also serves on the NABH Board of Trustees, will moderate the panel that will feature Jason Brooks, Ph.D., senior vice president of Human Resources at New Season; Rhonda Ashley-Dixon, vice president of Strategic Partnerships & Engagement at Vanderbilt Behavioral Health; Beth Kuhn, principal at Stonegate Strategies and former commissioner, Kentucky Department of Workforce Investment; and John Pallasch, founder and CEO of One Workforce Solutions and former U.S. assistant secretary for employment and training at the U.S. Labor Department (DOL).

This year’s panel discussion will include poll questions for the audience, and we urge NABH members to attend and engage with panelists during the question-and-answer period!

DOL Official Timothy Hauser to Discuss Parity on Tuesday, May 14 at 10 a.m.

Timothy D. Hauser, deputy assistant secretary for program operations of DOL’s Employee Benefits Security Administration (EBSA) will discuss parity when he kicks off Day 2 of the NABH 2024 Annual Meeting on Tuesday, May 14 at 10 a.m.

Hauser, who serves as EBSA’s chief operating officer, joined DOL in 1991 as a trial attorney for the Plan Benefits Security Division (PBSD), where he represented the department in federal district court and appellate litigation. From November 2000 until November 2013, Mr. Hauser was the associate solicitor of the division. As the head of PBSD, he was responsible for all of DOL’s legal work under ERISA.

Before joining DOL, Mr. Hauser worked as a trial attorney for six years at Legal Aid of Western Missouri. Hauser graduated from Harvard Law School in 1985 and earned his undergraduate degree at the University of Illinois.

Election Analyst David Wasserman to Examine 2024 Elections at 11 a.m.

Following Hauser’s presentation Tuesday morning, election analyst David Wasserman will provide Annual Meeting attendees with an in-depth look at this year’s upcoming presidential and congressional elections.

Wasserman is the senior editor for the non-partisan newsletter The Cook Political Report with Amy Walter, which has analyzed U.S. presidential, Senate, House, and gubernatorial races since 1984. Referred to as “pretty much the only person you need to follow on Election Night” according to Meet the Press host Chuck Todd, Wasserman is also a contributor to NBC News.

Prior to joining the The Cook Political Report with Amy Walter in 2007, Wasserman served for three years as House editor of Sabato’s Crystal Ball, a widely respected political analysis newsletter and website founded by renowned University of Virginia professor Larry Sabato (a former NABH Annual Meeting presenter).  Wasserman graduated from the University of Virginia.

NABH President and CEO Shawn Coughlin to Address Attendees at Annual Meeting Luncheon

Please join us for this year’s Annual Meeting Luncheon on Tuesday at Noon to hear brief remarks from NABH President and CEO Shawn Coughlin.

Coughlin will provide updates on NABH’s work and help prepare attendees who will head to Capitol Hill for congressional visits following the luncheon.

Help Us Advocate Your Issue Priorities at Hill Day 2024!

NABH is eager to welcome its members and guests to Hill Day 2024 on Tuesday, May 14 from 1:30 – 5 p.m. ET!

As always, Hill Day is an excellent opportunity for NABH members to meet personally with Members of Congress and their staff to share our association’s advocacy priorities. It’s not too late to register if you’re interested!

If you registered for the Annual Meeting, are interested in Hill Day, and have not yet signed up, please contact e-mail NABH Associate Manager for Congressional Affairs Emily Wilkins.

How it Works:

After you register for the NABH Annual Meeting, the NABH Congressional Affairs team will match you with legislators who represent your facility’s footprint.

On Hill Day, NABH will have our Advocacy Room open from 12:30 p.m. – 1:50 p.m. in the Renwick Room of the Salamander. Here NABH will help prepare you with materials and talking points to guide your conversations with Members of Congress and their staff. The Advocacy Room will reopen from 4:15 p.m. – 5:00 p.m. for you to debrief your meetings.

What We Need From You:

Please indicate in your Annual Meeting registration form that you are interested in Hill Day, and be sure to include all the states where your system has a footprint. If you have an existing relationship with a legislator, please let us know! This is very helpful when scheduling meetings.

Also, Hill Day participants—and all Annual Meeting attendees—can review the association’s 2024 Advocacy Priorities and Hill Day fact sheets before or during the Annual Meeting through our web-based meeting app.

Wednesday Policy Breakfast to Feature Remarks from Rep. Doris Matsui & NABH Consultant Meiram Bendat, J.D., Ph.D.

Join us for the Annual Meeting Policy Breakfast on Wednesday at 8 a.m. to watch a brief video from NABH Champion Rep. Doris Matsui (D-Calif.) and to learn about the ongoing Wit v. United Behavioral Health case from NABH consultant Meiram Bendat, J.D., Ph.D.

Matsui will highlight her legislation, the Behavioral Health Information Technology Coordination Act, and discuss why adopting BHIT is critical.

An attorney with a background in mental health, Bendat represented children and families in the Los Angeles child welfare system and treated patients before he founded Psych-Appeal, the country’s first private mental health insurance law firm, in 2011.

Since then, Bendat has helped patients and providers successfully challenge denials of mental health treatment through administrative appeals and impact litigation, recovering millions of dollars in wrongly withheld benefits.

The NABH team wishes everyone a safe trip to Washington, and we look forward to seeing you soon!

Please note: NABH will not publish CEO Update next week and will publish the next issue on May 24. For questions or comments about this CEO Update, please contact Jessica Zigmond

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DOL Official Timothy Hauser to Headline NABH Annual Meeting Day #2

NABH is pleased to announce Timothy D. Hauser, deputy assistant secretary for program operations at the U.S. Labor Department’s (DOL) Employee Benefits Security Administration (EBSA), will kick off our Annual Meeting’s second day on Tuesday, May 14 at 10 a.m. Hauser, who serves as EBSA’s chief operating officer, will discuss parity and be prepared to answer questions from attendees. Hauser joined DOL in 1991 as a trial attorney for the Plan Benefits Security Division (PBSD), where he represented the department in federal district court and appellate litigation. From November 2000 until November 2013, Hauser was the associate solicitor of the division. As the head of PBSD, Hauser was responsible for all of DOL’s legal work under ERISA. Before joining DOL, Hauser worked as a trial attorney for six years at Legal Aid of Western Missouri. He graduated from Harvard Law School in 1985 and earned his undergraduate degree at the University of Illinois. You can learn more about this year’s speakers and view our preliminary program on NABH’s Annual Meeting homepage. And please be sure to register for the Annual Meeting if you haven’t yet.   We look forward to seeing you in Washington!

Remember to Register for Hill Day 2024!

Please register for Hill Day 2024 on Tuesday, May 14 and urge members of your team to join you!   Hill Day is an excellent opportunity to meet one-on-one with legislators to discuss the issues that matter most to behavioral healthcare providers.   After you register for the NABH Annual Meeting, the NABH Congressional Affairs team will match you with legislators who represent you or your facility footprint. Closer to the day of the meeting, we will send you a meeting schedule, materials, and talking points to guide your conversations with Members of Congress and their staff. Please indicate in your Annual Meeting registration form that you are interested in Hill Day and be sure to include all the states where your system has a footprint. If you have an existing relationship with a legislator, please let us know!

SAMHSA’s Recent Grant Funding Opportunities Limit Financial Incentives for Contingency Management

The Substance Abuse and Mental Health Services Administration (SAMHSA) this week released funding opportunity notices for State Opioid Response and Tribal Opioid Response grants that limit financial incentives for contingency management to $75 per budget period. While the grants require implementing evidence-based practices, the funding limitation is contrary to what is known to be an evidence-based incentive amount that produces behavior change. This amount is inconsistent with what the Contingency Management Policy and Practice Group (CMPG) – known formerly as the Motivational Incentive Policy Group and of which NABH is a member – has advised the federal government. “This is a squandered opportunity to implement a highly effective treatment for stimulant use disorder, which is fueling almost half of our nation’s overdoses,” said NABH Director of Quality and Addiction Services Sarah Wattenberg, who serves as NABH’s CMPG representative. “If we can’t get a handle on stimulant use, we won’t see the overdose rate go down,” Wattenberg said before she cautioned providers against using $75 for incentives because they haven’t proven effective. The grant applications are due July 1, 2024.

Reminder: Please Complete Federal BHIT Data Standards Survey by May 12

Advocating for parity in behavioral health information technology (BHIT) is one of NABH’s top advocacy priorities. That’s why we strongly urge our members’ information technology, medical record documentation, and coding leaders to complete a federal survey by May 12 that will help create standardized behavioral health data elements. NABH alerted members about the survey from SAMHSA and the Office of the National Coordinator for Health Information Technology (ONC) in CEO Update earlier this year. Part of SAMHSA and ONC’s joint BHIT initiative, the survey presents more than 150 potential data elements for consideration, including many clinical elements, as well as provides a platform for survey respondents to submit alternative elements for evaluation. Ultimately, HHS expects to incorporate the final data metrics into the Center for Medicare and Medicaid Innovation’s eight-year project with eight states to develop alternative payment models and quality measures to advance integrated BH and physical healthcare services, including a Medicare per-member-per-month risk-adjusted payment, and a complementary Medicaid payment model and statewide IT approach. To participate in the survey, respondents must first create a user account using the log in feature in the top right of the USCDI+ Platform page. See the USCDI+ User Guides for help creating an account, navigating datasets, and submitting new data elements or comments. Learn more from this federal resource page, or e-mail USCDI.Plus@hhs.gov for further assistance.

Reminder: Please Submit Data to NABH’s Denial-of-Care Portal

NABH thanks all members who have submitted data to the association’s Denial-of-Care Portal. You have provided critical information that expands the portal and helps NABH strengthen its advocacy efforts related to erroneous prior-authorization denials. With guidance from our members, NABH has improved the portal by adding two elements:
  1. Time-based data on the number of days between a request for coverage and a plan’s denial, which improves our ability to assess and compare health plan responsiveness.
  1. The gap between days of provided care versus days of covered care to quantify and compare uncompensated days per health plan.
We strongly encourage all NABH members to submit their denial-of-care data in the portal. If you need help starting, or if you have other questions, please e-mail NABH Associate Manager for Congressional Affairs Emily Wilkins.

Fact of the Week

The American Psychological Association recently released a report that calls on social media companies to take responsibility to help protect youth mental health.   For questions or comments about this CEO Update, please contact Jessica Zigmond.

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Please Help Us Welcome Deputy National Coordinator for Health IT Steven Posnack on May 13!

NABH is pleased to welcome Deputy National Coordinator for Health Information Technology Steven Posnack, M.S., M.H.S., as our first 2024 Annual Meeting presenter on Monday, May 13 at 2:45 p.m. ET in the Salamander hotel’s Grand Ballroom. Posnack advises the national coordinator, executes the Office of the National Coordinator for Health Information Technology’s (ONC) mission, and represents ONC’s interests at a national and international level. Together with the national coordinator, Posnack also oversees ONC’s federal coordination, regulatory policy, public-private initiatives, and the overall implementation of statutory authorities and requirements, including those from the 21st Century Cures Act and HITECH Act. He will discuss behavioral health information technology at our Annual Meeting. Also, please join us for Monday’s workforce panel on Monday, May 13 at 4 p.m. This year’s panel of NABH members and workforce consultants will highlight NABH member best practices to recruit and retain talent as well as how to establish partnerships and “grow your own” programs to address your workforce needs. Please click here to learn about our panelists and other Annual Meeting speakers. And be sure to register for the meeting, reserve your hotel room, and view our preliminary program if you haven’t yet.   We look forward to seeing you in Washington!

Biden Administration Releases First National Strategy for Suicide Prevention

The Biden administration this week released the 2024 National Strategy for Suicide Prevention and accompanying federal action plan to combat America’s deadly mental health and overdose crises. The National Strategy was the result of a combined effort among the Substance Abuse and Mental Health Services Administration, the Centers for Disease Control and Prevention, the National Action Alliance for Suicide Prevention, and more than 20 agencies across 10 federal departments. The National Strategy maps out recommendations for addressing gaps and meeting the needs of at-risk populations, while the federal action plan identifies 200 discrete actions to be initiated and evaluated over the next three years. Actions include identifying ways to address substance use and suicide risk together in the clinical setting; funding a mobile crisis locator for use by 988 crisis centers; increasing support for survivors of suicide loss and others whose lives have been affected by suicide; and evaluating promising community-based suicide prevention strategies. The Biden administration said it will monitor and evaluate these strategies regularly to determine progress and success, and to further identify barriers to successful suicide prevention.

CMS Releases Final Rule on Medicare Managed Care Transparency and Accountability

NABH is pleased with the Centers for Medicare & Medicaid Services’ (CMS) final rule on transparency and accountability for Medicaid managed care plans that the agency released this week. Nearly a year after issuing its proposed rule – and facing firm opposition from healthcare insurance stakeholders – CMS released a rule with provisions that NABH strongly supports, including maximum appointment wait time standards aligned with commercial insurance, including a 10-day wait time standard for outpatient mental health and substance use disorder services. The rule also requires independent annual secret shopper surveys that assess appointment timeliness standards and provider director accuracy. And in an important move toward price transparency, health plans will be required to share their actual expenditures and revenues for state-directed payments and to report any identified or recovered overpayments to states within 30 days. Given the rule’s complex rollout schedule, CMS issued a detailed chart showing the staggered implementation plan for the rule, with effective dates ranging from immediate implementation to four years after its release. Additional information is available in the agency’s fact sheet.

NABH Comments to CMS About Agency’s Accrediting Organization Oversight Rule

NABH recently sent a comment letter to CMS about a proposed rule intended to improve and make more consistent the agency’s oversight of accrediting organizations (AO). NABH supports the rule’s overall direction, which is to improve the accountability and transparency of AO survey and accreditation activities. Of the nine AOs this rule would affect, The Joint Commission is the one of most interest to NABH members. “NABH appreciates that the proposed rule recognizes the current disparity of survey findings among The Joint Commission (and other AOs) and state survey agencies,” NABH wrote in our letter. “Such disparities raise red flags about the misaligned criteria, as well as the reliability of relevant surveyor training programs and preparedness of individual surveyors,” the letter continued. “Current inadequacies have resulted in inconsistent, and therefore at least partially inaccurate, survey findings. This entire process warrants closer examination by CMS of the overall scope and details of these inconsistencies – and the public sharing of related findings with stakeholders.”

NABH Opposes FTC’s Final Rule Banning Non-Compete Agreements

NABH staunchly opposes this week’s final rule banning noncompetes from the Federal Trade Commission (FTC) that the agency said it expects will generate new businesses, raise worker wages, and boost innovation. The FTC estimates that the final rule will lead to new business formation growing by 2.7% per year, resulting in more than 8,500 additional new businesses created each year. The FTC also expects the final will result in higher earnings for workers, with estimated earnings increasing for the average worker by an additional $524 per year; as well as lower healthcare costs by up to $194 billion over the next decade. The U.S. Chamber of Commerce and other business groups filed suit to stop the FTC from banning noncompetes, arguing the FTC doesn’t have the authority to prohibit companies from limiting their employees’ ability to work for competitors.   NABH weighed in on the proposed rule a year ago and acknowledged the FTC’s other efforts to address issues of genuine, unequal bargaining power between certain employers and certain types of workers. However, we opposed the proposed rule for several reasons. “First, the rule proposes an overly simplified, one-size-fits-all approach for all employees across all industries,” NABH said in our March 2023 comment letter. “From a behavioral healthcare perspective, the proposed rule would profoundly alter the healthcare labor market – particularly for physicians and senior hospital executives – by instantly invalidating millions of dollars of existing contracts,” the letter continued. “The rule would affect the full array of NABH members’ employees, including those who are highly trained and lower skilled; as well as both highly compensated and lower-wage employees.”

The Joint Commission Announces New Telehealth Accreditation Program

The Joint Commission this week announced its new Telehealth Accreditation Program for eligible hospitals, ambulatory, and behavioral healthcare organizations. Effective July 1, 2024, the program’s requirements contain many of the standards similar to other Joint Commission accreditation programs, such as requirements for information management, leadership, medication management, patient identification, documentation, and credentialing and privileging. Some requirements specific to the new telehealth program include:
  • Streamlined emergency management requirements to address providing care and clinical support remotely rather than in a physical building.
  • New standards for telehealth provider education and patient education about the use of telehealth platforms and devices.
  • New standards chapter focused on equipment, devices, and connectivity.
The Joint Commission’s announcement noted telehealth use increased by 154% during the COVID-19 pandemic’s early years before stabilizing and presently remaining at levels 38 times higher than they were in 2019.

NABH Telehealth Survey is Due Tuesday, April 30

NABH is eager to learn how your system uses telehealth services in its operations. Please remember to complete this brief survey by Tuesday, April 30, 2024.    Your responses will help guide our advocacy efforts. We also urge you to share this survey with IT colleagues who have insight into how your facilities use telehealth to support your patients. Please email NABH Executive Vice President for Government Relations and Public Policy Rochelle Archuleta if you have questions.

Reminder: The National Academies to Explore Mental Health Services for Anxiety & Mood Disorders in Women

The National Academies Forum on Mental Health and Substance Use Disorder will host a hybrid public workshop in Washington, D.C. and via webcast to explore mental health care services related to anxiety and mood disorders in women on April 29 and 30. Sponsored by the Health Resources and Services Administration, the workshop will examine currently available evidence to identify, define, and prepare strategies for the provision of essential healthcare services related to anxiety and mood disorders in women across the life course. Presentations will also describe health disparities, healthcare finances, and policies related to the quality and access of mental healthcare services available for women.

Reminder: Please Submit Data to NABH’s Denial-of-Care Portal

NABH thanks all members who have submitted data to the association’s Denial-of-Care Portal. You have provided critical information that expands the portal and helps NABH strengthen its advocacy efforts related to erroneous prior-authorization denials. With guidance from our members, NABH has improved the portal by adding two elements:
  1. Time-based data on the number of days between a request for coverage and a plan’s denial, which improves our ability to assess and compare health plan responsiveness.
  1. The gap between days of provided care versus days of covered care to quantify and compare uncompensated days per health plan.
We strongly encourage all NABH members to submit their denial-of-care data in the portal. If you need help starting, or if you have other questions, please e-mail NABH Associate Manager for Congressional Affairs Emily Wilkins.

Fact of the Week

Researchers have created an AI model that can identify accurately women at risk of child-birth related PTSD, Science Daily reports. The study notes early intervention is critical to prevent progression of a disorder that could carry serious health consequences for as many as 8 million women a year globally.   For questions or comments about this CEO Update, please contact Jessica Zigmond.

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RTI Study Shows Pervasive Disparities in Access to In-Network Behavioral Healthcare 

A report this week from not-for-profit research institute RTI International adds to mounting research showing a lack of access to affordable mental health and substance use disorder treatment in the United States continues. NABH helped sponsor the study, Behavioral Health Parity—Pervasive Disparities in Access to In-Network Care Continue, which found that patients went out-of-network 3.5 times more often to see a behavioral health clinician than a medical/surgical clinician, 8.9 times more often to see a psychiatrist, 10.6 times more often to see a psychologist, 6.2 times more often for acute behavioral inpatient care, and 19.9 times more often for sub-acute behavioral inpatient care. “It’s upsetting, though not surprising, that RTI researchers found what we’ve seen for too long: patients who need critical behavioral healthcare services are forced to seek that care out-of-network much more than they do for medical-surgical services because of inadequate insurer networks. This comes at higher personal costs to these patients,” NABH President and CEO Shawn Coughlin said in a statement. “Worsening the problem, behavioral healthcare providers are reimbursed at much lower rates than their peers in medical/surgical facilities. The Mental Health Parity and Addiction Equity Act passed more than 15 years ago,” he continued. “It’s time lawmakers and regulators ensure this critical law is implemented fairly and fully nationwide.” The study also found that in-network office visit reimbursement, which health plans use to encourage provider in-network participation, was higher for medical/surgical clinicians than office visits with behavioral clinicians: 22% higher on average; 48% higher at the 75th percentile; and 70% higher at the 95th percentile. Notably, physician assistants were reimbursed for office visits at an average amount 19% higher than psychiatrists and 23% higher than psychologists.

In Case You Missed It: Watch Our Foundation’s Talent-Recruitment, Part II Webinar

The NABH Education and Research Foundation hosted the second in its two-part webinar series about talent recruitment and retention on Thursday, April 18. NABH Board Chair Frank Ghinassi, Ph.D., A.B.P.P., president and CEO of Rutgers University Behavioral Health Care, and senior vice president of the Behavioral Health and Addictions Service Line at RWJBarnabas Health, co-led the webinar with workforce consultants Beth Kuhn of Stonegate Strategies and John Pallasch of One Workforce Solutions. The presenters discussed long-term solutions to recruiting and retaining talent through partnerships; how skills-based hiring is a more effective approach to talent management; and what funding sources are available to help NABH members in their workforce-related efforts.   If you missed it, please click here for the webinar’s recording, here for the presentation slides, and here for the poll question results. And be sure to join us for our Annual Meeting Workforce Panel on Monday, May 13 from 4 – 5 p.m. ET in the Salamander Washington DC’s Grand Ballroom. NABH Education and Research Foundation Vice President Jim Shaheen, CEO of New Season, will moderate the panel, which will include this week’s webinar presenters Kuhn and Pallasch, as well Jason Brooks, senior vice president of Human Resources at New Season, and Rhonda Ashley-Dixon, vice president of strategic partnership and engagement at Vanderbilt Behavioral Health.

Please Meet Our Exhibitors and Sponsors at the 2024 NABH 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 May 13-15 at the Salamander Washington, DC. Before then, you can view a list of our exhibitors and sponsors on our Annual Meeting homepage. Also, please register for the Annual Meeting, reserve your hotel room, and view our preliminary program, if you haven’t done so yet. We look forward to seeing you in Washington!

FTC Brings Case Against Monument to Enforce Health Data Privacy Protections

The Federal Trade Commission for the first time took enforcement action through the Opioid Addiction Recovery Fraud Prevention Act (OARFPA) to stop telehealth company Monument from disclosing health data to advertising platforms by bringing a case against the company, which treats patients with alcohol addiction virtually, Inside Health Policy reports The story also noted that Monument’s data-sharing practices also violated section 5 of the FTC Act, resulting in a proposed ban on data sharing with third parties and a $2.5 million civil penalty, FTC says. Enacted in 2018, OARFPA authorizes FTC to seek civil penalties for unfair or deceptive acts or practices related to substance use disorder treatment services or products.

Center for Health Strategies Examines Medicaid Options to Cover Incarcerated Youth

The Center for Health Care Strategies, together with the Annie E. Casey Foundation, has developed a policy cheat sheet outlining requirements that will expand Medicaid options to cover services for incarcerated youth starting in 2025.   Several provisions under the Consolidated Appropriations Act of 2023 will expand Medicaid services to youth who are incarcerated, of which nearly two-thirds have a diagnosable mental health or substance use disorder, according to the Medicaid Payment and CHIP Access Commission, or MACPAC. The fact sheet outlines the new requirements, opportunities for Medicaid to collaborate with the corrections sector, and next step for Medicaid agencies before the provisions take effect.

Reminder: The National Academies to Explore Mental Health Services for Anxiety & Mood Disorders in Women

The National Academies Forum on Mental Health and Substance Use Disorder will host a hybrid public workshop in Washington, D.C. and via webcast to explore mental health care services related to anxiety and mood disorders in women on April 29 and 30. Sponsored by the Health Resources and Services Administration, the workshop will examine currently available evidence to identify, define, and prepare strategies for the provision of essential healthcare services related to anxiety and mood disorders in women across the life course. Presentations will also describe health disparities, healthcare finances, and policies related to the quality and access of mental healthcare services available for women.

Reminder: Please Submit Data to NABH’s Denial-of-Care Portal

NABH thanks all members who have submitted data to the association’s Denial-of-Care Portal. You have provided critical information that expands the portal and helps NABH strengthen its advocacy efforts related to erroneous prior-authorization denials. With guidance from our members, NABH has improved the portal by adding two elements:
  1. Time-based data on the number of days between a request for coverage and a plan’s denial, which improves our ability to assess and compare health plan responsiveness.
  1. The gap between days of provided care versus days of covered care to quantify and compare uncompensated days per health plan.
We strongly encourage all NABH members to submit their denial-of-care data in the portal. If you need help starting, or if you have other questions, please e-mail NABH Associate Manager for Congressional Affairs Emily Wilkins.

Fact of the Week

Among U.S. college athletes, suicide is now the second leading cause of death after accidents—and  rates have doubled to 15.3% from 7.6% in the past 20 years, according to a study published in the British Journal of Sports Medicine. CNN analyzed the report’s findings in a recent article. For questions or comments about this CEO Update, please contact Jessica Zigmond.

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NABH Remembers Unit Committee Member Anthony Santucci, M.S.

NABH remembers with grateful appreciation Anthony Santucci, M.S., 50, of BayCare Behavioral Health, who died unexpectedly on March 25. Anthony served as BayCare’s director of nursing for 13 years and was an active and energetic member of NABH’s Behavioral Health Services within General Healthcare Systems Committee – known as the Unit Committee – for many years. Born and raised in South Jersey, Anthony earned his nursing degree at Wesley College in Delaware and continued his education at Jacksonville and Walden Universities, ultimately earning a Master of Science degree in nursing in 2016. Anthony was also a 2020 graduate of the Tampa Bay Chamber’s Leadership Tampa, an intensive executive leadership program, and was a devoted member of the Tampa Bay behavioral health community for more than 25 years. Anthony is survived by Jaclyn Santucci, his wife of 20 years, and their daughter Josephine Cecilia. Anthony will be missed by all who knew him. In lieu of flowers, donations can be made in Anthony’s memory to Feeding Tampa Bay or to the Pinellas County Hunter Association, a horseback riding association, via Zelle at 123pcha@gmail.com.

Register Today for Part II of Our Foundation’s Talent-Recruitment Webinar Series on April 18

Please join us and register today for the NABH Education and Research Foundation’s second webinar about recruiting and retaining talent next Thursday, April 18 from 2 p.m. – 3 p.m. ET. NABH Board Chair Frank Ghinassi, Ph.D., A.B.P.P. president and CEO, Rutgers University Behavioral Health Care and senior vice president, Behavioral Health and Addictions Service Line, RWJBarnabas Health, will co-lead this free, interactive webinar with workforce consultants Beth Kuhn of Stonegate Strategies and John Pallasch of One Workforce Solutions. Kuhn has more than 30 years of workforce experience and served previously as commissioner of the Kentucky Department of Workforce Investment and as Vermont’s director of workforce development. Pallasch has spent more than 20 years influencing organizational personnel, efficiency, and productivity in the public and private sectors and served previously as the assistant secretary for employment and training at the U.S. Labor Department. Together they will discuss establishing and developing partnerships to “grow your own” within your systems; explore funding opportunities to help support your workforce efforts; and urge you to focus more on skill sets and less on job responsibilities among your staff. Please share the registration link with your Human Resources, Operations, and Workforce Engagement teams!

The 2024 NABH Annual Meeting Hotel Cutoff Date is Now Sunday, April 28

The Salamander Washington, DC has extended its cutoff date for NABH 2024 Annual Meeting room reservations through Sunday, April 28. Please reserve your hotel room today and be sure to register for our Annual Meeting (May 13-15), if you have not done so yet. We look forward to seeing you in Washington!

House and Senate Committees Examine Behavioral Healthcare Policies in Hearings

House and Senate Committees returned from the Easter recess and reviewed several pending behavioral healthcare policies this week. In a hearing on Wednesday, April 10, the House Energy & Commerce Committee Health Subcommittee explored ways to support patients’ access to telehealth as lawmakers determine how best to extend digital health flexibilities in effect through Dec. 31. Lawmakers will need to decide whether to pursue a temporary or permanent extension of pandemic-era telehealth policies. Extending telehealth coverage beyond 2024 is expected to be costly, and if implemented in a budget neutral manner, would reduce funds available for other Medicare programs. Committee members said best practices on digital billing codes, policies that prevent overuse of telehealth services and limit fraud, and CMS’ ability to capture and report telehealth data are integral pieces for them to determine whether telehealth provisions will be extended permanently by year’s end. Lawmakers also expressed concerns that changes to virtual care policy will not hinder access to in-person care. Wednesday’s hearing announcement included a list of 15 telehealth bills that would extend or make permanent telehealth provisions. Two bills specific to behavioral healthcare include H.R. 3432, Rep. Doris Matsui’s (D-Calif.) Telemental Health Care Access Act, which eliminates certain restrictions relating to Medicare coverage of mental health services that are provided through telehealth; and H.R. 7858, the Telehealth Enhancement for Mental Health Act of 2024 from Reps. John James (R-Mich.), Don Davis (D-N.C), and David Schweikert (R-Ariz.), which would establish a Medicare “incident to” modifier for tele-mental health services. Lawmakers remain divided over whether to extend audio-only telehealth. Representatives who serve rural and underserved communities say audio-only telehealth may be the only way their constituents can experience virtual care. The ultimate collection of provisions – either temporary or permanent – will likely be included in a larger healthcare package expected to be taken up in a lame-duck session. The Senate Finance Health Subcommittee convened a roundtable to discuss opportunities to improve substance use disorder (SUD) treatments within federal health programs. Witnesses described how measures such as treatment prior authorization, low physician reimbursement rates, and inadequate funding perpetuate treatment barriers for individuals living with SUD. Both Democrats and Republican lawmakers expressed support for increasing access to care through peer support specialists, increased reimbursement rates, comprehensive care, and certified community behavioral health clinics (CCBHCs). Additional discussion items included the importance of a continuum of care and opportunities to reduce SUD stigma. One panelist highlighted increasing the availability of methadone treatment options, and several senators reiterated support for S. 644, the Modernization Opioid Treatment Access Act. Committee leaders indicated they will hold an official hearing about increasing access to SUD treatment in the future.

The National Academies to Explore Mental Health Services for Anxiety & Mood Disorders in Women

The National Academies Forum on Mental Health and Substance Use Disorder will host a hybrid public workshop in Washington, D.C. and via webcast to explore mental health care services related to anxiety and mood disorders in women on April 29 and 30. Sponsored by the Health Resources and Services Administration, the workshop will examine currently available evidence to identify, define, and prepare strategies for essential healthcare services related to anxiety and mood disorders in women across the life course. Presentations will also describe health disparities, healthcare finances, and policies related to the quality and access of mental healthcare services available for women.

Reminder: Please Submit Data to NABH’s Denial-of-Care Portal

NABH thanks all members who have submitted data to the association’s Denial-of-Care Portal. You have provided critical information that expands the portal and helps NABH strengthen its advocacy efforts related to erroneous prior-authorization denials. With guidance from our members, NABH has improved the portal by adding two elements:
  1. Time-based data on the number of days between a request for coverage and a plan’s denial, which improves our ability to assess and compare health plan responsiveness.
  1. The gap between days of provided care versus days of covered care to quantify and compare uncompensated days per health plan.
We strongly encourage all NABH members to submit their denial-of-care data in the portal. If you need help starting, or if you have other questions, please e-mail NABH Associate Manager for Congressional Affairs Emily Wilkins.

Fact of the Week

A new JAMA study shows probabilities of parents having anxiety-related visits (10.6% versus 7.0%), depression-related visits (8.4% versus 6.1%), and any mental health-related visits (18.1% versus 13.3%) were higher in families of children with cancer versus  children without cancer. The authors said the findings underline the importance of multi-level interventions – such as providing MH screening, counseling, and timely support and ensuring comprehensive insurance coverage and paid medical leave – to better meet the mental-health needs of these parents. For questions or comments about this CEO Update, please contact Jessica Zigmond.

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Please Join Us for Our Annual Meeting Workforce Panel on Tuesday, May 14!

Building on last year’s success, the NABH Education and Research Foundation will host a panel discussion featuring NABH members and workforce consultants during the 2024 Annual Meeting on Monday, May 13 from 4 p.m. – 5 p.m. ET. This year’s panel will focus on NABH member best workforce practices, workforce development boards, apprenticeships, fellowships, and other “grow your own” programs. It will feature the following panelists: Jason Brooks, Senior Vice President of Human Resources, New Season Rhonda Ashley-Dixon, Vice President, Strategic Partnerships & Engagement, Vanderbilt Behavioral Health Beth Kuhn, Principal, Stonegate Strategies and former Commissioner, Kentucky Department of Workforce Investment John Pallasch, Founder and CEO, One Workforce Solutions and former U.S. Assistant Secretary for Employment and Training, U.S. Labor Department The Foundation urges NABH members to attend the session and engage with panelists during the question-and-answer period. Also, please remember to register for the Annual Meeting and reserve your hotel room if you haven’t done so yet. We look forward to seeing you in Washington!

Learn About Long-term Solutions in the Fight for Talent!

Please join us for the NABH Education and Research Foundation’s second in its two-part webinar series about recruiting and retaining talent on Thursday, April 18 from 2 p.m. – 3 p.m.   NABH Board Chair Frank Ghinassi, Ph.D., A.B.P.P., who serves as president and CEO of Rutgers University Behavioral Health Care and senior vice president of the Behavioral Health and Addictions Service Line at RWJBarnabas Health, will co-lead this interactive webinar with workforce consultants Beth Kuhn of Stonegate Strategies and John Pallasch of One Workforce Solutions. Kuhn has more than 30 years of workforce experience and served previously as commissioner of the Kentucky Department of Workforce Investment and as Vermont’s director of workforce development. Pallasch has spent more than 20 years influencing organizational personnel, efficiency, and productivity in the public and private sectors and served previously as the assistant secretary for employment and training at the U.S. Labor Department.   Together they will present practical approaches to attracting and keeping top talent, such as developing partnerships and offering apprenticeship programs. Participants will come away with some applicable next steps to employ in their own systems to set the foundation for long-term solutions. Please click here to register and be sure to alert your members of your Human Resources, Operations, and Workforce Engagement teams to attend!

NABH Comments to Federal Agencies About Proposed BHIT Data Standards

NABH on March 29 submitted comments to the Substance Abuse and Mental Health Services Administration (SAMHSA) and the Office of the National Coordinator for Health Information Technology (ONC) on their joint effort to create official data standards for behavioral health information technology (IT). In addition to the association sending a comment letter, NABH members concurrently responded to the related online survey about potential behavioral health data items. As we know, behavioral healthcare providers were not eligible recipients of the HITECH Act of 2009 funding, and, as such, most IT vendors did not develop viable BHIT systems or tools at that time or since. More than 15 years after HITECH became law, our country needs a federal investment in BHIT to help our field align with the IT capacity of the rest of the continuum of healthcare providers. Our comments emphasized that a significant portion of our membership lacks an IT system compliant with the ONC standards set in 2015. As a result, many in our field face reduced efficiency and more administrative burden. We also noted that on the policy front, the ongoing use of outdated IT reduces the field’s ability to engage in recent policy initiatives that require modern interoperability. NABH recommended that the new behavioral health language include data metrics for behavioral health populations that tend to be overlooked by behavioral health IT system modules, such as for patients experiencing suicidality or the potential of harm to self or others; substance use disorder patients; patients in intensive outpatient programs or partial hospitalization programs; and adolescent and youth populations. Our letter also recommended social determinants of health to include in the new standards. In addition, we urged the initiative to consider data terms related to the emerging use of artificial intelligence within behavioral healthcare settings. Because this is a top priority of NABH, we urged SAMHSA and ONC to work closely with providers and other stakeholders on this long-awaited investment. This collaboration is of highest importance because it is expected that the data standards that emerge from this project will be used in future standards for BH electronic medical records.

NABH Weighs in On Physical Holds for Children and Youth in Joint Commission Letter

In a letter to The Joint Commission (TJC) this week, NABH noted that The Joint Commission’s proposal to modify standards on the use of physical holds for children and youth would affect NABH-member group homes, foster care, non-hospital residential treatment programs, and perhaps others – many of which are accredited by the Council on Accreditation. The Joint Commission’s proposed change would combine the current physical holding standards for children and youth with existing standards for restraints and seclusions for all individuals served. Because the brief proposal lacks a clear rationale, NABH’s letter outlined several key elements that stakeholders need before responding to the proposal. Specifically, we asked for a comprehensive policy justification and evidence, impact estimate, and explanation of any link between this proposal and efforts to combat workplace violence. NABH also requested a meeting with The Joint Commission to learn more about the proposal.

Reminder: U.S. Labor Department Seeks Information in Parity Enforcement Survey

The U.S. Labor Department is conducting an 11-question survey to better understand stakeholder views about the department’s federal parity law oversight and enforcement efforts. In particular, the survey focuses on compliance enforcement for non-quantitative treatment limitations, which include prior authorization protocols, network adequacy standards, and timeliness requirements. Click here to complete the survey, which opened on Wednesday, March 27 and closes on Wednesday, April 10.

Reminder: Please Submit Data to NABH’s Denial-of-Care Portal

NABH thanks all members who have submitted data to the association’s Denial-of-Care Portal. You have provided critical information that expands the portal and helps NABH strengthen its advocacy efforts related to erroneous prior-authorization denials. With guidance from our members, NABH has improved the portal by adding two elements:
  1. Time-based data on the number of days between a request for coverage and a plan’s denial, which improves our ability to assess and compare health plan responsiveness.
  1. The gap between days of provided care versus days of covered care to quantify and compare uncompensated days per health plan.
We strongly encourage all NABH members to submit their denial-of-care data in the portal. If you need help starting, or if you have other questions, please e-mail NABH Associate Manager for Congressional Affairs Emily Wilkins.

Fact of the Week

A new telehealth study focused on patients with Alcohol Use Disorder showed some groups were less likely to receive any video telehealth than telephone visits, suggesting that multiple treatment modalities should remain available to ensure treatment access. For questions or comments about this CEO Update, please contact Jessica Zigmond.

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CMS Proposes IPF PPS Reforms and FY 2025 Increase of 2.6%

The Centers for Medicare & Medicaid Services (CMS) on Thursday proposed a net update of 2.6 percentage points for fiscal year (FY) 2025 payment levels relative to FY 2024 levels for hospitals and units reimbursed under the inpatient psychiatric facility prospective payment system (IPF PPS). The update moderately varies by provider types, with a 2.2% increase for urban, freestanding for-profit providers, and a 2.4% increase for urban, freestanding not-for-profit hospitals, as well as for urban, for-profit and not-for-profit units. The IPF PPS rule also proposed budget-neutral adjustments to the Medicare severity diagnosis related groupd (DRG), which are payment categories that reflect a patient’s principal diagnosis, selected comorbidities, patient age, and the variable per diem adjustments. The proposed changes also include:
  • Maintaining the current 17 DRGs.
  • In response to the growing volume of these cases, CMS proposes to make these two current DRGs eligible for payment add-ons: DRGs 917 (Poisoning and toxic effects of drugs w MCC) and 918 (Poisoning and toxic effects of drugs w/out MCC). See Table 4 in the rule for more details.
  • Replacing DRGs 080 (Nontraumatic stupor & coma w MCC) and 081 (Nontraumatic stupor & coma w/o MCC) with DRGs 947 (Signs and Symptoms w MCC) and 948 (Signs and Symptoms w/out MCC), because volume in these current DRGs have decreased significantly and CMS said the proposed replacement DRGs are a more appropriate fit. See Table 3 in the rule for more details.
Regarding comorbidity payment add-ons, in an overall budget-neutral manner, CMS proposes multiple changes to these payment adjustment rates, as outlined in Table 8 in the rule. To maintain this payment system’s 2.0% outlier pool, CMS proposed to increase the fixed dollar loss threshold to $35,590 from $33,470, which will result in fewer cases qualifying for outlier payments. The rule also proposes to increase payments for electroconvulsive therapy to $660.30 in FY 2025 from the current rate of $385.58. Due to these adjustments, the base per diem was reduced to $874.93 from $895.63 (a 2.3% reduction) to ensure that overall payments remained budget neutral.  And our analysis will further explain this reduction and its overall financial impact to the industry. In addition, under the congressional mandate from the Consolidated Appropriations Act, 2023, the rule includes two requests for information (RFI) on potential future IPF PPS reforms. For the first RFI, CMS revisits and builds upon its 2022 technical report by flagging several potential future reforms to the current adjustments for rural IPFs, teaching IPFs, and “safety-net” IPFs. The second RFI in the rule proposes to develop a standardized IPF patient assessment instrument, which will be designed to implement in 2028. Please see the agency’s fact sheet for additional information about the proposed rule. Public comments are due by Tuesday, May 28. Also, please join NABH via Zoom on Tuesday, April 16 from 2 p.m. – 3 p.m. ET, when we’ll discuss the rule in greater detail, as well as priority issues that NABH will address in the association’s official comment letter.

View the NABH 2024 Annual Meeting Preliminary Program!

Earlier this week NABH shared its 2024 Annual Meeting preliminary program with members and meeting registrants. Unless noted otherwise, meeting sessions are open to all Annual Meeting attendees. Please remember 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!

Deadline to Advertise in the 2024 NABH Exhibitor and Sponsor Guide is Today, March 29!

NABH will distribute the 2024 NABH Exhibitor and Sponsor Guide to all registrants at the 2024 NABH Annual Meeting from May 13-15 at the Salamander Washington, DC. Be sure your organization is included in it!   All ads are due today, Friday, March 29, 2024. 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 for Part II of Our Foundation’s Talent-Recruitment Webinar Series!

Please join us on Thursday, April 18 at 2 p.m. ET for Part II of the NABH Education and Research Foundation’s talent-recruitment webinar series, which will explore long-term solutions. NABH Board Chair Frank Ghinassi, Ph.D., A.B.P.P. president and CEO, Rutgers University Behavioral Health Care and senior vice president, Behavioral Health and Addictions Service Line, RWJBarnabas Health, will lead the April webinar along with Kuhn and workforce consultant John Pallasch of One Workforce Solutions. Pallasch served previously as the assistant secretary for employment and training at the U.S. Labor Department. This interactive webinar will explore how to develop partnerships for apprenticeships and other “grow your own” programs.   Please click here to register.

ICYMI: Watch Part I of Our Foundation’s Talent-Recruitment Webinar Series!

On March 26, our foundation hosted Part I of its two-part, talent-recruitment webinar series, which focused on short-term solutions. If you missed it, please click here for the webinar’s recording, here for the presentation slides, and here for the poll question results.

U.S. Labor Department Seeks Information in Parity Enforcement Survey

The U.S. Labor Department is conducting an 11-question survey to better understand stakeholder views about the department’s federal parity law oversight and enforcement efforts. In particular, the survey focuses on compliance enforcement for non-quantitative treatment limitations, which include prior authorization protocols, network adequacy standards, and timeliness requirements. Click here to complete the survey, which opened on Wednesday, March 27 and closes on Wednesday, April 10.

Reminder: Please Submit Data to NABH’ Denial-of-Care Portal

NABH thanks all members who have submitted data to the association’s Denial-of-Care Portal. You have provided critical information that expands the portal and helps NABH strengthen its advocacy efforts related to erroneous prior-authorization denials. With guidance from our members, NABH has improved the portal by adding two elements:
  1. Time-based data on the number of days between a request for coverage and a plan’s denial, which improves our ability to assess and compare health plan responsiveness.
  1. The gap between days of provided care versus days of covered care to quantify and compare uncompensated days per health plan.
We strongly encourage all NABH members to submit their denial-of-care data in the portal. If you need help starting, or if you have other questions, please e-mail NABH Associate Manager for Congressional Affairs Emily Wilkins.

Fact of the Week

Perinatal mood and anxiety disorder (PMAD) diagnoses among privately insured people nationwide increased by 93.3% from 2008 to 2020, growing faster in 2015–20 than in 2008–14, according to a new study published in Health Affairs. For questions or comments about this CEO Update, please contact Jessica Zigmond.

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Congress Moves to Approve Final Spending Bill Before Government Shutdown Deadline

Congressional appropriators on Thursday unveiled legislative text for the final spending package for fiscal year 2024. The House will vote first on this six-bill “minibus,” which contains the appropriations bills for Labor-HHS-Education, Defense, Financial Services and General Government, Homeland Security, State-Foreign Operations, and Legislative Branch during a Friday session. The Senate is moving quickly to review the package before the federal funding deadline expires at midnight. Absent this “time agreement,” a brief weekend shutdown could be possible while the bill works its way to the president’s desk. Negotiations between House and Senate leadership broke down on another skinny health package. This deal would have included additional funding for community health centers, PBM reforms and price transparency provisions, as well as extensions for the Pandemic and All-Hazards Preparedness and Advancing Innovation Act (PAHPA) and the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment Act (SUPPORT). Lawmakers may consider these provisions during the congressional lame duck session after the elections. In the bill, HHS is set to receive an increase of $955 million above the current funding level to more than $117 billion. Behavioral healthcare funding includes more than $4.6 billion to support substance use prevention and treatment efforts to address the rising toll of opioid overdoses; $2 billion for the Substance Use Prevention, Treatment, and Recovery Services Block Grant; $1.575 billion for State Opioid Response grants; $145 million for the Rural Communities Opioid Response Program; and $1 billion for the Mental Health Block Grant. The bill also provides $153 million for the Behavioral Health Workforce Education and Training Program to support community-based clinical training and strengthen the mental health workforce through repayment of education loans for individuals working in either a Mental Health Professional Shortage Area or where the overdose death rate exceeds the national average. The package allocates $42 million to the Health Resources and Services Administration (HRSA) for the Office of the Advancement of Telehealth (OAT) for expenses, grants, contracts and “cooperative agreements for the advancement of telehealth activities; $1 million to connect rural veterans to health care facilities; and $20.9 million for rural hospitals to adopt health information technology.   The bill also provides an $18 million increase for the 988 Suicide Prevention Lifeline, building on the nearly $400 million increase in fiscal year 2023. The proposed boost comes after GOP leaders on the House Energy and Commerce Committee requested that the Government Accountability Office audit the Substance Abuse and Mental Health Services Administration’s (SAMHSA) oversight of funds to the lifeline, saying more than half of designated funding has gone unused.

Register Today for Next Week’s NABH Education and Research Foundation Workforce Webinar

There’s still time to register for the NABH Education and Research Foundation’s workforce webinar on Tuesday, March 26 from 2 p.m. – 3 p.m. ET. Next week’s webinar is the first in a two-part series that explores talent recruitment and retention. Foundation Vice President Jim Shaheen, CEO of New Season/Colonial Management Group, LP, Foundation Secretary Mary Pawlikowski, president at Vanderbilt Psychiatric Hospital and Clinics, and workforce consultant Beth Kuhn of Stonegate Strategies will lead participants in an interactive discussion to share their talent-recruitment and retention challenges, as well as their best, short-term strategies to address those problems. These practices include re-organizing recruitment teams to align with operations, developing alumni outreach initiatives, streamlining an organization’s onboarding process, conducting stay interviews, and more. Please join us and click here to register for Part I on March 26 at 2 p.m. ET! The second webinar in this series will examine longer-term solutions to recruiting talent – such as Registered Apprenticeship Programs, education and certification opportunities, fellowships, and more – on Thursday, April 18 at 2 p.m. ET. NABH Board Chair Frank Ghinassi, Ph.D., A.B.P.P. president and CEO, Rutgers University Behavioral Health Care and senior vice president, Behavioral Health and Addictions Service Line, RWJBarnabas Health, will lead the April webinar along with Kuhn and workforce consultant John Pallasch of One Workforce Solutions. Pallasch served previously as the assistant secretary for employment and training at the U.S. Labor Department.   Please join us and click here to register for Part II on April 18!

HHS Needs Your Feedback to Help Develop a Behavioral Healthcare Data Set

Through next Friday, March 29, HHS’ Office of the National Coordinator (ONC) – the federal agency that standardizes information technology requirements for healthcare providers – is collecting information about specific data elements to include in a new behavioral healthcare data set. NABH encourages you to help with this important project. The task is a joint effort between ONC and the Substance Abuse and Mental Health Services Administration (SAMHSA) to create the draft United States Core Data for Interoperability (USCDI) + BH to address core data and interoperability for behavioral health needs beyond the scope of the USCDI. In December 2023, ONC launched a new USCDI+ platform to support the organization, linking of domains, and functionality to solicit and receive feedback for all USCDI+ domains. HHS’ goal with this activity is to confirm the data points needed to improve and advance care continuity for patients who see behavioral healthcare providers and other healthcare providers. Survey respondents will identify the specific data metrics from among 187 options – such as the patient’s address, insurance information, clinical data points, and more – that HHS should collect, as well as items that HHS should not collect. Your expertise will help develop an eventual government-endorsed data set for the behavioral healthcare field and also influence a separate HHS effort to develop a future behavioral health information technology system.   Behavioral Health Information Technology, or BHIT, is one of NABH’s top advocacy priorities, so we strongly urge you and your teams’ health IT experts to complete ONC’s survey by no later than Friday, March 29. Meanwhile, NABH is working with its committees to prepare an association comment letter to ONC. Please contact Sarah Wattenberg with any questions.

White House Announces Challenge to Save Lives from Overdose

The Biden administration has announced The White House Challenge to Save Lives from Overdose, a nationwide call to action to stakeholders from all sectors to save lives by increasing training about and access to life-saving opioid overdose reversal medications. The White House urges organizations, philanthropists, local governments, and businesses large and small to participate in a variety of ways, such as training 100% of an organization’s employees on how and when to use an opioid reversal medication; ensure an opioid overdose reversal medication is in every first aid kit in worksites and schools; and purchase and distribute opioid overdose reversal medications to a certain number of employees. Click here to learn more about the challenge.

2024 Annual Meeting Hotel Reservation Cutoff Date is Approaching!

Please reserve your hotel room today at the Salamander Washington, DC for the 2024 NABH Annual Meeting from May 13-15, 2024! The Salamander, Washington DC’s reservation cutoff date is Sunday, April 14. And please remember to register for this year’s Annual Meeting, The Future of Behavioral Healthcare, if you haven’t done so yet. The Annual Meeting’s preliminary program will be available soon. We look forward to seeing you in Washington!

Advertise in the 2024 NABH Exhibitor and Sponsor Guide!

NABH will distribute the 2024 NABH Exhibitor and Sponsor Guide to all registrants at the 2024 NABH Annual Meeting from May 13-15 at the Salamander Washington, DC. Be sure your organization is included in it!   All ads are due by next Friday, March 29, 2024. 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 NABH’ Denial-of-Care Portal

NABH thanks all members who have submitted data to the association’s Denial-of-Care Portal. You have provided critical information that expands the portal and helps NABH strengthen its advocacy efforts related to erroneous prior-authorization denials. With guidance from our members, NABH has improved the portal by adding two elements:
  1. Time-based data on the number of days between a request for coverage and a plan’s denial, which improves our ability to assess and compare health plan responsiveness.
  1. The gap between days of provided care versus days of covered care to quantify and compare uncompensated days per health plan.
We strongly encourage all NABH members to submit their denial-of-care data in the portal. If you need help starting, or if you have other questions, please e-mail NABH Associate Manager for Congressional Affairs Emily Wilkins.

In Case You Missed It: NABH’s 2024 Advocacy Priorities

NABH has released its 2024 Advocacy Priorities, which we urge you to read and share with your Government Relations teams. Topping NABH’s priorities this year are parity, workforce, behavioral healthcare information technology, America’s ongoing addiction crisis, and the Institutions for Mental Diseases (IMD) exclusion.

Fact of the Week

A recent JAMA study reported Delta 8-THC use prevalence is appreciable among U.S. adolescents and is higher in states without marijuana legalization or existing Delta 8-THC regulations. The study noted that prioritizing surveillance, policy, and public health efforts addressing adolescent Delta 8-THC use may be warranted.   For questions or comments about this CEO Update, please contact Jessica Zigmond.

CEO Update 177

HHS Needs Your Feedback to Help Develop a Behavioral Healthcare Data Set

Through March 29, HHS’ Office of the National Coordinator (ONC) – the federal agency that standardizes information technology requirements for healthcare providers – is collecting information about specific data elements to include in a new behavioral healthcare data set. NABH encourages you to help with this important project. The task is a joint effort between ONC and the Substance Abuse and Mental Health Services Administration (SAMHSA) to create the draft United States Core Data for Interoperability (USCDI) + BH to address core data and interoperability for behavioral health needs beyond the scope of the USCDI. In December 2023, ONC launched a new USCDI+ platform to support the organization, linking of domains, and functionality to solicit and receive feedback for all USCDI+ domains. HHS’ goal with this activity is to confirm the data points needed to improve and advance care continuity for patients who see behavioral healthcare providers and other healthcare providers. Survey respondents will identify the specific data metrics from among 187 options – such as the patient’s address, insurance information, clinical data points, and more – that HHS should collect, as well as items that HHS should not collect. Your expertise will help develop an eventual government-endorsed data set for the behavioral healthcare field and also influence a separate HHS effort to develop a future behavioral health information technology system.   Behavioral Health Information Technology, or BHIT, is one of NABH’s top advocacy priorities, so we strongly urge you and your teams’ health IT experts to complete ONC’s survey by no later than Friday, March 29. Meanwhile, NABH is working with its committees to prepare an association comment letter to ONC. Please contact Rochelle Archuleta with any questions.

Register Today for the NABH Education and Research Foundation’s Talent-Recruitment Webinars

The NABH Education and Research Foundation will host a two-part webinar series about talent recruitment featuring NABH members and workforce experts in March and April. Part I –Talent Recruitment: Exploring Short-Term Solutions – on Tuesday, March 26 will feature Foundation Vice President Jim Shaheen, CEO of New Season/Colonial Management Group, LP; Foundation Secretary Mary Pawlikowski, president at Vanderbilt Psychiatric Hospital and Clinics; and workforce consultant Beth Kuhn of Stonegate Strategies. In this hourlong webinar, presenters will lead participants in an interactive discussion to share and discuss their talent-recruitment and retention challenges, as well as their best, short-term strategies to address those problems. These practices include re-organizing recruitment teams to align with operations, developing alumni outreach initiatives, streamlining an organization’s onboarding process, conducting stay interviews, and more. Please join us and click here to register for Part I on March 26 at 2 p.m. ET! The second webinar in this series will examine longer-term solutions to recruiting talent – such as Registered Apprenticeship Programs, education and certification opportunities, fellowships, and more – on Thursday, April 18 at 2 p.m. ET. NABH Board Chair Frank Ghinassi, Ph.D., A.B.P.P. president and CEO, Rutgers University Behavioral Health Care and senior vice president, Behavioral Health and Addictions Service Line, RWJBarnabas Health, will lead the April webinar along with Kuhn and workforce consultant John Pallasch of One Workforce Solutions. Pallasch served previously as the assistant secretary for employment and training at the U.S. Labor Department.   Please join us and click here to register for Part II on April 18!

President Biden’s Fiscal 2025 Budget Proposal Aims to Transform Behavioral Healthcare

President Biden this week unveiled his fiscal year (FY) 2025 budget proposal, which would provide considerable funding to achieve the Biden administration’s goal of transforming behavioral healthcare in America. Each year, the president’s budget proposal is most significant for sending a message about the administration’s priorities. President Biden’s FY 2025 proposal provides $1 billion to advance BHIT adoption and interoperability among providers. It also provides a combined total of $216 million for mental health programs, including $200 million from the Bipartisan Safer Communities Act, a 900% increase in program funding since 2021. The funds will help to increase the number of school-based counselors, psychologists, social workers, and other mental health professionals in K-12 schools. NABH is also pleased to see the president’s budget proposal seeks to strengthen parity by requiring all commercial market health plans to cover mental health and substance use disorder benefits; ensuring that plans have an adequate network of behavioral health providers; and improving the U.S. Labor Department’s (DOL) ability to enforce the law. The budget includes $275 million over 10 years to increase the DOL’s capacity to ensure that large group market health plans and issuers comply with mental health and substance use disorder requirements, and to act against plans and issuers that do not comply. The budget’s other behavioral healthcare provisions include: investing in strengthening the behavioral healthcare workforce, including integration into primary care settings; increasing funding for the Children’s Mental Health Initiative by $50 million; increasing funding for the State Opioid Response grant program, investing in a new technical assistance center to strengthen health providers’ understanding and treatment of substance use and women’s mental health; expanding the 988 Suicide and Crisis Lifeline, and more.

SAMHSA to Host Webinar Next Week on Assisted Outpatient Treatment Program for Individuals with Serious Mental Illness

SAMHSA will host a virtual webinar for prospective applicants interested in applying for the fiscal year 2024 Assisted Outpatient Treatment Program for Individuals with Serious Mental Illness (AOT). The webinar will provide an overview of SAMHSA’s late-February AOT funding opportunity and application requirements. Registration is not required for the webinar on Wednesday, March 20 from 2:30 – 4 p.m. ET.

Register Today for the 2024 NABH Annual Meeting

Please remember to register for the 2024 NABH Annual Meeting, The Future of Behavioral Healthcare and reserve your hotel room at the Salamander Washington, DC from May 13-15, 2024.   This year’s meeting will examine and discuss critical issues that behavioral healthcare providers manage today and will continue to address tomorrow, including access to care, parity, technology, workforce, the political environment, and more. We look forward to seeing you in Washington!

Join Us for Hill Day 2024

Please remember to sign up for Hill Day 2024 on Tuesday, May 14, the second day of this year’s Annual Meeting. Hill Day is an excellent opportunity to meet one-on-one with legislators to discuss the issues that matter most to behavioral healthcare providers. After you register for the NABH Annual Meeting, the NABH Congressional Affairs team will match you with legislators who represent you or your facility footprint. Closer to the day of the meeting, we will send you a meeting schedule, materials, and talking points to guide your conversations with Members of Congress and their staff. Please indicate in your Annual Meeting registration form that you are interested in Hill Day, and be sure to include all the states where your system has a footprint. If you have an existing relationship with a legislator, please let us know!

Reminder: Please Submit Data to NABH’ Denial-of-Care Portal

NABH thanks all members who have submitted data to the association’s Denial-of-Care Portal. You have provided critical information that expands the portal and helps NABH strengthen its advocacy efforts related to erroneous prior-authorization denials. With guidance from our members, NABH has improved the portal by adding two elements:
  1. Time-based data on the number of days between a request for coverage and a plan’s denial, which improves our ability to assess and compare health plan responsiveness.
  1. The gap between days of provided care versus days of covered care to quantify and compare uncompensated days per health plan.
We strongly encourage all NABH members to submit their denial-of-care data in the portal. If you need help starting, or if you have other questions, please e-mail NABH Associate Manager for Congressional Affairs Emily Wilkins.

In Case You Missed It: NABH’s 2024 Advocacy Priorities

NABH released its 2024 Advocacy Priorities, which we urge you to read and share with your Government Relations teams. Topping NABH’s priorities this year are parity, workforce, behavioral healthcare information technology, America’s ongoing addiction crisis, and the Institutions for Mental Diseases (IMD) exclusion.

Fact of the Week

In 2021 and 2022, people ages 75 and older had the highest suicide rate among all age groups, largely driven by males, according to the Centers for Disease Control and Prevention and noted in a recent Health Affairs article. For questions or comments about this CEO Update, please contact Jessica Zigmond.

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NABH Supported Behavioral Healthcare Riders in Funding Package Passes House and Awaits Senate Passage

House and Senate Leadership agreed to a six-bill spending package with a March 9 deadline that contains a narrow list of health measures, including several important NABH priorities. The agreement set up a Wednesday vote in the House, which passed the legislation 339-85 and sent the package to the Senate. The Senate is expected to consider and pass the legislation today or early tomorrow morning to avoid a partial government shutdown. Following passage of the initial package, lawmakers will have roughly three additional weeks to fund HHS as part of the second funding package which has a March 22 deadline. The limited health care riders include NABH priority provisions to permanently require state Medicaid plans to cover medication-assisted treatment and to create a permanent state Medicaid option allowing treatment of substance use disorder at institutions. Other behavioral health provisions include establishing Certified Community Behavioral Health Clinic services as an optional Medicaid benefit, requiring HHS to issue guidance on how states can improve integrating behavioral health with primary care, and a provision to make treatments more streamlined for justice-involved Medicaid beneficiaries — states must suspend rather than terminate coverage for incarcerated enrollees. The skinny health care package also includes funding to eliminate the statutorily required payment reductions intended to offset hospitals’ uncompensated care costs through Dec. 31, 2024. Notably excluded from the healthcare package is the Modernizing Opioid Treatment Access Act (MOTAA), which NABH and coalition partners advocated extensively to stop. Other healthcare provisions excluded include an extension of now-expired pandemic provisions allowing employers to offer telehealth as a separate benefit, highly-debated items related to prescription drugs and hospitals, such as pharmacy benefit manager (PBM) reforms, hospital price transparency measures, or any site neutral payment policies for hospitals. There is the potential that some healthcare provisions could move with the March 22 funding package or in a year-end health package following the November elections. Should another healthcare package emerge, NABH will continue to advocate for remaining SUPPORT Act provision priorities and to prevent any effort to include MOTAA.

HHS Announces Steps to Assist Providers After Change Healthcare Cyberattack

HHS on Thursday announced what the Centers for Medicare & Medicaid Services (CMS) is doing to help healthcare providers continue to serve patients following the late-February cyberattack on Change Healthcare, a unit of UnitedHealth Group (UHG). The HHS announcement also said the department is in regular contact with UHG leadership, state partners, and with numerous external stakeholders to better understand the nature of the impacts and to ensure the effectiveness of UHG’s response. “HHS has made clear its expectation that UHG does everything in its power to ensure continuity of operations for all health care providers impacted and HHS appreciates UHG’s continuous efforts to do so,” said in its statement. “HHS is also leading interagency coordination of the Federal government’s related activities, including working closely with the Federal Bureau of Investigations (FBI), the Cybersecurity and Infrastructure Security Agency (CISA), the White House, and other agencies to provide credible, actionable threat intelligence to industry wherever possible.” Click here to read about the steps CMS is taking to assist providers. And please contact NABH if your system has been affected by the cyberattack and/or if you have questions for NABH.

SAMHSA Announces $36.9 Million in Behavioral Healthcare Grant Funding

The Substance Abuse and Mental Health Services (SAMHSA) recently announced $36.9 million in grant program funding to support behavioral healthcare services nationwide. The funding covers a variety of areas, including $10 million for screening, brief intervention, and referral to treatment; more than $6 million to support first responders and others with training, administering, and distributing naloxone and other Food and Drug Administration (FDA)-approved opioid overdose reversal medications or devices; and more than $5 million to help expand and ensure that students in health professional receive SUD education early in their academic careers and have a basic knowledge of strategies to identify and treat addiction and support recovery after they graduate. Click here to read about the other funding opportunities.

Register for the NABH Education and Research Foundation’s Talent Recruitment Webinars

The NABH Education and Research Foundation will host a two-part webinar series about talent recruitment featuring NABH members and workforce experts in March and April. Part I –Talent Recruitment: Exploring Short-Term Solutions – will be held Tuesday, March 26, 2024 at 2 p.m. ET. Foundation Vice President Jim Shaheen, CEO of New Season/Colonial Management Group, LP, and Foundation Secretary Mary Pawlikowski, president at Vanderbilt Psychiatric Hospital and Clinics, will join workforce consultant Beth Kuhn of Stonegate Strategies for this interactive webinar to help NABH members learn about and share their best, short-term solutions to recruiting talent. Kuhn has more than 30 years of workforce experience and has served in both Democratic and Republican administrations, including in her roles as commissioner of the Kentucky Department of Workforce Investment and as Vermont’s director of workforce development. She has also served as chief engagement officer at the Kentucky Cabinet of Health and Family Services. The second webinar in this series will examine longer-term solutions to recruiting talent – such as Registered Apprenticeship Programs, education and certification opportunities, fellowships, and more – on Thursday, April 18 at 2 p.m. ET. NABH Board Chair Frank Ghinassi, Ph.D., A.B.P.P. president and CEO, Rutgers University Behavioral Health Care and senior vice president, Behavioral Health and Addictions Service Line, RWJBarnabas Health, will lead the April webinar with Kuhn and workforce consultant John Pallasch of One Workforce Solutions. Pallasch served previously as the assistant secretary for employment and training at the U.S. Labor Department. Please join us and click here to register for Part 1 on March 26 and here to register for Part 2 on April 18!

Alcohol Deaths Jump During Pandemic

A new CDC study found that more than 178,300 people died from excessive alcohol use during 2020 and 2021 in the U.S., a 29% increase from 2016 and 2017, and that the number of people who died per year increased by more than 40,000 within six years. Female deaths had a 35% spike compared to 27% for males.  The report suggests that increases may have been caused by changes in alcohol policies during the COVID-19 pandemic in which many states permitted alcohol carryout and delivery to homes for off-premises consumption.

SAMHSA to Hold Briefing on CFR Amendments

Join a virtual stakeholder briefing on Thursday, March 14, 3-4 pm ET, unveiling recent amendments to 42 CFR part 8 of the Code of Federal Regulations (CFR) governing opioid treatment program (OTP) certification and treatment standards. Published on Feb. 2, 2024, these revisions aim to enhance care access through reduced barriers, flexible treatment, and telehealth integration. This event will include a presentation from Dr. Yngvild Olsen, director of SAMHSA’s Center for Substance Abuse Treatment (CSAT), others, and followed by a Q&A and discussion. Register for this breifing here.

Register Today for the 2024 NABH Annual Meeting!

Please remember to register for the 2024 NABH Annual Meeting, The Future of Behavioral Healthcare and reserve your hotel room at the Salamander Washington, DC from May 13-15, 2024.   This year’s meeting will examine and discuss critical issues that behavioral healthcare providers manage today and will continue to address tomorrow, including access to care, parity, technology, workforce, the political environment, and more. We look forward to seeing you in Washington!

Reminder: Please Submit Data to NABH’ Denial-of-Care Portal

NABH thanks all members who have submitted data to the association’s Denial-of-Care Portal. You have provided critical information that expands the portal and helps NABH strengthen its advocacy efforts related to erroneous prior-authorization denials. With guidance from our members, NABH has improved the portal by adding two elements:
  1. Time-based data on the number of days between a request for coverage and a plan’s denial, which improves our ability to assess and compare health plan responsiveness.
  1. The gap between days of provided care versus days of covered care to quantify and compare uncompensated days per health plan.
We strongly encourage all NABH members to submit their denial-of-care data in the portal. If you need help starting, or if you have other questions, please e-mail NABH Associate Manager for Congressional Affairs Emily Wilkins.

In Case You Missed It: NABH’s 2024 Advocacy Priorities

Last week NABH released its 2024 Advocacy Priorities, which we urge you to read and share with your Government Relations teams. Topping NABH’s priorities this year are parity, workforce, behavioral healthcare information technology, America’s ongoing addiction crisis, and the Institutions for Mental Diseases (IMD) exclusion.

Fact of the Week

Research from the Treatment Advocacy Center (TAC) reports that bed availability within state psychiatric hospitals reached a low of 10.8 beds per population of 100,000 in 2023. TAC’s report attributed this trend to a variety of circumstances, including the COVID-19 pandemic and the increasing, disproportionate number of beds filled by individuals from the criminal legal system.   For questions or comments about this CEO Update, please contact Jessica Zigmond.

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Now Available: NABH 2024 Advocacy Priorities!

NABH is pleased to share its 2024 Advocacy Priorities, which we urge you to read and share with your Government Relations teams. Topping NABH’s priorities this year are parity, workforce, behavioral healthcare information technology, America’s ongoing addiction crisis, and the Institutions for Mental Diseases (IMD) exclusion. “NABH’s 2024 advocacy priorities reflect the organization’s mission to advance responsive, accountable, and clinically effective prevention, treatment, and care for children, adolescents, adults, and older adults with mental health (MH) and substance use disorders (SUD),” the advocacy priorities document notes. “2024 is a critically important year as the country continues to face intense access challenges for both MH and SUD patients. Demand for our services across all age groups nationwide has never been higher.

NABH Education and Research Foundation to Host Webinar Series on Talent Recruitment

The NABH Education and Research Foundation will host a two-part webinar series about talent recruitment featuring NABH members and workforce experts in March and April. Part I –Talent Recruitment: Exploring Short-Term Solutions – will be held Tuesday, March 26, 2024 at 2 p.m. ET. Foundation Vice President Jim Shaheen, CEO of New Season/Colonial Management Group, LP, and Foundation Secretary Mary Pawlikowski, president at Vanderbilt Psychiatric Hospital and Clinics, will join workforce consultant Beth Kuhn of Stonegate Strategies for this interactive webinar to help NABH members learn about and share their best, short-term solutions to recruiting talent. Kuhn has more than 30 years of workforce experience and has served in both Democratic and Republican administrations, including in her roles as commissioner of the Kentucky Department of Workforce Investment and as Vermont’s director of workforce development. She has also served as chief engagement officer at the Kentucky Cabinet of Health and Family Services. The second webinar in this series will examine longer-term solutions to recruiting talent – such as Registered Apprenticeship Programs, education and certification opportunities, fellowships, and more – on Thursday, April 18 at 2 p.m. ET. NABH Board Chair Frank Ghinassi, Ph.D., A.B.P.P. president and CEO, Rutgers University Behavioral Health Care and senior vice president, Behavioral Health and Addictions Service Line, RWJBarnabas Health, will lead the April webinar with Kuhn and workforce consultant John Pallasch of One Workforce Solutions. Pallasch served previously as the assistant secretary for employment and training at the U.S. Labor Department. Please join us and click here to register for Part 1 on March 26 and here to register for Part 2 on April 18!

Lawmakers Avert Government Shutdown; Healthcare Funding Package Slated for Late March

Federal lawmakers this week averted a partial government shutdown after the Senate on Thursday approved a two-step Continuing Resolution that clears the path for policymakers to conclude appropriations work and prepare for a healthcare funding package scheduled for March 22. The House and Senate moved quickly to pass a stopgap funding bill ready for President Biden’s signature this weekend, buying more time to finalize half a dozen spending bills that congressional leaders must pass by the new March 8 deadline. The vote will set up a first tranche of full-year spending bills, which include the Agriculture, Commerce-Justice-Science, Energy-Water, Interior-Environment, Military Construction-VA and Transportation-Housing and Urban Development measures. Enacting these bills would fund those agencies through Sept. 30. Congress will consider a second batch of bills as they face a new deadline of March 22 to avoid a partial government shutdown. That package includes the Defense, Financial Services, Legislative Branch, Homeland Security, Labor-HHS-Education and State-Foreign Operations measures. A final deal on the Labor-HHS bill could include a stripped-down healthcare package with a handful of priorities, including a NABH priority: an IMD provision that would make the state plan amendment option permanent. Other healthcare priorities expected in the bill include a partial fix to Medicare physician pay cuts, extended funding for community health centers, and delayed disproportionate share hospital cuts. Other long-debated health policy measures – including pharmacy benefit manger reforms, site-neutral hospital policies, transparency reforms, and some SUPPORT Act provision reauthorizations – are likely to be set aside until the lame-duck session after November’s elections. MOTAA proponents will likely continue to advocate for including this measure – which NABH will continue to oppose – in a November funding package.

SAMHSA to Host Webinar on Models to Reduce Frequent Service Utilization for Individuals with MH and SUD

The Substance Abuse and Mental Health Services Administration’s (SAMHSA) GAINS Center will host the webinar Implementing Complex Care Models to Reduce Frequent Service Utilization Among Individuals Experiencing Mental and Substance Use Disorders later this month. As SAMHSA noted in its announcement, people with complex healthcare needs, including mental and substance use disorders, can sometimes fall through service gaps and cycle among emergency, criminal justice, and hospital systems. Their complex needs require a person-centered approach to care and linkages to support treatment retention and recovery. Learn more in this webinar on Thursday, March 21 starting at 1:30 p.m. ET. Click here to register.

Now Open: 2024 NABH Annual Meeting Registration

Registration is now open for the 2024 NABH Annual Meeting, The Future of Behavioral Healthcare. Please join us at the Salamander Washington, DC from May 13-15, 2024 for this year’s Annual Meeting to examine and discuss critical issues that behavioral healthcare providers manage today and will continue to address tomorrow, including access to care, parity, technology, workforce, the political environment, and more. Click here to register for the meeting and reserve your hotel room. We look forward to seeing you in Washington!

Join Us for Hill Day 2024!

Please remember to sign up for Hill Day 2024 on Tuesday, May 14, the second day of this year’s Annual Meeting. Hill Day is an excellent opportunity to meet one-on-one with legislators to discuss the issues that matter most to behavioral healthcare providers. After you register for the NABH Annual Meeting, the NABH Congressional Affairs team will match you with legislators who represent you or your facility footprint. Closer to the day of the meeting, we will send you a meeting schedule, materials, and talking points to guide your conversations with Members of Congress and their staff. Please indicate in your Annual Meeting registration form that you are interested in Hill Day, and be sure to include all the states where your system has a footprint. If you have an existing relationship with a legislator, please let us know!

Reminder: Please Submit Data to NABH’ Denial-of-Care Portal

NABH thanks all members who have submitted data to the association’s Denial-of-Care Portal. You have provided critical information that expands the portal and helps NABH strengthen its advocacy efforts related to erroneous prior-authorization denials. With guidance from our members, NABH has improved the portal by adding two elements:
  1. Time-based data on the number of days between a request for coverage and a plan’s denial, which improves our ability to assess and compare health plan responsiveness.
  1. The gap between days of provided care versus days of covered care to quantify and compare uncompensated days per health plan.
We strongly encourage all NABH members to submit their denial-of-care data in the portal. If you need help starting, or if you have other questions, please e-mail NABH Associate Manager for Congressional Affairs Emily Wilkins.

Fact of the Week

In areas with some racial or ethnic diversity, there is a large decline in the geographic availability of buprenorphine prescribers and prescription fills, according to a new study from the University of Pittsburgh. “In areas that are less than 95% white, for example, there’s a 45 to 50% drop (in access),” said Coleman Drake in a U.S. News and World Report article. Drake is an assistant professor of health policy and management at Pitt Public Health in Pittsburgh and the study’s lead author.   For questions or comments about this CEO Update, please contact Jessica Zigmond.

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DOL Includes Mental Health in $200 Million Grant Announcement for Registered Apprenticeships

The U.S. Labor Department this week announced nearly $200 million in grants to support public-private partnerships that expand, diversify, and strengthen Registered Apprenticeships and included mental health occupations under the “care economy” sector that is eligible to apply. The funding opportunity includes $95 million of competitive grants through the second round of the Apprenticeship Building America Grant Program and $100 million in the second round of State Apprenticeship Expansion Formula Grants. The Apprenticeship Building America Grant Program aims to leverage Registered Apprenticeships as a workforce solution while assuring that people from underrepresented and underserved communities can access high-quality training and pre-apprenticeships that lead directly to enrolling in a Registered Apprenticeship program. In addition to the care economy, sectors include information technology/cybersecurity, K-12 teacher occupations, clean energy, hospitality, public sector, and supply chain sector (logistics, warehousing, transportation, manufacturing). Click here to learn about the second round of the Apprenticeship Building America Grant Program and here to learn about the State Apprenticeship Expansion Formula grants. The NABH Education and Research Foundation will host a webinar this spring to help members learn more about Registered Apprenticeships and will provide details soon.

U.S. Supreme Court Rejects UBH Request to Hear Claim Denial Case

In a win for behavioral healthcare providers, the U.S. Supreme Court this week rejected a request for appeal from United Behavioral Health (UBH) to hear a behavioral health claim denial case. The initial case centered on how health plans under the Employee Retirement Income Security Act (ERISA) handle clinician insights in the denial-appeal process and how those decisions should be communicated to members. UBH sought to challenge a prior court’s rule pertaining to whether the health plan gave the plaintiff – a patient who ultimately died by suicide – a full and fair review during the denial-appeals process. The Supreme Court’s rejection this week upholds the 10th U.S. Circuit Court of Appeals’ May 2023 ruling, which noted: “United argues its actions were not arbitrary and capricious because it met certain ERISA regulatory requirements. It points to regulations which discuss requirements for engagement with medical opinions in ERISA disability plans,” and continued: “We recognize the textual difference in the ERISA disability and ERISA medical regulations pointed out by United but disagree that the dialogue absolves United from its duty to engage in meaningful dialogue that includes a full and fair review of the insured’s claim.”

National Academies Report Urges Developing Standards to Limit Potential Social Media Harms on Adolescent Mental Health

A recent report from the National Academies of Sciences, Engineering, and Medicine (NASEM) recommends developing new industry standards to limit the potential harms of social media on adolescent mental health while bolstering its possible benefits. The report notes that during the past 15 years, an increase in young people’s smartphone usage has coincided with a decline in mental health, a damaging  association that U.S. Surgeon General Vivek Murthy, M.D., M.B.A, warned against in a May 2023 advisory. Click here to read the JAMA article about the NASEM report.

HHS & DOJ to Host Webinar on Tech-facilitated Abuse in Teen Relationships Next Week

In conjunction with February’s Teen Dating Violence Awareness Month, HHS and the U.S. Justice Department (DOJ) will host a webinar on Feb. 28 to help participants learn about the use of technology in teen dating and its related impacts on behavioral health. HHS’ Office of Family Violence Prevention and Services and Substance Abuse and Mental Health Services Administration, along with DOJ’s Office on Violence Against Women, will lead the 75-minute event, which will also examine non-consensual image-sharing and practices to address these challenges at the community level. Click here to register for the webinar, which will begin at 3 p.m. ET next Wednesday.

Now Open: 2024 NABH Annual Meeting Registration

Registration is now open for the 2024 NABH Annual Meeting, The Future of Behavioral Healthcare. Please join us at the Salamander Washington, DC from May 13-15, 2024 for this year’s Annual Meeting to examine and discuss critical issues that behavioral healthcare providers manage today and will continue to address tomorrow, including access to care, parity, technology, workforce, the political environment, and more. Click here to register for the meeting and reserve your hotel room. We look forward to seeing you in Washington!

Reminder: Please Submit Data to NABH’ Denial-of-Care Portal

NABH thanks all members who have submitted data to the association’s Denial-of-Care Portal. You have provided critical information that expands the portal and helps NABH strengthen its advocacy efforts related to erroneous prior-authorization denials. With guidance from our members, NABH has improved the portal by adding two elements:
  1. Time-based data on the number of days between a request for coverage and a plan’s denial, which improves our ability to assess and compare health plan responsiveness.
  1. The gap between days of provided care versus days of covered care to quantify and compare uncompensated days per health plan.
We strongly encourage all NABH members to submit their denial-of-care data in the portal. If you need help starting, or if you have other questions, please e-mail NABH Associate Manager for Congressional Affairs Emily Wilkins.

Fact of the Week

A recent report from union group National Nurses United showed 81.6% of nurses polled said they had experienced workplace violence in at least one form. Respondents reported the three most common types of violence were being verbally threatened (67.8%), physically threatened (38.7%), and being pinched or scratched (37.3%).   For questions or comments about this CEO Update, please contact Jessica Zigmond.

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NABH Remembers Youth Services Committee Member Mike Lyons, M.S.

NABH remembers with grateful appreciation Mike Lyons, M.S., 54, who died unexpectedly of a brain aneurysm on Sunday, Feb. 11. Mike served as vice president of specialty education for Universal Health Services’ (UHS) Behavioral Health Division, where he was responsible for implementing UHS’ Best in Class Academic Accountability System throughout the organization’s network of academic programs in acute, partial hospitalization, residential, and day-school settings. Mike also championed education legislation at the state and federal levels to make certain that children and adolescents with mental illness receive an equitable and quality educational experience. At the association, Mike was an influential and supportive member of the Youth Services Committee, where his fellow members and NABH team respected him highly for his insights, thoughtful comments, and devotion to helping kids learn. As an example, last year Mike sent his regrets for missing the 2023 Annual Meeting and Youth Services Committee meeting so he could attend the high school graduation ceremony at one of UHS’ facilities. Mike will be missed by all who knew him. There will be a celebration of Mike’s life at The Casa Bella Club House, 6005 Anello Drive, Melbourne, Florida 32940 from 2 – 5 p.m. on Saturday, Feb. 17. In lieu of flowers, donations can be made to Camp Marist, 22 Abel Boulevard, Effingham, New Hampshire, 03882. Under the leadership of the Marist Brothers for more than 70 years, Camp Marist is based in New Hampshire’s White Mountain Lakes region and is a place where children learn about character, leadership, and community.

NABH Sends MOTAA Opposition Letter to Congressional Leaders

This week NABH sent a letter to House and Senate leaders outlining the association’s strong opposition to the Modernizing Opioid Treatment Access Act (MOTAA). “The Modernizing Opioid Treatment Access Act (MOTAA) [H.R. 1359 / S. 644] would permit addiction physicians outside OTPs to prescribe methadone that would be dispensed through pharmacies,” NABH wrote in its letter. “This legislation has not been vetted appropriately with stakeholders, the House has not held a hearing to examine it, and the Senate has given it only a cursory review,” the letter continued. “The bill’s goal is to provide greater access to methadone; however, patient safety concerns with such an untested approach warrants further review and attention before further congressional consideration.” NABH cautioned that MOTAA would significantly introduce more danger of overdose given the safety profile of methadone (versus buprenorphine, for example). Instead, NABH wrote that implementing the Substance Abuse and Mental Health Services Administration’s (SAMHSA) regulations released on Feb. 2 would be a more effective approach to providing greater access. “They will allow greater access to individuals of all ages, provide greater convenience for patients, bolster the workforce, ease expansion to broader settings of care (medication units and mobile units), and more,” NABH wrote. “The regulations also recognize that methadone has a more dangerous pharmacological profile than other medications for OUD.”

CMS Clarifies Parameters on Using AI in Coverage Decisions for MA Plans

In a recent memo, the Centers for Medicare & Medicaid Services (CMS) clarified that Medicare Advantage (MA) plans cannot use artificial intelligence (AI) and algorithms to deny prior authorization requests but may use the technology to assist in coverage decisions. This clarification – published in the memo as frequently asked questions (FAQ) – is based on the agency’s April 2023 rule, which took effect on Jan. 1, 2024. In the FAQ, the agency responds to concerns about inappropriate coverage denials based on algorithms. “An algorithm or software tool can be used to assist MA plans in making coverage determinations, but it is the responsibility of the MA organization to ensure that the algorithm or artificial intelligence complies with all applicable rules for how coverage determinations by MA organizations are made,” the agency noted in its FAQ. This scrutiny aligns with recent lawsuits against UnitedHealth Group, Humana, and Cigna’s MA plans, as well as a 2022 HHS Office of the Inspector General report about the erroneous algorithm coverage decisions.

Kaiser Family Foundation to Examine Prior Authorization in Webinar Next Week

The Kaiser Family Foundation (KFF) will host a webinar on Feb. 22 featuring a panel of four experts who will explore why insurers use prior authorization, its effect on patients and providers, and how new regulations may change current practices. Larry Levitt, KFF’s executive vice president for health policy, will moderate the 45-minute discussion that will include Troyen Brennan, M.D., adjunct professor of health policy and management at the Harvard T.H. Chan School of Public Health and former CVS Care executive; Fumiko Chino, M.D., radiation oncologist at Memorial Sloan Kettering Cancer Center; Anna Schwamlein Howard, principal, policy development at the American Cancer Society Action Network; and Kaye Pestaina, KFF’s vice president and director of the Program on Patient and Consumer Protection.   Click here to register for the webinar, which is scheduled for Thursday, Feb. 22 at noon ET.

SAMHSA Releases Resource on Medicaid Coverage of Medications for Alcohol and Opioid Use Disorders

SAMHSA has released a report that provides an update on the present state of coverage, availability of, and access to medications within state Medicaid plans for treating ongoing alcohol use disorder (AUD) and opioid use disorder (OUD) and reversing an opioid overdose. The new resource also includes examples of efforts to increase access to medications for treating SUD. SAMHSA also developed an hourlong webinar and slides in conjunction with the report.

SAMHSA Announces New SUD-Related Funding Opportunities

SAMHSA this week released two separate notices of funding opportunities focused on SUD. In the first funding notice, SAMHSA will distribute up to 10 awards totaling $9.95 million to implement the screening, brief intervention, and referral to treatment public health model for children, adolescents, and/or adults in primary care and community health settings, HMOs, PPOs, health plans, federally qualified health centers, children’s hospitals, and more with a focus on screening for underage drinking, opioid use, and other substance use. The other funding notice will distribute up to 18 awards totaling $5.4 million to expand and assure that graduate-level healthcare students receive SUD education early in their academic careers and prepare them to identify and treat UD in mainstream healthcare after they graduate.

Now Open: 2024 NABH Annual Meeting Registration

Registration is now open for the 2024 NABH Annual Meeting, The Future of Behavioral Healthcare. Please join us at the Salamander Washington, DC from May 13-15, 2024 for this year’s Annual Meeting to examine and discuss critical issues that behavioral healthcare providers manage today and will continue to address tomorrow, including access to care, parity, technology, workforce, the political environment, and more. Click here to register for the meeting and reserve your hotel room. We look forward to seeing you in Washington!

Join Us for Hill Day 2024!

Please remember to sign up for Hill Day 2024 on Tuesday, May 14, the second day of this year’s Annual Meeting. Hill Day is an excellent opportunity to meet one-on-one with legislators to discuss the issues that matter most to behavioral healthcare providers. After you register for the NABH Annual Meeting, the NABH Congressional Affairs team will match you with legislators who represent you or your facility footprint. Closer to the day of the meeting, we will send you a meeting schedule, materials, and talking points to guide your conversations with Members of Congress and their staff. Please indicate in your Annual Meeting registration form that you are interested in Hill Day, and be sure to include all the states where your system has a footprint. If you have an existing relationship with a legislator, please let us know!

Reminder: Please Submit Data to NABH’ Denial-of-Care Portal

NABH thanks all members who have submitted data to the association’s Denial-of-Care Portal. You have provided critical information that expands the portal and helps NABH strengthen its advocacy efforts related to erroneous prior-authorization denials. With guidance from our members, NABH has improved the portal by adding two elements:
  1. Time-based data on the number of days between a request for coverage and a plan’s denial, which improves our ability to assess and compare health plan responsiveness.
  1. The gap between days of provided care versus days of covered care to quantify and compare uncompensated days per health plan.
We strongly encourage all NABH members to submit their denial-of-care data in the portal. If you need help starting, or if you have other questions, please e-mail NABH Associate Manager for Congressional Affairs Emily Wilkins.

Fact of the Week

Behavioral healthcare jobs made three of the top seven and five of the top 20 jobs in Indeed’s Best Jobs of 2024, which focused on jobs w/ a minimum salary of $75,000 and w/ at least 10% of postings that included remote or hybrid work.   For questions or comments about this CEO Update, please contact Jessica Zigmond.

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Now Open: 2024 NABH Annual Meeting Registration!

Registration is now open for the 2024 NABH Annual Meeting, The Future of Behavioral Healthcare. Please join us at the Salamander Washington, DC from May 13-15, 2024 for this year’s Annual Meeting to examine and discuss critical issues that behavioral healthcare providers manage today and will continue to address tomorrow, including access to care, parity, technology, workforce, the political environment, and more. Click here to register for the meeting and reserve your hotel room. We look forward to seeing you in Washington!

SAMHSA and ONC Launch Behavioral Health Information Technology Initiative

HHS’ Substance Abuse and Mental Health Services Administration (SAMHSA) and Office of the National Coordinator for Health Information Technology (ONC) this week announced they will invest more than $20 million of SAMHSA funds in the next three years to advance health information technology (IT) in behavioral healthcare and practice settings. The announcement acknowledged that behavioral healthcare providers lag behind other providers in health IT adoption in part because they are ineligible to participate in health IT incentive programs that the Centers for Medicare & Medicaid Services (CMS) provide. An ONC analysis of American Hospital Association survey data from 2019 and 2021 found that 86% of non-federal, general acute care hospitals had adopted a 2015-edition certified electronic health record (EHR), while only 67% of psychiatric hospitals had adopted the same certified EHR. Meanwhile, ONC analysis of SAMHSA survey data from 2020 show psychiatric hospitals lag even further behind in adoption of interoperability and patient engagement functions. To address these challenges, the Behavioral Health Information Technology (BHIT) Initiative will identify and pilot a set of behavioral health-specific data elements with SAMHSA’s Substance Use Prevention, Treatment, and Recovery Services Block Grant and Community Mental Health Services Block Grant grantees and Community Mental Health Services Block Grant grantees. The data elements will be coordinated via a new USCDI+ domain for behavioral health to improve the effectiveness and reduce the costs of data capture, use, and exchange for behavioral health providers. This year ONC, SAMHSA, and other federal partners will begin to identify data elements for the USCDI+ project as part of the broader BHIT Initiative. This collaborative approach will incorporate input on behavioral health priorities from a variety of individuals and entities including clinicians, grantees, states, and advocates. Then SAMHSA and ONC will coordinate with technology developers and participating providers on how to best include USCDI+ behavioral health data elements in health IT and pilot their use.

HHS Finalizes ‘42 CFR Part 2’ Rule to Better Align with HIPAA Standards

HHS on Thursday released its final Confidentiality of Substance Use Disorder (SUD) Patient Records rule to implement the Coronavirus Aid, Relief, and Economic Security Act (CARES) amendments to the federal substance use confidentiality rule – commonly known as 42 CFR part 2, or Part 2. Consistent with NABH recommendations, the new rules further align Part 2’s requirements with the Health Insurance Portability and Accountability Act’s (HIPAA) rules and the Health Information Technology for Economic and Clinical Health Act (HITECH). Although opponents to these changes argued they were unnecessary, HHS nonetheless adopted these modifications to align with HIPAA, a rule that has historically had fewer privacy protections than part 2. The new rule permits patients to provide one-time consent for the disclosure of treatment records; permits an accounting of disclosures; strengthens prohibitions against disclosure of records in civil, criminal, or legislative proceedings, and provides HHS with enforcement authority, including financial penalties. Importantly, the rule creates a new definition for SUD clinicians’ notes that is analogous to the protections HIPAA provides for psychotherapy notes. The rule will become effective 60 days after publication and compliance is not required until 2026. Meanwhile, HHS’ Office for Civil Rights plans to finalize changes to the HIPAA Notice of Privacy Practices (NPP) to address uses and disclosures of protected health information that is also protected by Part 2 along with other changes to the NPP requirements, in an upcoming final rule modifying the HIPAA privacy. In addition, HHS plans to implement in separate rulemaking the CARES Act antidiscrimination provisions that prohibit the use of patients’ Part 2 records against them.

CMS Releases Updated State Medicaid & CHIP Telehealth Toolkit

CMS this week released an updated State Medicaid & Children’s Health Insurance Program (CHIP) Telehealth Toolkit, a series of resources that include telehealth policies and information about telehealth platforms, billing best practices, strategies to deliver accessible and culturally competent care via telehealth, and more. The resources provide states with statutory and regulatory infrastructure issues to consider as they evaluate the need to expand their telehealth capabilities and coverage policies, including coverage and reimbursement policies, providers, and practitioners eligible to provider telehealth, technology requirements, considerations for specific populations, and state examples and strategies.

Prevent Suicide New Jersey to Host Safety Planning Intervention Workshop on Feb. 28

Prevent Suicide New Jersey, a partnership among state departments, professional and community organizations, schools, and families, will host a free workshop on Feb. 28 about the Stanley Brown Safety Planning Intervention (SPI), a collaborative, clinical intervention that results in a prioritized written list of warning signs, coping strategies, and resources for suicidal individuals. The virtual workshop will teach participants the six steps to create a safety plan: 1) recognizing warning signs; 2) identifying internal coping strategies; 3) identifying other people or social settings for distraction; 4) identifying individuals to ask for help; 5) identifying professionals and agencies for help; and 6) making the environment safe. The New Jersey Chapter, American Academy of Pediatrics (NJAAP), ABFT International Training Institute, LLC, and the U.S. Journal of Training are co-sponsoring the training, and the webinar is open to certified licensed community behavioral health clinicians, school-based behavioral health providers, and interested community members. Click here to register.

Reminder: Please Submit Data to NABH’ Denial-of-Care Portal

NABH thanks all members who have submitted data to the association’s Denial-of-Care Portal. You have provided critical information that expands the portal and helps NABH strengthen its advocacy efforts related to erroneous prior-authorization denials. With guidance from our members, NABH has improved the portal by adding two elements:
  1. Time-based data on the number of days between a request for coverage and a plan’s denial, which improves our ability to assess and compare health plan responsiveness.
  1. The gap between days of provided care versus days of covered care to quantify and compare uncompensated days per health plan.
We strongly encourage all NABH members to submit their denial-of-care data in the portal. If you need help starting, or if you have other questions, please e-mail NABH Associate Manager for Congressional Affairs Emily Wilkins.

Fact of the Week

Researchers at the University of Texas at Austin, the University of Texas at Dallas, and the University of Miami have identified a molecule that reduces hypersensitivity in trials in mice by binding to a protein they have shown is involved in neuropathic pain, according to a study published in Science Daily. The new compound, dubbed FEM-1689, does not engage opioid receptors in the body, making it a possible alternative to existing pain medications linked to addiction.   For questions or comments about this CEO Update, please contact Jessica Zigmond.

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NABH Alert: SAMHSA Updates OTP Regulations

The Substance Abuse and Mental Health Services Administration published Medications for the Treatment of Opioid Use Disorder late yesterday for public inspection. The final rule was published earlier today and becomes effective on April 2, 2024, with compliance by October 2, 2024. [Please note that this is a correction of the compliance date of October 2, 2026 that was published yesterday in the public notice.] NABH provided comments on the Notice of Proposed Rule Making that was issued in December 2022 calling for greater regulatory flexibility for opioid treatment programs (OTPs). The final regulations align closely to NABH recommendations and herald greater deference to clinical decision-making in the nation’s (OTPs). Among the provisions, the regulations:
  • Make permanent the Covid-era take-home schedule;
  • Permit methadone for new patients via audio-visual telemedicine with the dispensing of medication at the OTP (not audio-only).
  • Permit audio-only telemedicine when the patient is in the presence of a practitioner who is registered to prescribe SII, including dispensing.
  • Clarify (in response to NABH off-line discussion and official comments) that the prescription of methadone to community pharmacies is NOT permitted;
  • Change the requirement for a one-year history of OUD for eligibility so that now either the patient must a) meet diagnostic criteria for moderate-severe OUD, or b) be in OUD remission, or c) at high risk for overdose;
  • Remove the requirement for two treatment failures for people under 18 to be eligible for services;
  • Remove requirement for a one-year history of OUD for people recently released from a correctional facility, pregnant patients, or previously enrolled individuals;
  • Allow medication units to provide all OTP services;
  • Decouple medication and attendance at counseling services;
  • Permit interim treatment for 180 days, including at for-profit OTPs;
  • Permit mid-levels (“…those appropriate licensed by the state”) to prescribe without exemption;
  • Clarified accreditation standards to reduce potential for a burdensome increase in less-than 3-year accreditations;
  • Permit buprenorphine prescribing in an OTP via audio-only and audio-visual without an in-person evaluation; and
  • Update terminology to reflect contemporary, non-stigmatizing language.
The final rule additionally codifies the Consolidated Appropriations Act, 2023 elimination of the Drug Addiction and Treatment Act (DATA) Waiver by removing all relevant language.

CMS Proposes MA Rates for 2025

The Centers for Medicare & Medicaid Services (CMS), on Wednesday, released a calendar year (CY) 2025 advance notice which includes measures related to Medicare Advantage (MA) and other issues. The advance notice proposes an annual increase to MA payments of, on average, 3.7 percent ($16 billion), relative to 2024. This advance notice complements another CY 2025 proposed rule issued last November. It also builds upon technical updates in 2023 to the MA risk adjustment model that are designed to yield more accurate payments. CMS will accept comments on the advance notice through April 1. For additional background, see this CMS fact sheet. NABH appreciates CMS’s meaningful efforts in recent years to improve the MA program, including increasing the accountability and transparency of MA health plans as well as substantive proposals to enforce parity and improve the prior authorization program.

CMS Requests Information on MA In Push For Data Transparency

The Centers for Medicare & Medicaid Services (CMS), on Thursday, Jan. 24, requested information on Medicare Advantage (MA) data capabilities to increase data transparency. The RFI asked for recommendations for improving data capabilities to increase accuracy on coverage, enhance quality of care, and better inform healthcare professionals. This RFI builds upon CMS’ extensive regulatory activity to increase transparency and accountability of Medicare Advantage plans. CMS is aiming to have comprehensive data on the MA program made publicly available and thus allowing for further comparative analyses between other health programs. Click here to read the full press release.

SAMSHA Releases Guide for Overdose Prevention and Response

The SAMHSA Overdose Prevention Toolkit provides guidance on preventing and responding to an overdose and the role of opioid overdose reversal medications. The toolkit emphasizes that harm reduction and access to treatment are essential aspects of overdose prevention. Appendices are directed to specific audiences, such as people who use drugs (PWUD), people taking prescribed opioids, first responders, healthcare practitioners, and others. Click here to access the toolkit.

GAO Evaluates the Potential Expansion of FHA Loans to Behavioral Health Hospitals

The Government Accountability Office last week issued recommendations to Congress on the pros and cons on the possible expansion of the Federal Housing Authority (FHA) Hospital Mortgage Insurance Program. Any expansion in the future would expand access to higher-acuity behavioral health services. Today, this FHA program funds loans to general acute-care hospitals for capital improvements, not including hospitals focused on treating behavioral health patients due to their, on average, smaller size, revenue, and margins. The report, commissioned by Congress, suggests that any expansion of this program be coupled with parameters to mitigate potential risks, such as initially limiting the volume loans to newly eligible hospitals through a pilot program, and requiring regular loan performance updates from FHA to Congress

SAMHSA Offers Consumer Guide for Peer Support in Substance Use Recovery

The newly released peer support recovery guide from The Substance Abuse and Mental Health Services Administration (SAMHSA) provides an in-depth look into the role of peer specialists. SAMHSA states that readers can utilize visual aids and consumer forms to better understand the range of services provided by peer specialists and how they can be a resource to those in recovery from substance use. Click here to access the guide.

HHS’ Office of Long Covid Welcomes Ian Simon as Director

The Department of Human and Health Services (HHS) appointed Ian Simon as the director of the Office of Long Covid Research and Practice. In this position, Simon will lead HHS towards a coordinated government response to better understand the long-term impacts of COVID-19. Simon was the assistant director for health strategy and bio preparedness at the White House’s Office of Science and Technology Policy. He also brings additional experience from his time at the National Institute of Allergy and Infectious Diseases (NIAID).

Reminder: SAMHSA Releases Updated 988 Partner Toolkit

The Substance Abuse and Mental Health Services Administration (SAMHSA) has released an updated 988 Partner Toolkit that the agency says is designed to help users better navigate the bank of materials available to promote the lifeline in communities. The toolkit has the same video PSAs, social media promotions, FAQs, and print materials, and is now available to search by target audience, population, language, and resource type. Click here to access the toolkit.

Reminder: NABH’s Enhanced Denial-of-Care Portal is Now Available

NABH thanks all members who have submitted data to the association’s Denial-of-Care Portal. You have provided critical information that expands the portal and helps NABH strengthen its advocacy efforts related to erroneous prior-authorization denials. With guidance from our members, NABH has improved the portal by adding two elements:
  1. Time-based data on the number of days between a request for coverage and a plan’s denial, which improves our ability to assess and compare health plan responsiveness.
  1. The gap between days of provided care versus days of covered care to quantify and compare uncompensated days per health plan.
We strongly encourage all NABH members to submit their denial-of-care data in the portal. If you need help starting, or if you have other questions, please e-mail NABH Associate Manager for Congressional Affairs Emily Wilkins.

Save the Date for the NABH 2024 Annual Meeting!

Please plan to join us at the Salamander Washington, DC from May 13-15, 2024 for this year’s Annual Meeting, The Future of Behavioral Healthcare. Registration will open in February.

Fact of the Week

A study from JAMA Internal Medicine found that pregnant patients treated with buprenorphine within the first trimester had an 18% lower risk of congenital malformations than those treated with methadone.   For questions or comments about this CEO Update, please contact Jessica Zigmond.

SAMHSA Updates OTP Regulations

SAMHSA Updates OTP Regulations

Updated Feb. 2, 2024 The Substance Abuse and Mental Health Services Administration published Medications for the Treatment of Opioid Use Disorder late yesterday for public inspection. The final rule was published earlier today and becomes effective on April 2, 2024, with compliance by October 2, 2024. [Please note that this is a correction of the compliance date of October 2, 2026 that was published yesterday in the public notice.] NABH provided comments on the Notice of Proposed Rule Making that was issued in December 2022 calling for greater regulatory flexibility for opioid treatment programs (OTPs). The final regulations align closely to NABH recommendations and herald greater deference to clinical decision-making in the nation’s (OTPs). Among the provisions, the regulations:
  • Make permanent the Covid-era take-home schedule;
  • Permit methadone for new patients via audio-visual telemedicine with the dispensing of medication at the OTP (not audio-only).
  • Permit audio-only telemedicine when the patient is in the presence of a practitioner who is registered to prescribe SII, including dispensing.
  • Clarify (in response to NABH off-line discussion and official comments) that the prescription of methadone to community pharmacies is NOT permitted;
  • Change the requirement for a one-year history of OUD for eligibility so that now either the patient must a) meet diagnostic criteria for moderate-severe OUD, or b) be in OUD remission, or c) at high risk for overdose;
  • Remove the requirement for two treatment failures for people under 18 to be eligible for services;
  • Remove requirement for a one-year history of OUD for people recently released from a correctional facility, pregnant patients, or previously enrolled individuals;
  • Allow medication units to provide all OTP services;
  • Decouple medication and attendance at counseling services;
  • Permit interim treatment for 180 days, including at for-profit OTPs;
  • Permit mid-levels (“…those appropriate licensed by the state”) to prescribe without exemption;
  • Clarified accreditation standards to reduce potential for a burdensome increase in less-than 3-year accreditations;
  • Permit buprenorphine prescribing in an OTP via audio-only and audio-visual without an in-person evaluation; and
  • Update terminology to reflect contemporary, non-stigmatizing language.
The final rule additionally codifies the Consolidated Appropriations Act, 2023 elimination of the Drug Addiction and Treatment Act (DATA) Waiver by removing all relevant language.

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CMS $50 Million in Grants for School-Based Health Services, Particularly for Mental Health

The Centers for Medicare & Medicaid Services (CMS) this week announced $50 million in state grant funding to connect millions more children to critical healthcare services, especially mental health, in schools. The funding comes through the Bipartisan Safer Communities Act and will provide 20 states up to $2.5 million each in funding that can help states implement, enhance, and expand school-based health services through Medicaid and the Children’s Health Insurance Program, or CHIP. “This funding will be transformational for states at any stage in developing school-based health services programs, which represent one of CMS’ most powerful tools for expanding access to care for our children,” CMS Administrator Chiquita Brooks-LaSure said in an announcement about the funding. “Medicaid and CHIP cover over 39 million children. This targeted support is one way CMS can help kids get the health care they need by meeting them where they are — in school.” CMS said it anticipates a total of 20 grant awards, with a minimum of 10 awards to states that have yet to cover school-based health services for all children covered under Medicaid or CHIP. In addition, the agency said up to 10 grants are intended for states that have taken initial steps to expand school-based health services, with the hope that these grants will enhance or refine their existing programs. Applications for grant funding are due by March 25 and funding is expected by this summer. Click here for more information.

National Academy for State Health Policy Updates State Opioid Settlement Tracker

The National Academy for State Health Policy (NASHP) this month updated its tracker to show how states are implementing administrative structures to disburse an expected $50 billion awarded to states and localities from opioid-related lawsuits, which includes $26 billion awarded to 46 states as part of the National Opioid Settlement. These structures include strategies for engaging a wide variety of stakeholders on priorities for reducing opioid-related deaths and investing in SUD prevention, treatment, and recovery infrastructure. NASHP released an issue brief about its tracker in December 2022 to show funding allocated to each state through the National Opioid Settlement, as well as laws, agreements, and processes that states have established for allocating the funds.

Now Available: NABH Education and Research Foundation Webinar Resources and Interview

Thank you to all who joined or watched our foundation’s webinar, Redesigning the Present and Future Behavioral Healthcare Workforce, on Tuesday, Jan. 23. NABH regrets that we were unable to hear from NABH Education and Research Foundation President and co-presenter Don Parker soon after the webinar began due to a power outage in Parker’s service area. Below is an exchange between Parker and co-presenter Beth Kuhn, principal at workforce consultancy Stonegate Strategies, in a post-webinar interview. BK: Don, what can you tell us about the top workforce challenges you experienced at Hackensack Meridian Health System? DP: At the start of the COVID-19 pandemic, the Hackensack Merdian Health System asked the system’s Behavioral Health Care Transformation Services to develop a post-pandemic strategy recognizing that we would have two major problems to deal with: a rapidly increasing demand for behavioral healthcare, given all of the fear, loss, isolation and uncertainty our citizens were experiencing, and an unpredictable reaction from our staff who had the same fears but just multiplied given the nature of their jobs in health care. Although we slowed our feared staff exodus, similar to every other hospital in America, it increased and has led to shortages across the professions. As we now face both supply (under staffing of all levels of professionals) and demand (unprecedented demand for behavioral health from every age cohort) our HMH team has turned its focus to improving retention and attracting new recruits to bolster our veterans. BK: Your system has been especially focused on building partnerships to support your talent supply efforts.  What can you tell us about your approach? DP: Knowing we would face a shortage of psychiatrists, HMH initiated 64 psychiatry resident slots and 16 fellowships (heavily weighted to children). Our first class graduated last year and began to fill our ranks.  For the many residents and fellows we recruited to stay at HMH, we engaged them in an “Earn While You Learn” program for their final year. They received what would be equal to a signing bonus in monthly increments for the year. It provided great recruitment and retention. Our health system created two new nursing school partnerships with all the nurses rotating through the HMH psychiatry locations. The exposure has proven to be highly beneficial to our nursing recruitment. On the Mental Health Technician front, we have initiated several programs in partnership with the Local Workforce Investment Boards and the Community Colleges. I have had more than a 30-year history of working closely with WIBs. I also served as chairman of the WIB in my county in New Jersey for several years. I have been a Board Member of the Community College in my County for 17 years and personally started my education in a Junior College. BK: One webinar participant asked for information on what “resiliency investments” look like. It seems to me that you have some answers within your overall retention strategy. DP: Our administrative staff were deeply concerned that we would experience an exodus of our staff due to the sheer everyday extreme stress they were experiencing. During the pandemic HMH engaged in multiple staff support strategies, from shortened schedules, on the spot individual and group counseling, integrative medicine delivered remotely or on the spot, as well every morale booster we could engage in. In addition, as a retention strategy, HMH has shifted to a Strength-based motivational system (our version of Strength-based therapy). We expect that the focus on creating a mindset as a Survivor as opposed to being a victim of the pandemic will have a major impact on improving retention. BK: Apprenticeship seems to hold a lot of potential, both in bringing more professionals into your system and in prompting workforce redesign.  Tell us about HMH apprenticeship efforts. DP: Our post-pandemic initiatives have featured two collaborations with Middlesex Community College in New Jersey and the WIB Board. In Fall 2023, we worked with Middlesex to develop and deliver a certification as a Mental Health Technician. While not specifically designated as an apprenticeship, it served the purpose, as the academics, designed in collaboration with the HMH staff, were delivered to the college, with the on-the-job at HMH Psychiatric Hospitals. HMH has engaged in designing a second MHT Certification with a specialization in Integrative medicine. Each of our four psychiatric inpatient hospitals at HMH provide a daily curriculum filled with options for patients to engage in relaxation exercises, music therapy, yoga, Qigong, exercise programs, and a substantial exposure to art therapy. We expect this initiative will expand our recruitment pool to all the integrative medicine providers who practice in the community and can blend their practices with a job that offers steady income and benefits.

Reminder: SAMHSA Releases Updated 988 Partner Toolkit

The Substance Abuse and Mental Health Services Administration (SAMHSA) has released an updated 988 Partner Toolkit that the agency says is designed to help users better navigate the bank of materials available to promote the lifeline in communities. The toolkit has the same video PSAs, social media promotions, FAQs, and print materials, and is now available to search by target audience, population, language, and resource type. Click here to access the toolkit.

Reminder: NABH’s Enhanced Denial-of-Care Portal is Now Available

NABH thanks all members who have submitted data to the association’s Denial-of-Care Portal. You have provided critical information that expands the portal and helps NABH strengthen its advocacy efforts related to erroneous prior-authorization denials. With guidance from our members, NABH has improved the portal by adding two elements:
  1. Time-based data on the number of days between a request for coverage and a plan’s denial, which improves our ability to assess and compare health plan responsiveness.
  1. The gap between days of provided care versus days of covered care to quantify and compare uncompensated days per health plan.
We strongly encourage all NABH members to submit their denial-of-care data in the portal. If you need help starting, or if you have other questions, please e-mail NABH Associate Manager for Congressional Affairs Emily Wilkins.

Save the Date for the NABH 2024 Annual Meeting!

Please plan to join us at the Salamander Washington, DC from May 13-15, 2024 for this year’s Annual Meeting, The Future of Behavioral Healthcare. Registration will open in February.

Fact of the Week

Semaglutide, a highly popular medication that the U.S. Food and Drug Administration has approved to treat obesity and manage type 2 diabetes, was associated with a 49% to 73% lower risk of first-time or recurring suicidal ideations compared with other medications for controlling obesity and type 2 diabetes that work via different mechanisms, according to a recent NIH-funded study.   For questions or comments about this CEO Update, please contact Jessica Zigmond.

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NABH Education and Research Foundation to Kick Off Webinar Series Next Week

The NABH Education and Research Foundation is pleased to host its first webinar, Redesigning the Present and Future of Behavioral Healthcare, on Tuesday, Jan. 23, 2024 from 2 p.m. – 3 p.m. ET. Foundation President Donald Parker, who serves as president of Behavioral Health Care Transformation Services for Hackensack Meridian Health, will co-lead the webinar with workforce consultant Beth Kuhn of Stonegate Strategies. Kuhn has more than 30 years of workforce experience – with special interest and expertise in behavioral healthcare workforce development – and has served in both Democratic and Republican administrations, including in her roles as commissioner of the Kentucky Department of Workforce Investment and as director of workforce development at the Vermont Department of Labor. Kuhn’s accomplishments include creating the Strategic Initiative for Transformation Employment, or SITE, a statewide model designed to bridge the gap between recovery and workforce participation for individuals active in their recovery from substance use issues. During this interactive webinar, participants are encouraged to ask questions of Kuhn and Parker, who will provide an overview of existing behavioral healthcare workforce challenges; explain why America’s current workforce structure doesn’t meet present or future workforce needs; suggest redesign strategies, present examples of current successes; and offer ideas about how to leverage current options to help providers develop a more robust workforce system. Please join us and click here to register for this free webinar!

Congress Clears Stop Gap Funding Extension, Delaying Potential Healthcare Package

Staving off a government shutdown, House and Senate lawmakers passed legislation this week to extend the federal government’s current funding deadlines into March. The House passed the bill in 314-108 vote hours after the Senate passed the measure 77-18. The legislation extends funding for agencies under four appropriations bills that were scheduled to expire today, Jan. 19 – Agriculture, Rural Development, Food and Drug Administration, and related agencies; Energy and Water Development; Military Construction, Veterans Affairs, and related agencies; and Transportation, Housing and Urban Development, and related agencies – until March 1. Funding covered under the remaining eight bills that were scheduled to expire Feb. 2 have been extended through March 8. Lawmakers have indicated they expect this is the final stopgap spending measure needed for fiscal year 2024. Several non-controversial healthcare provisions were included in the March 8 stopgap measure, such as providing continued funding for community health centers, teaching health centers and the National Health Service Corps; funding special diabetes programs; averting steep cuts to hospitals that have a high volume of uninsured and Medicaid patients; and providing continued funding for the Sexual Risk Avoidance Education Program, which aims to limit teen pregnancy and domestic violence. The bill did not address several expired health programs, including the SUPPORT Act reauthorization; the global HIV/AIDS program, the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR); the Pandemic and All-Hazards Preparedness Act; and heath price transparency legislation. Lawmakers are expected to include those programs in a potential March deal, if Congress doesn’t have to punt again with another spending patch. NABH continues to advocate for SUPPORT Act reauthorization and to stop the Modernizing Opioid Treatment Access Act (MOTAA) as part of a broader healthcare package. Health policy leaders in the House and Senate remain in negotiations on a final package.

CMS Increases Prior Authorization Timeliness and Transparency in Final Rule

The Centers for Medicare & Medicaid Services (CMS) this week finalized a rule that takes concrete steps to shorten the prior authorization process, which physicians and providers use to request health plan coverage for medical treatments and services that a physician has prescribed for a patient. In part, this rule responds to recent government audits that found that many government-contracted health plans were denying coverage inappropriately for services that actually were covered. The rule mostly takes effect for managed contracts in 2026 and beyond for insurers who contract with Medicare, Medicaid, and the Children’s Health Insurance Program, but not private insurance. Specifically, health plans will be required to make prior authorization coverage decisions within seven days and 72 hours for urgent requests. The rule also requires health plans to provide a specific reason for denying a prior-authorization request, which will help facilitate the correction of fixable claims as well as denial appeals. These payers also will be required to report their clinical and/or policy basis publicly for prior-authorization denials. Finally, to further reduce administrative burden, payers will now be required to conduct prior authorizations using a common electronic interface for transactions and data exchange, using Health Level 7 and other applications. Overall, CMS estimates that the final rule will reduce federal healthcare expenditures by approximately $15 billion over 10 years. Click here to learn more in the agency’s fact sheet.

CMS Announces Model to Test Approaches for Advancing Integration in Behavioral Health

CMS on Thursday introduced its Innovation in Behavioral Health (IBH) model to improve the care quality and outcomes for adults with Medicare and Medicaid who have mental health conditions and/or substance use disorder (SUD) by connecting them with the physical, behavioral, and social supports they need. The CMS Innovation Center will test the new IBH model, under which community-based behavioral healthcare practices will form interprofessional care teams composed of behavioral and physical health providers, as well as community-based supports. This new model supports President Biden’s mental health strategy and implements an action item in the HHS Roadmap for Behavioral Health Integration.   “The Biden-Harris administration will continue to explore innovative ways to help people with mental health conditions and/or substance use disorder,” HHS Secretary Xavier Becerra said in an announcement. “Put simply, mental health is health—and by expanding access to the high-quality care that people need, we are changing lives.” CMS’ announcement said through the interprofessional care teams, people will experience an integration of services that will bridge the gaps between physical and behavioral health. The model enables a “no wrong door” approach, meaning that regardless of how patients enter care, they will have access to all available services. Through this practice, IBH also aims to reduce overall program expenditures. The model will launch in Fall 2024, and CMS said it expects it to operate for eight years in up to eight states. CMS will release a notice of funding opportunity for the model in Spring 2024. Click here to learn more.

SAMHSA Releases Updated 988 Partner Toolkit

The Substance Abuse and Mental Health Services Administration (SAMHSA) has released an updated 988 Partner Toolkit that the agency says is designed to help users better navigate the bank of materials available to promote the lifeline in communities. The toolkit has the same video PSAs, social media promotions, FAQs, and print materials, and is now available to search by target audience, population, language, and resource type. Click here to access the toolkit.

Reminder: NABH’s Enhanced Denial-of-Care Portal is Now Available

NABH thanks all members who have submitted data to the association’s Denial-of-Care Portal. You have provided critical information that expands the portal and helps NABH strengthen its advocacy efforts related to erroneous prior-authorization denials. With guidance from our members, NABH has improved the portal by adding two elements:
  1. Time-based data on the number of days between a request for coverage and a plan’s denial, which improves our ability to assess and compare health plan responsiveness.
  1. The gap between days of provided care versus days of covered care to quantify and compare uncompensated days per health plan.
We strongly encourage all NABH members to submit their denial-of-care data in the portal. If you need help starting, or if you have other questions, please e-mail NABH Associate Manager for Congressional Affairs Emily Wilkins.

Save the Date for the NABH 2024 Annual Meeting!

Please plan to join us at the Salamander Washington, DC from May 13-15, 2024 for this year’s Annual Meeting, The Future of Behavioral Healthcare. Registration will open in February. Fact of the Week SAMHSA’s Food and Mood Project aims to promote emotional wellness and reduce the impact of mental health and substance use conditions among the nation’s K-12 population by implementing strategies that address the intersection among behavioral health, food/nutrition security, and cultural food diversity.   For questions or comments about this CEO Update, please contact Jessica Zigmond.

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Congress Returns to Urgent Funding Deadlines and Full 2024 Agenda

Congress returned to Washington this week facing two deadlines to fund all federal government operations as it works to clear some policy priorities – including a healthcare package with the SUPPORT Act’s reauthorization – ahead of the 2024 campaign season. In early January, House Speaker Mike Johnson (R-La.) and Senate Majority Leader Chuck Schumer (D-N.Y.) agreed to topline funding figures, allowing congressional appropriations leaders to begin the process of negotiating each of the spending allocations for all 12 spending bills. Congress has until Jan. 19 before the first government funding deadline for the U.S. Agriculture, Energy, Housing and Urban Development, Transportation, and Veterans Affairs Departments. All other departments, including HHS, are funded through Feb. 2. There is a growing likelihood that Congress will have to pass a short-term continuing resolution (CR) to allow lawmakers to agree on funding, although conservative House members are strongly opposed to that action and threaten to derail progress. Congressional leaders have indicated a healthcare package will likely be included in the first funding bill, due to the urgency in addressing several expired health programs and funding provisions for physician payments. This package will include several healthcare bills the House and Senate have passed.   NABH continues to advocate strongly for the SUPPORT Acts reauthorization with new provisions and opposes the Modernizing Opioid Treatment Access Act (MOTAA), which only the Senate HELP Committee has passed and the House has not considered. MOTAA proponents are strongly advocating for this bill to be included in the final package, and NABH and coalition partners are working with both congressional chambers to prevent this effort. This advocacy includes working with members of the Senate HELP Committee who oppose MOTAA to continue raising concerns with their Senate leadership; contacting members who serve on the Senate Judiciary Committee; contacting other senators who share concerns with law enforcement officials about implementing this legislation; as well as contacting members of the House Energy and Commerce Committee and House Judiciary Committee. House Energy & Commerce Republicans remain strongly opposed to including MOTAA in any legislative package. NABH continues to emphasize to Members of Congress that there is no consensus on MOTAA and these policies need more vetting. Other health policies that lawmakers might fold into a larger legislative package include addressing expired telehealth regulations, Medicare’s physician pay cut, transparency measures, reporting requirements for insurers, hospitals and pharmacy benefit managers, and site-neutral payment provisions. In addition, funds for graduate medical education, community health centers, and special diabetes programs sunset on Jan. 19, and certain Medicaid disproportionate share hospital cuts are delayed until that date. NABH will continue to support provisions important to our members and fight to prevent bad policies from becoming law. Please see next week’s edition of CEO Update for the latest information.  

NABH Education and Research Foundation to Host Workforce Webinar on Jan. 23

Please join us for the NABH Research and Education Foundation’s first webinar, Redesigning the Present and Future of Behavioral Healthcare, on Tuesday, Jan. 23, 2024 from 2 p.m. – 3 p.m. ET. Foundation President Donald Parker, who serves as president of Behavioral Health Care Transformation Services for Hackensack Meridian Health, will co-lead the webinar with workforce consultant Beth Kuhn of Stonegate Strategies. Kuhn has more than 30 years of workforce experience – with special interest and expertise in behavioral healthcare workforce development – and has served in both Democratic and Republican administrations, including in her roles as commissioner of the Kentucky Department of Workforce Investment and as Vermont’s director of workforce development. Kuhn’s accomplishments include creating the Strategic Initiative for Transformation Employment, or SITE, a statewide model designed to bridge the gap between recovery and workforce participation for individuals active in their recovery from substance use issues. During this interactive webinar, participants are encouraged to ask questions of Parker and Kuhn, who will provide an overview of existing behavioral healthcare workforce challenges; explain why America’s current workforce structure doesn’t meet present or future workforce needs; suggest redesign strategies, present examples of current successes; and offer ideas about how to leverage current options to help providers develop a more robust workforce system. Please click here to register for this free webinar and share the link with members of your teams!

CMS Administrator Brooks-LaSure to Outline Agency’s 2024 Priorities in Stakeholder Call

The Centers for Medicare & Medicaid Services (CMS) Administrator Chiquita Brooks-LaSure will host a stakeholder call to discuss the agency’s 2023 accomplishments, 2024 priorities, and CMS Strategic Plan on Tuesday, Jan. 23. CMS Principal Administrator and Chief Operating Officer Jon Blum and other members of the CMS leadership team will also serve as presenters during the hourlong call, which will begin at 1 p.m. ET. Click here to register.

CMS Releases State Plan Summaries for American Rescue Plan of 2021

CMS has released state spending plan summaries for a section of the American Rescue Plan of 2021 (ARP) that provides information about the amount of money spent on activities to enhance, expand, or strengthen community-based services. NABH members might find the report useful because it includes information about state spending on efforts related to workforce, technology, education, behavioral healthcare support for youth, housing and homelessness, and more. Click here for the full report and to read your state’s summary.

Save the Date for the NABH 2024 Annual Meeting!

Registration will open soon for the NABH 2024 Annual Meeting, The Future of Behavioral Healthcare, at the Salamander Washington, DC from May 13-15, 2024. Please plan to join us!  

Reminder: NABH’s Enhanced Denial-of-Care Portal is Now Available

NABH thanks all members who have submitted data to the association’s Denial-of-Care Portal. You have provided critical information that expands the portal and helps NABH strengthen its advocacy efforts related to erroneous prior-authorization denials. With guidance from our members, NABH has improved the portal by adding two elements:
  1. Time-based data on the number of days between a request for coverage and a plan’s denial, which improves our ability to assess and compare health plan responsiveness.
  1. The gap between days of provided care versus days of covered care to quantify and compare uncompensated days per health plan.
We strongly encourage all NABH members to submit their denial-of-care data in the portal. If you need help starting, or if you have other questions, please e-mail NABH Associate Manager for Congressional Affairs Emily Wilkins.

Fact of the Week

About 52,000 Medicare enrollees experienced an opioid overdose in 2022; however, only 18% of Medicare patients with opioid use disorder received medication-assisted treatment, according to a report from the HHS Office of the Inspector General. For questions or comments about this CEO Update, please contact Jessica Zigmond.

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NABH Welcomes Frank Ghinassi, Ph.D. as 2024 Board Chair

NABH is pleased to welcome Rutgers University Behavioral Health Care (UBHC) President and CEO Frank Ghinassi, Ph.D. as chair of the NABH Board of Trustees for 2024. A longstanding NABH member, Frank has served the association in many capacities, including as board treasurer, Quality Committee chair, and Annual Meeting program chair. As UBHC’s CEO, Frank is responsible for a statewide system of academically based mental health and addiction services across New Jersey; managing an annual operating budget of $320 million and 2,200 staff and faculty. UBHC, one of the largest providers of behavioral and addictions healthcare in the country, offers a wide range of clinical services across all diagnosis, and across the lifespan, including inpatient units, partial hospitalization programs, intensive outpatient programming, case management, traditional outpatient treatment, correctional health care, a Certified Community Behavioral Health Center, peer operated helplines for service members, veterans, mothers of children with special needs, law enforcement officers and child protection workers, a statewide suicide prevention hotline and a clinical research and training institute, as well as an array of specialty and peer support services. Frank also serves as professor at Rutgers Graduate School of Applied and Professional Psychology; an adjunct professor of psychiatry at Rutgers Robert Wood Johnson Medical School; an adjunct associate professor of psychiatry at the University of Pittsburgh School of Medicine; and a core faculty member at Rutgers Global Health Institute. The association’s Washington-based team is eager to work with Frank this year and appreciates his vision and leadership. NABH is also grateful to Sheppard Pratt President and CEO Harsh Trivedi, M.D., M.B.A. for his service as the association’s 2023 board chair and all he has done to promote NABH, its priorities, and its mission. Thank you, Harsh!

NABH Letter to CMS Cites Concerns about Medicare Advantage Plans that Block Access to Care

NABH this week sent a letter to the Centers for Medicare & Medicaid Services (CMS) expressing concerns about Medicare Advantage (MA) plans that either block or delay access to behavioral healthcare services. The association’s letter endorsed and also made recommendations related to the rule’s positive provisions, such as incentivizing MA coverage for additional behavioral healthcare practitioners and inclusion in a health plans’ provider networks; annually analyzing the health equity level of MA plans relative to underserved populations; and laying the groundwork for increased data collection on MA coverage decisions, appeals and decision rationales. NABH’s letter also urged CMS to modify its existing proposal to improve the appeals process for MA enrollees in certain settings to include behavioral healthcare settings, which the letter describes in detail.

Sen. John Fetterman Discusses His Battle with Depression on NBC’s ‘Meet the Press’

In an exclusive interview with NBC News’ “Meet the Press” on Dec. 31, Sen. John Fetterman (D-Pa.) spoke candidly about his experience with clinical depression and how he is grateful for receiving treatment. The first-term senator was discharged March 31 from Walter Reed National Medical Center, where he had received treatment for clinical depression. Fetterman checked himself in for treatment on Feb. 15 last year following a battle with depression that worsened during his recovery from a stroke he suffered in May 2022. “The line [is] ‘I’m living my best life,’ and I really am, because I just am so grateful,” Fetterman told journalist Kristen Welker. “And I’m always talking about mental health because I want everybody that can hear that is that help works, and you should get help. And please, don’t suffer any longer, because you deserve to be better. And I’m so grateful to do that, and I’m paying it forward by talking about it.” Click here to watch Fetterman’s interview.

NABH Education and Research Foundation to Host Workforce Webinar on Jan. 23

The NABH Education and Research Foundation is pleased to host its first webinar, Redesigning the Present and Future of Behavioral Healthcare, on Tuesday, Jan. 23, 2024 from 2 p.m. – 3 p.m. ET. NABH Education and Research Foundation President Donald Parker, who serves as president of Behavioral Health Care Transformation Services for Hackensack Meridian Health, will co-lead the webinar with workforce consultant Beth Kuhn of Stonegate Strategies. Kuhn has more than 30 years of workforce experience – with special interest and expertise in behavioral healthcare workforce development – and has served in both Democratic and Republican administrations, including in her roles as commissioner of the Kentucky Department of Workforce Investment and as Vermont’s director of workforce development. Kuhn’s accomplishments include creating the Strategic Initiative for Transformation Employment, or SITE, a statewide model designed to bridge the gap between recovery and workforce participation for individuals active in their recovery from substance use issues. Throughout this interactive webinar, participants are encouraged to ask questions of Parker and Kuhn, who will provide an overview of existing behavioral healthcare workforce challenges; explain why America’s current workforce structure doesn’t meet present or future workforce needs; suggest redesign strategies, present examples of current successes; and offer ideas about how to leverage current options to help providers develop a more robust workforce system. The Foundation will also ask attendees poll questions during the hourlong webinar to gauge member interest in future workforce events and resources. Please join us and click here to register for this free webinar!

National Academies to Host Webinar on Behavioral Healthcare Provider Experience with Public Insurance Programs Next Week

The National Academies’ Committee on Strategies to Improve Access to Behavioral Health Care Services through Medicare and Medicaid will host a virtual webinar that discusses behavioral healthcare provider experiences with public insurance programs on Wednesday, Jan. 10. This webinar will examine the experiences of behavioral healthcare providers who accept Medicare, Medicaid, and Marketplace insurance and discuss what can be done to increase access to behavioral healthcare services for this patient population. Click here to register for the two-hour webinar, which starts at 2 p.m. ET next Wednesday.

Reminder: NABH’s Enhanced Denial-of-Care Portal is Now Available

NABH thanks all members who have submitted data to the association’s Denial-of-Care Portal. You have provided critical information that expands the portal and helps NABH strengthen its advocacy efforts related to erroneous prior-authorization denials. With guidance from our members, NABH has improved the portal by adding two elements:
  1. Time-based data on the number of days between a request for coverage and a plan’s denial, which improves our ability to assess and compare health plan responsiveness.
  1. The gap between days of provided care versus days of covered care to quantify and compare uncompensated days per health plan.
We strongly encourage all NABH members to submit their denial-of-care data in the portal. If you need help starting, or if you have other questions, please e-mail NABH Associate Manager for Congressional Affairs Emily Wilkins.

Save the Date for the NABH 2024 Annual Meeting!

Please mark your calendars and plan to join us at the Salamander Washington, DC from May 13-15, 2024 for this year’s NABH Annual Meeting!

Fact of the Week

A new study in Psychiatry Research suggests ethnoracial inequities in patient assignment to buildings that differed in clinical and physical conditions. Examining data from more than 18,000 unique patients during a period of six years, researchers said the findings serve as a call to action for hospital systems to examine the ways in which structural racism impact clinical care.   For questions or comments about this CEO Update, please contact Jessica Zigmond.

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NABH Education and Research Foundation to Host Workforce Webinar in January

The NABH Education and Research Foundation is pleased to host its first webinar, Redesigning the Present and Future of Behavioral Healthcare, on Tuesday, Jan. 23, 2024 from 2 p.m. – 3 p.m. ET. Foundation President Donald Parker, who serves as president of Behavioral Health Care Transformation Services for Hackensack Meridian Health, will co-lead the webinar with workforce consultant Beth Kuhn of Stonegate Strategies. Kuhn has more than 30 years of workforce experience – with special interest and expertise in behavioral healthcare workforce development – and has served in both Democratic and Republican administrations, including in her roles as commissioner of the Kentucky Department of Workforce Investment and as Vermont’s director of workforce development. Kuhn’s accomplishments include creating the Strategic Initiative for Transformation Employment, or SITE, a statewide model designed to bridge the gap between recovery and workforce participation for individuals active in their recovery from substance use issues. During this interactive webinar, participants are encouraged to ask questions of Parker and Kuhn, who will provide an overview of existing behavioral healthcare workforce challenges; explain why America’s current workforce structure doesn’t meet present or future workforce needs; suggest redesign strategies, present examples of current successes; and offer ideas about how to leverage current options to help providers develop a more robust workforce system. Please join us and click here to register for this free webinar!

NABH 2024 Board Election Ballots Due Friday, Dec. 29!

NABH has e-mailed system members NABH Board of Trustees candidate profiles and a ballot to elect new members to the 2024 Board. If you have not done so, please vote for the open Board Chair-Elect position and four available Board seats; 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. 29, 2023. New Board members and the Board Chair-elect will take office in January 2024.

SAMHSA Releases Advisory on Implementing Low-Barrier Care to Expand Access and Improve Outcomes for Individuals with SUD

The Substance Abuse and Mental Health Services Administration (SAMHSA) has released an advisory that outlines recommendations to implement low barrier models of care to significantly expand access to lifesaving treatment for individuals with substance use disorders (SUD). Despite evidence showing the effectiveness of SUD treatment, fewer than 10% of individuals who need care receive it. Barriers such as lack of treatment availability, strict program requirements, stigma, and discrimination. The advisory emphasizes the importance of low barrier care in overcoming substantial gaps in access to SUD treatment and engaging more people in care.

Reminder: NABH’s Enhanced Denial-of-Care Portal is Now Available

NABH thanks all members who have submitted data to the association’s Denial-of-Care Portal. You have provided critical information that expands the portal and helps NABH strengthen its advocacy efforts related to erroneous prior-authorization denials. With guidance from our members, NABH has improved the portal by adding two elements:
  1. Time-based data on the number of days between a request for coverage and a plan’s denial, which improves our ability to assess and compare health plan responsiveness.
  1. The gap between days of provided care versus days of covered care to quantify and compare uncompensated days per health plan.
We strongly encourage all NABH members to submit their denial-of-care data in the portal. If you need help starting, or if you have other questions, please e-mail NABH Associate Manager for Congressional Affairs Emily Wilkins.

Save the Date for the NABH 2024 Annual Meeting!

Please mark your calendars and plan to join us at the Salamander Washington, DC from May 13-15, 2024 for next year’s NABH Annual Meeting!

Fact of the Week

The Centers for Disease Control and Prevention reports that while the provisional number of suicides in 2022 (49,449) was 3% higher than in 2021 (48,183), suicide rates for people in age groups 10–14, 15–24, and 25–34 declined 18%, 9%, and 2%, respectively, from 2021 to 2022.

Happy Holidays from NABH!

NABH will not publish CEO Update next week and will resume on Friday, Jan. 5, 2024. The entire NABH team wishes you, your families, and your teams a very happy, healthy, and safe holiday season!   For questions or comments about this CEO Update, please contact Jessica Zigmond.

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House & Senate Advance Key Behavioral Healthcare Legislation to Consider in the New Year

The House and Senate advanced several behavioral healthcare-related bills this week that NABH either supports and opposes and Congress is expected to consider early in the New Year.   The Senate Health, Education, Labor and Pensions (HELP) Committee marked up several pieces of legislation, including reauthorization of the SUPPORT Act and S. 644, the Modernizing Opioid Treatment Access Act (MOTAA). The Committee approved its version of the SUPPORT Act reauthorization bill 19-1. This bill would reauthorize programs to improve the prevention, treatment, and recovery of substance use disorders (SUD), including supporting training for first responders and programs that support youth and mental health. The legislation also directs the U.S. Health and Human Services Department (HHS) and the Drug Enforcement Agency (DEA) to establish a special registration program permitting physicians to prescribe controlled substances through telemedicine, among other provisions. The Modernizing Opioid Treatment Access Act, S. 644 was reported favorably as amended by a roll call vote of 16-5 with Ranking Member Sen. Bill Cassidy, M.D. (R-La.) supporting the legislation. Sens. Susan Collins (R-Maine), Rob Marshall (R-Kan.), Tommy Tuberville (R-Ala.), Markwayne Mullin (R-Okla.), and Ted Budd (R-NC) voted against the bill. NABH opposed the bill, which would expand access to methadone by permitting take-home prescribing of the drug through pharmacies.   On Wednesday the House passed both the Lower Costs, More Transparency Act (H.R. 5378), and the H.R.4531, the Support for Patients and Communities Reauthorization (SUPPORT) Act of 2023.  H.R. 5378 contains provisions to promote more transparency within various sectors of the healthcare industry; delay certain disproportionate share payment cuts; and extend funding for community health centers, the National Health Service Corp, and teaching health centers that operate graduate medical education (GME) programs. The bill also increases reporting requirements for insurers, hospitals and pharmacy benefit managers, and changes Medicare payment policy so that drugs administered in a hospital outpatient department are reimbursed at the same rate as they are in a physician’s office, a policy known as site-neutral payments.   Meanwhile, House Energy and Commerce Subcommittee on Health Chair Brett Guthrie (R-Ky.) and Rep. Anne Kuster (D-N.H.) led H.R.4531, the Support for Patients and Communities Reauthorization (SUPPORT) Act of 2023, which the House passed in a 386-37 vote. The bill includes several important NABH priorities, including permanently lifting Medicaid’s IMD Exclusion, which restricts access to care for rehab and institutional care services; ensuring Medicaid beneficiaries have access to Medication Assisted Treatment; reauthorizing resources for residential SUD treatment for pregnant and postpartum women; and monitoring prescribing of antipsychotic medications. The House Energy and Commerce Committee passed H.R. 4531 in a 49-0 vote this past July. These healthcare bills, in addition to the Senate Finance Committee’s previously passed Better Mental Health Care, Lower-Cost Drugs and Extenders Act, which included language from S. 3098, the Securing Advances and a Variety of Evidence-Based (SAVE) Institutions for Mental Diseases (IMD) Options Act which would make the state plan amendment option permanent, will be rolled into one healthcare package for Congress to consider in the New Year. Other healthcare issues include addressing scheduled cuts to the Medicare Physician Fee Schedule (MPFS), reform and transparency for pharmacy benefit managers (PBM) and Medicare Advantage (MA) plans, and other bipartisan policies to address drug shortages, antimicrobial resistance, and workforce needs. Congress has two early deadlines in 2024 to move the healthcare package across the finish line — Jan. 19 and Feb. 2, the latter of which includes the deadline for Labor-HHS-Education funding bill. NABH and allied partners will be working to stop MOTAA and include our policy priorities in this final package.

HHS Takes Step to Regulate AI in Health Data, Technology, and Interoperability Final Rule

HHS this week unveiled the department’s data-related priorities for the next two years in a rule that includes information about data sharing across the government and the private sector and using artificial intelligence (AI) to boost medical innovation and improve health outcomes. HHS’ Office of the National Coordinator (ONC) for Health Information Technology finalized its Health Data, Technology, and Interoperability rule, which establishes the first transparency requirements for AI and other predictive algorithms that are part of certified health information technology. ONC reports that it certifies health IT that supports care delivered by more than 96% of hospitals and 78% of office-based physicians nationwide. The final rule also implements the 21st Century Cures Act’s requirement to adopt a Condition of Certification (the “Insights Condition”) for developers of certified health IT to report certain metrics as part of their participation in the Certification Program. These metrics will give more insight into how certified health IT is used in support of care delivery. Click here to learn when ONC will host information sessions about the rule in January and February.

CMS Releases Guidance on Dually Eligible Beneficiaries Receiving Medicare Part B Marriage and Family Therapist, Mental Health Counselor, and Intensive Outpatient Services

The Centers for Medicare & Medicaid Services (CMS) on Thursday released Guidance to State Medicaid Agencies on Dually Eligible Beneficiaries Receiving Medicare Part B Marriage and Family Therapist Services, Mental Health Counselor Services, and Intensive Outpatient Services, an informational bulletin with changes that take effect on Jan. 1, 2024.   Beginning in the New Year, Medicare will become the primary payer for dually eligible beneficiaries receiving these services from Medicare-enrolled practitioners or providers. According to CMS, typically state Medicaid agencies may not pay claims if it is likely that a third party (such as Medicare) is liable for the claim, as Medicaid is generally the payer of last resort. For dually eligible beneficiaries, Medicare is generally liable for claims for Medicare-covered services, including MFT services, MHC services, and IOP services furnished on or after Jan. 1, 2024, and therefore state Medicaid agencies are required to cost-avoid claims for such services, or seek reimbursement from the practitioner or provider. Currently, MFTs and MHCs provide services that can be covered as an optional state plan benefit such as services of other licensed practitioners under the Medicaid state plan. IOP services are generally covered through the optional rehabilitative services benefit under the Medicaid state plan.

AMCHP and ASTHO Release Guidance on Public Health Approaches to Perinatal Substance Use

The Association of Maternal & Child Health Programs (AMCHP) and the Association of State and Territorial Health Officials (ASTHO) have released a special issue of the Maternal and Child Health Journal focused on public health approaches to perinatal substance use. This December 2023 special issue features 21 open-access articles with the latest research, programs, and policy initiatives related to perinatal substance use that highlight approaches to preventing and mitigating the harmful effects of perinatal substance use and improving maternal and child health. AMCHP and ASTHO will host a virtual forum about the special issue on Tuesday, Dec. 19 at 12:30 p.m. ET. Click here to learn more and register.

NABH 2024 Board Election Ballots Due Friday, Dec. 29!

NABH has e-mailed system members NABH Board of Trustees candidate profiles and a ballot to elect new members to the 2024 Board. If you have not done so, please vote for the open Board Chair-Elect position and four available Board seats; 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. 29, 2023. New Board members and the Board Chair-elect will take office in January 2024.

Reminder: NABH’s Enhanced Denial-of-Care Portal is Now Available

NABH thanks all members who have submitted data to the association’s Denial-of-Care Portal. You have provided critical information that expands the portal and helps NABH strengthen its advocacy efforts related to erroneous prior-authorization denials. With guidance from our members, NABH has improved the portal by adding two elements:
  1. Time-based data on the number of days between a request for coverage and a plan’s denial, which improves our ability to assess and compare health plan responsiveness.
  1. The gap between days of provided care versus days of covered care to quantify and compare uncompensated days per health plan.
We strongly encourage all NABH members to submit their denial-of-care data in the portal. If you need help starting, or if you have other questions, please e-mail NABH Associate Manager for Congressional Affairs Emily Wilkins.

Save the Date for the NABH 2024 Annual Meeting!

Please mark your calendars and plan to join us at the Salamander Washington, DC from May 13-15, 2024 for next year’s NABH Annual Meeting!

Fact of the Week

Overdoses in the United States involving methadone were 48% higher in 2020 than in 2019, according to a study of overdose deaths during the COVID-19 pandemic published in Forensic Science International.   For questions or comments about this CEO Update, please contact Jessica Zigmond.

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Senate HELP Committee to Mark Up SUPPORT Act Reauthorization Bill Next Week

The Senate Health, Education, Labor, and Pensions (HELP) Committee is slated to mark up the Substance-Use Disorder Prevention that Promotes Opioid Recovery and Treatment Act’s (SUPPORT Act) reauthorization bill along with other legislation – including the Modernizing Opioid Treatment Access Act (MOTAA) – on Tuesday, Dec. 12. The SUPPORT Act expired on Sept. 30, and Congress has long been expected to reauthorize the opioid treatment and prevention programs that the 2018 law created. NABH sent a Government Relations Network alert asking members to contact Senate HELP Committee members and urge them to apply an all-hands-on-deck approach to America’s mental health and addiction crises by reauthorizing the SUPPORT Act’s expired provisions. The association also asked NABH members to encourage HELP Committee members to oppose the MOTAA bill, which would threaten patient safety if methadone prescriptions were allowed outside opioid treatment programs. While the MOTAA bill was not incorporated into the underlying SUPPORT Act, lawmakers will consider it as stand-alone legislation and the committee may pass it. If this happens, NABH will work with partners to oppose the bill if it moves to the full Senate for a vote and also urge House lawmakers not to consider it. Also next week, the House is expected to pass its version of the SUPPORT Act, which includes several NABH priorities. The House Energy and Commerce Committee passed this bill with bipartisan support and did not consider the MOTAA bill in this legislation. Meanwhile, House and Senate conferees are negotiating a broader healthcare package for Congress to consider in early 2024. NABH will provide the latest information about these and other congressional actions next week and future editions of CEO Update.

ONDCP to Host Webinar on Medicaid 1115 Re-Entry Demonstration Opportunity on Dec. 12

The White House Office of National Drug Control Policy (ONDCP) will host a webinar on Tuesday, Dec. 12 to highlight the state of Washington’s work on the Medicaid Re-Entry Demonstration Opportunity that the Centers for Medicare and Medicaid Services (CMS) announced in April 2023. The opportunity allows states to cover a package of pre-release services, including medications for opioid use disorder and connection to substance use disorder care, for up to 90 days before an incarcerated individual’s release date. To date, 16 states have applied for the waiver and two states have been approved. Click here to register for the 90-minute webinar, which will begin at 2:30 p.m. ET on Tuesday.

National Academies to Host Webinar About Social Media and Adolescent Health on Dec. 13

The National Academies of Sciences, Engineering, and Medicine will host a webinar next week highlighting the conclusions and recommendations from the Academies’ ad hoc committee that drafted a report about social media’s effect on adolescents’ mental and physical health. Click here to learn more and register for the hourlong webinar, which will start at noon ET on Wednesday, Dec. 13.

CMS Provides Guidance to States on Mandatory Medicaid and CHIP Core Set Reporting Requirements

CMS sent a letter to state health officials that offered guidance about implementing the reporting requirements outlined in the Mandatory Medicaid and Children’s Health Insurance Program (CHIP) Core Set Reporting final rule that the agency released in August. The letter includes guidance about mandatory reporting regulations and adherence to reporting guidance; Core Set measures for which reporting is mandatory in 2024; the populations who must be included in reporting and the population exemption process; categories of stratified data that must be reported in or before 2025; measures subject to stratification in 2025; attribution rules; and the Child and Adult Core Set State Plan Amendment.

Reminder: Please Contribute Data to NABH’s Enhanced Denial-of-Care Portal

NABH thanks all members who have submitted data to the association’s Denial-of-Care Portal. You have provided critical information that expands the portal and helps NABH strengthen its advocacy efforts related to erroneous prior-authorization denials. With guidance from our members, NABH has improved the portal by adding two elements:
  1. Time-based data on the number of days between a request for coverage and a plan’s denial, which improves our ability to assess and compare health plan responsiveness.
  1. The gap between days of provided care versus days of covered care to quantify and compare uncompensated days per health plan.
We strongly encourage all NABH members to submit their denial-of-care data in the portal. If you need help starting, or if you have other questions, please e-mail NABH Associate Manager for Congressional Affairs Emily Wilkins.

Save the Date for the NABH 2024 Annual Meeting!

Please mark your calendars and plan to join us at the Salamander Washington, DC from May 13-15, 2024 for next year’s NABH Annual Meeting!

Fact of the Week

The first government-sanctioned overdose prevention centers (OPCs) opened in New York City in November 2021, drawing concerns that they might increase crime and disorder. A new study in JAMA that examined two OPCs and 17 syringe service programs found no significant increases in crimes recorded by the police or calls for emergency service.   For questions or comments about this CEO Update, please contact Jessica Zigmond.

CEO Update 163

Please Urge Your Senators to Reauthorize the SUPPORT Act and Oppose MOTAA

As Congress returned this week for its year-end push, NABH continues to advocate for federal lawmakers to reauthorize the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act (SUPPORT) and oppose the Modernizing Opioid Treatment Access Act (MOTAA). The Senate Health, Education, Labor and Pensions (HELP) Committee has not announced a markup for these bills; however, lawmakers may act on them during the first or second week of December. As NABH outlined in a letter to Sen. Bill Cassidy, M.D. (R-La.) on Nov. 22, the association supports efforts to reauthorize the expired provisions of the SUPPORT Act. NABH wrote in the letter that the nation’s mental health crisis requires an all-hands-on-deck approach, and that it makes no sense to limit grantees based on a facility’s tax status when many individuals who need mental health and substance use disorder services are not able to access those services. Meanwhile, in a letter to the Senate HELP Committee this week, NABH expressed our firm opposition to the MOTAA bill, which would threaten patient safety if methadone prescription would be allowed outside Opioid Treatment Programs (OTPs). Our concern reflects the complexity of this patient population, which requires comprehensive and ongoing clinical oversight that would be difficult for busy pharmacies to provide. To assure patient safety, NABH supports additional research and data collection prior to altering current methadone prescribing protections provided by OTPs. Please help NABH’s advocacy efforts by contacting Senate HELP Committee members in your region and urge their support to reauthorize the SUPPORT Act and oppose MOTAA. Thank you for your support! Please contact NABH Director for Congressional Affairs Andy Dodson if you have questions.

HHS OIG Reports Low Misuse of Medicare Part D Buprenorphine

A new report from HHS’ Office of the Inspector General (OIG) found most Medicare Part D beneficiaries prescribed buprenorphine for opioid use disorder received recommended amounts in 2022, meaning there was likely little misuse of the drug. The findings are similar to a 2021 report’s results, which led the OIG to conclude in the new review that there continues to be little risk of buprenorphine misuse among Part D enrollees. Click here to read the full report.

Bipartisan Policy Center to Host Medicare Reform Webinar on Dec. 11

The Bipartisan Policy Center (BPC) will explore potential solutions to improve the beneficiary experience and ensure a fiscally responsible Medicare program, which nearly 20% of Americans rely on for healthcare coverage and is estimated to become insolvent by 2031. During the discussion, BPC will release federal policy recommendations meant to enhance Medicare benefits, increase competition, establish better program management, and improve financing. The hourlong event starts at 11:30 a.m. ET. Click here to register.

NIDA to Host ‘Monitoring the Future’ Survey Data Release Webinar on Dec. 13

The National Institute on Drug Abuse (NIDA) at the National Institutes of Health (NIH) will host a webinar to discuss results from its annual Monitoring the Future (MTF) survey on Wednesday, Dec. 13. The MTF survey has measured drug and alcohol use and related attitudes among adolescent students nationwide since 1975. In it, a nationally representative sample of survey participants report their drug use behaviors across three time periods: lifetime, past year, and past month. NIDA funds the survey, which is conducted by the University of Michigan. This year, the hourlong briefing will feature Marsha Lopez, Ph.D., M.H.S., who serves as chief of the epidemiology research branch in NIDA’s Division of Epidemiology, Services and Prevention Research. The webinar will begin at 10 a.m. ET. Click here to register.

National Academies to Host Workshop that Examines Adult ADHD Diagnosis & Treatment

The National Academies’ Forum on Drug Discovery, Development and Translation and Forum on Neuroscience and Nervous System Disorders will host a workshop to explore the diagnosis and treatment of adults with Adult Attention-Deficit/Hyperactivity (ADHD) Disorder and the challenges and opportunities for drug development on Dec. 12 and 13. The workshop is intended to offer professionals who typically diagnose ADHD—such as physicians, psychologists, social workers, nurse practitioners, and other licensed counselors or therapists—as well as drug developers, researchers, and regulators, to discuss and support the public health goal of treating adults with ADHD safely and effectively. Supported partly through a grant from the Food and Drug Administration’s Center for Drug Evaluation and Research, the workshop will be presented on Tuesday, Dec. 12 from 8:30 a.m. – 5 p.m. ET and on Wednesday, Dec. 13 from 8:30 a.m. – 2 p.m. ET. Click here to register.

Reminder: NABH’s Enhanced Denial-of-Care Portal is Now Available

NABH thanks all members who have submitted data to the association’s Denial-of-Care Portal. You have provided critical information that expands the portal and helps NABH strengthen its advocacy efforts related to erroneous prior-authorization denials. With guidance from our members, NABH has improved the portal by adding two elements:
  1. Time-based data on the number of days between a request for coverage and a plan’s denial, which improves our ability to assess and compare health plan responsiveness.
  1. The gap between days of provided care versus days of covered care to quantify and compare uncompensated days per health plan.
We strongly encourage all NABH members to submit their denial-of-care data in the portal. If you need help starting, or if you have other questions, please e-mail NABH Associate Manager for Congressional Affairs Emily Wilkins.

Save the Date for the NABH 2024 Annual Meeting!

Please mark your calendars and plan to join us at the Salamander Washington, DC from May 13-15, 2024 for next year’s NABH Annual Meeting! Fact of the Week Drug overdose deaths rose noticeably between January to June 2018 and July to December 2021 among 10- to 44-year-old girls and women who were pregnant or pregnant within the previous 12 months, according to a new study by NIDA researchers at the NIH. For questions or comments about this CEO Update, please contact Jessica Zigmond.

CEO Update 162

SAMHSA Releases 2022 National Survey on Drug Use and Health

Among U.S. adults aged 18 or older in 2022, 23.1%, or 59.3 million people, had any mental illness in the past year while 48.7 million people aged 12 or older, or 17.3%, had a substance use disorder (SUD) in the past year, according to the Substance Abuse and Mental Health Services Administration’s (SAMHSA) 2022 National Survey on Drug Use and Health (NSDUH). The annual report provides nationally representative data on the use of tobacco, alcohol, and drugs; SUDs; mental health issues; and receipt of substance use and mental health treatment among the civilian, noninstitutionalized population aged 12 or older in the United States. In addition, the 2022 Methodological Summary and Definitions report summarizes the information users need to properly interpret NSDUH estimates related to substance use and mental health. This report accompanies the annual detailed tables and provides information on overall methodology, key definitions for measures and terms used in 2022 NSDUH reports and tables, along with some analysis of these measures and of the survey as a whole.

NIH Study Examines How to Reduce Suicide Risk Among Young People in Hospital EDs

The National Institutes of Health (NIH) has released Emergency Department Safety Assessment and Follow-Up Evaluation 2 (ED-SAFE 2), a study that shows it’s possible to significantly reduce suicidal behaviors among young people at risk for suicide in emergency departments. ED-SAFE is a randomized clinical trial designed to improve suicide risk screening and detection in emergency department settings. The trial differs from similar studies because routine clinical staff—rather than researchers—deliver the suicide risk intervention, according to the NIH. This approach increases the likelihood that the suicide prevention strategies can be reliably implemented and sustained in the real world. ED-SAFE is also the largest practical clinical trial of suicide-related best practices in emergency departments.

National Academies Examines How to Support and Sustain the Current and Future Workforce to Care for People with Serious Illness

The National Academies Roundtable on Quality Care for People with Serious Illness has released a resource from its April 2023 public workshop that explored strategies and approaches to address major workforce challenges for those who care for people with serious illness. The workshop built on a 2019 Roundtable workshop, Building the Workforce We Need to Care for People with Serious Illness. Click here to access the free resource.

SAMHSA to Host Webinar on Certified Peer Specialist Career Outcomes Study

SAMHSA’s Office of Recovery will host a webinar later this month to discuss the results from the Certified Peer Specialist (CPS) Career Outcomes Study. Laysha Ostrow, Ph.D. will present some of the findings from the three-year study, including information about wages and financial wellbeing, workplace burnout, and CPS in rural areas. The webinar will start Monday, Nov. 27 at 1 p.m. ET. Click here to register.

Reminder: NABH’s Enhanced Denial-of-Care Portal is Now Available

NABH thanks all members who have submitted data to the association’s Denial-of-Care Portal. You have provided critical information that expands the portal and helps NABH strengthen its advocacy efforts related to erroneous prior-authorization denials. With guidance from our members, NABH has improved the portal by adding two elements:
  1. Time-based data on the number of days between a request for coverage and a plan’s denial, which improves our ability to assess and compare health plan responsiveness.
  1. The gap between days of provided care versus days of covered care to quantify and compare uncompensated days per health plan.
We strongly encourage all NABH members to submit their denial-of-care data in the portal. If you need help starting, or if you have other questions, please e-mail NABH Associate Manager for Congressional Affairs Emily Wilkins.

Fact of the Week

More Americans used illicit drugs in 2022 than in 2021, with illicit marijuana being the most common. Nearly 62 million people used illicit marijuana last year, up from 52.5 million in 2021, according to the 2022 National Survey on Drug Use and Health.

Save the Date for the NABH 2024 Annual Meeting!

Please mark your calendars and plan to join us at the Salamander Washington, DC from May 13-15, 2024 for next year’s NABH Annual Meeting!

Happy Thanksgiving!

The NABH staff wishes its members and their families a very happy, healthy, and safe Thanksgiving! NABH will not publish CEO Update next week and will resume on Friday, Dec. 1, 2023.   For questions or comments about this CEO Update, please contact Jessica Zigmond.

CEO Update 161

Senate Finance Committee Advances ‘Better Mental Health Care, Lower-Cost Drugs and Extenders Act’

The Senate Finance Committee on Wednesday advanced the bipartisan Better Mental Health Care, Lower-Cost Drugs and Extenders Act in a unanimous vote. The healthcare package partially mitigates Medicare payment cuts for physicians, extends certain expiring Medicare and Medicaid provisions, targets pharmacy benefit manager practices, and extends several substance use disorder (SUD) measures that expired on Oct. 1 as lawmakers missed the deadline to reauthorize the SUPPORT Act. Included in the legislation is language from S. 3098, the Securing Advances and a Variety of Evidence-Based (SAVE) Institutions for Mental Diseases (IMD) Options Act that Sens. John Thune (R-S.D.), Maggie Hassan (D-N.H.), and Marsha Blackburn (R-Tenn.) introduced to make the state plan amendment option permanent, a provision also included in the House Energy & Commerce Committee-passed SUPPORT Act Reauthorization bill. Some states, including South Dakota and Tennessee, opted into a state plan amendment option authorized under the SUPPORT Act that allows states to avoid the IMD Exclusion. Without renewal, states avoiding the payment exclusion will be forced to terminate payments to IMD facilities or cover such costs through state funds. Other provisions in the legislation include prohibiting states from terminating Medicaid coverage for incarcerated individuals and expanding access to mental health and SUD services for Medicaid-eligible individuals 30 days prior to their release from incarceration. The legislation also requires the Centers for Medicare & Medicaid Services (CMS) to collect and publish data from Medicare Advantage plans on the number of prior authorization requests, denials, and appeals for mental health and SUD services at the plan level, including the timelines of prior authorization decisions and justifications for denials. Senate Finance Committee leaders said the goal is to include the Better Mental Health Care, Lower-Cost Drugs and Extenders Act legislation into a broader healthcare package, a second Continuing Resolution (CR), or end-of-year omnibus funding package.

CMS Extends MA Coverage to Additional Behavioral Healthcare Practitioners

In a proposed rule released this week, CMS proposed several changes to increase access to behavioral healthcare services for Medicare Advantage (MA) enrollees. As required by law, CMS proposed to expand network adequacy standards for MA plans by adding a new category of specialists, “outpatient behavioral health” providers, as a required element of each network. Practitioners in this new category would include marriage and family therapists, mental health counselors, opioid treatment program providers, community mental health centers, addiction-medicine physicians, and other providers already providing traditional Medicare-covered addiction medicine and behavioral health counseling or therapy services. Also, CMS would extend the existing 10% compensation boost to this new category of practitioners for any MA network that has at least one provider group providing telehealth services. Comments on this rule are due to CMS by Jan. 25, 2024.

White House, ONDCP, Domestic Policy Council, and 12 Federal Agencies Release Recovery-Ready Workplace Toolkit

The White House, the Office of National Drug Control Policy, the Domestic Policy Council, and a dozen federal departments and independent agencies released their Recovery-Ready Workplace Toolkit: Guidance and Resources for Private and Public Sector Employers this week. The 140-page resource supports the fourth pillar of President Biden’s Unity Agenda for the Nation: beating the opioid and overdose epidemic. Specifically, the toolkit is designed to help businesses and other employers prevent and respond more effectively to substance misuse among employees, build their workforces through hiring of people in recovery, and develop a recovery-supportive workplace culture. It is also intended to serve as a resource to states, local governments, labor organizations, business groups, and non-profits considering launching multi-employer recovery-ready workforce initiatives at the local or state levels.

HHS Releases ‘Action for Adolescents: A Call to Action for Adolescent Health and Well-Being’

HHS recently released Action for Adolescents: A Call to Action for Adolescent Health and Well-Being, a new effort to promote collaboration and prompt action to improve the health and well-being of U.S. adolescents nationwide. Take Action for Adolescents is a research-based resource that outlines a vision, key principles, and eight goals, including: 1) Eliminate disparities to advance health equity, 2) Increase youth agency and youth engagement, 3) Ensure access to safe and supportive environments, 4) Increase coordination and collaboration within and across systems, 5) Expand access to health care and human services, 6) Strengthen training and support for caring adults, 7) Improve health information and health literacy, and 8) Support, translate, and disseminate research. The resource also includes a Take Action toolkit. In other HHS news related to the nation’s youth, HHS Secretary Xavier Becerra was recently named Chair of the U.S. Interagency Council on Homelessness and announced $6.1 million in new measures on affordable housing and support for runaway youth. Some of that funding will be used to enhance a variety of supportive services, including mental health services, on-site child care, financial literacy and coaching, GED preparation classes, transportation assistance, and early childhood and youth programs.

Reminder: NABH’s Enhanced Denial-of-Care Portal is Now Available

NABH thanks all members who have submitted data to the association’s Denial-of-Care Portal. You have provided critical information that expands the portal and helps NABH strengthen its advocacy efforts related to erroneous prior-authorization denials. With guidance from our members, NABH has improved the portal by adding two elements:
  1. Time-based data on the number of days between a request for coverage and a plan’s denial, which improves our ability to assess and compare health plan responsiveness.
  1. The gap between days of provided care versus days of covered care to quantify and compare uncompensated days per health plan.
We strongly encourage all NABH members to submit their denial-of-care data in the portal. If you need help starting, or if you have other questions, please e-mail NABH Associate Manager for Congressional Affairs Emily Wilkins.

Fact of the Week

For young people between the ages of 15 to 24, time spent in person with friends has reduced by nearly 70% during the last two decades to 40 minutes per day in 2020 from roughly 150 minutes per day in 2003 to 40 minutes per day in 2020, according to The U.S. Surgeon General’s Advisory on the Healing Effects of Social Connection and Community.

Save the Date for the NABH 2024 Annual Meeting!

Please mark your calendars and plan to join us at the Salamander Washington, DC from May 13-15, 2024 for next year’s NABH Annual Meeting!

Many Thanks to All Veterans!

This Veterans Day Weekend, NABH thanks its members and their families who have served or are serving in the U.S. military. We appreciate your sacrifice and service.   For questions or comments about this CEO Update, please contact Jessica Zigmond.

NABH Board of Trustees Meeting: November 16-17, 2023

[vc_row][vc_column width=”1/2″][vc_column_text]Nov. 16-17, 2023 Conrad Washington, DC 950 New York Avenue NW, Washington, DC 20001 NABH BOARD OF TRUSTEES DINNER Thursday, Nov. 16, 2023 6 p.m. – 6:30 p.m. — Board Reception: Estuary Blue Willow Private Dining Room – Third Floor 6:30 p.m. – 8:30 p.m. — Dinner: Estuary Blue Willow Private Dining Room – Third Floor NABH BOARD OF TRUSTEES MEETING Friday, Nov. 17, 2023 9 a.m. — Board Meeting: Grand Ballroom D – Second Floor Breakfast will be served. Noon — Adjournment Next Meeting:  Monday, May 13, 2024: Salamander Washington, DC Noon – 2 p.m. ET.[/vc_column_text][/vc_column][vc_column width=”1/2″][vc_column_text]

Agenda

[/vc_column_text][vc_column_text]
[/vc_column_text][/vc_column][/vc_row][vc_row][vc_column][vc_separator][vc_tta_accordion][vc_tta_section title=”I. Introductions” tab_id=”1686005901041-68d8a9cc-4428″][/vc_tta_section][vc_tta_section title=”II. Minutes Approval” tab_id=”1686005901051-9df22098-5588″][vc_column_text]Minutes:
 
 
 
[/vc_column_text][/vc_tta_section][vc_tta_section title=”III. New Member Ratification” tab_id=”1686006268257-9d5d2e6f-01b6″][vc_column_text]
[/vc_column_text][/vc_tta_section][vc_tta_section title=”IV. Election Forecast” tab_id=”1686006341766-d5722352-f7fa”][/vc_tta_section][vc_tta_section title=”V. Legislative Updates” tab_id=”1686006435773-489b3a15-6d9b”][vc_column_text]
  1. End of Year
  2. SUPPORT Act
  3. Modernizing Opioid Treatment Access Act (M-OTAA)
  4. Workforce
  5. Contingency Management
[/vc_column_text][/vc_tta_section][vc_tta_section title=”VI. Regulatory Update” tab_id=”1686006546109-39d49d49-816d”][vc_column_text]
  1. 2024 Payment Final Rules
  2. No Surprises Act Proposed Rule: Independent Dispute Resolution
  3. Final Parity Rule
  4. Medicaid MCO Proposed Rule
[/vc_column_text][/vc_tta_section][vc_tta_section title=”VII. Payment Reform” tab_id=”1686006646771-7deece09-f7f8″][vc_column_text]
  1. IPF PPS
[/vc_column_text][/vc_tta_section][vc_tta_section title=”VIII. White House Artificial Intelligence (AI) Executive Order: NABH Guiding Principles” tab_id=”1686006662665-1348a950-af15″][/vc_tta_section][vc_tta_section title=”IX. Communications Update” tab_id=”1686006679340-e3096b32-746e”][/vc_tta_section][vc_tta_section title=”X. NABH Champions PAC” tab_id=”1686006790781-fc809496-0e9b”][/vc_tta_section][vc_tta_section title=”XI. NABH Priorities” tab_id=”1686006902969-43c5dc4c-76d9″][vc_column_text]
  1. NABH Strategic Plan Review and Revision Planning
  2. Board Member Priorities
  3. Board Meeting Assessment
[/vc_column_text][/vc_tta_section][vc_tta_section title=”XII. Break (10 minutes)” tab_id=”1686006946189-6469f8fb-4019″][/vc_tta_section][vc_tta_section title=”XIII. NABH Education and Research Foundation” tab_id=”1686007042401-c3ff710f-1207″][vc_column_text]
  1. 2023 Activities
  2. Webinar Series
  3. 2024 Priorities
  4. Contribution Solicitation
[/vc_column_text][/vc_tta_section][vc_tta_section title=”XIV. Adjournment” tab_id=”1686007256184-0ca87f50-246d”][/vc_tta_section][/vc_tta_accordion][/vc_column][/vc_row]

CEO Update 160

White House Asks Congress for $1.55 Billion to Address Nation’s Fentanyl Crisis

The Biden administration this week requested $1.55 billion from Congress for HHS’ Substance Abuse and Mental Health Services Administration (SAMHSA) State Opioid Response grants to provide treatment, harm reduction, and recovery support services in all states and territories to combat the nation’s ongoing fentanyl crisis.   Thanks to historic funding and bipartisan efforts, the rate of overdose deaths is slowing after a period of exponential increase, access to treatment is expanding, and historic amounts of fentanyl are being seized at our borders,” the White House said in a fact sheet about the Biden administration’s domestic spending requests to Congress. “But our work to beat the overdose epidemic is far from over and additional resources are needed to continue the Administration’s aggressive action to save lives.”

CDC: Healthcare Workers Report a Decrease in Odds of Burnout if They Trust Management

Healthcare workers continued to face a mental health crisis in 2022, although positive working conditions were associated with less burnout and better mental health, the Centers for Disease Control and Prevention (CDC) concluded in a Vital Signs report released this week. From 2018 to 2022, healthcare workers reported an increase of 1.2 days of poor mental health during the previous 30 days (to 4.5 days from 3.3 days), while the percentage who reported feeling burnout very often increased to 19% from 11.6%, the findings showed. However, the report found healthcare workers experienced a decrease in odds of burnout if they trusted management, had supervisor help, had enough time to complete work, and felt their workplace supported productivity. The report highlighted the CDC’s National Institute for Occupational Safety and Health (NIOSH), which has implemented efforts to promote the mental health and well-being of healthcare workers, including a national social marketing campaign, Impact Wellbeing, which emphasizes primary prevention strategies such as worker participation in decision-making, supportive supervision, and increasing psychological safety for help-seeking. “NIOSH has also developed burnout training for supervisors of public health workers and through its efforts has emphasized improving the work environment, rather than asking workers to be more resilient or fix problems themselves,” the report said.

SAMHSA Summary Report Shows Climate Change is a Social Determinant of Mental Health

A recent SAMHSA report concluded climate change is a social determinant of mental health; behavioral health systems should become “climate-informed;” and intergenerational trauma will be one of the layered effects of climate-related environmental change. The report summarized the findings from SAMHSA’s August 2022 request for information that sought feedback about potential agency actions regarding mental health and substance use wellbeing in the context of climate change and health equity. Respondents suggested SAMHSA should develop an agency-wide climate action plan to serve as a roadmap for change and integration of climate-informed behavioral health in SAMHSA research, programs, contracts, technical assistance, and reports. They also said SAMHSA should support increased resources and allowable costs that shift behavioral health systems toward public behavioral health strategies for mental health promotion, substance use prevention, community-level response, and community-based mental health resilience. “Respondents emphasized that a protective factor for healthcare workers is adequate training and preparation,” the report said. “Therefore, building out a climate-informed behavioral health system that provides resources to an increasingly diverse behavioral health workforce is protective to both the behavioral health workforce and the communities they serve,” it continued. “Timely and tailored interventions need to be designed in such a way that they can be altered over time to meet current and evolving needs.”

CMS Seeking Feedback to Improve Provider Resources

The Centers for Medicare and Medicaid Services (CMS) is conducting a study to help the agency improve user experience with Medicare program and billing resources. Responses are confidential, and the survey should take about 10 minutes to complete. Click here to take the survey, which is due Thursday, Nov. 9.

SAMHSA Releases 988 Lifeline Videos

SAMHSA has produced two new videos that promote the 988 Lifeline. Called “Impact of the 988 Lifeline” and “You Matter PSA,” the videos are included in SAMHSA’s 988 Partner Toolkit. In its announcement, SAMHSA noted that its 988 fact sheet, available in both English and Spanish, has been helpful in communicating about the 988 Lifeline’s services and successes.

Reminder: NABH’s Enhanced Denial-of-Care Portal is Now Available!

NABH thanks all members who have submitted data to the association’s Denial-of-Care Portal. You have provided critical information that expands the portal and helps NABH strengthen its advocacy efforts related to erroneous prior-authorization denials. With guidance from our members, NABH has improved the portal by adding two elements:
  1. Time-based data on the number of days between a request for coverage and a plan’s denial, which improves our ability to assess and compare health plan responsiveness.
  1. The gap between days of provided care versus days of covered care to quantify and compare uncompensated days per health plan.
We strongly encourage all NABH members to submit their denial-of-care data in the portal. If you need help starting, or if you have other questions, please e-mail NABH Associate Manager for Congressional Affairs Emily Wilkins.

Reminder: The O’Neill Institute to Host Webinar on Recovery Housing Next Month

The O’Neill Institute’s Addiction and Public Policy Initiative will host a webinar next month about the current state of recovery housing and the opportunities for improving recovery housing in the United States. As the O’Neil Institute explains, social determinants, such as housing, and expanded access to medications for substance use disorder are part of effective, long-term solutions. National standards for recovery housing, along with protecting the rights of individuals under the law, are central to facilitating a needed societal shift and maximizing opportunities for people with substance use disorder. Recognizing the critical role that housing plays in improving outcomes for people with substance use disorder (SUD), SAMHSA recently issued Best Practices for Recovery Housing, and the U.S. Justice Department protects the rights of individuals with SUD afforded under the Fair Housing Act and the Americans with Disabilities Act.

Fact of the Week:

More than 1 million hospital emergency department visits are attributed annually to children and adolescents with a mental health disorder diagnosis, according to a new CDC study. For questions or comments about this CEO Update, please contact Jessica Zigmond.

CEO Update 159

Reminder: NABH Board Nominations Due Today, Friday, Oct. 20! 

NABH is seeking help from members as the NABH Selection Committee prepares to consider possible nominees to serve on the NABH Board of Trustees. Specifically, NABH requests that members help the association identify: ► Board Chair-Elect and      ► Four Board seats that will become available in 2024 The Selection Committee is particularly interested in identifying senior managers who represent the broad diversity within the NABH membership, including various levels of care, organizational structures, and size. Please download a nomination form to share your recommendations of individuals you would like to see included in the single slate for 2024. Please attach a curriculum vitae (CV) for each person you recommend. This will help the Selection Committee in its deliberations. You are welcome to suggest yourself. Please return this form (and candidates’ CVs) by today, Oct. 20, 2023, to maria@nabh.org.

Sens. Thune, Hassan, and Blackburn Introduce SAVE IMD Options Act

Sens. John Thun (R-S.D.), Maggie Hassan (D-N.H.), and Marsha Blackburn (R-Tenn.) on Thursday introduced the Securing Advances and a Variety of Evidence-Based (SAVE) Institutions for Mental Disease (IMD) Options Act. The bipartisan legislation would establish a permanent state plan option in Medicaid that allows states to provide patients between the ages of 21 and 64 with substance use disorder (SUD) treatment in an IMD. Current law does not allow federal Medicaid funds to be used for those patients at IMDs, which include hospitals, nursing facilities, or other institutions with more than 16 beds that provide care for mental health diseases, including SUD. NABH strongly supports the bill and is working with the lawmakers’ congressional staff to provide support. “Establishing a permanent state option in Medicaid for substance use disorder treatment provided in IMD will provide states with certainty and ensure individuals have access to this lifesaving treatment,” NABH President and CEO Shawn Coughlin said in a news release about the bill.

NABH Submits Parity Comments to HHS, DOL, and Treasury

NABH this week submitted comments to the U.S. Health and Human Services, Labor, and Treasury Departments on this year’s proposed parity rule and thanks all members who provided feedback. In its letter, NABH recognized the three departments for their collective determination to enforce the Mental Health Parity and Addiction Equity Act (MHPAEA) that passed 15 years ago this month and has yet to be implemented fully and fairly nationwide. NABH’s letter also said the association especially supports the proposed rule’s requirement that each plan’s comparative analysis on parity compliance include substantive data on non-quantitative treatment limitations (NQTL), including network composition. These requirements will do much to enforce both the letter and spirit of the MHPAEA, NABH noted. The letter continued by categorizing NABH’s comments into the following sections: 1) parity in behavioral healthcare benefits, 2) NQTL comparative analysis requirements, 3) improving and expanding meaningful parity standards, and 4) network adequacy. “We appreciate that the rule addresses ambiguous definitions that contribute to the disparity between mental and physical healthcare,” the letter said in a section about clarifying meaningful coverage and scope of covered services. “Such ambiguity tends to yield overly flexible interpretations that generally favor health plans over patients. In particular, the proposed, more specific definitions for ‘meaningful coverage’ and ‘scope of covered services’ will bring valuable clarity and consistency to coverage determinations,” it continued. “Of notable benefit, we strongly support the proposed requirement for plans that provide behavioral healthcare benefits in any classification of care, to do so in all classifications of care. Similarly, we urge the departments to add to the final rule a definition of ‘meaningful’ as it applies to scope of covered MH and SUD benefits in each classification.”

Fewer Medicare Advantage Plans Earned a 5-Star Rating for 2024

In its 2024 Star Ratings released last week, the Centers for Medicare & Medicaid Services (CMS) gave 31 Medicare Advantage (MA) contracts a five-star rating, a notable drop from the 57 contracts that earned the top rating in 2023. An MA contract must earn at least a four-star rating to receive a quality bonus payment from CMS. MA open enrollment for 2024 kicked off on Oct. 15 using new MA requirements that CMS finalized in April and will take effect on Jan. 1, 2024. The 40 quality metrics that apply to MA plans with a drug benefit in 2024 will include new restrictions on deceptive marketing, multiple prior authorization improvements, and affordable drug pricing, with the latter required by law. CMS is in the process of remaking the star-rating system to remove incentives that inadvertently permitted lower quality and unnecessary spending. This effort includes applying more stringent criteria for star-rating quality metrics, which are expected to result in fewer insurers securing high ratings and greater financial benefits for insurers focused on treating disadvantaged populations. CMS’ effort also includes changes from the 2024 MA final rule, which strives to improve coverage, ensure timely access to care, and advance parity between MA and traditional fee-for-service coverage.

The National Academies Seeks Experts to Participate in Workshop to Explore Data-Collection Efforts for People Who Use Drugs

The National Academies is seeking suggestions for experts to participate in a White House Office of National Drug Control Policy-sponsored workshop to explore data-collection efforts, evidence gaps, and research needs on harm-reduction services for people who use drugs (PWUD). Specifically, the workshop will examine harm-reduction services that aim to prevent overdose and infectious disease transmission; enhance the health, safety, and wellbeing of PWUD; and offer low-threshold options for accessing SUD treatment. According to the National Academies, services include syringe services programs; providing fentanyl and xylazine test strips; distributing naloxone and other reversal medications; and facilitating connections to social services for PWUD in need of medical services, stable housing, food-assistance, or employment. Nominations are due next Wednesday, Oct. 25 to help the National Academies establish a 10-person, volunteer planning committee for the project. Click here to learn more and submit a nomination.

Reminder: NABH’s Enhanced Denial-of-Care Portal is Now Available!

NABH thanks all members who have submitted data to the association’s Denial-of-Care Portal. You have provided critical information that expands the portal and helps NABH strengthen its advocacy efforts related to erroneous prior-authorization denials. With guidance from our members, NABH has improved the portal by adding two elements:
  1. Time-based data on the number of days between a request for coverage and a plan’s denial, which improves our ability to assess and compare health plan responsiveness.
  1. The gap between days of provided care versus days of covered care to quantify and compare uncompensated days per health plan.
We strongly encourage all NABH members to submit their denial-of-care data in the portal. If you need help starting, or if you have other questions, please e-mail NABH Associate Manager for Congressional Affairs Emily Wilkins.

Reminder: The O’Neill Institute to Host Webinar on Recovery Housing Next Month

The O’Neill Institute’s Addiction and Public Policy Initiative will host a webinar next month about the current state of recovery housing and the opportunities for improving recovery housing in the United States. As the O’Neil Institute explains, social determinants, such as housing, and expanded access to medications for substance use disorder are part of effective, long-term solutions. National standards for recovery housing, along with protecting the rights of individuals under the law, are central to facilitating a needed societal shift and maximizing opportunities for people with substance use disorder. Recognizing the critical role that housing plays in improving outcomes for people with substance use disorder (SUD), SAMHSA recently issued Best Practices for Recovery Housing, and the U.S. Justice Department protects the rights of individuals with SUD afforded under the Fair Housing Act and the Americans with Disabilities Act.

Fact of the Week:

New data from the Centers for Disease Control and Prevention show 1 out of 5 persons who died from drug overdoses in 2020 worked in construction or restaurants. For questions or comments about this CEO Update, please contact Jessica Zigmond.

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FDA Creates Advisory Committee to Examine Digital Health Technologies

The U.S. Food and Drug Administration (FDA) this week announced it has created a Digital Health Advisory Committee to help the agency explore the scientific and technical issues related to digital health technologies (DHTs), such as artificial intelligence/machine learning (AI/ML), augmented reality, virtual reality, digital therapeutics, wearables, remote patient monitoring and software. The new committee will advise the FDA on issues related to DHTs and provide expertise to help the agency better understand benefits, risks, and clinical outcomes associated with use of DHTs. “As one of our strategic priorities, our goal is to advance health equity in part through expanding access by bringing prevention, wellness, and healthcare to all people where they live – at home, at work, in big cities and rural communities,” Jeff Shuren, M.D., J.D., director of the FDA’s Center for Devices and Radiological Health, said in an announcement. “Digital health technologies are critical for achieving this transformation in care delivery,” he continued. “As digital health technologies advance, the FDA must capitalize on knowledge from inside and outside of the agency to help ensure we appropriately apply our regulatory authority in a way that protects patient health while continuing to support innovation.” FDA’s announcement said the committee should be fully operational in 2024.

SAMHSA Releases Mental Health Client-Level Data 2021 Annual Report

The Substance Abuse and Mental Health Services Administration (SAMHSA) this week released Mental Health Client-Level Data (MH-CLD) 2021: Data on Clients Receiving Mental Health Treatment Services Through State Mental Health Agencies, the annual report that details the total number of clients receiving mental health treatment services in 2021 by demographics, national outcomes measures, and the top five mental health diagnoses for children (ages 0-17) and adults (ages 18 and older) by geographic distribution. SAMHSA uses the MH-CLD data to better understand publicly funded mental health treatment service systems. The data are also used to inform decisions about how SAMHSA’s uses its mental health block grant funds, and are used to help the agency learn about the technical assistance and support needs of mental health providers and the communities they serve.

CMS Administrator Brooks-LaSure to Host Stakeholder Update Next Week

CMS Administrator Chiquita Brooks-LaSure and her leadership team will provide a stakeholder and partner update about the agency’s recent accomplishments and efforts to advance the CMS Strategic Plan on Tuesday, Oct. 17. Click here to RSVP for the hourlong call, which starts at 1 p.m. ET.

Manatt Health to Host Webinar Next Week on Emerging Fraudulent Healthcare Schemes

Manatt Health will host a webinar next week to help providers and health plans navigate the emerging landscape of fraudulent healthcare schemes and provide practical answers to the legal questions that resulted from recent litigation and enforcement actions. The free webinar will feature panelists — all of whom have successfully defended litigants who have been forced to deal with inducement-based lawsuits in both federal and state courts – who will share an overview of the current litigation and policy landscape and offer insights into how providers and plans can protect themselves and their organizations. The webinar also will discuss the findings from internal investigations that have uncovered fraudulent activities and improper conduct impacting patients’ health and safety and providers’ and plans’ financial viability. Click here to register for the hourlong webinar on Tuesday, Oct. 17, which starts at 1 p.m. ET.

NABH’s Enhanced Denial-of-Care Portal is Now Available!

NABH thanks all members who have submitted data to the association’s Denial-of-Care Portal. You have provided critical information that expands the portal and helps NABH strengthen its advocacy efforts related to erroneous prior-authorization denials. With guidance from our members, NABH has improved the portal by adding two elements:
  1. Time-based data on the number of days between a request for coverage and a plan’s denial, which improves our ability to assess and compare health plan responsiveness.
  1. The gap between days of provided care versus days of covered care to quantify and compare uncompensated days per health plan.
We strongly encourage all NABH members to submit their denial-of-care data in the portal. If you need help starting, or if you have other questions, please e-mail NABH Associate Manager for Congressional Affairs Emily Wilkins.

Reminder: NABH Board Nominations Due Next Friday, Oct. 20! 

NABH is seeking help from members as the NABH Selection Committee prepares to consider possible nominees to serve on the NABH Board of Trustees. Specifically, NABH requests that members help the association identify: ► Board Chair-Elect and      ► Four Board seats that will become available in 2024 The Selection Committee is particularly interested in identifying senior managers who represent the broad diversity within the NABH membership, including various levels of care, organizational structures, and size. Please download a nomination form to share your recommendations of individuals you would like to see included in the single slate for 2024. Please attach a curriculum vitae (CV) for each person you recommend. This will help the Selection Committee in its deliberations. You are welcome to suggest yourself. Please return this form (and candidates’ CVs) by Friday, Oct. 20, 2023, to maria@nabh.org.

The O’Neill Institute to Host Webinar on Recovery Housing Next Month

The O’Neill Institute’s Addiction and Public Policy Initiative will host a webinar next month about the current state of recovery housing and the opportunities for improving recovery housing in the United States. As the O’Neil Institute explains, social determinants, such as housing, and expanded access to medications for substance use disorder are part of effective, long-term solutions. National standards for recovery housing, along with protecting the rights of individuals under the law, are central to facilitating a needed societal shift and maximizing opportunities for people with substance use disorder. Recognizing the critical role that housing plays in improving outcomes for people with substance use disorder (SUD), SAMHSA recently issued Best Practices for Recovery Housing, and the U.S. Justice Department protects the rights of individuals with SUD afforded under the Fair Housing Act and the Americans with Disabilities Act.

Fact of the Week:

Nearly 40% of primary care providers (PCPs) are screening patients for behavioral health conditions, according to a new report from The Advisory Board, which included survey responses from 300 PCPs. For questions or comments about this CEO Update, please contact Jessica Zigmond.

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DEA Extends Pandemic Telemedicine Rules Through December 2024

The Drug Enforcement Administration (DEA) on Friday said it will extend its eased, COVID-19 pandemic rules for prescribing controlled substances via telemedicine through Dec. 31, 2024. This is DEA’s second extension of these rules; the agency first extended its pandemic-era, telehealth regulations in May 2023, which are set to expire on Nov. 11, 2023. DEA said in its notice that DEA and HHS continue to consider revisions to the agency’s March 2023 proposed rule and that DEA’s telemedicine listening sessions last month helped inform this latest extension. NABH reported on those listening sessions in CEO Update on Sept. 15.

FDA Issues Draft Guidance on Developing Treatment Drugs for Stimulant Use Disorders

The U.S. Food and Drug Administration (FDA) this week issued draft guidance for developing drugs to treat stimulant use disorders. Stimulant Use Disorders: Developing Drugs for Treatment addresses the FDA’s current recommendations regarding the overall development program and clinical trial designs for developing drugs to treat moderate-to-severe cocaine use disorder, methamphetamine use disorder, or prescription drug stimulant use disorder. The FDA will accept public comments about the guidance through Monday, Dec. 4. Click here for comment submission instructions.

CMS Seeks Feedback on Assessing Parity Compliance in Medicaid Managed Care, ABPs, & CHIP

The Centers for Medicare & Medicaid Services (CMS) is seeking public comments about a set of questions regarding processes to assess compliance with mental health parity ad addiction equity requirements for Medicaid managed care arrangements, Medicaid Alternative Benefit Plans (ABPs), and the Children’s Health Insurance Program. (CHIP). The questions for comment address a variety of topics, including model formats (e.g., templates) and key questions to consider that could make documenting compliance with parity requirements more efficient and effective; processes that states and managed care plans use to determine whether existing coverage policies are comparable for mental health and substance use disorders compared with medical and surgical benefits; how data should be collected; and more. CMS will accept public comments here through Monday, Dec. 4. NABH will submit comments.

CBO Estimates Federal Subsidies for Health Insurance to be $1.8 Trillion in 2023

In a new report, the Congressional Budget Office (CBO) estimates federal subsidies for health insurance in 2023 to be $1.8 trillion, or 7% of the nation’s Gross Domestic Product. Meanwhile, the CBO and the Joint Committee on Taxation (JCT) together project those net subsidies to grow substantially–reaching $3.3. trillion, or 8.3% of GDP, by 2033. The CBO said this is the first time the projections reflect the entire population instead of only the civilian, noninstitutionalized population younger than 65.

CMS Administrator Brooks-LaSure to Host Stakeholder Update on Oct. 17

CMS Administrator Chiquita Brooks-LaSure and her leadership team will provide a stakeholder and partner update about the agency’s recent accomplishments and efforts to advance the CMS Strategic Plan on Tuesday, Oct. 17. Click here to RSVP for the hourlong call, which starts at 1 p.m. ET.

NIMH Marks 75th Anniversary with Podcast Series

The National Institute of Mental Health is honoring its 75th anniversary with a podcast series that explores the stories behind influencers and innovators in mental health research and the lives of people with mental illness. The latest podcasts feature “Depression: The Case for Ketamine,” and “Understanding and Preventing Youth Suicide.” Click here to listen.

Please Nominate Members for the NABH Board of Trustees!

NABH is seeking help from members as the NABH Selection Committee prepares to consider possible nominees to serve on the NABH Board of Trustees. Specifically, NABH requests that members help the association identify: ► Board Chair-Elect and      ► Four Board seats that will become available in 2024 The Selection Committee is particularly interested in identifying senior managers who represent the broad diversity within the NABH membership, including various levels of care, organizational structures, and size. Please download a nomination form to share your recommendations of individuals you would like to see included in the single slate for 2024. Please attach a curriculum vitae (CV) for each person you recommend. This will help the Selection Committee in its deliberations. You are welcome to suggest yourself. Please return this form (and candidates’ CVs) by Friday, Oct. 20, 2023, to maria@nabh.org.

Fact of the Week:

People who work shift work are 22% more likely to develop depression than those who work a regular daytime schedule, according to a recent study published in JAMA Network Open. For questions or comments about this CEO Update, please contact Jessica Zigmond.

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HHS Releases Contingency Plan as Federal Government Shutdown Looms

HHS this week released a government shutdown contingency plan if federal lawmakers don’t pass legislation by Saturday, Sept. 30 to extend government funding and maintain federal operations. If they don’t, critical federal services will end at 12:01 a.m. on Sunday. The ongoing government funding talks have put on hold consideration of all other bills that are set to expire after Sept. 30, including the SUPPORT Act reauthorization. NABH expects reauthorization to move through both chambers of Congress after lawmakers resolve the federal funding issue. Meanwhile, here are HHS’ plans for the agencies that affect NABH members: the Agency for Healthcare Research and Quality, Centers for Medicare & Medicaid Services, Health Resources and Services Administration, National Institutes of Health, and Substance Abuse and Mental Health Services Administration.

SAMHSA Announces $131.7 Million in Grants for Youth and Families  

The Substance Abuse and Mental Health Services Administration (SAMHSA) this week said it awarded $131.7 million in grant programs to connect youth and families with behavioral healthcare services. The awards will fund a variety of programs and services, including cooperative agreements for school-based, trauma-informed support services for mental healthcare, expanding substance use treatment capacity in adult and family drug courts, preventing youth overdose, and more. Click here to read more about the awards.

Joint Commission Revises Terms to Reflect Current Terminology in Addiction Medicine

The Joint Commission said it has revised two terms for Behavioral Health Care and Human Services to reflect current terminology in the addiction medicine field. “Medication-assisted treatment” has been updated to “medications for substance use disorders,” and, if the requirement needs to be more specific, the term used is “medications for opioid use disorder” or “medications for alcohol use disorder.” Meanwhile, the Joint Commission removed “detoxification,” which is now referred to as “withdrawal,” “withdrawal management,” or “medically supervised withdrawal management.” “These revisions are editorial in nature and do not change any requirements,” the Joint Commission said in its announcement, adding that any questions should be directed to the organization’s Department of Standards and Survey Methods. The changes take effect on Jan. 1, 2024.

October is Youth Substance Use and Misuse Prevention Month

As National Recovery Month draws to a close, the nation now turns to Youth Substance Use Prevention Month and Substance Misuse Prevention Month for October. SAMHSA has created a Prevention Month toolkit with shareable social media graphics to help people promote the message of prevention for kids and family and developed other resources and events to help communities participate. In conjunction with Prevention Month, SAMHSA this week announced it awarded $42.6 million in grants to 17 states and 60 communities—located across 33 states—as a foundational investment for substance use prevention. Click here to learn more.

Please Nominate Members for the NABH Board of Trustees!

NABH is seeking help from members as the NABH Selection Committee prepares to consider possible nominees to serve on the NABH Board of Trustees. Specifically, NABH requests that members help the association identify: ► Board Chair-Elect and      ► Four Board seats that will become available in 2024 The Selection Committee is particularly interested in identifying senior managers who represent the broad diversity within the NABH membership, including various levels of care, organizational structures, and size. Please download a nomination form to share your recommendations of individuals you would like to see included in the single slate for 2024. Please attach a curriculum vitae (CV) for each person you recommend. This will help the Selection Committee in its deliberations. You are welcome to suggest yourself. Please return this form (and candidates’ CVs) by Friday, Oct. 20, 2023, to maria@nabh.org.

Fact of the Week:

Between 2014 and 2019, the national Hispanic population increased by 4.5%, or 5.2 million people. During the same period, the proportion of facilities that offered treatment in Spanish declined by 17.8%, or a loss of 1,163 Spanish-speaking mental health facilities, according to a study published in Psychiatric Services. Overall, 44 states saw a decline in the availability of services in Spanish, despite growth in Hispanic populations across all states.   For questions or comments about this CEO Update, please contact Jessica Zigmond.

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White House Recovery Summit Seeks to Create a ‘Recovery-Ready Nation’

As part of Recovery Month, the White House this week held a Recovery Summit to celebrate people with substance use disorders (SUD) who are in treatment and to discuss ways that Americans can build a recovery-ready nation.   The Office of National Drug Control Policy Director Rahul Gupta, M.D., M.P.H. hosted the event, and one highlight included a panel of high school students who shared their personal recovery journeys. Assistant Secretary for Mental Health and Substance Use Disorders Miriam Delphin-Rittmon, Ph.D., who leads the Substance Abuse and Mental Health Services Administration (SAMHSA), moderated the panel, and Sen. Jeanne Shaheen (D-N.H.) and Rep. Paul Tonko (D-N.Y.) offered remarks. Sarah Wattenberg, director of quality and addiction services at NABH, represented the association at the summit. Click here to learn more.

SAMHSA Releases New Data on Recovery from SUD and Mental Health Problems Among Adults

About 70 million U.S. adults aged 18 and older perceived they ever had a substance use and/or mental health problem, according to a new report SAMHSA released this week. Using data from the 2021 National Survey on Drug Use and Health, the report also showed that for substance use specifically, 29 million adults perceived they ever had a substance use problem, and 20.9 million people (or 72.2%) considered themselves to be in recovery or to have recovered from their drug or alcohol use problem.   For mental health, of the 58.7 million adults who perceived they ever had a mental health problem, 38.8 million (or 66.5%) considered themselves to be in recovery or to have recovered from their mental health problem. Click here to read the report, Recovery from Substance Use and Mental Health Problems Among Adults in the United States.

2023 NABH Membership Directory Updates Are Due Wednesday, Sept. 27!

NABH has extended the deadline for system members to submit changes about their organizations for the 2023 NABH Directory to Wednesday, Sept. 27. NABH’s online-only 2023 Membership Directory is an essential member benefit that helps the association advance its advocacy efforts. Last month NABH sent system members a link to the association’s membership-update tool. To help ensure we have the most accurate information on our members, please use the link to verify your system’s information. 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 to help provide NABH with an accurate picture of our membership. If you need assistance, please contact Maria Merlie maria@nabh.org or 202-393-6700, ext. 104.

Reminder: Deadline for Health Data Privacy Feedback to Senate HELP Committee is Next Week

Senate Health, Education, Labor, and Pensions (HELP) Committee Ranking Member Sen. Bill Cassidy, M.D. (R-La.) announced earlier this month he’s seeking information from stakeholders about ways to improve the privacy protections of health data in a way that safeguards sensitive information while balancing the need to support medical research. According to a Senate HELP Committee announcement, Cassidy, an NABH Champion, hopes to use the stakeholder feedback to identify solutions to modernize HIPAA and ensure that all health data are safeguarded properly.   The deadline to submit feedback is Thursday, Sept. 28. Click here to read Cassidy’s full request and here to submit comments.    

Reminder: CMS to Host Webinar on Person-Centered Approaches to Improving Behavioral Health Condition Management

CMS’ Medicare-Medicaid Coordination Office recently announced an upcoming webinar that will examine how traditional silos of care impede comprehensive approaches to care coordination and explore potential solutions to improve behavioral health condition management in persons with intellectual and developmental disabilities. Presenters include Andrea Witwer, Ph.D., associate clinical professor in psychiatry and behavioral health at Ohio State; family caregiver Patricia Nobbie, Ph.D.; and Olivia Ayers, LMCH, LPC, clinical director at Elevate Certified Community Behavioral Health Clinic in Iowa. The 90-minute webinar will be held on Wednesday, Sept. 27 starting at 2:30 p.m. ET. Click here to learn more and to register.

Fact of the Week:

Researchers at the not-for-profit research institute RTI International have found that approximately 3.7 million, or 1.8%, of U.S. adults ages 18 to 65, have a lifetime history of schizophrenia spectrum disorders— a figure two-to-three times higher than previous studies. The findings came from the Mental Health and Substance Use Disorder Prevalence Study, which SAMHSA funds.   For questions or comments about this CEO Update, please contact Jessica Zigmond.

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NABH Comments on 2024 OPPS and Physician Payment Proposed Rules

This week NABH submitted a comment letter to the Center for Medicare & Medicaid Services (CMS) about the agency’s proposed rules pertaining to both the outpatient prospective payment system (OPPS) and physician fee schedule (PFS) for 2024. Outpatient PPS Proposed Rule. Among the rule’s multiple behavioral healthcare provisions, a key item was CMS’ proposed design and implementation of the congressionally mandated intensive outpatient program (IOP) as a new Medicare benefit in hospital outpatient departments, community mental health centers, federally qualified health centers, rural health clinics, and opioid treatment programs. NABH generally supports CMS’ proposed approach of basing many of the new IOP design features on the existing partial hospitalization program (PHP) framework because PHPs treat a similar mix of patients, although with a higher level of intensity. That said, NABH raised concerns regarding some of the proposed design features, including the need to align the new IOP patient eligibility criteria with the clinical characteristics of current IOP populations. Specifically, NABH urged CMS to remove these criteria: “adequate support system at home” and “risk of danger to self or others” as they would exclude a significant portion of the patient population for whom this benefit is intended.   NABH expressed additional concerns related to the implementation of IOP benefit by opioid treatment programs including that the physician-driven IOP certification and treatment planning requirements do not align with the scopes of practice of non-physician professionals nor with the ASAM requirements for IOP and other level of care assessments; that additional specialty care settings should be considered for IOP services; and that CMS develop a contingency management bundle for individuals with stimulant use disorder. Physician Fee Schedule Proposed Rule. NABH’s comments about the PFS rule respond to CMS’ proposed 2.0% increase for psychiatric service payments, relative to CY 2023 rates, which starkly contrasts to the proposed decrease for overall PFS payments of negative 3.3%. Our comments recommend increases for both overall and psychiatric services due to significant workforce and other pressures facing all healthcare providers. We also support the agency’s provision to set payments to 150% of facility-based payments for “psychotherapy for crisis” services that are furnished in a setting other than a physician’s office or mobile unit or home. In addition, we support CMS’ proposal to allow three new behavioral healthcare practitioners to bill under Medicare Part B: marriage and family therapists, mental health counselors (MHCs), and addiction counselors that meet Medicare criteria for MHCs. NABH also called for a 10 percentage-point increase in payments for these providers and the addition of psychiatric mental health nurse practitioners to this group. We also recommended that telehealth services offered by community health integration, social determinants of health, and principal illness navigation specialists be covered; that remote monitoring codes be developed for opioid treatment programs and office-based opioid treatment providers; and that progressively decreasing buprenorphine reimbursement rates be re-evaluated and increased.

Providers Share the Negative Impact of Returning to DEA’s Pre-Pandemic Telemedicine Rules

The Drug Enforcement Administration held a two-day listening session this week in response to almost 40,000 comments it received earlier in the year about its proposal to reimpose in-person visits for the prescribing of controlled substances, including buprenorphine.   DEA Administrator Anne Milgram announced that the agency would provide an additional comment period for telemedicine. This would likely require an extension of the telemedicine flexibilities offered during the COVID-19 pandemic. Testimony over the course of two days addressed how changes to pandemic-era telemedicine rules would impede care for individuals needing medication for attention-deficit/hyperactivity disorder and opioid use disorder, individuals in end-of-life care needing opioids for pain relief, individuals receiving gender-affirming care, and many others. The listening session requested recommendations on a “special registration” process that Congress requested many years ago.

National Academies Seeking Experts to Participate in Study to Develop National Prevention Infrastructure for Behavioral Health Disorders Blueprint

The National Academies of Sciences, Engineering, and Medicine is seeking suggestions for experts to participate in a study to develop a Blueprint for a National Prevention Infrastructure for Behavioral Health Disorders.   The study also will identify funding needs and strategies to support the infrastructure; identify gaps in policy research and health services research that may serve as barriers to implementing the program; and recommend state and federal policies to support the financing and infrastructure, including workforce development and data interoperability for promoting behavioral health. Click here to learn more about the scope of work for the ad hoc committee that will develop the blueprint and click here to submit recommendations of volunteer experts. The deadline to submit recommendations is Wednesday, Sept. 20.

SAMHSA Releases Resources to Help Communities Address Opioid Overdose Crisis

The Substance Abuse and Mental Health Services Administration (SAMHSA) this week released two resources to help community practitioners end America’s opioid crisis. SAMHSA commissioned RTI International to develop—together with a SAMHSA technical expert panel— Engaging Community Coalitions to Decrease Opioid Overdose Deaths and Opioid-Overdose Reduction Continuum of Care Approach. The guides are based on insights and tools from the ongoing National Institutes of Health (NIH) HEALing Communities Study. NIH and SAMHSA launched that study in 2019 to test the effect of an integrated set of evidence-based practices across healthcare, behavioral health, justice, and other community-based settings.

Reminder: Sept. 28 Deadline for Health Data Privacy Feedback to Senate HELP Committee

Senate Health, Education, Labor, and Pensions (HELP) Committee Ranking Member Sen. Bill Cassidy, M.D. (R-La.) last week announced he’s seeking information from stakeholders about ways to improve the privacy protections of health data in a way that safeguards sensitive information while balancing the need to support medical research. According to a Senate HELP Committee announcement, Cassidy, an NABH Champion, hopes to use the stakeholder feedback to identify solutions to modernize HIPAA and ensure that all health data are safeguarded properly. The deadline to submit feedback is Thursday, Sept. 28. Click here to read Cassidy’s full request and here to submit comments.   

Reminder: CMS to Host Webinar on Person-Centered Approaches to Improving Behavioral Health Condition Management

CMS’ Medicare-Medicaid Coordination Office recently announced an upcoming webinar that will examine how traditional silos of care impede comprehensive approaches to care coordination and explore potential solutions to improve behavioral health condition management in persons with intellectual and developmental disabilities. Presenters include Andrea Witwer, Ph.D., associate clinical professor in psychiatry and behavioral health at Ohio State; family caregiver Patricia Nobbie, Ph.D.; and Olivia Ayers, LMCH, LPC, clinical director at Elevate Certified Community Behavioral Health Clinic in Iowa. The 90-minute webinar will be held on Wednesday, Sept. 27 starting at 2:30 p.m. ET. Click here to learn more and to register.

Deadline Extended! 2023 NABH Membership Directory Updates Are Due Sept. 27

NABH has extended the deadline for system members to submit changes about their organizations for the 2023 NABH Directory to Wednesday, Sept.27. NABH’s online-only 2023 Membership Directory is an essential member benefit that helps the association advance its advocacy efforts. Last month NABH sent system members a link to the association’s membership-update tool. To help ensure we have the most accurate information on our members, please use the link to verify your system’s information. 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 of your system’s facilities to help provide NABH with an accurate picture of our membership. If you need assistance, please contact Maria Merlie maria@nabh.org or 202-393-6700, ext. 104.

Reminder: Please Submit Your Managed Care Denials Data to Support NABH Advocacy

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:

Recent research found that, overall, people with mental health conditions seemed to have an elevated risk of heat-related death. This was even more severe for people with schizophrenia: a 200% increase compared with typical summers. For questions or comments about this CEO Update, please contact Jessica Zigmond.

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CMS Announces AHEAD Model to Improve Overall Health of State Population

The Centers for Medicare & Medicaid Services on Thursday unveiled its States Advancing All-Payer Health Equity Approaches and Development (AHEAD) model to better address chronic disease, behavioral health, and other medical conditions among state populations. CMS said the new approach is intended to help participating states be better equipped to promote health equity, increase access to primary care services, set healthcare expenditures on a more sustainable trajectory, and lower healthcare costs for patients.   AHEAD also includes specific payment models for participating hospitals and primary care practices as a tool to achieve the model’s goals. Through AHEAD, CMS said it aims to strengthen primary care, improve care coordination for people with Medicare and Medicaid, and increase screening and referrals to community resources such as housing and transportation to address social drivers of health. CMS will issue awards to up to eight states, and each selected state will have an opportunity to receive up to $12 million from CMS to support state implementation. The agency said states interested in participating in the model may apply during two different application periods and elect to participate in one of three cohorts with staggered start dates and performance years. CMS will release the Notice of Funding Opportunity, which includes the specific application requirements, in the late fall.

CMS Releases Request for Applications for New ‘Making Care Primary’ Model

CMS also announced it is now accepting applications for its recently introduced voluntary Making Care Primary, or MCP, model. Launching on July 1, 2024, the 10.5-year model will be tested in eight states – Colorado, North Carolina, New Jersey, New Mexico, New York, Minnesota, Massachusetts, and Washington – and is meant to give primary care clinicians the tools they need to form partnerships with healthcare specialists and leverage community-based connections to address patients’ needs. “This model will attempt to strengthen coordination between patients’ primary care clinicians, specialists, social service providers, and behavioral health clinicians, ultimately leading to chronic disease prevention, fewer emergency room visits, and better health outcomes,” CMS said in its announcement about accepting applications. CMS also said its new MCP care approach communicates the agency’s vision for three domains: care management, care integration, and community engagement. For the second domain of care integration, CMS said participants will strengthen their connections with specialty care clinicians while using “evidence based behavioral health screening and evaluation to improve patient care and coordination.” CMS will accept applications through Thursday, Nov. 30, 2023 by 11:59 p.m. ET. Click here for more details and eligibility requirements.

Cassidy Seeks Information to Improve Americans’ Health Data Privacy

Senate Health, Education, Labor, and Pensions (HELP) Committee Ranking Member Sen. Bill Cassidy, M.D. (R-La.) on Thursday announced he’s seeking information from stakeholders about ways to improve the privacy protections of health data in a way that safeguards sensitive information while balancing the need to support medical research. According to a Senate HELP Committee announcement, Cassidy, an NABH Champion, hopes to use the stakeholder feedback to identify solutions to modernize HIPAA and ensure that all health data are safeguarded properly. The deadline to submit feedback is Thursday, Sept. 28. Click here to read Cassidy’s full request and here to submit comments.       

CMS Announces Webinar on Person-Centered Approaches to Improving Behavioral Health Condition Management

CMS’ Medicare-Medicaid Coordination Office this week announced an upcoming webinar that will examine how traditional silos of care impede comprehensive approaches to care coordination and explore potential solutions to improve behavioral health condition management in persons with intellectual and developmental disabilities. Presenters include Andrea Witwer, Ph.D., associate clinical professor in psychiatry and behavioral health at Ohio State; family caregiver Patricia Nobbie, Ph.D.; and Olivia Ayers, LMCH, LPC, clinical director at Elevate Certified Community Behavioral Health Clinic in Iowa. The 90-minute webinar will be held on Wednesday, Sept. 27 starting at 2:30 p.m. ET. Click here to learn more and to register.

2023 NABH Membership Directory Update Deadline is Next Week!

The deadline for NABH system members to submit changes about their organizations for the 2023 NABH Directory is Wednesday, Sept. 13. NABH’s online-only 2023 Membership Directory is an essential member benefit that helps the association advance its advocacy efforts. Last month NABH sent system members a link to the association’s membership-update tool. To help ensure we have the most accurate information on our members, please use the link to verify your system’s information. 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 to help provide NABH with an accurate picture of our membership. If you need assistance, please contact Maria Merlie maria@nabh.org or 202-393-6700, ext. 104.

Reminder: Please Submit Your Managed Care Denials Data to Support NABH Advocacy

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:

Of people appointed to HHS between 2004 and 2020, about one-third (32%) left for positions in industry, according to a comprehensive Health Affairs study of the “revolving door” in healthcare regulation. Axios, Becker’s Hospital Review, and Fierce Healthcare were among the news outlets that reported on the findings, which raise questions about the potential conflict-of-interest risks between industry and the federal department that regulates it. For questions or comments about this CEO Update, please contact Jessica Zigmond.

CEO Update 152

Biden Highlights Parity in National Recovery Month Proclamation

Today kicks off National Recovery Month, a nationwide observance every September since 1989 to promote and support new evidence-based treatment and recovery practices, the nation’s recovery community, and the dedication of service providers and communities who make recovery in all its forms possible. In his proclamation on the annual observance, President Biden noted that drug overdoses last year took more than 100,000 American lives and that addressing the country’s substance use disorder (SUD) crisis is a core pillar of his Unity Agenda. “That work starts by fulfilling the promise of true parity for mental health and substance use disorder treatment for all Americans,” Biden said in the proclamation. “Mental health and substance use disorder care is healthcare.  It is essential to people’s well-being — to their ability to lead full and productive lives, to find joy and meaning, to take care of themselves and their loved ones, and to give back to their communities and our nation,” he continued. “It is about dignity. Health insurers should cover it the same way they would cover treatment for a broken bone or any other kind of health condition.  And since I took office, that is what we have been fighting to do.” Click here to access the Substance Abuse and Mental Health Services Administration (SAMHSA) National Recovery Month toolkit. And please remember to follow NABH @NABHBehavioral and on LinkedIn at the National Association for Behavioral Healthcare to read and share our social media posts about National Recovery Month.

Appellate Court Vacates Earlier Ruling in Wit v. UBH Case

A three-judge panel in the 9th U.S. Circuit Court of Appeals last week vacated its prior holdings in the ongoing Wit v. United Behavioral Health (UBH) case for the second time and issued this opinion. NABH consultant Meiram Bendat, JD, Ph.D, founder and president of Psych Appeal, summarized the decision: “Essentially, the appellate court affirmed the trial court’s findings that UBH’s medical necessity guidelines were inconsistent with generally accepted standards of care (GASC), but also held that the trial court erred in holding that UBH’s plans required it to cover all services consistent with GASC,” Bendat wrote, adding, “The appellate court affirmed the trial court’s class certification order to allow the classes to pursue their breach of fiduciary duty claim. The trial court findings that UBH violated the laws of jurisdictions requiring the use of state-mandated criteria also remain undisturbed,” he continued. “The appellate court also walked away from its previous holdings that remand is not an available remedy under ERISA and that all absent class members must exhaust their administrative remedies prior to pursuing their claims in court.”   Bendat added that—absent another petition for review—the case will be sent back to the trial court, which will likely again clarify that it based UBH’s liability on UBH’s deviation from GASC in its medical necessity guidelines, which were intended to implement the GASC requirement in the plans. The trial court is also expected to answer several other questions the 9th Circuit posed. “In short, plaintiffs are now in a far better position than they were last year,” Bendat wrote. “Hopefully, folks can appreciate how important it is to have laws like SB 855, which require medical necessity to be made consistent with GASC and which don’t vest plan administrators with discretion to adopt self-serving clinical guidelines with which to deny claims.”

HRSA Announces More than $80 Million in Funding for Rural Communities to Combat Opioid Crisis

HHS’ Health Resources and Services Administration (HRSA) announced Thursday more than $80 million in awards to rural communities in 39 states to support key strategies that respond to the overdose risk from fentanyl and other opioids. HRSA funding will support interventions such as distributing the lifesaving overdose reversal drug naloxone to prevent overdose; creating and expanding treatment sites in rural areas to provide medications to treat opioid use disorder; expanding access to behavioral health care for young people in rural communities; and, caring for infants in rural areas who are at-risk for opioid exposure or experiencing symptoms related to opioid exposure. Click here to learn more and here to see the list of awardees.

SAMHSA Awards $57.6 Million to Connect Americans with Substance Use Recovery and Treatment Supports

As part of Overdose Awareness Week and the start of National Recovery Month, SAMHSA this week announced $57.6 million in seven grant programs to connect Americans who misuse substances to recovery and treatment supports. According to SAMHSA, the grant awards facilitate ongoing efforts throughout the nation in treatment, recovery support and harm reduction – three of the pillars of the HHS’ Overdose Prevention Strategy. Click here to read about the grant programs.

SAMHSA Releases Guide for Reentry from Criminal Justice Settings for People with Mental Health Conditions and SUD

SAMHSA has released Best Practices for Successful Reentry From Criminal Justice Settings for People Living With Mental Health Conditions and/or Substance Use Disorders, which examines the types of interventions that support successful reentry for adults with mental health conditions and/or substance use disorders who are leaving jail/prison. The 85-page guide includes an issue brief on the topic, current evidence on three interventions, guidance for identifying and implementing evidence-based practices to support reentry, and more.

Manatt to Examine Latest Wit v. UBH Ruling in Mental Health Parity Webinar 

Manatt litigation and benefits experts will discuss a host of parity issues in an upcoming webinar, including the latest federal report to Congress, action items for health plans and service providers, and the latest decision in the Wit v. UBH case.   Presenters will include Manatt partners Joe Laska and Harvey Rochman, as well as Jean Kim, special counsel, executive compensation and employee benefits. The hourlong webinar will take place Tuesday, Sept. 19 at 1 p.m. ET.   Click here to register.

Please Update Your Member Information for the 2023 NABH Membership Directory! 

NABH is developing its online-only 2023 Membership Directory, an essential member benefit that helps the association in its advocacy efforts. NABH has sent members a link to the association’s membership-update tool. To help ensure we have the most accurate information on our members, please use the link to verify your system’s information. 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 membership. The deadline to submit your changes to NABH is Wednesday, Sept. 13. If you need assistance, please contact Maria Merlie maria@nabh.org or 202-393-6700, ext. 104. As always, thank you for your time and for all you do to advance NABH’s Mission and Vision!

Reminder: Please Submit Your Managed Care Denials Data to Enhance NABH Advocacy

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:

This summer Texas lawmakers enacted Tucker’s Law. which mandates that middle schools and high schools educate students about fentanyl abuse prevention and drug-poisoning awareness. NABH wishes its members, their teams, and families a happy and safe Labor Day weekend! For questions or comments about this CEO Update, please contact Jessica Zigmond.