Author: Administrator

President Biden Signs Debt Ceiling Increase, Staving Off Medicare Provider Cuts  

President Biden on Thursday signed legislation that permits a federal debt ceiling increase and also forestalls expected Medicare payment cuts to providers. Passed by Congress this week, the bill to raise the federal government’s borrowing limit by about $2.5 trillion—and cover its obligations into 2023—also delays through March 2022 the 2% Medicare sequestration cuts that were to take effect in January. After the first quarter of 2022, a phased-in, 1% cut will take effect for the second quarter, followed by the full 2% cut for the third and fourth quarters of the year. Under the legislation, the sequestration will be increased to 2.25% for the first two quarters of 2030, increasing to 3% in quarters three and four of 2030. The bill would also extend the Medicare conversion factor through calendar year 2022 at a rate of 3%, marking a reduction in provider reimbursement by 0.75 percent from the 3.75 conversion factor in 2021.

Senate Majority Leader Schumer Says More Time Needed for ‘Build Back Better Act’

Senate Majority Leader Charles Schumer (D-N.Y.) on Friday signaled that the Biden administration’s Build Back Better Act will be delayed as discussions continue about the $1.7 trillion climate and social spending plan. Reports have noted that Democrats are continuing to push for action on the legislation before Christmas, but that ongoing conversations between the White House and Sens. Joe Manchin (D-W.Va.) and Kyrsten Sinema (D-Ariz.)—both of whom have expressed concern about passing another trillion-dollar spending bill—will push the legislation into 2022. “The president requested more time to continue his negotiations, and so we will keep working with him, hand in hand, to bring this bill over the finish line and deliver on these much-needed provisions,” Schumer said on the Senate floor.” Schumer did not say when the Senate will consider the measure.

HHS Releases 2022 Regulatory Priorities

The U.S. Health and Human Services Department (HHS) has included behavioral health in the department’s recently released Statement of Regulatory Priorities for 2022. Beginning on page 5 of the 15-page document, HHS noted it will propose two rules intended to extend telehealth flexibilities for substance use disorder treatments granted during the Covid-19 public health emergency. One rule will propose revisions to the Substance Abuse and Mental Health Services Administration’s (SAMHSA) regulations that would make permanent regulatory flexibilities for opioid treatment programs to provide extended take-home doses of methadone to patients when it is safe to do so. In the other telehealth rule, HHS will propose revisions to SAMHSA regulations to permanently allow opioid treatment programs to provide buprenorphine via telehealth services. The document also describes HHS’ plans to work with the U.S. Labor Department on a rule related to the Mental Health Parity and Addiction Treatment Equity Act and the Consolidated Appropriations Act, 2021 related to compliance. Finally, the HHS plan said it will work on revisions related to Part 2 requirements to align rules about the confidentiality of SUD treatment records with rules that the Health Insurance Portability and Accountability Act of 1996 and the Coronavirus Aid, Relief, and Economic Security Act of 2020 require.

CMS Adds Mental Health and SUD Measures to Children’s Core Healthcare Quality Measurement Set

The Centers for Medicare & Medicaid Services (CMS) has added two measures to the 2022 updates to the core set of children’s healthcare quality measures. In Follow-Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence: Ages 13-17, the measure assesses the percentage of emergency department (ED) visits for beneficiaries aged13 and older with a principal diagnosis of alcohol or other drug (AOD) abuse or dependence who had a follow-up visit for AOD abuse or dependence. The other measure, Follow-Up After Emergency Department Visit for Mental Illness: Ages 6-17, assesses the percentage of ED visits for beneficiaries aged 6 and older with a principal diagnosis of mental illness or intentional self-harm and who had a follow-up visit for mental illness.

CDC Data Show Drug Overdose Deaths Involving Fentanyl Increasing

A new report from the Centers for Disease Control and Prevention (CDC) shows that in 2019 and 2020, deaths involving illegal fentanyl increased 94% in the West, 65% in the South, and 33% in the Midwest. “Pressed into counterfeit pills made to look like oxycodone or other painkillers, illegally made fentanyl has been showing up east of the Mississippi where heroin is sold and in two-thirds of drug overdose deaths charted by CDC through April,” the report noted. Meanwhile, HHS’ Office of the Inspector General (OIG) this week released a data brief that reported many Medicare beneficiaries are not receiving medication to treat their opioid use disorder. “About 1 million Medicare beneficiaries were diagnosed with opioid use disorder in 2020. Yet less than 16 percent of these beneficiaries received medication to treat their opioid use disorder, raising concerns that beneficiaries face challenges accessing treatment,” the OIG’s data brief noted. “Furthermore, less than half of the beneficiaries who received medication to treat their opioid use disorder also received behavioral therapy. These services may be provided in-person or via telehealth; however, the full extent to which beneficiaries use telehealth for behavioral therapy is unknown as Medicare does not require opioid treatment programs to report this information.”

SAMHSA Releases New Prescribing Tools for Buprenorphine in Primary Care Settings

SAMHSA has published a new resource to provide primary care providers with information on how to implement opioid use disorder treatment using buprenorphine. The publication highlights common barriers and identifies strategies to address them and also includes specific tactics to support buprenorphine implementation.

SAMHSA to Host Webinar on Harm Reduction Grant Program on Monday

SAMHSA is accepting applications for its first harm-reduction program and will host a webinar Monday, Dec. 20 to review the program’s requirements. The agency said it expects to award about $30 million in grants with funding from the American Rescue Plan for programs intended to increase access to a range of community harm-reduction services and to support harm-reduction providers as they work to prevent overdose deaths. The webinar will be held on Monday at 2 p.m. ET. Click here to register.

Reminder: NABH Denial-of-Care Portal is Open to Members

NABH’s Denial-of-Care Portal is available for members to provide information about their experiences with managed care organizations that impose barriers to care through insurance-claim denials. NABH’s Managed Care Committee worked for more than a year to develop the Denial-of-Care Portal as a way to collect specific data on insurers who deny care—often without regard for parity or the effects on patients. This NABH member-only, survey-like tool allows users to add the name of a managed care organization, type of plan, level of care, type of care (mental health or substance use disorder), duration of approved treatment, duration of unapproved treatment, criteria used to deny a claim, and more. The portal allows members to submit individual examples of claim denials or upload multiple entries via Excel. It also includes sections on appeals and physician participation. In time, the tool could be a valuable resource for the NABH team’s advocacy efforts. Please e-mail Emily Wilkins, NABH’s administrative coordinator, if you have questions about the portal.

Fact of the Week

From August 2019 to April 2021, only 7.4% of people in an emergency department for an opioid overdose received a prescription for naloxone within 30 days of the visit, according to a new study in Open Minds.

Happy Holidays from NABH!

NABH will not publish CEO Update for the next two weeks and will resume on Friday, Jan. 7, 2022. 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.

Surgeon General Issues Advisory on Nation’s Youth Mental Health Crisis

U.S. Surgeon General Vivek Murthy, M.D. this week issued the U.S. Surgeon General’s Advisory on Protecting Youth Mental Health, which outlines recommendations to address America’s youth mental health crisis. “Even before the pandemic, an alarming number of young people struggled with feelings of helplessness, depression, and thoughts of suicide — and rates have increased over the past decade,” Murthy said in a news release. “The Covid-19 pandemic further altered their experiences at home, school, and in the community, and the effect on their mental health has been devastating,” he continued, adding that the future of the country’s well-being depends on how we support and invest in the next generation. The 53-page advisory recommends that individuals, families, community organizations, technology companies, governments, and others recognize that mental health is an essential part of overall health; empower youth and their families to recognize, manage, and learn from difficult emotions; ensure that every child has access to high-quality, affordable, and culturally competent mental healthcare; support the mental health of children and youth in educational, community, and childcare settings and expand and support the early childhood and education workforce; address the economic and social barriers that contribute to poor mental health for young people, families, and caregivers; and increase timely data collection and research to identify and respond to youth mental health needs more rapidly. “This includes more research on the relationship between technology and youth mental health, and technology companies should be more transparent with data and algorithmic processes to enable this research,” the Surgeon General’s announcement said.

SAMHSA Announces $30 Million in Harm-Reduction Grant Funding

The Substance Abuse and Mental Health Services Administration (SAMHSA) this week said it will issue about $30 million in American Rescue Plan funding for the agency’s first harm-reduction grant program to help prevent overdose deaths and reduce the health risks associated with drug use. SAMHSA will accept applications from state, local, tribal, and territorial governments; tribal organizations; not-for-profit, community-based organizations; and behavioral health organizations to increase access to a range of community services and supports. “The reality is, evidence-based harm reduction services are out of reach for far too many people,” Rahul Gupta, M.D., director of the Office of National Drug Control Policy, said in SAMHSA’s announcement. “Building on the Biden-Harris Administration’s efforts to expand evidence-based prevention, treatment and recovery support services, this historic funding will help make harm reduction services more accessible, so we can meet people where they are and save lives,” Gupta added.

HHS Report Shows Medicare Telehealth Visits for Behavioral Health Increased 32-Fold in 2020

The number of Medicare fee-for-service (FFS) beneficiary telehealth visits for behavioral health increased to 10.1 million in 2020 from 317,800 in 2019, reflecting a 32-fold increase, according to a new report from the U.S. Health and Human Services’ (HHS) Assistant Secretary for Planning and Evaluation’s (ASPE).   Medicare Beneficiaries’ Use of Telehealth in 2020: Trends by Beneficiary Characteristics and Location showed that Medicare telehealth flexibilities “mitigated declines in in-person visits during the pandemic in 2020, but there is also evidence of disparities by race/ethnicity and for rural populations.” Researchers examined claims data from the 34.9 million Medicare FFS beneficiaries who had part A or B coverage and found that the number of Medicare FFS beneficiary telehealth visits rose 63-fold to nearly 52.7 million in 2020 from about 840,000 in 2019. Despite the increase in telehealth visits during the pandemic, total utilization of all Medicare FFS Part B clinician visits declined about 11% in 2020 compared with 2019 levels, the report showed. “Visits to behavioral health specialists showed the largest increase in telehealth in 2020,” the report noted. “Telehealth comprised a third of total visits to behavioral health specialists. While data limitations preclude clear identification of audio-only telehealth services, up to 70% of these telehealth visits during 2020 were potentially reimbursable for audio-only services,” it added.

CMS Updates State Medicaid & CHIP Telehealth Toolkit

The Centers for Medicare & Medicaid Services (CMS) this week released updates to the agency’s State Medicaid and Children’s Health Insurance Program (CHIP) Telehealth Toolkit: Policy Considerations for States Expanding Use of Telehealth, Covid-19 Version.   CMS said it updated the resource to clarify that states may deliver covered services via audio-only telehealth both during the Covid-19 public health emergency and beyond. The toolkit provides quick facts, state considerations, pediatric considerations, a state checklist, and an appendix that includes frequently asked questions. “This guide is intended to help states identify which aspects of their statutory and regulatory infrastructure may impede the rapid deployment of telehealth capabilities in their Medicaid program,” the toolkit noted. “As such, this guide will describe each of these policy areas and the challenges they present below. The toolkit concludes with a list of questions state policymakers can use to ensure they have explored and/or addressed potential obstacles.”

NABH Submits Comments on Surprise Billing to Federal Agencies

NABH this week sent a letter to five federal agencies that expressed concerns about the second set of regulations issued to implement the No Surprises Act. NABH’s main concern in the interim final rule titled “Requirements Related to Surprise Billing; Part II” is the interpretation of the independent dispute resolution (IDF) provisions to highly favor health plans and issuers. “The interim final rule requires IDR entities to presume that the plan or issuer’s median in-network payment rate is the appropriate out-of-network reimbursement rate,” NABH said in its letter to HHS Secretary Xavier Becerra and top officials at the U.S. Labor Department, U.S. Treasury Department, Internal Revenue Service, and Office of Personnel Management. “This interpretation is contrary to the clear intent of Congress that required IDR arbiters to consider a long list of factors specified in the law including the median in-network rate. NABH added that it is also concerned about provisions in the interim final rule regarding good-faith estimates for uninsured and self-pay patients about the potential cost of care. “It is unclear how these requirements align with the price transparency requirements established earlier this year,” NABH wrote. “We urge you to issue additional guidance on how these two sets of rules overlap and differ.

CMS Hosts Open Door Forum to Highlight Provider Requirements in the ‘No Surprises Act’

CMS hosted an open door forum this week to explain provider requirements in the No Surprise Act that will take effect Jan. 1. Beginning next month, consumers will have new billing protections when receiving emergency care, non-emergency care from out-of-network providers at in-network facilities, and air ambulance services from out-of-network providers. The requirements apply mostly to items and services provided to people enrolled in group health plans, group or individual health insurance coverage, Federal Employees Health Benefits plans, and the uninsured. These requirements don’t apply to people with coverage through programs such as Medicare, Medicaid, Indian Health Services, Veterans Affairs Health Care, or TRICARE that have other protections against high medical bills. Click here to view the presentation and here to access the provider requirements and resources page.

Reminder: NABH Denial-of-Care Portal is Open to Members

NABH’s Denial-of-Care Portal is available for members to provide information about their experiences with managed care organizations that impose barriers to care through insurance-claim denials. NABH’s Managed Care Committee worked for more than a year to develop the Denial-of-Care Portal as a way to collect specific data on insurers who deny care—often without regard for parity or the effects on patients. This NABH member-only, survey-like tool allows users to add the name of a managed care organization, type of plan, level of care, type of care (mental health or substance use disorder), duration of approved treatment, duration of unapproved treatment, criteria used to deny a claim, and more. The portal allows members to submit individual examples of claim denials or upload multiple entries via Excel. It also includes sections on appeals and physician participation. In time, the tool could be a valuable resource for the NABH team’s advocacy efforts. Please e-mail Emily Wilkins, NABH’s administrative coordinator, if you have questions about the portal.

Fact of the Week

Suicidal behaviors among high school students increased during the decade preceding the Covid-19 pandemic, with 19% seriously considering attempting suicide, a 36% increase from 2009 to 2019, and about 16% having made a suicide plan in the prior year, a 44% increase from 2009 to 2019, according to data from the Centers for Disease Control and Prevention. For questions or comments about this CEO Update, please contact Jessica Zigmond.

U.S. Overdose Deaths Reach Record High During Covid-19 Pandemic

More than 100,000 Americans died of overdoses for the 12-month period that ended in April 2021, marking the first time the number of U.S. overdose deaths has surpassed 100,000 in a year, according to provisional data from the National Center for Health Statistics (NCHS). This record number represents a nearly 30% increase from the 78,000 deaths in the prior year. Meanwhile, the NCHS data show that overdose deaths in the United States have more than doubled since 2015. “This translates to an American perishing from a drug overdose death every five minutes,” Rahul Gupta, M.D., M.P.H., M.B.A., director of the Office of National Drug Control Policy (ONDCP) told National Public Radio in an interview on Wednesday. “This is unacceptable, and it requires an unprecedented response.” Also this week, Gupta’s office released a state model law to help make access to the prescription naloxone consistent nationwide. The law offers a template of recommended legislative provisions that states can enact so they can offer access to the life-saving treatment. The model law maps out ways to expand access to naloxone; addresses the need to provide uniformity in the ability of citizens to access antagonists such as naloxone; protects individuals administering opioid antagonists such as naloxone from unjust persecution; requires health insurance coverage of opioid antagonists, and more. “No one should die from an overdose, and naloxone is one of the most effective tools we have to save lives,” Gupta said in ONDCP’s announcement. “But sadly, today, people with substance use disorders are overdosing and dying across the country because naloxone access depends a great deal on where you live.”

SAMHSA Extends Take-Home Methadone Flexibilities to OTPs for One Year

The Substance Abuse and Mental Health Services Administration (SAMHSA) on Thursday said it will extend for one year the methadone take-home flexibilities it provided to opioid treatment programs (OTPs) at the start of the Covid-19 pandemic in March 2020 and is “considering mechanisms to make this flexibility permanent.”   This flexibility has allowed OTPs to dispense 28 days of take-home methadone doses for stable patients and up to 14 days of take-home methadone medication to less stable patients, based on provider assessments. SAMHSA’s announcement said it is extending the flexibilities for a year “effective upon the eventual expiration of the Covid-19 Public Health Emergency. Click here to read SAMHSA’s announcement.

Provider Relief Fund Reporting Period 1 Ends Nov. 30

The Health Resources and Services Administration (HRSA) this week reminded providers that the 60-day grace period for the Provider Relief Fund (PRF) Reporting Period 1 ends Tuesday, Nov. 30. Non-compliant providers still have time to complete their reporting requirements, HRSA noted, by submitting their report to the PRF reporting portal by Nov. 30. Providers who fail to meet the deadline will be required to return their PRF payments by Dec. 30, 2021. HRSA also provided a Returning Funds Fact Sheet and additional information is available on the PRF Reporting Resources webpage.

OSHA Suspends Enforcement of Vaccine Mandate for Businesses

The U.S. Labor Department’s Occupational Safety and Health Administration (OSHA) announced it has suspended enforcement of its vaccine mandate for businesses, pending litigation. Earlier this month OSHA released an Emergency Temporary Standard that requires employers with 100 or more employees to develop, implement, and enforce a mandatory Covid-19 vaccination policy to minimize the risk of the deadly virus. “While OSHA remains confident in its authority to protect workers in emergencies, OSHA has suspended activities related to the implementation and enforcement of the ETS pending future developments in the litigation,” the agency announced on its website.

NABH and Other Behavioral Health Groups Release Plan for 988 Crisis Hotline Response

NABH and 14 other behavioral health organizations and advocacy groups this week released A Consensus Approach and Recommendations for the Creation of a Comprehensive Crisis Response System to help guide the mental health and substance crisis response mandated in the National Suicide Hotline Designation Act of 2020. The 17-page roadmap outlines the scope of implementing the 988 Crisis Hotline that will begin operating in July 2022. It also highlights the following seven pillars for transforming mental health and substance use care: early identification and prevention, emergency and crisis response, equity and inclusion, integration and partnership, fair and equivalent coverage, standards for care, and workforce capacity. “988 is not just a new number to call,” the guide states. “It is an opportunity to rethink how we approach mental health, substance use disorders, and suicide prevention in our communities.”

Reminder: NABH Denial-of-Care Portal is Open to Members

NABH’s Denial-of-Care Portal is available for members to provide information about their experiences with managed care organizations that impose barriers to care through insurance-claim denials. NABH’s Managed Care Committee worked for more than a year to develop the Denial-of-Care Portal as a way to collect specific data on insurers who deny care—often without regard for parity or the effects on patients. This NABH member-only, survey-like tool allows users to add the name of a managed care organization, type of plan, level of care, type of care (mental health or substance use disorder), duration of approved treatment, duration of unapproved treatment, criteria used to deny a claim, and more. The portal allows members to submit individual examples of claim denials or upload multiple entries via Excel. It also includes sections on appeals and physician participation. In time, the tool could be a valuable resource for the NABH team’s advocacy efforts. Please e-mail Emily Wilkins, NABH’s administrative coordinator, if you have questions about the portal.

Fact of the Week

In fiscal year 2020, SAMHSA’s Projects for Assistance in Transition from Homelessness (PATH) grantees enrolled 60,000 individuals and connected nearly 40,000 to community mental health services. Nearly 40% of these individuals reported co-occurring disorders and approximately 39% of these individuals experienced chronic homelessness.   For questions or comments about this CEO Update, please contact Jessica Zigmond.

CMS Freezes CY 2022 Methadone Reimbursement Rates in Interim Final Rule

In an interim final rule (IFR), the Centers for Medicare & Medicaid Services (CMS) said it will freeze methadone reimbursement rates for calendar year (CY) 2022. CMS is establishing a limited exception to the current CMS methodology for determining rates for the drug episode of care for methadone (HCPCS G2067-weekly bundle) and the add-on take-home for methadone (HCPCS G2708) by freezing rates at the CY2021 rate. The most recent average sale price (ASP) quarterly rates for oral methadone decreased by just more than 50% over last year’s rate, resulting in a reimbursement rate of 17.64 versus the CY 2021 rate of 37.38 (100% of ASP). CMS said the reduction is due to the inclusion of methadone tablets, where previously only the oral concentrate form was reflected in ASP sales. In addition, because ASP is not required for oral methadone, only a small number of manufacturers report ASP data. Moreover, CMS is not clear about OTP utilization rates for the oral and tablet forms of methadone; however, the agency has heard anecdotally that OTPs use oral methadone exclusively. CMS said that collectively, these three factors raised concerns about implementing such a “sudden and significant decrease in the rate for methadone” [that] could affect the ability of OTPs to continue to offer services to Medicare beneficiaries, thereby impeding access to treatment for OUD, at a time when overdose deaths are at an all-time high.” The freeze of reimbursement rates at the CY 2021 rates will allow time for further research and discussion with stakeholders to develop a new payment methodology in time for the CY 2023 payment rate determination. CMS requested information from stakeholders on the following are of interest:

• The exception being made
• Frequency of use of methadone oral concentrate compared with tablets, and how this should factor into rate setting
• How the reduced payment changes (discussed above) will affect operations and beneficiary access to treatment

Public comments are due by Jan. 3, 2022. The rule will be published in the Federal Register on Nov. 19 and will become effective on Jan. 1, 2022.

NABH Sends Letters to U.S. Senate Finance and HELP Committees

NABH recently sent letters to members of the influential Senate Finance and Senate Health, Education, Labor, & Pensions (HELP) Committees that provided detailed information and recommendations about how to improve access to mental health and addiction treatment. The first letter to Senate Finance Committee Chairman Ron Wyden (D-Ore.) and Ranking Member Mike Crapo (R-Idaho) was a response to a request for information from the senators this summer. In it, NABH emphasized ensuring parity; expanding telehealth; strengthening workforce; increasing integration, coordination, and access; improving access for children and youth; and increasing Medicare Advantage accountability for mental health and addiction treatment. NABH also sent a letter to Senators Christopher Murphy (D-Conn.) and Bill Cassidy, M.D. (R-La.) of the Senate HELP Committee regarding their request for feedback on the programs authorized in the Mental Health Reform Act of 2016. “The pandemic has highlighted and amplified the need for improved access to mental health and addiction treatment,” NABH President and CEO Shawn Coughlin explained in both letters. “Studies have consistently found significantly higher levels of anxiety and depression and suicidal ideation. In addition, alcohol consumption has increased significantly,” he added. “Drug overdose deaths increased almost 30% in 2020 to more than 90,000 deaths, the highest number ever recorded over a 12-month period. Although suicide rates seemed to have leveled off and decreased last year, there have been troubling increases in suicides and suicidal ideation among certain subgroups including Black Americans and adolescent girls.” Both letters also noted that experts expect mental health and substance use disorders to remain elevated long after the Covid-19 pandemic ends.

NABH and Other Behavioral Health Groups Send Letter to OSHA on Workplace Violence

NABH led development of a stakeholder group letter to the U.S. Labor Department’s Occupational Safety and Health Administration (OSHA) about ensuring the safety of personnel in healthcare settings, including those focused on behavioral health. The letter from NABH, the American Nurses Association, the American Psychiatric Association, the National Alliance on Mental Illness, the National Association of State Mental Health Program Directors, and the National Council for Mental Wellbeing followed an early August meeting with representatives from all of the organizations and OSHA that focused on settings where people access mental health or substance use disorder treatment. NABH and the other organizations highlighted a variety of issues, including incorporating trauma-informed care to inform both environmental interventions and settings; conducting debriefing sessions when incidents do occur, including the patient’s perspective to inform additional prevention measures; and providing clinician and staff development/training on de-escalation techniques.

The Commonwealth Fund and Council of State Governments Release Policy Options to Advance Mental Health

The Commonwealth Fund and the Council of State Governments have released Mental Health Resource Guide for State Policymakers, a new resource based on state priorities, best practices, and perspectives from leaders in the field of mental health. Overseen by an advisory group of state legislators, health officials, and experts, the guide focuses on four policy areas: social isolation and loneliness, maternal mental health, social determinants of mental health, and mental health insurance parity. “The resource guide addresses the issue of workforce shortages, and also highlights ways to stretch existing resources, including, for instance, providing peer support and consultation between primary care and behavioral health providers,” The Commonwealth Fund noted in its announcement about the guide. “Some strategies include expanding telehealth psychiatric services and incorporating mental health screening and interventions into various settings like schools, senior centers, workplaces, primary care offices, and in law enforcement.”

ASAM and Well Being Trust Release Toolkit for Strengthening Patient-Centered Addiction Care

The American Society of Addiction Medicine (ASAM) and the Well Being Trust this week released Speaking the Same Language: A Toolkit for Strengthening Patient-Centered Addiction Care in the United States, a toolkit written by Manatt Health Strategies to emphasize the need for adopting a common framework to addiction care in the United States. The toolkit is meant to educate stakeholders about the strategies and tools available to support more effective implementation of The ASAM Criteria and also provide legislative, regulatory, and contractual language that interested states can use.

SAMHSA to Host Webinar on Behavioral Health Equity on Tuesday, Nov. 16

The Substance Abuse and Mental Health Services Administration (SAMHSA) will host Advancing Behavioral Health Equity: National CLAS Standards in Action on Tuesday, Nov. 16 at 2:30 p.m. ET. The webinar will examine real-world examples of behavioral health service providers who use the National Standards for Culturally and Linguistically Appropriate Services (CLAS) and the Behavioral Health Implementation Guide.   Presenters include Assistant Secretary for Mental Health and Substance Use Miriam Delphin-Rittmon, Ph.D. and Rear Admiral Felicia Collins, M.D., M.P.H., director of the U.S. Health and Human Services Department’s Office of Minority Health. Click here to register.

NABH 2021 Annual Meeting Photos and Recorded Sessions Now Available!

Photos and recorded sessions from last month’s Annual Meeting are now available on the association’s Annual Meeting webpage. NABH looks forward to welcoming members to the 2022 Annual Meeting in Washington from June 13-15, 2022!

Reminder: NABH Denial-of-Care Portal is Open to Members

NABH’s Denial-of-Care Portal is available for members to provide information about their experiences with managed care organizations that impose barriers to care through insurance-claim denials. NABH’s Managed Care Committee worked for more than a year to develop the Denial-of-Care Portal as a way to collect specific data on insurers who deny care—often without regard for parity or the effects on patients. This NABH member-only, survey-like tool allows users to add the name of a managed care organization, type of plan, level of care, type of care (mental health or substance use disorder), duration of approved treatment, duration of unapproved treatment, criteria used to deny a claim, and more. The portal allows members to submit individual examples of claim denials or upload multiple entries via Excel. It also includes sections on appeals and physician participation. In time, the tool could be a valuable resource for the NABH team’s advocacy efforts. Please e-mail Emily Wilkins, NABH’s administrative coordinator, if you have questions about the portal.

Fact of the Week

A new study shows that the Centers for Disease Control and Prevention’s 2016 Guideline for Prescribing Opioids for Chronic Pain was associated with substantial reductions in dispensing opioids, including a reduction in patients’ rate of receiving at least one opioid prescription by about 20 percentage points by December 2018 with the counterfactual, no-guideline scenario.   For questions or comments about this CEO Update, please contact Jessica Zigmond.

CMS Issues Emergency Rule Requiring Covid-19 Vaccination for Medicare & Medicaid Providers

The Centers for Medicare & Medicaid Services (CMS) on Thursday issued an emergency regulation requiring Covid-19 vaccination for eligible staff at certain healthcare facilities that participate in the Medicare and Medicaid programs. Facilities covered under this regulation must establish a policy that ensures all eligible staff have received the first dose of a two-dose Covid-19 vaccine or a one-dose Covid-19 vaccine by Dec. 5, 2021 before they provide any care or treatment, CMS said in its announcement. All eligible staff must have received the necessary shots to be vaccinated—either two doses of the Pfizer or Moderna vaccines or one dose of the Johnson & Johnson vaccine—by Jan. 4, 2022. The regulation provides exemptions based on recognized medical conditions, religious beliefs, observances, or practices. “Ensuring patient safety and protection from Covid-19 has been the focus of our efforts in combatting the pandemic and the constantly evolving challenges we’re seeing,” CMS Administrator Chiquita Brooks-LaSure said in the announcement. “Today’s action addresses the risk of unvaccinated healthcare staff to patient safety and provides the stability and uniformity across the nation’s healthcare system to strengthen the health of people and the providers who care for them.” The regulations became effective today, Friday, Nov. 5, and CMS will accept comments on this interim final rule until Jan. 4, 2022. Click here for details about submitting comments.

OSHA Releases Covid-19 Vaccination and Testing Requirements in the Workplace

The Occupational Safety and Health Administration (OSHA) on Thursday released an emergency temporary standard (ETS) that requires employers with 100 or more employees to develop, implement, and enforce a mandatory Covid-19 vaccination policy to minimize the risk of the deadly coronavirus. In the highly anticipated rule, OSHA noted an exception for employers who instead adopt a policy that requires employees to choose either to get vaccinated or to undergo Covid-19 testing at least once per week in the workplace and wear a face covering at work. The testing requirement for unvaccinated workers is scheduled to begin on Jan. 4, 2022, and employers must comply with all other requirements in the ETS—such as providing paid time off for employees to get vaccinated and “reasonable time and paid sick leave” to recover from the vaccination’s potential side effects—by Dec. 6, 2021. Employees who fall under the ETS rule must have their final vaccination dose by Jan. 4, 2022. “We must take action to implement this emergency temporary standard to contain the virus and protect people in the workplace against the grave danger of Covid-19,” U.S. Labor Secretary Marty Walsh said in a news release. “Many businesses understand the benefits of having their workers vaccinated against Covid-19, and we expect many will be pleased to see this OSHA rule go into effect.” According to the rule, states and U.S. territories that have their own OSHA-approved occupational and health plans must “either amend their standards to be identical or ‘at least as effective’ as the new standard or show that an existing state plan standard covering this area is ‘at least as effective’ as the new federal standard.” Of the 28 states and territories with OSHA-approved state plans, 22 cover both public and private sector employees and six states and territories (Connecticut, Illinois, Maine, New Jersey, New York, and the Virgin Islands) cover only state and local governments. OSHA released a fact sheet about the ETS and will accept written comments about any aspect of the rule by Dec. 6, 2021. Click here to submit comments and attachments.

CMS Releases Final Medicare Physician Fee Schedule and OPPS Rules for 2022

CMS this week released both the final Medicare Physician Fee Schedule (PFS) and final hospital outpatient prospective payment system (OPPS) regulations for 2022. Highlights for both regulations are included below. PFS Highlights: The final PFS for next year includes a cut to practitioner rates due to a statutory budget neutrality requirement. In addition, a 3.75% payment increase provided in the Consolidated Appropriations Act for 2021 is expected to expire. Click here for additional details about the agency’s payment provisions. For telehealth services, the Medicare program will continue covering mental health and substance use disorder services via telehealth after the public health emergency ends. The frequency of in-person visits that will be required for those receiving care via telehealth has been modified to lessen the frequency. Instead of every six months, CMS changed its proposal to require in-person visits once every 12 months for those receiving behavioral health treatment via telehealth. CMS also will allow for exceptions to this 12-month interval if both the provider and patient agree the risks and burdens outweigh the benefits and this is documented. The requirement that beneficiaries receiving mental health treatment via telehealth must have been seen in-person during the prior six months before the first telehealth service will be maintained because this previous in-person visit requirement was established in the statute. Meanwhile, Medicare will continue to cover audio-only telehealth for mental health. CMS also clarified that MH services include treatment of substance use disorders for purposes of Medicare coverage of audio-only telehealth. Providers must have the capacity to offer telehealth via audio and visual technology. CMS is requiring use of a service-level modifier for services provided via audio-only telehealth. Medicare will continue to cover a long list of services covered via telehealth on a temporary basis during the pandemic until the end of CY 2023. Click here to see the telehealth services that will be covered for 2022. For the nation’s Opioid Treatment Programs (OTPs), the Medicare program will continue to cover individual and group therapy and substance use counseling provided by OTPs via audio-only, telehealth technology after the public health emergency ends. This coverage of audio-only is limited to situations when video is not available to the beneficiary or they do not consent to the use of video. In addition, CMS made final the proposal that new service-level modifier be appended to claims submitted for the counseling and therapy add-on code when services are furnished via audio-only. The agency is not finalizing the prior proposal to require additional documentation in the medical record to support the use of audio-only services. CMS also finalized its proposals to provide annual updates and locality adjustments for the add-on payments for the non-drug components for opioid antagonist medication (i.e., naloxone) that were new for CY 2021, to provide a new code for a higher dose of the naloxone nasal spray, pricing methodologies for this higher dose naloxone product; reaffirmed recoupment of duplicative payments for naloxone (where separately paid under Medicare Part B or D) from the OTP; and finalized a new code (G1028) for a higher dose 8mg naloxone nasal spray. The agency also published an interim final rule, the “Opioid Treatment Programs: CY2022 Methadone Payment Exception” in which CMS proposes to extend 2021 OTP reimbursement rates for methadone under the OTP benefit through 2023. OPPS Rule Highlights: In this rule, CMS made final its earlier proposal to set a minimum civil monetary penalty of $300 per day that would apply to smaller hospitals with bed counts of 30 or fewer beds and apply a penalty of $10 per bed, per day for hospitals with a bed count greater than 30 beds, not to exceed a maximum daily dollar amount of $5,5500. The maximum would be imposed if hospitals do not provide documentation of bed counts. CMS also finalized its proposal to maintain the existing methodology for per diem partial hospitalization rates using calendar year (CY) 2019 claims and cost report data to develop the CY 2022 rates. CMS will also use the CY 2021 finalized per diem costs as cost floors for CY 2022. CMS did not specify that Medicare will continue coverage of services by partial hospitalization programs (PHPs) via telehealth. The agency noted comments, including some from NABH, that expressed strong support for continued coverage and said it will consider these comments in future rulemaking. The agency did not address whether Medicare would continue to cover PHP facility fees for telehealth services, which could require a legislative change.

NABH Supports Sound the Alarm for Kids! Campaign

NABH is proud to be one of more than 75 organizations to support Sound the Alarm for Kids!, a campaign from the Children’s Hospital Association, American Academy of Pediatrics, and the American Academy of Child and Adolescent Psychiatrists to urge Congress to enact legislation and increase funding to address children’s mental health. The campaign notes there has been a 25% increase in overall mental health-related emergency department visits for kids between the ages of 5 and 11 between 2019 and 2020, while emergency department visits for youth between the ages of 12 and 17 have seen a 31% increase in that same period. “The latest data from SAMHSA show that almost 3 million adolescents had serious thoughts of suicide last year, with more than 1 million who said they made suicide plans,” NABH President and CEO Shawn Coughlin said in the campaign’s news release on Nov. 2. “These statistics are even more troubling as we face significant shortages across behavioral healthcare professions and treatment settings,” he added. “We are eager to work with policymakers, workforce agencies, and partner organizations to identify where the gaps in access to care are—and how we can fill those gaps.”

Aaron Beck, M.D., ‘Father of Cognitive Therapy’ Dies at 100

NABH remembers with grateful appreciation psychiatrist Aaron Beck, M.D., who died Nov. 1 in Philadelphia, for his pragmatic approach to psychotherapy that changed the treatment of depression, anxiety, and other mental disorders in the United States. “He took a hundred years of dogma, found that it didn’t hold up, and invented something brief, lasting and effective to put in its place,” Steven Hollon, a psychologist at Vanderbilt University, told The New York Times. “He basically saved psychotherapy from itself.”

Reminder: NABH Denial-of-Care Portal is Open to Members

NABH’s Denial-of-Care Portal is available for members to provide information about their experiences with managed care organizations that impose barriers to care through insurance-claim denials. NABH’s Managed Care Committee worked for more than a year to develop the Denial-of-Care Portal as a way to collect specific data on insurers who deny care—often without regard for parity or the effects on patients. This NABH member-only, survey-like tool allows users to add the name of a managed care organization, type of plan, level of care, type of care (mental health or substance use disorder), duration of approved treatment, duration of unapproved treatment, criteria used to deny a claim, and more. The portal allows members to submit individual examples of claim denials or upload multiple entries via Excel. It also includes sections on appeals and physician participation. In time, the tool could be a valuable resource for the NABH team’s advocacy efforts. Please e-mail Emily Wilkins, NABH’s administrative coordinator, if you have questions about the portal.

Fact of the Week

Grant funding from the National Institute of Mental Health (NIMH) for research into bipolar disorder is lower than funding for other serious mental illness research and focuses heavily on basic science research instead of clinical research, according to an article published in Journal of Affective Disorders. For questions or comments about this CEO Update, please contact Jessica Zigmond.

Provider Relief Fund Phase 4 Application Deadline is Next Week

The U.S. Health and Human Services Department (HHS) will accept applications for Phase 4 of the Provider Relief Fund (PRF) and American Rescue Plan (ARP) rural payments through next Tuesday, Oct. 26 by 11:59 p.m. ET. PRF Phase 4 is open to a broad range of healthcare providers affected by the Covid-19 pandemic, and ARP Rural is open to Medicare, Medicaid, or the Children’s Health Insurance Program (CHIP) providers who serve rural patients. Click here for more information and here to apply. And if you missed it, HHS hosted a briefing session to provide information about these funding opportunities. Click here to watch the video.

CDC Estimates About 20% of Adults Received Some Mental Health Treatment in 2020

A new report from the Centers for Disease Control and Prevention’s (CDC) National Center for Health Statistics estimates that 20.3% of adults received any mental health treatment in 2020, including 16.5% who had taken prescription medication for their mental health and 10.1% who received counseling or therapy from a mental health professional. The data also showed that women were more likely than men to have received any mental health treatment, and that non-Hispanic white adults (24.4%) were more likely than non-Hispanic black (15.3%), Hispanic (12.6%), and non-Hispanic Asian (7.7%) adults to have received any mental health treatment. Meanwhile, as the level of urbanization decreased, the percentage of adults who had taken medication for their mental health increased, and the percentage who had received counseling or therapy decreased, the report showed.

Bipartisan Policy Center Webinar Discusses Mental Health Workforce Shortage

The Bipartisan Policy Center this week hosted a panel of healthcare and policy experts to discuss solutions to the nation’s mental health workforce shortage, including workforce expansion, community training, and behavioral healthcare and primary care service integration. Panelists included Benjamin Miller, Psy.D., president of the Well Being Trust; former U.S. Surgeon General Regina Benjamin, M.D., who is also founder and CEO of BayouClinic, Inc.; and Shekhar Saxena, M.D., professor of the Practice of Global Mental Health, Harvard T.H. Chan School of Public Health. Click here to watch the recorded webinar.

Urban Institute Study Examines Commercial Insurance Markups Over Medicare Prices

Psychiatry was among a group of medical specialties that had the lowest commercial markups relative to Medicare prices, according to a new study from the Urban Institute. The report shows that family medicine, obstetrics and gynecology, dermatology, ophthalmology, and psychiatry averaged about 110% of Medicare rates or less, while the following nine specialties received commercial payments between 120% and 150% of Medicare rates, on average: gastroenterology, cardiology, general surgery, and orthopedics. Researchers analyzed March 2019 to February 2020 data from FAIR Health’s private health insurance claims database covering more than 150 million people nationwide. The sample included 17 physician specialties and about 20 services per specialty that represent about 40% of total professional spending. FAIR Health is an independent, national, not-for-profit organization that provides information to consumers.

NABH Wants to Hear from You: Please Evaluate the 2021 Annual Meeting

NABH this week sent Annual Meeting attendees a survey to evaluate the 2021 Annual Meeting. If you attended the meeting and have not submitted an evaluation, please take a moment to complete the survey. As a reminder, our Speakers & Presentations page includes presentations that NABH has permission to post publicly, and the 2021 Exhibitor & Sponsor Guide is available on both the NABH Resources and Exhibitors & Sponsors pages on our website. Annual Meeting photos and videos will be posted to our Annual Meeting page later this month. We look forward to seeing everyone in Washington from June 13-15, 2022 for next year’s Annual Meeting!

Reminder: NABH Denial-of-Care Portal is Open to Members

NABH’s Denial-of-Care Portal is available for members to provide information about their experiences with managed care organizations that impose barriers to care through insurance-claim denials. NABH’s Managed Care Committee worked for more than a year to develop the Denial-of-Care Portal as a way to collect specific data on insurers who deny care—often without regard for parity or the effects on patients. This NABH member-only, survey-like tool allows users to add the name of a managed care organization, type of plan, level of care, type of care (mental health or substance use disorder), duration of approved treatment, duration of unapproved treatment, criteria used to deny a claim, and more. The portal allows members to submit individual examples of claim denials or upload multiple entries via Excel. It also includes sections on appeals and physician participation. In time, the tool could be a valuable resource for the NABH team’s advocacy efforts. Please e-mail Emily Wilkins, NABH’s administrative coordinator, if you have questions about the portal.

Fact of the Week

A new study published in Health Affairs found that people with mental health disorders had 50% higher rates of severe maternal morbidity compared with people without mental health disorders, and $458 higher costs per delivery hospitalization. For questions or comments about this CEO Update, please contact Jessica Zigmond.

HHS Hosts Technical Webinars as Provider Relief Fund Phase 4 Application Deadline Approaches

The U.S. Health and Human Services Department (HHS) will accept applications for Phase 4 of the Provider Relief Fund (PRF) through Tuesday, Oct. 26. HHS’ Health Resources and Services Administration (HRSA) administers provider relief programs and is using a single application portal to make $17 billion in PRF phase 4 general distribution payments and $8.5 billion in American Rescue Plan Act (ARP) rural payments available to the nation’s providers. To offer guidance for providers, HRSA has produced a series of webinars for Phase 4 and ARP rural applications on how to navigate the application portal and provide the required financial documentation. These sessions include:

• Phase 4 and ARP Rural: Overview and Portal Demonstration
  • Thursday, Sept. 30: View the recorded webcast.
  • Tuesday, Oct. 5: View the recorded webcast.
  • Download the slides.

• Phase 4 and ARP Rural: Providing Supporting Documentation
  • Wednesday, Oct. 13: View the recorded webcast.
  • Thursday, Oct. 21: 3 p.m. to 4 p.m. ET: Register to attend.

HHS also hosted a briefing session to provide information about these funding opportunities. Click here to watch the video.

NASHP Examines How States are Spending American Rescue Plan Act Funds

The National Academy for State Health Policy (NASHP) has developed a state-by-state analysis to show how states are using funds from the $1.9 trillion American Rescue Plan Act (ARP) that became law on March 11, 2021. The ARP provides considerable funding for continued pandemic response, including $195.3 billion in Coronavirus State Fiscal Recovery Funds for the 50 states and Washington, D.C. Those funds must be obligated by Dec. 31, 2024 and expended by Dec. 31, 2026. Click here to view NASHP’s map and accompanying state profiles to see the status of the State Fiscal Recovery Fund.

Palo Alto University Announces Training to Incorporate Digital Therapy Tools in Mental Health Practices

Palo Alto University has announced it will begin offering a 50-hour training program for incorporating digital therapy tools into mental health practices. According to the university, the new program—Foundations of Digital Mental Health— will offer “foundational knowledge, training, and best practices necessary” for delivering mental health services online. Course topics include Technology and Mental Health for Children and Adolescents: Screen Time, Digital Interventions, and Teletherapy; Suicide, Risk Assessment & Treatment Planning Via Tele-Mental Health; and Evidence-Based Internet Interventions to Reduce Health Disparities. Click here to learn more and to register.

NABH 2021 Annual Meeting Presentations & Exhibitor & Sponsor Guide Available Online

Thank you to all who attended NABH’s 2021 Annual Meeting in Washington last week! NABH was pleased to welcome in person top officials from SAMHSA and the U.S. Labor Department, former National Institute of Mental Health Director Tom Insel, M.D., New York Times bestselling author and four-time Emmy winner Larry Sabato, Ph.D. of the University of Virginia, award-winning singer and mental health advocate Judy Collins, and others. Please visit our Speakers & Presentations page to view the presentations that included slides and that NABH has permission to post publicly. Also, NABH mailed copies of the 2021 Exhibitor & Sponsor Guide to members this week, and the guide’s online version is available on both the NABH Resources and Exhibitors & Sponsors pages on our website. Annual Meeting photos and videos will be posted to our Annual Meeting page later this month. We look forward to seeing everyone in Washington from June 13-15, 2022 for next year’s Annual Meeting!

Please Nominate Members to the 2022 NABH Board of Trustees Slate of Candidates Today!

Please help the NABH Selection Committee identify potential candidates for Board Chair-Elect and two Board seats that will become available in 2022 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 ballot for 2022. Please attach a curriculum vitae (CV) for each individual you recommend. This will help the Selection Committee in its deliberations. You are welcome to suggest yourself. Please return this form and candidates’ CVs to maria@nabh.org by the end of today, Oct. 15.

Reminder: NABH Denial-of-Care Portal is Open to Members

NABH’s Denial-of-Care Portal is available for members to provide information about their experiences with managed care organizations that impose barriers to care through insurance-claim denials. NABH’s Managed Care Committee worked for more than a year to develop the Denial-of-Care Portal as a way to collect specific data on insurers who deny care—often without regard for parity or the effects on patients. This NABH member-only, survey-like tool allows users to add the name of a managed care organization, type of plan, level of care, type of care (mental health or substance use disorder), duration of approved treatment, duration of unapproved treatment, criteria used to deny a claim, and more. The portal allows members to submit individual examples of claim denials or upload multiple entries via Excel. It also includes sections on appeals and physician participation. In time, the tool could be a valuable resource for the NABH team’s advocacy efforts. Please e-mail Emily Wilkins, NABH’s administrative coordinator, if you have questions about the portal.

Fact of the Week

An analysis of electronic health records of nearly 580,000 fully vaccinated people in the United States found that the risk of SARS-CoV-2 breakthrough infection among vaccinated patients with substance use disorders was low overall, but higher than the risk among vaccinated people without substance use disorders.   For questions or comments about this CEO Update, please contact Jessica Zigmond.

Reminder: Provider Relief Fund Phase 4 Application Deadline is Oct. 26

The U.S. Health and Human Services Department (HHS) is accepting applications for phase 4 of the Provider Relief Fund (PRF) through Tuesday, Oct. 26. HHS’ Health Resources and Services Administration (HRSA) administers provider relief programs and is using a single application portal to make $17 billion in PRF phase 4 general distribution payments and $8.5 billion in American Rescue Plan rural payments available to the nation’s providers. Click here to learn more about the programs and how to apply.

President Biden Honors Everyone in Recovery in Video Message

President Biden helped to conclude National Recovery Month this week with a brief video celebrating all Americans in recovery. The president acknowledged that about 23 million Americans are in recovery and millions more are affected by addiction. He also sent a clear message to people who are not in recovery, and to people with loved ones who are not in recovery. “You are not alone. This is personal to millions of families,” President Biden said. “This is personal to my family. My son has written about it. And I know—I know there is hope,” he added. “Treatment works. Recovery is possible. And my administration is here to support every person and their family on their journey to recovery.”

SAMHSA to Establish New Office of Recovery

The Substance Abuse and Mental Health Services Administration (SAMHSA) is launching an Office of Recovery within the Office of the Assistant Secretary for Mental Health and Substance Use to advance the agency’s commitment to recovery for all Americans. “We have identified recovery as a crosscutting principle throughout SAMHSA’s policies and programs,” Assistant Secretary for Mental Health and Substance Use Miriam Delphin-Rittmon, Ph.D. said in an announcement. “In standing up this new office, SAMHSA is committed to growing and expanding recovery support services nationwide.” SAMHSA’s announcement said the new office will have a dedicated team with an understanding of recovery to promote policies, programs, and services to those in or seeking recovery.

NABH 2021 Annual Meeting is Next Week

NABH is pleased to welcome attendees to the NABH 2021 Annual Meeting in Washington Oct.6-8! Please join us at the Mandarin Oriental hotel and hear from our speakers, including Acting Assistant Secretary Ali Khawar from the U.S. Labor Department’s Employee Benefits Security Administration, SAMHSA Administrator Miriam Delphin-Rittmon, Ph.D., former National Institute of Mental Health Director Tom Insel, M.D., folk singer and mental health advocate Judy Collins, and more. Learn more about our speakers on our Annual Meeting webpage, and please be sure to register if you have not done so yet. We look forward to seeing you next week!

Please Nominate Members to the 2022 NABH Board of Trustees Slate of Candidates

Please help the NABH Selection Committee identify potential candidates for Board Chair-Elect and two Board seats that will become available in 2022 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 ballot for 2022. Please attach a curriculum vitae (CV) for each individual you recommend. This will help the Selection Committee in its deliberations. You are welcome to suggest yourself. Please return this form and candidates’ CVs to maria@nabh.org by Friday, Oct. 15, 2021.

Reminder: NABH Denial-of-Care Portal is Open to Members

NABH’s Denial-of-Care Portal is available for members to provide information about their experiences with managed care organizations that impose barriers to care through insurance-claim denials. NABH’s Managed Care Committee worked for more than a year to develop the Denial-of-Care Portal as a way to collect specific data on insurers who deny care—often without regard for parity or the effects on patients. This NABH member-only, survey-like tool allows users to add the name of a managed care organization, type of plan, level of care, type of care (mental health or substance use disorder), duration of approved treatment, duration of unapproved treatment, criteria used to deny a claim, and more. The portal allows members to submit individual examples of claim denials or upload multiple entries via Excel. It also includes sections on appeals and physician participation. In time, the tool could be a valuable resource for the NABH team’s advocacy efforts. Please e-mail Emily Wilkins, NABH’s administrative coordinator, if you have questions about the portal.

Fact of the Week

Physicians have prescribed 44% fewer opioids over the past decade, yet fatal and non-fatal drug overdoses have continued to climb, according to a new report from the American Medical Association.

CEO Update Will Publish Next on Friday, Oct. 15

NABH will not publish CEO Update next week due to the Annual Meeting. Please look for our next edition on Friday, Oct. 15.   For questions or comments about this CEO Update, please contact Jessica Zigmond.

NABH to Welcome SAMHSA Administrator Miriam Delphin-Rittmon, Ph.D. at 2021 Annual Meeting

Assistant Secretary for Mental Health and Substance Use Miriam Delphin, Rittmon, Ph.D. will address attendees at the 2021 NABH Annual Meeting on Thursday, Oct. 7 at 1:30 p.m.   Dr. Miriam Delphin-Rittmon serves as administrator of the Substance Abuse and Mental Health Services Administration (SAMHSA). She previously served for six years as commissioner of the Connecticut Department of Mental Health and Addiction Services. Prior to her appointment at SAMHSA, Dr. Delphin-Rittmon was an adjunct associate professor at Yale University, where she served on faculty for 20 years. At Yale, Dr. Delphin-Rittmon served as the director of Cultural Competence and Research Consultation with the Yale University Program for Recovery and Community Health. In May 2014, Dr. Delphin-Rittmon completed a two-year White House appointment working as a senior advisor to the administrator at SAMHSA. In that position, she worked on a range of policy initiatives addressing behavioral health equity, workforce development, and healthcare reform. Throughout her career in the behavioral health field, Dr. Delphin-Rittmon has extensive experience in the design, evaluation, and administration of mental health, substance use and prevention services and systems and has received several awards for advancing policy in these areas. Please visit our Annual Meeting homepage to learn more about our speakers and register for the meeting, if you have not done so yet. We look forward to seeing you in Washington!

Joint Commission Names HCA’s CMO Jonathan Perlin, M.D., Ph.D. as Next President

The Joint Commission’s Board of Commissioners this week named Jonathan Perlin, M.D., Ph.D. as the organization’s next president, effect March 1, 2022. Perlin serves currently as president of clinical operations and chief medical officer of Nashville-based HCA Healthcare, where he leads a team of clinicians and data scientists in setting clinical and professional policy, implementing clinical data tools, and working to improve outcomes. Before he joined HCA in 2006, Perlin served as the under secretary for health at the U.S. Veterans Affairs Department and later served as chair of the Veterans Affairs’ secretary’s special medical advisory group. Perlin earned a master of science degree in health administration and a doctorate in pharmacology with his medical degree as part of the physician scientist training program at the Medical College of Virginia.

Joint Webinar to Present New Directions for Substance Use Prevention is Sept. 27

The National Institute on Drug Abuse (NIDA), the Partnership to End Addiction, and the American Psychological Association will host a webinar on Monday, Sept. 27 that will highlight how to establish a framework for an earlier and broad approach to substance use prevention. Former NIDA Director Nora Volkow, M.D. will serve as one of the speakers during the presentation, which will also help participants learn how to implement an earlier and broader approach using today’s policy environment. The webinar will begin at noon ET. Click here to register.

CMS to Host Webinar on Hospital Restraint and Seclusion on Sept. 28

The Centers for Medicare & Medicaid Services (CMS) will host a webinar titled “CMS Hospital Restraint and Seclusion: Navigating the Most Problematic CMS Standards and Proposed Changes” on Tuesday, Sept. 28. Webinar instructor Laura Dixon served as director of facility patient safety and risk management and operations for COPIC, a professional medical liability insurance provider, from 2014 until 2020. Dixon will lead the webinar, which will define the CMS restraint requirement of what hospitals must document in internal logs if a patient dies within 24 hours with having two soft restraints on; describe that CMS has restraint-education requirements for staff; discuss specific items that must be documented in the medical record for the one-hour, face-to-face evaluation on patients who are violent or self-destructive; and more. The hourlong webinar will begin at 1 p.m. ET on Sept. 28. Click here to learn more and register.

Please Nominate Members to the 2022 NABH Board of Trustees Slate of Candidates

Please help the NABH Selection Committee identify potential candidates for Board Chair-Elect and two Board seats that will become available in 2022. 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 ballot for 2022. Please attach a curriculum vitae (CV) for each individual you recommend. This will help the Selection Committee in its deliberations. You are welcome to suggest yourself. Please return this form and candidates’ CVs to maria@nabh.org by Friday, Oct. 15, 2021.

Reminder: NABH Denial-of-Care Portal is Open to Members

NABH’s Denial-of-Care Portal is available for members to provide information about their experiences with managed care organizations that impose barriers to care through insurance-claim denials. NABH’s Managed Care Committee worked for more than a year to develop the Denial-of-Care Portal as a way to collect specific data on insurers who deny care—often without regard for parity or the effects on patients. This NABH member-only, survey-like tool allows users to add the name of a managed care organization, type of plan, level of care, type of care (mental health or substance use disorder), duration of approved treatment, duration of unapproved treatment, criteria used to deny a claim, and more. The portal allows members to submit individual examples of claim denials or upload multiple entries via Excel. It also includes sections on appeals and physician participation. In time, the tool could be a valuable resource for the NABH team’s advocacy efforts. Please e-mail Emily Wilkins, NABH’s administrative coordinator, if you have questions about the portal. 

Fact of the Week 

From 2014 to 2018, emergency department visits made by adults with alcohol and substance use disorders increased by 30%, while hospitalizations among patients with those disorders increased by 57%, according to a new study in the Journal of General Internal Medicine. For questions or comments about this CEO Update, please contact Jessica Zigmond.

HHS Provides More Information About Latest Covid Provider Relief Fund Announcement

The U.S. Health and Human Services Department (HHS) this week hosted a webinar to provide details about the department’s recent announcement that it is making available $25.5 billion in new Covid relief funding for providers. The department also released some fact sheets, including one about the payment methodology for phase three funding, information about the application process and eligibility, and provider relief funding reporting requirements. These materials are posted on NABH’s Covid-19 resources page.

NABH Comments on 2022 Medicare Physician Payment Schedule & OPPS Proposed Rules

NABH this week sent comment letters to the Centers for Medicare & Medicaid Services (CMS) about two proposed rules for fiscal year 2022: the Physician Payment Schedule and Hospital Outpatient Prospective Payment System. In the physician payment schedule letter, NABH provided an overview and statistics to support what behavioral healthcare providers have managed during the Covid-19 pandemic as the need for mental health and addiction treatment services continues to rise. NABH strongly supported Medicare coverage of audio-only telehealth mental health services and opioid treatment program services; opposed the agency’s in-person requirement for coverage of telehealth for mental health services; opposed the CMS’ proposal to reduce reimbursement for behavioral health providers to implement budget-neutrality requirements; encouraged CMS to seek comments on reimbursing for contingency management services; and more. Commenting on CMS’ hospital outpatient prospective payment system rule, NABH supported the agency’s proposals to use the 2021 calendar year reimbursement rates for partial hospital as the cost floor for 2022 rates and to use 2019 data to calculate the 2022 rates. The association also recommended that CMS continue to cover partial hospitalization program services via audio-only telehealth. “Our members are concerned that many of their more vulnerable patients are unemployed or under-employed and sometimes homeless and do not have access to video technology. Moreover, access to broadband service to support video and audio technology is often very limited in rural areas,” NABH’s letter said. “These regions also face the most severe shortages of behavioral healthcare providers— particularly PHP providers,” it continued. “Limiting coverage to PHP services via telehealth to video and audio technology will limit the utility of telehealth for reaching individuals that face the greatest barriers to accessing PHP providers.

Virtual Congressional Briefing Next Week to Highlight How Recovery Supports Save Lives 

Substance Abuse and Mental Health Services Administration (SAMHSA) Administrator Miriam Delphin-Rittmon, Ph.D. will offer remarks at “Turning Policy Into Action—How Recovery Supports Save Lives,” a virtual congressional briefing on Tuesday, Sept. 21 at 2 p.m. ET. Other speakers will include U.S. Surgeon General Vivek Murthy, M.D., Rep. Paul Tonko (D-N.Y.), Rep. David McKinley, (R-W.Va.), and leaders from some addiction and recovery organizations. Click here to register.

Joint Webinar to Present New Directions for Substance Use Prevention is Sept. 27

The National Institute on Drug Abuse (NIDA), the Partnership to End Addiction, and the American Psychological Association will host a webinar on Monday, Sept. 27 that will highlight how to establish a framework for an earlier and broad approach to substance use prevention. Former NIDA Direct Nora Volkow, M.D. will serve as one of the speakers during the presentation, which will also help participants learn how to implement an earlier and broader approach using today’s policy environment. The webinar will begin at noon ET. Click here to register.

Reminder: NABH Denial-of-Care Portal is Open to Members

NABH’s Denial-of-Care Portal is available for members to provide information about their experiences with managed care organizations that impose barriers to care through insurance-claim denials. NABH’s Managed Care Committee worked for more than a year to develop the Denial-of-Care Portal as a way to collect specific data on insurers who deny care—often without regard for parity or the effects on patients. This NABH member-only, survey-like tool allows users to add the name of a managed care organization, type of plan, level of care, type of care (mental health or substance use disorder), duration of approved treatment, duration of unapproved treatment, criteria used to deny a claim, and more. The portal allows members to submit individual examples of claim denials or upload multiple entries via Excel. It also includes sections on appeals and physician participation. In time, the tool could be a valuable resource for the NABH team’s advocacy efforts. Please e-mail Emily Wilkins, NABH’s administrative coordinator, if you have questions about the portal.

2021 NABH Annual Meeting Hotel Cut-Off Date is Today!

Please be sure to reserve your hotel room today at the Mandarin Oriental Washington, DC for the 2021 NABH Annual Meeting. The hotel’s room reservation cut-off date is today, Friday, Sept. 17, 2021. And please visit our Annual Meeting webpage to register for the meeting, learn about our speakers, and view the list of our exhibitors and sponsors. We look forward to seeing you in Washington!

Fact of the Week

A new survey of 1,250 U.S. military veterans who served in Afghanistan sometime between the period 2001-2021 showed that 90% of those veterans with a history of mental illness are experiencing new or worsening mental health systems since the Taliban takeover in late August. For questions or comments about this CEO Update, please contact Jessica Zigmond.

HHS Announces $25.5 Billion in Covid-19 Provider Funding

The Biden administration announced Friday that the U.S. Health and Human Services Department (HHS) is making available $25.5 billion in new funding for healthcare providers affected by the Covid-19 pandemic. According to an announcement, the funding—which HHS is making available through the Health Resources and Services Administration (HRSA)—includes $8.5 billion in American Rescue Plan resources for providers who serve rural Medicaid, Children’s Health Insurance Program (CHIP), or Medicare patients, and an additional $17 billion for Provider Relief Fund (PRF) Phase 4 for a wide range of providers who can document revenue loss and expenses associated with the pandemic. “This funding critically helps healthcare providers who have endured demanding workloads and significant financial strains amidst the pandemic,” HHS Secretary Xavier Becerra said in the announcement. “The funding will be distributed with an eye towards equity, to ensure providers who serve our most vulnerable communities will receive the support they need.” HHS also said that consistent with requirements included in the Coronavirus Response and Relief Supplemental Appropriations Act of 2020, PRF Phase 4 payments will be based on providers’ lost revenues and expenditures between July 1, 2020 and March 31, 2021. The combined application for American Rescue Plan funding and PRF Phase 4 will open on Sept. 29.

Biden Administration to Expand Vaccination Requirements for Healthcare Facilities

The Biden administration on Thursday announced it will require Covid-19 vaccinations for staff within all Medicare and Medicaid-certified facilities to protect both healthcare workers and patients from the deadly virus and its more contagious Delta variant. The Centers for Medicare & Medicaid Services (CMS) said it is developing an interim final rule with comment period that it expects to release in October. “As the Delta variant continues to spread, we know the best defense against it lies with the Covid-19 vaccine,” CMS Administrator Chiquita Brooks-LaSure said in a news release. “Data show that the higher the level of vaccination rates among providers and staff, the lower the infection rate is among patients who are dependent upon them for care,” she continued. “Now is the time to act. I’m urging everyone, but especially those fighting this virus on the front lines, to get vaccinated and protect themselves, their families, and their patients from Covid-19.” The NABH team will continue to learn more and keep members apprised of how the new rule will affect providers who work in psychiatric facilities and addiction treatment centers.

SAMHSA Awards $17.8 Million for Mental Health Awareness Training

The Substance Abuse and Mental Health Services Administration (SAMHSA) announced it has released 145 awards totaling $17.8 million to help communities build mental health awareness among individuals who interact with people who experience or exhibit symptoms of a mental health disorder and refer them to appropriate services. Each Mental Health Awareness Training grant recipient will receive up to $125,000 for the first year of this five-year grant program, which will train school personnel, emergency first responders, law enforcement, veterans, armed services members, and their families to recognize the signs and symptoms of mental health disorders, particularly serious mental illness and/or serious emotional disturbances, to respond safely and appropriately. Click here to read the list of grant recipients.

NABH Sends Comments to CMS on Surprise Billing

In a letter to CMS this week, NABH highlighted the increased need for mental health and addiction treatment during the pandemic and asked the agency to mitigate the extent to which new surprise billing rules impose additional burdens on behavioral healthcare providers. “Many psychiatric hospitals have negative net operating margins despite offering services that are in high demand in communities across the country,” NABH said in its letter about CMS’ requirements related to surprise billing. “The Covid-19 pandemic has added to the strain on these facilities with additional financial losses and unexpected costs, including those related to greatly increased use of personal protective equipment, increased screening of individuals coming into the facilities with additional staffing needs for screening, and other infection-control measures, including isolation rooms and units, software and hardware purchases to facilitate telework for administrative staff and telehealth for patients, and lost revenue due to 2 decreased patient volume because of infection concerns and reduced referrals.” NABH added that it supports the position in the agency’s rules to “exclude behavioral healthcare services from the prohibition on notice and consent to balance bill.” Click here to read CMS’ July news release about the surprise billing requirements and here to read the interim final rule.

Reminder: NABH Denial-of-Care Portal is Open to Members

NABH’s Denial-of-Care Portal is available for members to provide information about their experiences with managed care organizations that impose barriers to care through insurance-claim denials. NABH’s Managed Care Committee worked for more than a year to develop the Denial-of-Care Portal as a way to collect specific data on insurers who deny care—often without regard for parity or the effects on patients. This NABH member-only, survey-like tool allows users to add the name of a managed care organization, type of plan, level of care, type of care (mental health or substance use disorder), duration of approved treatment, duration of unapproved treatment, criteria used to deny a claim, and more. The portal allows members to submit individual examples of claim denials or upload multiple entries via Excel. It also includes sections on appeals and physician participation. In time, the tool could be a valuable resource for the NABH team’s advocacy efforts. Please e-mail Emily Wilkins, NABH’s administrative coordinator, if you have questions about the portal.

2021 NABH Annual Meeting Hotel Cut-Off Date is Next Week

Please be sure to reserve your hotel room today at the Mandarin Oriental Washington, DC for the 2021 NABH Annual Meeting! The hotel’s cut-off date is next Friday, Sept. 17, 2021. And please visit our Annual Meeting webpage to register for the meeting, if you have not done so yet. We look forward to seeing you in Washington!

Fact of the Week

Findings from a new study suggest a co-response team could lead to a lower chance of an individual entering into the criminal justice system during a crisis call with police, which has major implications for reducing the criminalization of mental illness if alternatives to police response for people with serious mental illness continues to spread throughout the United States. For questions or comments about this CEO Update, please contact Jessica Zigmond.

SAMHSA’s Distress Helpline Available for Victims of Hurricane Ida

The Substance Abuse and Mental Health Services Administration’s (SAMHSA) Disaster Distress Helpline (DDH) is providing immediate crisis counseling to people who have experienced Hurricane Ida, including survivors, first responders, witnesses, or those who have seen related media reports. In a statement, Assistant Secretary for Mental Health and Substance Use Miriam Delphin-Rittmon, Ph.D. urged people to access the helpline, adding that people who have lived through a traumatic event can experience anxiety, worry, or insomnia. Disaster survivors and responders can call the DDH at 1-800-985-5990 24 hours a day, seven days a week, 365 days a year. Click here for more information. NABH appreciates and thanks its members who have continued to provide quality behavioral healthcare services in regions of the United States that Hurricane Ida has affected.

MACPAC Publishes Briefs on Healthcare Needs in Criminal and Juvenile Justice Systems

The Medicaid and CHIP Payment and Access Commission (MACPAC) has released a series of fact sheets on topics related to behavioral healthcare, including two focused on the healthcare needs of adults in the criminal justice system and adolescents in the juvenile healthcare system. In its brief Health Care Needs of Adults in the Criminal Justice System, MACPAC reported that, “with few exceptions, Medicaid beneficiaries under community supervision reported higher rates of behavioral health conditions than their privately insured or uninsured peers. They also reported receiving mental health or substance use disorder (SUD) treatment at higher rates. However, Black beneficiaries with behavioral health conditions reported receipt of treatment at lower rates than their white peers.” Meanwhile, nearly one third (31.0%) of those with mental illness reported that they needed mental health treatment or counseling but did not receive it. These rates did not differ by coverage type. Female beneficiaries with a mental health condition who were under community supervision reported higher rates (41.0%) of unmet need than their male counterparts (21.3%). In addition, beneficiaries under community supervision with SUD were more likely to engage in treatment compared with those with private insurance, or adults who are uninsured (see Table 9 in the brief). Specifically, they were nearly twice as likely as privately insured or uninsured peers to report receiving such treatment in the past year. In its brief Health Care Needs and Use of Services by Adolescents Involved with the Juvenile Justice System, MACPAC concluded the following findings:

• Roughly 21.7% of youth who stayed in jail or juvenile detention reported experiencing a major depressive episode (MDE) at some point in their lifetime, and approximately 16.4% reported experiencing one in the past year.

• Among Medicaid beneficiaries who stayed in jail or juvenile detention, females were nearly three times as likely to experience a MDE in the past year compared with their male peers. They also reported receipt of specialty mental health treatment at higher rates.

• Few Medicaid beneficiaries report receipt of mental health treatment while in jail or juvenile detention.

•  Roughly one in five beneficiaries who stayed in jail or juvenile detention had a substance use disorder in the past 12 months. However, only 16.9% received treatment in the past year.

MACPAC also released Medicaid Coverage of Qualified Residential Treatment Programs for Children in Foster Care, which offered a brief summary of the Centers for Medicare & Medicaid Services’ September 2019 guidance on the Institutions for Mental Diseases (IMD) exclusion and Qualified Residential Treatment Program (QRTPs), as well as information about how states are implementing changes to the Family First Prevention Services Act.

CAHPS Program Releases Questions to Ask Patients About Accessing Mental Healthcare Services

The Agency for Healthcare Research and Quality (AHRQ)’s Consumer Assessment of Healthcare Providers and Systems (CAHPS^®) program has released new questions to gather information about patients’ experiences with access to mental healthcare services, including therapy and medication. An announcement noted that the six questions can be added to either the CAPHS Health Plan Survey or the CAHPS Clinician & Group Survey. Click here to review the mental healthcare questions for the Health Plan Survey 5.0 and 5.1, and here to review the mental healthcare questions for the Clinician & Group Survey 3.0 and 3.1. The agency noted that the new questions complement the CAHPS research team’s ongoing work to develop and test a standalone survey designed to assess patient experience with care for mental or behavioral health issues. Click here to learn more about CAHPS mental health surveys.

HRSA Reorganizes to Meet Priorities in Changing Healthcare Landscape

After a decade of growth, the Health Resources and Services Administration (HRSA) announced it has reorganized the agency to better meet its priorities. As part of that restructuring, HRSA has established a Provider Relief Bureau (PRB) to manage and distribute financial support for the nation’s healthcare providers as they continue to respond to the Covid-19 pandemic. HRSA also created an Office for the Advancement of Telehealth (OAT) within the Office of the Administrator to serve as HHS’ focal point for fostering telehealth use more broadly, and an Office of Special Health Initiatives (OSHI) to oversee the 340B Drug Pricing Program. Click here to see HRSA’s new organization chart and here for more details in the Federal Register.

U.S. Researchers Find Increased Likelihood of Arrhythmia Hospitalization in Youth With CUD

A new study from the American Academy of Addiction Psychiatry shows Cannabis Use Disorder (CUD) was associated with a 47% to 52% increased likelihood of arrhythmia hospitalizations in the younger population. The large, national study compared 570,000 patients between the ages of 15 and 54 who were admitted to the hospital between 2010-2014 for a primary diagnosis of arrhythmia, or an irregular heart rate, with 67,662,082 non-arrhythmia inpatients. According to the findings, atrial fibrillation was the most prevalent arrhythmia raising concerns for stroke and other embolic events. “The fact that atrial fibrillation is the most prevalent arrhythmia is of special concern since it can result in stroke and other embolic events,” researchers noted in the study. “Physicians need to familiarize themselves with cannabis abuse or dependence as a risk factor for arrhythmia.”

Reminder: NABH Denial-of-Care Portal is Open to Members

NABH’s Denial-of-Care Portal is a new resource for members to provide information about their experiences with managed care organizations that impose barriers to care through insurance-claim denials. NABH’s Managed Care Committee worked for more than a year to develop the Denial-of-Care Portal as a way to collect specific data on insurers who deny care—often without regard for parity or the effects on patients. This NABH member-only, survey-like tool allows users to add the name of a managed care organization, type of plan, level of care, type of care (mental health or substance use disorder), duration of approved treatment, duration of unapproved treatment, criteria used to deny a claim, and more. The portal allows members to submit individual examples of claim denials or upload multiple entries via Excel. It also includes sections on appeals and physician participation. In time, the tool could be a valuable resource for the NABH team’s advocacy efforts. Please e-mail Emily Wilkins, NABH’s administrative coordinator, if you have questions about the portal.

2021 NABH Annual Meeting Hotel Cut-Off Date is Now Sept. 17!

Please be sure to reserve your hotel room today at the Mandarin Oriental Washington, DC for the 2021 NABH Annual Meeting! The hotel’s cut-off date is now Friday, Sept. 17, 2021. And please visit our Annual Meeting webpage to register for the meeting, if you have not done so yet. We look forward to seeing you in Washington!

Fact of the Week 

Denver, Salt Lake City, and Minneapolis are reported to be the three best U.S. cities for mental health, while Dallas, Houston, and Jacksonville are the three worst, according to a new survey from telehealth company CertaPet. Researchers examined the following seven factors to determine the rankings: therapy session rate by state, total prescription charges by state, mandatory treatment laws grade by state, criminalization of mental illness by state, number of residents per one mental health provider by county,  poor mental health days by county, and overall community wellbeing. For questions or comments about this CEO Update, please contact Jessica Zigmond.

Mental Health Companies Headspace and Ginger Plan $3 Billion Merger

Mental health companies Headspace and Ginger this week announced plans to merge, forming a new company called Headspace Health with a reported value of $3 billion. A story in the publication Stat reported that the move will place the new company in the top echelon of companies competing for significant pieces of the mental health market. In addition, the pair of companies offer complementary services. Headspace sells directly to consumers and businesses and focuses on self-directed meditation, a way for companies to offer a basic mental health resource to workers. Meanwhile, Ginger is a mental health app that offers users an opportunity to chat with a trained behavioral health coach within seconds and meet with a licensed therapist or psychiatrist via video within days. Both companies were established in 2010 and claim to cover more than 100 million people worldwide, according to Stat.

Analysis of Multi-District Litigation Settlement Agreement Highlights Implications for Nation’s Overdose Crisis 

A new report from two public health experts examines the implications from the recent settlement agreement that seven attorneys general announced with the three largest opioid distributors and  Johnson & Johnson over lawsuits filed against them for their role in the nation’s opioid crisis. A bipartisan group of seven state attorneys general announced the settlement in July, and a key question has been whether the settlement funds—and other funds from opioid litigation—will be used wisely. The report noted that more than 50 organizations endorsed five principles to outline the process that states and local jurisdictions should implement when deciding how to use the money they will receive. NABH was among those organizations. The principles include spending the money to save lives; using evidence to guide spending; investing in youth prevention; focusing on racial equity; and developing a fair and transparent process for where to spend the funds. “Many parts of the settlement agreement are generally consistent with these principles,” wrote authors Josh Rising, M.D., a pediatrician and public health physician and Sara Whaley, a research associate at Johns Hopkins University. “However, considerable discretion in state and local implementation leaves a major role for advocacy. The best use of billions of dollars to address addiction and overdose are at stake.”

Ohio State Seeks Providers for Study on Traumatic Brain Injury Screening in Behavioral Healthcare Organizations 

The Ohio State University College of Social Work is conducting a study to understand behavioral health providers’ attitudes and beliefs about screening for traumatic brain injury (TBI) in behavioral healthcare organizations. The university is currently seeking licensed behavioral health providers in the United States (i.e., psychologists, social workers, counselors, nurses, psychiatrists) to participate in this web-based study. Survey respondents will be asked to complete an online training on how to screen for TBI (approximately 30-45 minutes) and complete a 15-minute survey. Participants will receive a certificate of completion for one continuing education (CE) credit for completing the training, and also will be enrolled for the chance to win a $50 gift card. There will be 55 winners from the gift card drawing. The National Institute of Neurological Disorders and Stroke is funding the study (Grant #1F31NS124263-01), and Ph.D. candidate Kathryn A. Coxe is leading it. For additional information or questions, please contact Kathryn at: coxe.6@osu.edu. Click here to participate in the study.

Joint Commission to Start 11-part Behavioral Healthcare Accreditation Webinar Series on Aug. 28

The Joint Commission will present an 11-part Behavioral Healthcare and Human Services Accreditation Webinar Series to help providers prepare their staffs to maintain compliance. Session topics include information management, medication management, infection prevention and control, patient safety, environment of care, and more. The Joint Commission will present the series—which will be made available Aug. 28—on demand so that organization teams can view the webinars when it’s convenient for them. Click here to learn more, including information about special healthcare system discounts.

Center for Rural Opioid Prevention, Treatment & Recovery to Host Webinar Aug. 31

The Center for Rural Opioid Prevention, Treatment & Recovery (CROP+TR) will host a webinar later this month to review the prevalence of methamphetamine use and co-use with opioids, the effect of methamphetamine on the health of people with opioid use disorder, and potentially effective interventions for methamphetamine. The webinar will be held on Tuesday, Aug. 31 at 4 p.m. ET. Click here to register.

Reminder: NABH Denial-of-Care Portal is Open to Members

NABH’s Denial-of-Care Portal is a new resource for members to provide information about their experiences with managed care organizations that impose barriers to care through insurance-claim denials. NABH’s Managed Care Committee worked for more than a year to develop the Denial-of-Care Portal as a way to collect specific data on insurers who deny care—often without regard for parity or the effects on patients. This NABH member-only, survey-like tool allows users to add the name of a managed care organization, type of plan, level of care, type of care (mental health or substance use disorder), duration of approved treatment, duration of unapproved treatment, criteria used to deny a claim, and more. The portal allows members to submit individual examples of claim denials or upload multiple entries via Excel. It also includes sections on appeals and physician participation. In time, the tool could be a valuable resource for the NABH team’s advocacy efforts. Please e-mail Emily Wilkins, NABH’s administrative coordinator, if you have questions about the portal.

Singer Judy Collins and Former NIMH Director Tom Insel, M.D. to Kick Off 2021 Annual Meeting

Join us at the NABH 2021 Annual Meeting on Wednesday, Oct. 6 to hear from award-winning singer, songwriter, and author Judy Collins. A strong mental health and suicide-prevention advocate, Ms. Collins wrote Sanity and Grace in 2003 about her 33-year-old son’s death by suicide in 1992. NABH is also pleased to welcome Thomas R. Insel, M.D., co-founder and president of Mindstrong Health and former director of the National Institute of Mental Health (NIMH) at the National Institutes of Mental Health. If you have not done so yet, please register for the Annual Meeting and reserve your hotel room today. Our new hotel cut-off date is Friday, Sept. 17. We look forward to seeing you in Washington!

Fact of the Week

Research shows Black youth younger than age 13 die by suicide at nearly twice the rate of white kids, and, over time, their suicide rates have grown even as rates have decreased for white children. For questions or comments about this CEO Update, please contact Jessica Zigmond.

SAMHSA Distributes $11 million to Train First Responders & Community Groups on Overdose Prevention

The Substance Abuse and Mental Health Services Administration (SAMHSA) has distributed 13 grants totaling $11 million to reduce the number of prescription drug and overdose-related deaths and adverse events by training first responders and other essential community groups. SAMHSA’s announcement said grantees will receive up to $850,000 per year over five years for a total of $55.2 million (this distribution was for the first year). “The more SAMHSA does to equip communities across the country to prevent fatal overdoses, the more opportunities our loved ones will have to pursue treatments for substance use disorders and experience long-term recovery,” HHS Assistant Secretary for Mental Health and Substance Use Miriam E. Delphin-Rittmon, Ph.D. said in an announcement. “This is a need that preceded the Covid-19 pandemic and has only grown more urgent over the course of the past 18 months,” added Rittmon, who leads SAMHSA. Click here to see a full list of the grant recipients.

Kaiser Family Foundation Examines Pandemic’s Effects on Parents and Children 

A new report from the Kaiser Family Foundation has found that 36% of parents say their child fell behind in their social and emotional development, and about 29% said their child experienced mental health or behavioral health problems due to the Covid-19 pandemic. Kaiser’s latest Covid-19 Vaccine Monitor examines the pandemic’s effects on children’s academic and social development as a new school year approaches. Among the study’s notable conclusions is a finding that parents whose children attended school all or mostly online, or who had a mix of online and in-person schooling, were more likely than parents whose child attended school all or mostly in-person to say they had a child who had these adverse effects, even after controlling for other demographic factors and type of school setting. The study also showed that 42% of parents reported that their children experienced at least one new mental health symptom in the past 12 months that they had not experienced before the pandemic, including difficulty concentrating on schoolwork (27%), problems with nervousness or being easily scared or worried (19%), trouble sleeping (18%), poor appetite or overeating (15%), and frequent headaches or stomachaches (11%).

SAMHSA Releases Guide About Report to Congress on Preventing and Reducing Underage Drinking

SAMHSA has released a user’s guide about the agency’s report to Congress on how to prevent and reduce underage drinking. The brief resource provides an overview of the report for prevention professionals, state and local agencies, and community-based organizations.

Ohio State Seeks Providers for Study on Traumatic Brain Injury Screening in Behavioral Healthcare Organizations 

The Ohio State University College of Social Work is conducting a study to understand behavioral health providers’ attitudes and beliefs about screening for traumatic brain injury (TBI) in behavioral healthcare organizations. The university is currently seeking licensed behavioral health providers in the United States (i.e., psychologists, social workers, counselors, nurses, psychiatrists) to participate in this web-based study. Survey respondents will be asked to complete an online training on how to screen for TBI (approximately 30-45 minutes) and complete a 15-minute survey. Participants will receive a certificate of completion for one continuing education (CE) credit for completing the training, and also will be enrolled for the chance to win a $50 gift card. There will be 55 winners from the gift card drawing. The National Institute of Neurological Disorders and Stroke is funding the study (Grant #1F31NS124263-01), and Ph.D. candidate Kathryn A. Coxe is leading it. For additional information or questions, please contact Kathryn at: coxe.6@osu.edu. Click here to participate in the study.

Joint Commission to Start 11-part Behavioral Healthcare Accreditation Webinar Series on Aug. 28

The Joint Commission will present an 11-part Behavioral Healthcare and Human Services Accreditation Webinar Series to help providers prepare their staffs to maintain compliance. Session topics include information management, medication management, infection prevention and control, patient safety, environment of care, and more. The Joint Commission will present the series—which will be made available Aug. 28—on demand so that organization teams can view the webinars when it’s convenient for them. Click here to learn more, including information about special healthcare system discounts.

Center for Rural Opioid Prevention, Treatment & Recovery to Host Webinar Aug. 31

The Center for Rural Opioid Prevention, Treatment & Recovery (CROP+TR) will host a webinar later this month to review the prevalence of methamphetamine use and co-use with opioids, the effect of methamphetamine on the health of people with opioid use disorder, and potentially effective interventions for methamphetamine. The webinar will be held on Tuesday, Aug. 31 at 4 p.m. ET. Click here to register.

Reminder: NABH Denial-of-Care Portal is Open to Members

NABH’s Denial-of-Care Portal is a new resource for members to provide information about their experiences with managed care organizations that impose barriers to care through insurance-claim denials. NABH’s Managed Care Committee worked for more than a year to develop the Denial-of-Care Portal as a way to collect specific data on insurers who deny care—often without regard for parity or the effects on patients. This NABH member-only, survey-like tool allows users to add the name of a managed care organization, type of plan, level of care, type of care (mental health or substance use disorder), duration of approved treatment, duration of unapproved treatment, criteria used to deny a claim, and more. The portal allows members to submit individual examples of claim denials or upload multiple entries via Excel. It also includes sections on appeals and physician participation. In time, the tool could be a valuable resource for the NABH team’s advocacy efforts. Please e-mail Emily Wilkins, NABH’s administrative coordinator, if you have questions about the portal.

Register Today for the NABH 2021 Annual Meeting!

Registration is open for the NABH 2021 Annual Meeting from Wednesday, Oct. 6 – Friday, Oct. 8, 2021 at the Mandarin Oriental Washington, DC. We hope you join us as we recognize our meeting theme, Expanding Access: Right Care. Right Setting. Right Time. Please visit our Annual Meeting webpage to register for the meeting and to reserve your hotel room. We look forward to seeing you in Washington!

Fact of the Week

Individuals who experience early episode psychosis (EEP) were more likely to visit the emergency department for mental health related issues and to have an inpatient psychiatric hospital stay than those with late episode psychosis (LEP), according to research published in Psychiatric Services this month. For questions or comments about this CEO Update, please contact Jessica Zigmond.

Miriam Delphin-Rittmon Sworn in As Assistant Secretary for Mental Health and Substance Use

The Substance Abuse and Mental Health Services Administration (SAMHSA) announced that Miriam Delphin-Rittmon, Ph.D., former commissioner of the Connecticut Department of Mental Health and Addiction Services, is the new assistant secretary for mental health and substance use and agency’s administrator. In May 2014, Delphin-Rittmon completed a two-year White House appointment working as a senior adviser to the then-assistant secretary for mental health and substance use and SAMHSA administrator. “Miriam’s experience in creating and administering mental health, substance use, and prevention services and systems will serve the nation well as we work to tackle the impact of the pandemic on behavioral health,” HHS Secretary Xavier Becerra said in a statement. “On top of that, her strong leadership at federal, state and local levels offers her considerable perspective,” he added. Delphin-Rittmon earned her bachelor’s degree in social science from Hofstra University in 1989, and her master and doctoral degrees in clinical psychology from Purdue in 1992 and 2001, respectively. Click here to read her full biography.

Experts Provide Advice and Templates on Writing a Medical Necessity Letter

Authors with medical, legal, public policy, and personal experience have published advice in the Journal of Psychiatric Practice on how to provide a routine, medical necessity letter as a way to improve access to care. Mark DeBofsky, M.D., Joseph Feldman, M.B.A., NABH member Eric Plakun, M.D., and Cheryl Potts, M.B.A. authored the eight-page article, which also includes a template letter for providers.

JAMA Psychiatry Publishes Study on Contingency Management for Patients Receiving Medication for OUD

JAMA Psychiatry this week published a study of the results from an investigation of contingency management for patients who receive medication for opioid use disorder (MOUD). The purpose of the study was to examine the association of contingency management, a behavioral intervention in which patients receive material incentives contingent on objectively verified behavior change, with end-of-treatment outcomes related to stimulant use, polysubstance use, illicit opioid use, cigarette smoking, therapy attendance, and medication adherence The study’s authors noted that the results provide evidence that supports using contingency management in addressing key clinical problems among patients receiving MOUD, including the ongoing problems of comorbid psychomotor stimulant misuse. The study importantly notes that a) CM is most effective with higher earnings potential, confirming that the level of financial incentives are critical to the success of the intervention; b) cases of Medicaid fraud have never been found involving CM; and c) targeting too many drugs simultaneously decreases the effect size, although the effect remains statistically significant. “Policies facilitating integration of contingency management into community MOUD services are sorely needed,” the authors wrote.

CMS to Host Webinar on Price Transparency on Wednesday, Aug. 11 

CMS will host a Medicare National Stakeholder Webinar on Price Transparency next week to discuss how hospitals can meet the requirements of the Hospital Price Transparency Final Rule that became effective on Jan. 1, 2021. As a result of the rule, U.S. hospitals are required to 1) provide publicly accessible standard charge information online about the items and services with a comprehensive machine-readable file with all items and services, and 2) a display of 300 shoppable services in a consumer-friendly format. The agency will review the document “8 Steps to a Machine-Readable File of All Items & Services” and highlight both good and bad examples of hospital compliance. CMS will host the webinar on Wednesday, Aug. 11 from 2 p.m. to 3:30 p.m. ET. Click here to register.

SAMHSA to Host Virtual Roundtable about Creating a Diverse Behavioral Health Workforce on Aug. 18 

SAMHSA’s National Network to Eliminate Disparities in Behavioral Health will host a virtual roundtable later this month to discuss strategies that motivate racially and ethnically diverse individuals to consider behavioral healthcare as a career path. The event will address how community-based organizations are working to diversify the behavioral health workforce, such as recruiting and retaining a racially and ethnically diverse staff. SAMHSA will host the virtual roundtable on Wednesday, Aug. 18 at 1 p.m. ET. Click here to learn more and register.

Joint Commission to Start 11-part Behavioral Healthcare Accreditation Webinar Series on Aug. 28 

The Joint Commission will present an 11-part Behavioral Healthcare and Human Services Accreditation Webinar Series to help providers prepare their staffs to maintain compliance. Session topics include information management, medication management, infection prevention and control, patient safety, environment of care, and more. The Joint Commission will present the series—which will be made available Aug. 28—on demand so that organization teams can view the webinars when it’s convenient for them. Click here to learn more, including information about special healthcare system discounts.

Reminder: NABH Denial-of-Care Portal is Open to Members

NABH’s Denial-of-Care Portal is a new resource for members to provide information about their experiences with managed care organizations that impose barriers to care through insurance-claim denials. NABH’s Managed Care Committee worked for more than a year to develop the Denial-of-Care Portal as a way to collect specific data on insurers who deny care—often without regard for parity or the effects on patients. This NABH member-only, survey-like tool allows users to add the name of a managed care organization, type of plan, level of care, type of care (mental health or substance use disorder), duration of approved treatment, duration of unapproved treatment, criteria used to deny a claim, and more. The portal allows members to submit individual examples of claim denials or upload multiple entries via Excel. It also includes sections on appeals and physician participation. In time, the tool could be a valuable resource for the NABH team’s advocacy efforts. Please e-mail Emily Wilkins, NABH’s administrative coordinator, if you have questions about the portal.

Register Today for the NABH 2021 Annual Meeting!

Registration is open for the NABH 2021 Annual Meeting from Wednesday, Oct. 6 – Friday, Oct. 8, 2021 at the Mandarin Oriental Washington, DC. We hope you join us as we recognize our meeting theme, Expanding Access: Right Care. Right Setting. Right Time. Please visit our Annual Meeting webpage to register for the meeting and to reserve your hotel room. We look forward to seeing you in Washington!

Fact of the Week

In 2019, 22.1% of U.S. adults with chronic pain used a prescription opioid in the past three months, according to a new report from the Centers for Disease Control and Prevention.   For questions or comments about this CEO Update, please contact Jessica Zigmond.

CMS to Raise IPF PPS Payment Rates by 2% in 2022

The Centers for Medicare & Medicaid Services (CMS) said it will update payment rates for IPFs by 2.0% next year in the fiscal year (FY) 2022 Inpatient Psychiatric Facility Prospective Payment System (IPF PPS) final rule the agency released Thursday. The calculation is based on the final IPF market basket estimate of 2.7% less a 0.7 percentage point productivity adjustment. CMS said it will also update the outlier threshold to maintain outlier payments at 2% of total payments, which will result in a 0.1% overall increase to aggregate payments. CMS said it estimates total payments to IPFs to increase by 2.1%, or about $80 million, in 2022 compared with payments in 2021. The final rule also made updates to the Inpatient Psychiatric Facility Quality Reporting Program (IPF QRP), including a final proposal to adopt the Covid-19 Vaccination Coverage Among Healthcare Personnel (HCP) measure to the IPF QRP for the FY 2023 payment determination. The Centers for Disease Control and Prevention (CDC) developed the process measure to track Covid-19 vaccination coverage among HCP in IPFs. The measure will be reported using the Covid-19 Modules on the CDC’s National Healthcare Safety Network web portal. In addition, the final rule said that for the FY 2024 payment determination, CMS is finalizing its proposal to adopt the Follow-up After Psychiatric Hospitalization (FAPH) measure to the IPF QRP. This measure uses an expanded cohort based on the Follow-up After Hospitalization for Mental Illness (FUH) measure—which is currently in the IPF QRP—to include patients with substance use disorders. The final rule also said CMS is not finalizing removal of the Alcohol Use Brief Intervention Provided or Offered and Alcohol Use Brief Intervention (SUB-2/2a) measure or the Tobacco Use Treatment Provided or Offered and Tobacco Use Treatment (TOB-2/2a) measure. This was a response to public comments that indicated these measures still provide benefits that outweigh the costs of retaining them in the IPF QRP measure set. More information is available in the agency’s fact sheet, and the final rule will be published in the Federal Register on Wednesday, Aug. 4.

NABH and Other Advocacy Groups Urge Congress to Invest in Children’s Mental Health

NABH and more than two dozen other advocacy organizations sent a letter to Senate leaders this week urging federal lawmakers to invest more funding in children’s mental health. The letter recommended that Congress strengthen Medicaid; extend and preserve telehealth flexibilities; strengthen systems of care through better coordination and integration; invest in infrastructure to promote care in the appropriate setting; and support growing the pediatric mental health workforce. The Children’s Hospital Association spearheaded the letter, and other organizations that signed on include the American Academy of Family Medicine, the American Academy of Pediatrics, the American Hospital Association, the American Association of Medical Colleges, Mental Health America, and the National Alliance on Mental Illness.

CMS to Host Webinar on Price Transparency on Wednesday, Aug. 11

CMS will host a Medicare National Stakeholder Webinar on Price Transparency to discuss how hospitals can meet the requirements of the Hospital Price Transparency Final Rule that became effective on Jan. 1, 2021. As a result of the rule, U.S. hospitals are required to 1) provide publicly accessible standard charge information online about the items and services with a comprehensive machine-readable file with all items and services, and 2) a display of 300 shoppable services in a consumer-friendly format. The agency will review the document “8 Steps to a Machine-Readable File of All Items & Services” and highlight both good and bad examples of hospital compliance. CMS will host the webinar on Wednesday, Aug. 11 from 2 p.m. to 3:30 p.m. ET. Click here to register.

SAMHSA Resource Summarizes How States Regulate Underage Drinking 

The Substance Abuse and Mental Health Resources Administration (SAMHSA) has released Learn the Law: How Does Your State Prevent Underage Drinking?, a new publication that includes 24 legal policy summaries to help people track how states regulate underage drinking as a way to help inform prevention work.

Reminder: NABH Denial-of-Care Portal is Open to Members

NABH’s Denial-of-Care Portal is a new resource for members to provide information about their experiences with managed care organizations that impose barriers to care through insurance-claim denials. NABH’s Managed Care Committee worked for more than a year to develop the Denial-of-Care Portal as a way to collect specific data on insurers who deny care—often without regard for parity or the effects on patients. This NABH member-only, survey-like tool allows users to add the name of a managed care organization, type of plan, level of care, type of care (mental health or substance use disorder), duration of approved treatment, duration of unapproved treatment, criteria used to deny a claim, and more. The portal allows members to submit individual examples of claim denials or upload multiple entries via Excel. It also includes sections on appeals and physician participation. In time, the tool could be a valuable resource for the NABH team’s advocacy efforts. Please e-mail Emily Wilkins, NABH’s administrative coordinator, if you have questions about the portal.

Register Today for the NABH 2021 Annual Meeting!

Registration is open for the NABH 2021 Annual Meeting from Wednesday, Oct. 6 – Friday, Oct. 8, 2021 at the Mandarin Oriental Washington, DC. We hope you join us as we recognize our meeting theme, Expanding Access: Right Care. Right Setting. Right Time. Please visit our Annual Meeting webpage to register for the meeting and to reserve your hotel room. We look forward to seeing you in Washington!

Fact of the Week

Regardless of the primary medical risk factors for severe Covid-19, patients with mental illness were more likely to die of Covid-19 than their peers, according to new research consisting of 16 observational studies from seven countries that involved more than 19,000 patients.   For questions or comments about this CEO Update, please contact Jessica Zigmond.

CMS Accepting Grant Applications for SUPPORT Act Demonstration Project

The Centers for Medicare & Medicaid Services (CMS) on Friday released a notice of funding opportunity to solicit applications for the Substance Use Disorder Prevention that Promotes Opioid Recovery and Treatment Act (SUPPORT) 36-month demonstration project. Open only to the 15 states receiving planning grants, the demonstration project is intended to increase treatment capacity of Medicaid-participating providers to provide substance use disorder (SUD) treatment and recovery services. CMS also released a technical supplement that provides information about how the agency will implement the SUPPORT Act payment provision for those states selected for the demonstration. The agency will host an informational webinar for applicants on Thursday, July 29 (and will provide information on that later) and is expected to issue awards on Sept. 10. The period of performance is between September 2021 and September 2024.

Survey Shows 84% of Americans Want to Continue Receiving Mental Health Treatment via Telehealth After Pandemic

A recent online survey of more than 1,000 Americans shows that 74% of respondents said their provider made virtual mental health services available during the Covid-19 pandemic, while 84% said they want to continue receiving mental health treatment via telehealth services after the pandemic ends. Market research company Propeller Insights conducted the survey on behalf of DrFirst, which published a survey last October that found 44% of Americans used telehealth services during the pandemic, although some admitted they multitasked and did not pay close attention during their appointments. In the May 2021 survey, 68% of respondents said the pandemic had worsened their mental health, while 17% said they sought mental health assistance for the first time.

NABH Sends Comments to ONDCP on National Drug Control Strategy

NABH this week provided a series of recommendations to the Office of National Drug Control Policy (ONDCP) on the office’s biennial National Drug Control Strategy. In a letter to Regina LaBelle, ONDCP’s acting director, NABH offered detail suggestions related to telehealth and the Covid-19 pandemic, Medicare and Medicaid, contingency management, workforce management, and medication assisted treatment (MAT). “The Centers for Medicare & Medicaid Services (CMS) should review Medicare, Medicare Advantage, and Qualified Health Plan reimbursement levels and strategies for substance use treatment services (for telehealth and non-telehealth services alike) to bring reimbursement for addiction providers to levels that are more consistent with their education, credentialing, and medical peers,” NABH President and CEO Shawn Coughlin wrote, adding later that Medicare should cover all intermediate levels of care for addiction treatment (e.g., freestanding intensive outpatient, partial hospitalization, residential) for substance use disorders and reimburse facility fees; collaborate with stakeholders to establish new conditions of participation. Other suggestions include recommending that all workforce data collection and reporting efforts at the U.S. Labor Department separate substance use from mental health providers and services, and that the U.S. Justice Department assure individuals with a substance use disorder have access to all forms of MAT while in jail and prison.

NABH Asks OSHA to Delay ETS Compliance Deadline

NABH on July 1 sent a letter to the U.S. Labor Department’s Occupational Safety and Health Administration (OSHA) requesting that the agency delay the compliance deadline for its workplace safety rule. Last month OSHA released the rule, known as the Covid-19 Health Care Emergency Temporary Standard (ETS), to protect workers from exposure to the virus that causes Covid-19. Essential requirements of the ETS include, but are not limited to: developing and implementing a plan for each workplace; designating workplace safety coordinator(s), knowledgeable in infection control principles and practices, with the authority to implement, monitor, and ensure compliance with the plan; conducting a workplace-specific hazard assessment; and seeking the involvement of nonmanagerial employees and their representatives in the hazard assessment and plan’s development and implementation. “The new Covid-19 ETS final rule is long and complex,” NABH President and CEO Shawn Coughlin wrote in the association’s letter to James Frederick, acting assistant secretary of labor at OSHA. “It establishes many very specific requirements related to patient screenings, personal protective equipment, physical barriers, cleaning and disinfection, ventilation, vaccination, training, recordkeeping, reporting, etc. These provisions will likely require significant changes in the policies and procedures healthcare providers have already implemented to prevent Covid-19 infection.” The letter also said it’s important to consider the effects of the new requirements in the context of the challenges behavioral healthcare providers are currently facing. “Mental health and addiction treatment providers continue to experience increased need for their services as indicated by the dramatic increase in drug overdose deaths over the past year and continued elevated levels of anxiety and depression and suicidal ideation,” the letter said, adding that emergency department visits for mental health reasons were up 31% among children and adolescents earlier this year, and suspected suicide attempts were up 51% among teenage girls. NABH requested that OSHA delay the compliance deadline for the ETS—which became effective immediately when it was published in the Federal Register on June 17— for at least an additional six months.

SAMHSA to Host Third Webinar on Future of Telehealth Services in Drug Courts on July 21

The Substance Abuse and Mental Health Services Administration (SAMHSA) will host the final installment of its virtual learning community series on the future of telehealth services in drug courts on Wednesday, July 21. This last part of this three-part series will provide guidance on what to consider when delivering treatment court services in virtual formats, including both court proceedings and treatment services. The webinar will also feature a brief review of essential services elements, policies, and procedures necessary to support effective delivery, as well as strategies for ongoing quality assurance and ideas on how to track appropriate outcomes. The webinar will be held on Wednesday, July 21 at 1 p.m. ET, and a discussion segment will follow at 2 p.m. ET. Click here to register.

Reminder: NABH Denial-of-Care Portal is Open to Members

NABH’s Denial-of-Care Portal is a new resource for members to provide information about their experiences with managed care organizations that impose barriers to care through insurance-claim denials. NABH’s Managed Care Committee worked for more than a year to develop the Denial-of-Care Portal as a way to collect specific data on insurers who deny care—often without regard for parity or the effects on patients. This NABH member-only, survey-like tool allows users to add the name of a managed care organization, type of plan, level of care, type of care (mental health or substance use disorder), duration of approved treatment, duration of unapproved treatment, criteria used to deny a claim, and more. The portal allows members to submit individual examples of claim denials or upload multiple entries via Excel. It also includes sections on appeals and physician participation. In time, the tool could be a valuable resource for the NABH team’s advocacy efforts. Please e-mail Emily Wilkins, NABH’s administrative coordinator, if you have questions about the portal.

Register Today for the NABH 2021 Annual Meeting!

Registration is open for the NABH 2021 Annual Meeting from Wednesday, Oct. 6 – Friday, Oct. 8, 2021 at the Mandarin Oriental Washington, DC. We hope you join us as we recognize our meeting theme, Expanding Access: Right Care. Right Setting. Right Time. Please visit our Annual Meeting webpage to register for the meeting and to reserve your hotel room. We look forward to seeing you in Washington!

Fact of the Week

A new study in JAMA Psychiatry found that of the 14.1 million adults reported having alcohol use disorder (AUD), only 7.3% reported receiving any AUD treatment, and an even smaller percentage—1.6%–reported using medications for AUD.

NABH Introduces Denial-of-Care Portal for Members

NABH this week introduced the NABH Denial-of-Care Portal, a resource for members to provide information about their experiences with managed care organizations that impose barriers to care through insurance-claim denials. NABH’s Managed Care Committee has worked for more than a year to develop the Denial-of-Care Portal as a way to collect specific data on insurers who deny care—often without regard for parity or the effects on patients. This NABH member-only, survey-like tool allows users to add the name of a managed care organization, type of plan, level of care, type of care (mental health or substance use disorder), duration of approved treatment, duration of unapproved treatment, criteria used to deny a claim, and more. The portal allows members to submit individual examples of claim denials or upload multiple entries via Excel. It also includes sections on appeals and physician participation. In time, the tool could be a valuable resource for the NABH team’s advocacy efforts. “One of the best ways we can advocate for parity enforcement with policymakers and regulators is to provide hard data from our members that show how insurers are not complying with the landmark 2008 parity law,” said NABH President and CEO Shawn Coughlin. “We hope to gather this critical data through our new Denial-of-Care Portal.” Please e-mail Emily Wilkins, NABH’s administrative coordinator, if you have questions about the portal.

LifePoint Health to Acquire Kindred Healthcare

Brentwood, Tenn.-based LifePoint Health and Louisville, Ky.-based Kindred Healthcare announced they have entered into an agreement for LifePoint to acquire Kindred in a deal expected to close in the fourth quarter of 2021. The deal will provide LifePoint with opportunities to “develop and expand critical behavioral health services across the country,” the companies said in a joint news release. LifePoint owns and operates community hospitals, regional health systems, physician practices, outpatient centers, and post-acute facilities nationwide, while Kindred is a specialty hospital company that delivers acute health services in long-term, acute-care hospitals, inpatient rehabilitation hospitals, acute rehabilitation units, and its behavioral health line business, all of which specialize in treating the most medically complex patients. Kindred Behavioral Health is an NABH member.

SAMHSA Distributes $3.3 Million in Garrett Lee Smith Campus Suicide Prevention Grants

The Substance Abuse and Mental Health Services Administration (SAMHSA) has released $3.3 million in grant awards to 33 colleges through the agency’s Garrett Lee Smith Campus Suicide Prevention grant program. The program is named after former Sen. Gordon Smith’s (R-Ore.) son Garrett Lee Smith, who died by suicide at age 21 in 2003. In 2004, President George W. Bush signed the Garrett Lee Smith Memorial Act, which authorized $82 million for suicide-prevention and awareness programs at the nation’s colleges. The Biden administration is strengthening the program through American Rescue Plan of 2021 funding, which enables SAMHSA to expand the program’s reach by eight colleges. “This grant program provides crucial support to college and university communities at a critical time,” Acting Assistant Secretary for Mental Health and Substance Use Tom Coderre said in an announcement. “Pre-pandemic, college had already been a time and environment where young adults often experienced the onset or worsening of mental health problems,” he added. “The Covid-19 pandemic has exacerbated mental health crises for adolescents and young adults. We want this grant program to provide needed supports to as many students as possible, and we are grateful for the infusion of American Rescue Plan funding to strengthen that support.”

DEA to Publish Mobile Methadone Rule on June 28

The Drug Enforcement Administration (DEA) announced it will publish the final “mobile methadone” rule on Monday, June 28. The final rule will allow narcotic treatment programs (NTPs) to operate mobile components as a coincident activity permitted under the NTP’s registration. Based on these revisions, NTP registrants who operate mobile component to dispense narcotic drugs in schedules II-V at remote location(s) for maintenance or detoxification treatment do not need a separate registration for such mobile components. This final rule waives the requirement of a separate registration at each principal place of business or professional practice where controlled substances are dispensed. Operation is permitted only in the state where the registrant is registered.

LaBelle Says Biden Administration Supports Legislation to Eliminate Federal Crack and Powder Cocaine Sentencing Disparity

Regina LaBelle, the acting director of the White House Office of National Drug Control Policy, testified in a Senate Judiciary Committee hearing this week that the Biden administration supports legislation that would eliminate the disparity in sentencing between crack and powder cocaine, which she said disproportionately affects people of color. Sens. Dick Durbin (D-Ill.) and Cory Booker (D-N.J.), both members of the Senate Judiciary Committee, introduced the Eliminating a Quantifiably Unjust Application of the Law Act (EQUAL) in late January. The bill aims to eliminate the crack and powder cocaine sentencing disparity and ensure that those who were convicted or sentenced for a federal offense involving cocaine can receive a re-sentencing under the new law. NBC News reported that LaBelle told the Senate panel that “The current disparity is not based on evidence; it has caused significant harm for decades, particularly for individuals, families and communities of color,” and is “a significant injustice in our legal system.”

OSHA Releases Fact Sheet and Guidance on Covid-19 Healthcare ETS

The U.S. Labor Department’s Occupational Safety and Health Administration (OSHA) this week released a fact sheet about OSHA’s Covid-19 Healthcare Emergency Temporary Standard (ETS) that was published in the Federal Register this month. OSHA also published additional guidance and implementation information about the ETS. To learn more about the ETS, please see the June 11 edition of CEO Update.

CMS Publishes Frequently Asked Questions on Interoperability and Patient Access Rule

CMS published Frequently Asked Questions (FAQs) on various topics related to the agency’s May 2020 Interoperability and Patient Access final rule. The FAQs include additional guidance about the Admission, Discharge, and Transfer Patient Event Notification Conditions of Participation that apply to America’s psychiatric hospitals.

DEA Hires McCance-Katz as Legislative Policy Analyst

Elinore McCance-Katz, M.D., Ph.D., who served as the assistant secretary for mental health and substance use in the Trump administration, is now a senior civil servant in the Drug Enforcement Agency (DEA). DEA has hired McCance-Katz as a legislative policy analyst focused on drug diversion, or the illegal use of drugs. According to reports, officials said the role is GS-15, the highest level under the federal General Schedule, and it positions McCance-Katz to help shape the Biden administration’s strategy on drug enforcement. President Biden’s nominee to run DEA, former New Jersey Attorney General Anne Milgram, is still awaiting Senate confirmation.

Registration Now Open for the NABH 2021 Annual Meeting

Registration is open for the NABH 2021 Annual Meeting from Wednesday, Oct. 6 – Friday, Oct. 8, 2021 at the Mandarin Oriental Washington, DC. We hope you join us as we recognize our meeting theme, Expanding Access: Right Care. Right Setting. Right Time. Please visit our Annual Meeting webpage to register for the meeting and to reserve your hotel room. We look forward to seeing you in Washington!

Fact of the Week

Since 9/11, four times as many U.S. service members and veterans have died by suicides than have been killed in combat, according to a new report from Brown University.

CEO Update Will Publish Next on Friday, July 9

NABH will not publish CEO Update next Friday, July 2 and will publish the next issue on Friday, July 9. The NABH team wishes you and your families a happy and safe Independence Day weekend! For questions or comments about this CEO Update, please contact Jessica Zigmond.

SAMHSA Awards Grant to Vibrant Emotional Health to Administer 988 Crisis Hotline

The Substance Abuse and Mental Health Services Administration (SAMHSA) this week announced Vibrant Emotional Health will be the administrators for the new 988 dialing code for the National Suicide Prevention Lifeline that will be available in July 2022. A pair of SAMHSA grants totaling $48 million—including $32 million in Coronavirus Response and Relief Supplemental Appropriations Act 2021 funding—will finance the effort to use technology to help Americans in mental health crisis and save lives. Vibrant has administered the lifeline since it was created in 2005. “These grants will work to expand the nation’s call centers’ capacity and technological readiness as the Lifeline’s shift to 988 becomes operational next summer,” Tom Coderre, acting assistant secretary for mental health and substance use and the interim head of SAMHSA, said in announcement. “Until that launch, we ask anyone who needs help or who has a loved one at risk of suicide to call or chat with Lifeline operators at 1-800-273-8255.”

Senate Finance Committee Examines Integrated Payment Models for Primary and Mental Healthcare

The Senate Finance Committee this week held a hearing to discuss mental healthcare in America and payment models that integrate mental health with primary care. In his prepared statement, Senate Finance Committee Chairman Ron Wyden (D-Ore.) said every American who needs mental healthcare should have it, “but the shameful reality is, the United States does not come close to meeting that bar today. Multiple federal laws say that mental healthcare is supposed to be on a level playing field with physical health care,” Wyden’s statement continued. “In practice, however, the system still reflects the dangerous, old stigma against recognizing and treating mental illness, and that’s why millions of people are falling through the cracks.” Members of the influential Senate panel heard from the executive director of the Wallowa Valley Center for Wellness Clinic in Oregon, one of the state’s dozen Certified Community Behavioral Health Clinics, which provides same-day treatment to patients through an integrated primary and mental healthcare model. A Modern Healthcare story reported that while the funding for the model—which comes from an enhanced Medicaid reimbursement rate based on expected costs of care—is not permanent, emergency department admissions for mental health in Wallowa County is down and the amount of veterans accessing behavioral healthcare is up 300% since the demonstration began.

NABH and Other Healthcare Groups Send Letter to United Healthcare About ED Policy

NABH was one of more than 30 healthcare and medical organizations this week that sent a letter to United Healthcare CEO Brian Thompson about the insurance company’s new policy to allow for the retroactive denial of coverage for emergency care in hospital emergency departments (EDs). The new policy will have serious medical consequences for patients, and the groups requested that United rescind the policy permanently. “Even before the Covid-19 pandemic, the need for access to mental healthcare and substance use services was reaching crisis levels,” the letter said. “In 2019, less than half of adults with mental health conditions received services, and nearly 90% of those with a substance use disorder did not receive treatment. EDs around the country often serve as the only safety net for a fragmented mental health infrastructure,” it continued. “For those in crisis for whom the ED is a lifeline for care, an added threat of a retroactive denial of coverage under this policy can be devastating.” Other groups that signed the letter include the American College of Emergency Physicians, the American College of Surgeons, the American Medical Association, the Emergency Nurses Association, the Federation of American Hospitals, The Kennedy Forum, and the Well Being Trust.

SAMHSA to Host Webinar on Behavioral Health Disorders and the Criminal Justice System on July 6

SAMHSA will host a webinar about strategies to create community-based crisis systems for people with behavioral health disorders who are at risk for involvement with the criminal justice system. The webinar will be held Tuesday, July 6 from 3:30 p.m. to 5:30 p.m. ET. Click here to register.

Register Today for the NABH 2021 Annual Meeting

Registration is open for the NABH 2021 Annual Meeting from Wednesday, Oct. 6 – Friday, Oct. 8, 2021 at the Mandarin Oriental Washington, DC. We hope you join us as we recognize our meeting theme, Expanding Access: Right Care. Right Setting. Right Time. Please visit our Annual Meeting webpage to register for the meeting and to reserve your hotel room. We look forward to seeing you in Washington!

Fact of the Week

In a new study of nearly 43,000 adults who responded to a national survey on drug and alcohol use in 2019, researchers found that roughly 6% had alcohol use disorder, fewer than 10% of whom reported receiving any treatment for their condition. The authors suggest the findings highlight the need for more even access to medication for alcohol use disorder. For questions or comments about this CEO Update, please contact Jessica Zigmond.

OSHA Releases Covid-19 Workplace Safety Rule for Healthcare Workers

The U.S. Labor Department’s Occupational Safety and Health Administration (OSHA) on Thursday released a workplace safety rule intended to protect workers from exposure to SARS-Cov-2, the virus that causes Covid-19. Called an Emergency Temporary Standard (ETS), the rule applies only to workers in healthcare settings, a disappointment for unions and other workplace safety advocates. Essential requirements of the ETS include, but are not limited to: developing and implementing a plan for each workplace; designating workplace safety coordinator(s), knowledgeable in infection control principles and practices, with the authority to implement, monitor, and ensure compliance with the plan; conducting a workplace-specific hazard assessment; and seeking the involvement of nonmanagerial employees and their representatives in the hazard assessment and plan’s development and implementation. The ETS also includes requirements about personal protective equipment, physical distancing, cleaning and disinfection, training, vaccination, ventilation, and more. Click here for more information in OSHA’s summary of the rule.

Senators Murphy and Cassidy Introduce The Parity Implementation Assistance Act

Senators Chris Murphy (D-Conn.) and Bill Cassidy, M.D. (R-La.) this week introduced The Parity Implementation Assistance Act to offer incentives to states to comply with mental health parity requirements. The bill would authorize $25 million in grants for states to support their oversight efforts of health insurance plans’ compliance with parity. The new legislation builds on the Murphy-Cassidy Mental Health Parity Compliance Act of 2019, which became law last year and provided federal and state health insurance regulators with additional resources to monitor and assure compliance with mental health parity laws. U.S. Reps. Tony Cárdenas (D-Calif.) and Brian Fitzpatrick (R-Pa.) are introducing a companion bill in the House. “We applaud Senators Murphy and Cassidy and Representatives Cárdenas and Fitzpatrick for their continued leadership and steadfast commitment to improving compliance with MHPAEA,” NABH President and CEO Shawn Coughlin said in the senators’ joint news release about the bill this week. “The Parity Implementation Assistance Act would provide critically needed resources to state regulators so they can improve parity enforcement using the new documentation requirements,” he added.

Americans Identify Affordability and Provider Availability as Biggest Barriers to Accessing Care

A new Bipartisan Policy Center-Morning Consult national poll found that 51% of Americans surveyed cited affordability and 41% cited availability of providers taking new patients as the two biggest barriers to accessing the care they need. Meanwhile, a majority of Americans (58%) said the cost of a provider and whether the provider is in their insurance network (58%) are their top priorities when seeking treatment. “This survey shows that we must tackle the high cost and the enormous shortage of mental health professionals in our country by advancing the integration of primary care and mental health and substance use services,” Marilyn Serafini, the Bipartisan Policy Center’s health project director, said in an announcement about the poll. “We know integrated care works. It enhances treatment, improves outcomes, and is cost effective.”

MHA Names Schroeder Stribling as New President and CEO 

Mental Health America this week named Schroeder Stribling as the community-based, not-for-profit’s new president and CEO, effective June 28. Stribling will start her new role after 18 years at N Street Village, a not-for-profit that provides housing support services for women and families in Washington, D.C.  Most recently Stribling served as N Street Village’s CEO and helped the organization expand to eight locations from one. She also helped diversify revenue streams, create partnerships with government entities, and lead city-wide initiatives on homelessness. Before her time at N Street Village, Stribling was a senior social worker at Johns Hopkins Bayview Hospital, where she was responsible for implementing new mental health programs in the inner-city Head Start school system. Stribling earned a bachelor’s degree in political science from Wellesley College, a master’s degree in social work from Smith College, and a certificate in nonprofit management from Georgetown University.

Forbes Reports Venture Funding for Mental Health Hits Record High

Venture investors poured a record $1.5 billion into mental health startups in 2020, as 42% of U.S. adults reported symptoms of anxiety or depression, compared with about 11% who reported those symptoms in 2019, according to a recent article in Forbes. The article notes there are now seven mental health unicorns in the United States, up from only two a year ago. In venture capital, a unicorn is a privately held company valued at more than $1 billion. Forbes identifies the U.S.-based mental health unicorns as Genoa ($2.5 billion), Lyra Health ($2.3 billion), Calm ($2 billion), BetterUp ($1.7 billion), Talkspace ($1.4 billion), Modern Health ($1.4 billion), and Ginger ($1.1 billion). “I hope that the interest in mental health is now persistent,” Lisa Suennen, a healthcare investor who leads the venture fund at law firm and consultancy Manatt, Phelps & Phillips, said in the article. Suennen added that both the funding surge and ballooning valuations concern her. “Some of these valuations are beyond appropriate given the underlying fundamentals,” Suennen said. “And that’s not unique to mental health, that’s digital health across the board right now.”

AMA and Advocacy Resource Center Highlight National and State Research on America’s Overdose Crisis

The American Medical Association and Advocacy Resource Center have released a nearly 30-page issue brief that aggregates data on the nation’s drug overdose crisis from national, state, and local public health agencies, law enforcement, emergency medical services, hospitals, treatment centers, journals, and the media. Every state has reported an increase in overdose deaths during the Covid-19 pandemic, according to the issue brief.

HRSA Announces New Education Loan Repayment Program 

The U.S. Health Department’s Health Resources and Services Administration (HRSA) announced a new loan repayment program that broadens the types of providers and facilities that are eligible to participate and provides a higher rate of repayment.   The STAR-LRP will provide repayment of education loans for individuals working in a full-time substance-use disorder (SUD) treatment job that involves direct patient care at a STAR LRP-approved facility located in either a Health Professional Shortage Area (HPSA) designated for Mental Health, or a county/municipality where the average drug overdose death rate exceeds the national average. Participants will receive up to $250,000 in exchange for six years of full-time SUD employment (including fellowship) that involves direct treatment or recovery support of patients with or in recovery from a substance use disorder. The program expands access to SUD treatment through the inclusion of disciplines and treatment facilities that are not eligible for existing loan repayment programs. The STAR-LRP is open to master’s level social workers, psychologists, counselors, marriage and family therapists, psychiatric mental health practitioners, occupational therapists, psychology doctoral interns, and behavioral health paraprofessionals and physicians, physician assistants, and nurses, who are involved full-time in SUD treatment employment (including fellowships). Among the eligible facilities are for-profit programs, including but not limited to inpatient psychiatric facilities, inpatient rehabilitation, non-opioid SUD Treatment facilities, opioid treatment programs, office-based opioid treatment, outpatient rehabilitation. HRSA anticipates making $28 million available to fund approximately 112 loan repayment awards in FY 2021. Applications are due by July 22, 2021, 7:30 p.m. ET.

DOJ Accepting Applications for Opioid, Stimulant, and Substance Abuse Program Training and Technical Assistance Program

The U.S. Justice Department’s Office of Justice Programs and Bureau of Justice Assistance will accept grant applications for its Comprehensive Opioid, Stimulant, and Substance Abuse Program (COSSAP) Training and Technical Assistance Program through Monday, June 21. The program’s purpose is to identify one provider to support a collaborative team and coordinate training and technical assistance for state, tribal, and local criminal justice and substance abuse treatment agencies and their partner agencies for more than 400 COSSAP site-based programs. Click here to learn more and to apply.

Registration Now Open for the NABH 2021 Annual Meeting

Registration is open for the NABH 2021 Annual Meeting from Wednesday, Oct. 6 – Friday, Oct. 8, 2021 at the Mandarin Oriental Washington, DC. We hope you join us as we recognize our meeting theme, Expanding Access: Right Care. Right Setting. Right Time. Please visit our Annual Meeting webpage to register for the meeting and to reserve your hotel room. We look forward to seeing you in Washington!

Fact of the Week

Nearly one in four older U.S. adults between the ages of 50 and 80 reported they had three or more alcoholic drinks in one sitting, according to a new poll from the University of Michigan’s National Poll on Healthy Aging.

President Biden’s $6 Trillion Budget Proposal Includes Funding Increases for SAMHSA

President Biden’s $6 trillion budget proposal for 2022 includes significant funding increases for several Substance Abuse and Mental Health Services Administration (SAMHSA) programs, including a $1.65 billion increase—including 10% set aside for recovery services—for the agency’s Substance Abuse Prevention, Treatment, and Recovery Block Grant for a total of about $3.51 billion in that program. The president’s budget—notable for mapping out the president’s priorities—also includes:

• An $825-million funding increase for SAMHSA’s Community Mental Health Services Block Grant for a total of $1.58 billion, with $75 million set aside for crisis-stabilization services,

• $750-million increase in State Opioid Response grants for a total of $2.25 billion,

• An additional $125 million for Certified Community Behavioral Health Clinics,

• A $78-million increase for the National Suicide Prevention Lifeline for a total of $102 million to prepare for the nation’s “988” behavioral health crisis hotline, and

• $4.4-million increase for opioid treatment programs for a total of $13.1 million.

The budget also includes a $27-million increase for the U.S. Labor Department’s Employee Benefits and Security Administration to enforce the Mental Health Parity and Addiction Equity Act.

CMCS Releases Bulletin on American Rescue Plan’s Medicaid, CHIP, and BHP Provisions

The Center for Medicaid and CHIP Services (CMCS) this week released a bulletin that provides information to states on the Medicaid, CHIP, and Basic Health Program (BHP) provisions in the American Rescue Plan. Part of the guidance includes section 9813, the “State Option to Provide Qualifying Community-Based Mobile Crisis Intervention Services,” which adds a new section to the Social Security Act and provides states the option to provide for certain “qualifying community-based mobile crisis intervention services” to be covered under the Medicaid state plan or a waiver of such plan during a five-year period beginning on April 1, 2022. In addition, the bulletin said states will be eligible for a federal matching rate of 85% for qualifying community-based mobile crisis intervention services during each of the first 12 fiscal quarters between April 1, 2022 through March 31, 2027, in which a state meets the requirements in the statute. This provision also provides funding for the HHS secretary to issue planning grants to states to develop state plan amendments or waiver requests to provide such qualifying community-based mobile crisis intervention services. CMCS said it plans to issue additional guidance in the coming months on certain provisions and is available to provide states with technical assistance as they begin to implement these changes.

EEOC Releases Updated Guidance Regarding Covid-19 Vaccinations, Incentives

The U.S. Equal Employment Opportunity Commission (EEOC) recently released its first updated guidance about Covid-19 vaccinations since December 2020. The new guidance addresses mandatory vaccination policies, employer-provided vaccine incentives, confidentiality, and accommodating workers who may be unwilling or unable to obtain a vaccination. Click here to read a summary of the provisions.

National Guard Officers to Provide Temporary Staffing at Oregon State Hospital

The Oregon State Hospital will begin training 30 members of the National Guard on Monday to fill an unprecedented staffing shortage at the Salem-based psychiatric hospital, according to a news report in The Oregonian. National Guard members will spend about two weeks learning how to work directly with patients, including training on de-escalation and behavioral emergencies. The story noted that the National Guard will help serve patient meals, escort patients to and from treatment, and with other activities on the unit. The state hospital has faced a staffing shortage since last year when employees began taking Covid-19-related leave.

Kennedy Forum to Host June 7 Webinar on Future of Mental Healthcare

The Kennedy Forum will feature Mental Health America CEO Paul Gionfriddo and National Alliance on Mental Illness CEO Daniel Gillison, Jr. in a webinar about the future of mental healthcare on Monday, June 7. Other panelists will include Kennedy Forum founder and former U.S. Rep. Patrick Kennedy (D-R.I.); Peter O’Brien, chairman of The Kennedy Forum Illinois; and Cheryl Potts, executive director at The Kennedy Forum Illinois. The webinar will begin at 2 p.m. ET. Click here to register.

DOJ Accepting Applications for Opioid, Stimulant, and Substance Abuse Program Training and Technical Assistance Program

The U.S. Justice Department’s Office of Justice Programs and Bureau of Justice Assistance will accept grant applications for its Comprehensive Opioid, Stimulant, and Substance Abuse Program (COSSAP) Training and Technical Assistance Program through Monday, June 21. The program’s purpose is to identify one provider to support a collaborative team and coordinate training and technical assistance for state, tribal, and local criminal justice and substance abuse treatment agencies and their partner agencies for more than 400 COSSAP site-based programs. Click here to learn more and to apply.

Registration Now Open for the NABH 2021 Annual Meeting

Registration is open for the NABH 2021 Annual Meeting from Wednesday, Oct. 6 – Friday, Oct. 8, 2021 at the Mandarin Oriental Washington, DC. We hope you join us as we recognize our meeting theme, Expanding Access: Right Care. Right Setting. Right Time. Please visit our Annual Meeting webpage to register for the meeting and to reserve your hotel room. We look forward to seeing you in Washington!

Fact of the Week

New research from Athenahealth shows women were twice as likely as men to receive a diagnosis of anxiety from their primary care provider (6.5% versus 3.3%), and were also diagnosed with depression at twice the rate (4.2% versus 2.1%). For questions or comments about this CEO Update, please contact Jessica Zigmond.

NABH Submits Comments on IPF-PPS FY 2022 Proposed Rule NABH on Friday submitted comments to the Centers for Medicare & Medicaid Services (CMS) on the agency’s inpatient psychiatric facility (IPF) prospective payment system (PPS) proposed rule for fiscal year 2022. The eight-page letter provided an overview of how the Covid-19 pandemic has led to an increasing need for quality mental health and addiction treatment in America, and how previous pandemics have had an effect on behavioral health for years to come. NABH offered comments on labor market delineations, the wage index, and several issues related to the Inpatient Psychiatric Facility Quality Reporting Program. CMS will accept public comments until Monday, June 7. U.S. Senate Confirms Chiquita Brooks-LaSure as CMS Administrator In a 55-44 vote, the U.S. Senate this week confirmed Chiquita Brooks-LaSure to lead CMS as the agency’s administrator. Most recently Brooks-LaSure served as the managing director of the health division at Manatt, Phelps & Phillips. Previously she served as the director of coverage policy at the U.S. Health and Human Services Department (HHS) during the Obama administration, where she led implementation of the Affordable Care Act’s coverage and insurance reform policy provisions. Earlier, the Senate Finance Committee had split evenly on whether to advance Brooks-LaSure’s nomination, with all Republicans on the panel not supporting her. Senate Majority Leader Chuck Schumer (D-N.Y.) was able to bring her nomination vote to the Senate floor through a procedural vote.

HHS Commits $4.8 Billion to Reimburse Providers for Covid-19 Testing for the Uninsured

HHS this week announced it will dedicate $4.8 billion from the American Rescue Plan to support the Health Resources and Services Administration’s (HRSA) Covid-19 Uninsured Program. Specifically, the funding will allow the program to reimburse healthcare providers for testing uninsured individuals for Covid-19. “As we vaccinate the country, let’s continue taking the preventive measures necessary to keep the virus under control and prevent it from spreading,” HHS Secretary Xavier Becerra said in an announcement. “Testing remains critical and now it’s available at no cost to those who need it,” he added. “This funding will help ensure everyone has access to testing regardless of whether they have health insurance.” Click here to learn more about HRSA’s Covid-19 Uninsured Program.

NABH and Other National Organizations Urge Biden Administration to Name ONDCP Director

This week NABH coordinated an effort among several leading addiction treatment groups and other national organizations to send a letter urging President Biden to name a director to the White House Office of National Drug Control Policy (ONDCP). Regina LaBelle, on a leave of absence from her position as program director of the Addiction and Public Policy Initiative at Georgetown’s O’Neill Institute for National and Global Health Law, currently serves as the office’s acting director. NABH and the other organizations—including the American College of Emergency Physicians, the American Society of Addiction Medicine, the National Association of Addiction Treatment Providers, and the National Safety Council—expressed concern that a nominee to the post has not yet been named, especially when the Covid-19 global pandemic has accelerated the nation’s drug overdose deaths through a combination of treatment disruptions, social isolation, and other challenges. “The Biden-Harris Administration’s Statement of Drug Policy Priorities for Year One was a concise and focused document that clearly identified issues that need addressing,” the letter said. “An ONDCP director is now needed to implement, and build upon, those priorities for a nation that continues to be devastated by the preventable and treatable disease of addiction and drug overdoses.” Politico wrote a story about the letter on May 27, calling it “the first notable sign of public pressure on Biden to fill the drug czar role, which he’s long supported.”

NABH and Other Mental Health and Addiction Groups Urge Congress to Fund 988 Hotline Infrastructure

NABH was one of more than two dozen mental health and addiction organizations that sent a letter to congressional leaders, requesting that Congress provide funding to build the needed infrastructure to support the nation’s 988 crisis hotline. In its letter to the majority and minority leaders in the House and Senate, the organizations recommend that Congress, at a minimum, invest $10 billion in a 988 crisis hotline infrastructure package. “While there is a clear vision for what a successful 988 crisis response system requires, there are very few examples of systems that meet these standards,” the letter said. “Existing suicide prevention call centers rely on a patchwork of inadequate funding, leaving insufficient capacity to meet current needs, let alone the increased demand spurred by the adoption of 988,” it continued. “There is growing availability of mobile crisis teams, but demand still far outstrips supply, particularly for children and adolescents. And there is a nationwide dearth of crisis stabilization programs. Finally, there are widespread shortages of behavioral health professionals to staff crisis response systems.” The groups noted that the funding could provide for technology, training, and operations at crisis call centers; expand capital projects to include crisis receiving and stabilization and peer respite programs; broaden federal loan repayment criteria to include crisis call centers, mobile crisis teams, crisis receiving and stabilization programs; and develop behavioral health workforce training programs.

Napolitano, Kaptur, Lee Urge HHS to Expand Mental Health Workforce

NABH recently supported a letter from three House Democrats who are urging HHS to include mental health and substance use treatment providers within the $7.6 billion public health workforce expansion included in the American Rescue Plan.   In their May 21 letter to HHS, Reps. Grace Napolitano (D-Calif.), Marcy Kaptur (D-Ohio), and Barbara Lee (D-Calif.) wrote that a section of the new law can support about 100,000 new positions. The congresswomen—with support from other Democrats—recommend that one-third of those positions be devoted to behavioral health. “This number would permit each small county to add five behavioral health providers, each mid-sized county to add 10 providers, and each large county to add 20 providers,” they wrote. “County public health workers should also receive basic training for the screening of common mental health and substance use disorders, which would allow them to identify struggling Americans and refer them to services,” they added. Click here to read the full letter.

New DOE Guidance on American Rescue Plan Funding for Schools Includes Mental Health

The U.S. Education Department (ED) recently released a set of frequently asked questions (FAQ) about how funding under the Elementary and Secondary School Emergency Relief (ESSER) Fund, including the American Rescue Plan’s ESSER program, and the Governor’s Emergency Education Relief Fund, may be used to address the pandemic’s effects on students in pre-K-12 education. The FAQ mentions mental health services throughout the document and includes providing “positive behavioral interventions and supports and mental health services for children with disabilities” and “meeting rising mental health and behavioral needs (for example, contracting with community mental health providers to support students virtually and/or on-site at school).” Members of the NABH team have had recent discussions with the ED staff and discussed several items outlined in the guidance.

AHRQ Seeking Information on Evaluation of Mental Health Applications

HHS’ Agency for Health Research and Quality (AHRQ) is seeking scientific information to help inform the agency’s review on Evaluation of Mental Health Applications, which AHRQ’s Evidence-based Practice Centers Program is conducting. The federal notice said access to both published and unpublished pertinent, scientific information will improve the quality of the review. Submissions are due 30 days from the May 21 notice. Click here to learn more.

NABH President and CEO Highlights IMD Repeal in LinkedIn Pulse Article

As Mental Health Month draws to a close, NABH President and CEO Shawn Coughlin this week reflected on improving America’s approach to mental healthcare in part by repealing Medicaid’s outdated Institutions for Mental Diseases (IMD) exclusion. In a LinkedIn Pulse article, Coughlin provided an overview of the IMD exclusion and highlighted congressional leaders who are working to solve this issue: Reps. Tom Emmer (R-Minn.) and Grace Napolitano (D-Calif.). Emmer has re-introduced Expanding Access to Inpatient Mental Health Act, which would eliminate the IMD exclusion’s arbitrary cap on mental health services. Specifically, it would eliminate the 15-day cap for Managed Care Organizations (MCOs) and Prepaid Inpatient Health Plan (PIHP) beneficiaries receiving care in an IMD. Meanwhile, Napolitano’s Increasing Behavioral Health Treatment Act would repeal the IMD exclusion and  require states to submit a plan to: increase access to outpatient and community-based behavioral health care; increase availability of crisis stabilization services; and improve data sharing and coordination between physical health, mental health, and addiction treatment providers and first responders. “Efforts such as these,” Coughlin wrote, “could ensure Medicaid beneficiaries finally receive the professionally guided care they deserve, and we can ensure that clinicians, not artificial restrictions, govern mental healthcare for all Americans.”

Kennedy Forum to Host June 7 Webinar on Future of Mental Healthcare

The Kennedy Forum will feature Mental Health America CEO Paul Gionfriddo and National Alliance on Mental Illness CEO Daniel Gillison, Jr. in a webinar about the future of mental healthcare on Monday, June 7. Other panelists will include Kennedy Forum founder and former U.S. Rep. Patrick Kennedy (D-R.I.); Peter O’Brien, chairman of The Kennedy Forum Illinois; and Cheryl Potts, executive director at The Kennedy Forum Illinois. The webinar will begin at 2 p.m. ET. Click here to register.

Registration Now Open for the NABH 2021 Annual Meeting

Registration is open for the NABH 2021 Annual Meeting from Wednesday, Oct. 6 – Friday, Oct. 8, 2021 at the Mandarin Oriental Washington, DC. We hope you join us as we recognize our meeting theme, Expanding Access: Right Care. Right Setting. Right Time. Please visit our Annual Meeting webpage to register for the meeting and to reserve your hotel room. We look forward to seeing you in Washington!

Fact of the Week

A recent study of more than 2,800 U.S. coal miners showed that nearly 40% of these workers reported symptoms consistent with major depressive disorder and anxiety, while more than one in 10 reported actively thinking about suicide.   For questions or comments about this CEO Update, please contact Jessica Zigmond.

SAMHSA to Distribute $3 Billion in Block Grants; Becerra Forms Behavioral Health Council

The U.S. Health and Human Services Department (HHS) this week announced the Substance Abuse and Mental Health Services Administration (SAMHSA) will distribute $3 billion in American Rescue Plan funding, the largest aggregate funding amount to date for the agency’s mental health and substance use block grant programs. According to HHS’ announcement, the Community Mental Health Services Block Grant Program and Substance Abuse Prevention and Treatment Block Grant Program will disperse $1.5 billion each to states and territories. This funding amount follows a March announcement of supplemental funding of almost $2.5 billion for these programs. SAMHSA has expedited federal funding to grantees to help the nation’s communities manage their mental health and substance use needs during the Covid-19 pandemic. Meanwhile, HHS Secretary Xavier Becerra has formed a Behavioral Health Coordinating Council to collaborate what the department has described as “innovative, transparent, equitable, and action-oriented approaches” to addressing HHS’ behavioral health agenda. Assistant Secretary for Health Rachel Levine, M.D. and HHS’ assistant secretary for mental health and substance use will serve as co-chairs of the new coordinating council, which is composed of senior leaders across the department. Tom Coderre currently serves as the acting assistant secretary for mental health and substance use. “Behavioral health is a priority for the Department of Health and Human Services,” Becerra said in an announcement. “The Covid-19 pandemic has made clear the need to invest resources in our nation’s mental health and address the inequities that still exist around behavioral healthcare. That’s why we are making this historic investment in mental health and substance use services,” he added. “In addition, this national problem calls for department-wide coordination to address the issue. That’s why I am convening the Behavioral Health Coordinating Council to work across HHS to facilitate collaboration and strategic planning as we implement our behavioral health agenda.” Also this week, HHS announced the Health Resources and Services Administration (HRSA) will disperse $14.2 million from the American Rescue Plan to expand pediatric mental healthcare access by integrating telehealth services into pediatric primary care. The funding will go toward Pediatric Mental Health Care Access (PMHCA) projects in new states and geographic areas nationwide and will provide teleconsultations, training, technical assistance, and care coordination for pediatric primary care providers to diagnose, treat and refer children and youth with mental health conditions and substance use disorders.

CMS Data Show Vulnerable Americans Forgoing Mental Healthcare During Pandemic

The Centers for Medicare & Medicaid Services (CMS) late last week released new findings that show Medicaid and Children’s Health Insurance Program (CHIP) beneficiaries have forgone millions of primary, preventive, and mental healthcare visits from March 2020 through October 2020 compared with the same period in 2019. The agency also reported that while some treatments have rebounded to pre-pandemic levels, mental health services have been the slowest to pick up. According to the data, there has been a 34-percent decline in the number of mental health services used by children under age 19, compared with the same time period in 2019, and a 22-percent decline in the number of mental health services used by adults aged 19 to 64, compared with the same time period in 2019. This translates to about 14 million fewer mental health services for children and approximately 12 million fewer mental health services for adults, for a total of nearly 26 million fewer mental health services used across both groups. Meanwhile, although preliminary reports show increased drug-related mortality due to the pandemic, substance use disorder services utilization fell by 3.6 million services (a 13-percent decline) when compared with the same time period in 2019. “More than 100 million Americans, including 43 million children, relied on us to deliver access to mental health and other services they needed through Medicaid and CHIP in 2020,” CMS Acting Administrator Liz Richter said in an announcement, adding that the new data provide a glimpse into how the pandemic has affected America’s most vulnerable people. “While we’re encouraged that people are accessing some healthcare services at pre-pandemic levels, there is work to do to connect people to mental healthcare services and to ensure we fill the gap in other types of services that was caused by the pandemic,” Richter said.

DOJ Accepting Applications for Opioid, Stimulant, and Substance Abuse Site-based Program Grants

The U.S. Justice Department (DOJ) has announced that applications for its Comprehensive Opioid, Stimulant, and Substance Abuse Program (COSSAP) are due June 21. Developed in the Comprehensive Addiction and Recovery Act (CARA), COSSAP is intended to reduce the effect of opioids, stimulants, and other substances on individuals and communities, including a reduction in the number of overdose fatalities. The program is also meant to mitigate the effects of crime victims by supporting collaborative initiatives. Click here for more information about how to apply.

SAMHSA to Host Meth and OUD Webinar Next Week

SAMHSA will host a webinar next week to discuss recent trends in co-occurring methamphetamine use and opioid use disorder (OUD), including overdose fatalities. The webinar, Meth 2.0 and Opioid Use Disorder—A Collision of Epidemics, will also address treatment approaches. Click here to register.

CMS to Host Quality Measurement Webinars Next Month

CMS will host CMS Quality Measurement: Where It’s Headed and How We’ll Get There, a webinar that will highlight the agency’s efforts to improve quality measures and provide information on available quality-measurement resources. The webinar, which will be presented twice in June, will address CMS’ goals for advancing quality measurement in the next five to 10 years, and agency staff will provide an overview of the agency’s new Digital Quality Measurement Blueprint. Click here to register for the June 15 webinar and here to register for the webinar on June 17.

Kennedy Forum to Host Parity Webinar Featuring U.S. Labor Secy. Martin Walsh on May 27

U.S. Labor Department (DOL) Secy. Martin Walsh will serve as a panelist during the Kennedy Forum’s webinar, “Mental Health Parity: Ending Discrimination in Health Insurance Coverage,” on Thursday, May 27. The hourlong webinar will address a range of issues, including DOL’s role in enforcing the 2008 Mental Health Parity and Addiction Equity Act; common parity violations and how they inhibit access to care; new statutory requirements requiring plans to conduct detailed parity analyses; and more. Free for attendees, the webinar will also feature Kennedy Forum founder and former U.S. Rep. Patrick Kennedy (D-R.I.) and Ann Marie Sullivan, M.D., commissioner for New York’s Office of Mental Health. Click here to register.

Registration Now Open for the NABH 2021 Annual Meeting

Registration is open for the NABH 2021 Annual Meeting from Wednesday, Oct. 6 – Friday, Oct. 8, 2021 at the Mandarin Oriental Washington, DC. We hope you join us as we recognize our meeting theme, Expanding Access: Right Care. Right Setting. Right Time. Please visit our Annual Meeting webpage to register for the meeting and to reserve your hotel room. We look forward to seeing you in Washington!

Fact of the Week

The Trevor Project’s 2021 National Survey on LGBTQ Mental Health reports that 42% of LGBTQ youth seriously considered attempting suicide in the past year, including more than half of transgender and nonbinary youth. For questions or comments about this CEO Update, please contact Jessica Zigmond.

NABH and Other Healthcare Groups Urge HHS to Extend Provider Relief Fund Deadline

NABH and eight other healthcare associations this week urged the U.S. Health and Human Services Department (HHS) to extend the June 30 deadline by which providers must use their Covid-19 Provider Relief Fund (PRF) payments. Instead, the groups wrote in a letter to HHS Secretary Xavier Becerra, HHS should use the length of the public health emergency as a guideline for providers to finish using the funds. The letter also requested that HHS expedite distributing the remaining PRF resources. “Congress has allocated $178 billion to date to aid all types of health care providers through the PRF and designated in the most recent Covid-19 relief package an additional $8.5 billion through the Rural Relief Fund,” the letter noted. “However, not all of the funds have been distributed, and those that have may not yet have been fully utilized by the recipients,” it continued. “We previously noted the ongoing financial burden our members are facing; add to this the uncertainty regarding when the pandemic will ease more considerably to allow for a full return to “business as usual,” such as regular wellness visits and the resumption of scheduled surgeries,” the letter said, adding that the nation’s hospitals will continue to face challenges beyond the June 30 deadline. Separately this week, Secy. Becerra signaled his department is considering it. “Some folks have asked for an extension,” Becerra was reported as saying during a House Energy and Commerce Health Subcommittee hearing. “We’re looking at that very, very closely.”

Biden Administration Plans to Open Applications for Billions in Provider Grants 

News outlets this week reported the Biden administration plans to open applications for billions of dollars in grants for hospitals and other healthcare providers before the end of May. Hospitals have asked administration officials to release more of the funds that Congress approved in December 2020. To date, providers have been reimbursed for only a portion of their losses through June 2020 due to the Covid-19 pandemic. According to the stories—which sourced people familiar with the plans—the next tranche of money will deplete most of the money in the $178 billion fund to help providers.

CMS Issues Guidance on Requirements Added to Medicare’s Conditions of Participation 

The Centers for Medicare & Medicaid Services on May 7 released interpretive guidance on the new hospital admission, discharge, and transfer notification requirements that were added to the Medicare program’s Conditions of Participation. The new rules became effective on May 1, 2021, after having been delayed because of the pandemic.

Overdose Prevention Network to Host Youth Engagement Discussion on May 26

The Overdose Prevention Network will host a 30-minute online discussion about how youth engagement and providing stability can play a meaningful role in supporting overdose prevention and providing connections to treatment. Part of the organization’s “Meet the Partner” series, the “Saving Lives with Youth Engagement” session will feature Graciela Razo, harm reduction coordinator for Safe Horizon’s Streetwork Project in New York City. Click here to learn more and register.

Kennedy Forum to Host Parity Webinar Featuring U.S. Labor Secy. Martin Walsh on May 27

U.S. Labor Department (DOL) Secy. Martin Walsh will serve as a panelist during the Kennedy Forum’s webinar, “Mental Health Parity: Ending Discrimination in Health Insurance Coverage,” on Thursday, May 27. The hourlong webinar will address a range of issues, including DOL’s role in enforcing the 2008 Mental Health Parity and Addiction Equity Act; common parity violations and how they inhibit access to care; new statutory requirements requiring plans to conduct detailed parity analyses; and more. Free for attendees, the webinar will also feature Kennedy Forum founder and former U.S. Rep. Patrick Kennedy (D-R.I.) and Ann Marie Sullivan, M.D., commissioner for New York’s Office of Mental Health. Click here to register.

Registration Now Open for the NABH 2021 Annual Meeting!

Registration is open for the NABH 2021 Annual Meeting from Wednesday, Oct. 6 – Friday, Oct. 8, 2021 at the Mandarin Oriental Washington, DC. We hope you join us as we recognize our meeting theme, Expanding Access: Right Care. Right Setting. Right Time. Please visit our Annual Meeting webpage to register for the meeting and to reserve your hotel room. We look forward to seeing you in Washington!

Fact of the Week

A new study in JAMA found fatal drug overdoses in San Francisco increased by 50% during after the Covid-19 pandemic lockdown. For questions or comments about this CEO Update, please contact Jessica Zigmond.

May 7 is National Children’s Mental Health Awareness Day

To honor National Children’s Mental Health Awareness Day today, NABH President and CEO Shawn Coughlin published a LinkedIn Pulse article about the critical role that residential treatment plays in youth behavioral healthcare. The article highlights Residential Treatment: A Vital Component of the Behavioral Healthcare Continuum, the white paper that NABH released in April. Please click here to visit our Youth Services webpage to download the paper and access shareable social media messages, especially during Mental Health Month throughout May. Also for Mental Health Month, the National Association of Medicaid Directors (NAMD) this week released fact sheets to promote the role that Medicaid programs play in ensuring access to mental health and addiction treatment. The first fact sheet shows how Medicaid supports crisis support systems, and the second resource highlights opportunities for Medicaid programs to provide addiction treatment.

Registration Now Open for the NABH 2021 Annual Meeting!

Registration is open for the NABH 2021 Annual Meeting from Wednesday, Oct. 6 – Friday, Oct. 8, 2021 at the Mandarin Oriental Washington, DC. We hope you join us as we recognize our meeting theme, Expanding Access: Right Care. Right Setting. Right Time. Please visit our Annual Meeting webpage to register for the meeting and to reserve your hotel room. We look forward to seeing you in Washington!

NABH Submits Comments to HHS on HIPAA Privacy Rules

NABH this week sent comments to the U.S. Health and Human Services Department’s (HHS) Office of Civil Rights (OCR) about the office’s proposed rule, “Proposed Modifications to the HIPAA Privacy Rule to Support, and Remove Barriers to, Coordinated Care and Individual Engagement.” HHS released the proposed rule in January, and the Biden administration’s freeze on certain regulations issued during the prior administration did not apply to this one. The letter includes sections about overlap among Health Insurance Portability and Accountability Act (HIPAA), interoperability, and 42 CFR Part 2 regulations; modifications to the right to inspect and obtain copies of protected health information; information disclosure to third parties; care coordination and case management; standards for disclosing information when in an individual’s interest or to prevent harm; and notices of privacy practices. “As Covid-19 continues to have a significant impact on behavioral health, mental health and addiction treatment providers must remain focused on improving access to care,” NABH President and CEO Shawn Coughlin wrote in the letter. “They continue to struggle with the new demands imposed by social distancing and precautions they must take to prevent Covid-19 infection. Healthcare staff and providers were already greatly strained by the ongoing stress and demands created by this pandemic,” he continued. “Moreover, behavioral healthcare providers and HIT vendors are still working to implement the new interoperability standards as they continue to face staffing shortages,” he wrote, adding that NABH urges OCR to delay the deadline of this and any additional regulatory changes such as those in the proposed rule.

Patients with Mental Health Conditions in EDs During Pandemic More Likely to Require Admission

New research from JAMA shows that patients with mental health (MH) conditions presenting for emergency department (ED) visits since the onset of the pandemic have been more likely to require admission and have had longer admissions. “The COVID-19 pandemic continues to place novel stressors on the provision of pediatric MH care,” the article noted. “Our findings may reflect challenges in disposition to definitive MH care and may suggest a scarcity of MH treatment resources.” The researchers went on to write that their limitations in the study include an inability to account for the complexity of presenting MH conditions and the limited generalizability to non-children’s hospitals. Still, they continued, the findings of the cross-sectional study underscore the need for increased pediatric MH services.”

HRSA to Host Provider Webcast on Covid-19 Coverage Assistance Fund on May 12

HHS’ Health Resources and Services Administration (HRSA) has announced a new program that covers the costs of administering Covid-19 vaccines to patients enrolled in health plans that either do not cover vaccination fees or cover them with patient cost-sharing. HRSA will host an informational webcast for providers to present an overview of its Coverage Assistance Fund on Wednesday, May 12 at 2 p.m. ET. Click here to learn more and register.

Fact of the Week

Nearly one in five adults between the ages of 50 and 80 said their overall mental health has gotten worse since the pandemic began in March 2020, and an equal percentage said their sleep suffered in that time too, according to a new aging study from the University of Michigan. For questions or comments about this CEO Update, please contact Jessica Zigmond.

Mental Health Awareness Month Begins Saturday, May 1

Mental Health Awareness Month, also referred to as Mental Health Month, kicks off Saturday, May 1 to recognize the millions of Americans living with a mental illness. Please be sure to follow NABH on Twitter and LinkedIn to help promote Mental Health Month, and visit the websites for the National Alliance on Mental Illness (NAMI) and Mental Health America for more information and toolkits.

HHS Provides Exemptions for Buprenorphine Prescribers for Fewer Than 30 Patients

The U.S. Department of Health and Human Services (HHS) announced this week that practitioners prescribing buprenorphine, a controlled substance, for opioid use disorder to fewer than 30 patients are exempt from certain regulatory requirements codified under 21 U.S.C. 823(g)(2)(B)(i)-(ii). Under the new guidance, physicians, physician assistants, nurse practitioners, clinical nurse specialists, certified registered nurse anesthetists, and certified nurse midwives are exempt from having to make certain training related certifications and certifying their capacity to provide counseling and other ancillary services. The guideline does not remove the DATA 2000 Waiver, otherwise known as the ‘X-Waiver.’ Providers are still required to file a Notice of Intent with the Substance Abuse and Mental Health Services Administration. The exemption applies to practitioners who are state-licensed and DEA-registered. It also generally limits prescribing to patients who are located in states where the practitioner is licensed. Practicing under this exemption does not count toward the time requirements for prescribing to a higher patient limit under 21 U.S.C. 823(g)(2)(B)(iii). This exemption also applies to other Schedule III, IV, and V drugs. Tuesday’s guidance encourages practitioners to provide access to psychosocial services to improve treatment retention and outcomes. In addition, medical education institutions are strongly encouraged to implement comprehensive training in substance use disorder diagnosis and management. In late January, the Biden administration placed a freeze on Trump administration guidelines that intended to exempt physicians from the X-Waiver. That notice cited clinical concerns and stated the Executive Branch did not have the legal authority to make the change.

GAO Releases Behavioral Health Study on Access, Claims Payments, and Covid-19 Effects 

In a report released Friday, the Government Accountability Office (GAO) said evidence collected during the Covid-19 pandemic suggests the prevalence of behavioral health conditions has increased, while access to in-person behavioral health services has decreased. The report noted that Centers for Disease Control and Prevention (CDC) surveys found about 38% of respondents reported symptoms of anxiety or depression from April 2020 through February 2021, reflecting an increase of 11% since 2019. Meanwhile, U.S. emergency department visits for overdoses and suicide attempts from mid-March to mid-October 2020 were up 36% and 26%, respectively, since 2019. The study also highlighted issues related to payment for services. “Officials GAO interviewed from provider organizations offered anecdotal examples of problems with payments for behavioral health services, including examples suggesting that denials and delays were more common for these services than they were for medical/surgical services,” the report said. “However, most officials were not aware of published data that could confirm their concerns, and data from reports from two states on claims denials either did not support their concerns or were inconclusive,” it continued. “In addition, a report in one state that examined mental health parity—requirements that behavioral health benefits are not more restrictive than medical/surgical benefits—found that the rate of complaints associated with behavioral health services was notably lower than those for medical/surgical services.”

CMS Launches Behavioral Health Follow-up Care Learning Collaborative

The Centers for Medicare & Medicaid Services (CMS) has launched the “Improving Behavioral Health Follow-up Care Learning Collaborative” to support state Medicaid and Children’s Health Insurance Program (CHIP) agencies’ efforts to improve access, coordination, and follow-up care for beneficiaries who visit an emergency department or who are hospitalized for a mental health or substance use condition. In an announcement, CMS said state behavioral health agencies, managed care plans, and providers will learn about evidence-based interventions to improve access to timely follow-up behavioral healthcare during the global pandemic recovery period and beyond. The new learning collaborative includes a four-part webinar series beginning next month and an “affinity group” starting in July. According to CMS, states interested in acting on the concepts and strategies introduced in the webinar series will have an opportunity to participate in an action-oriented affinity group that will facilitate state-to-state learning and support state teams in designing, implementing, and scaling up quality-improvement projects in their state. Click here for more details about the webinar series and affinity group and here to register for the webinars.

NABH Welcomes Comments on Federal Privacy Regulations

Earlier this year, HHS issued a notice of proposed rulemaking (NPRM) that outlined significant changes to federal privacy regulations. The Biden administration’s freeze on certain regulations issued during the prior administration does not apply to this proposed rule, and the current administration has extended the deadline for comments on this NPRM to May 6, 2021. Notably, the NPRM includes a section entitled “Encouraging Disclosures of PHI [Personal Health Information] when Needed to Help Individuals Experiencing Substance Use Disorder (Including Opioid Use Disorder), Serious Mental Illness, and in Emergency Circumstances.” This link to that section discusses the following proposed changes to federal privacy regulations:

• Revising the standard for determining when a disclosure or use of PHI is in the best interests of the individual to be based on a “good faith belief” instead of “exercise professional judgment”; and

• Changing the standard for use or disclosure of PHI to prevent or lessen a “serious or imminent threat” to the health or safety of a person or the public to instead be allowable based on a “serious and reasonably foreseeable threat” to a person or the public.

This section of the proposed rule also includes scenarios illustrating how the proposed changes to the privacy rules would help improve care for patients. NABH welcomes comments about these changes and requests that members send any comments to Kirsten Beronio, NABH’s director of policy and regulatory affairs, by next Tuesday, May 4.

NIDA Director Says Addiction Should be Treated, Not Penalized in Health Affairs Blog

People with substance use disorders need treatment, not punishment, and drug use disorders should be approached with a demand for high-quality care and compassion for those affected. Those are the words of Nora Volkow, M.D., director of the National Institute on Drug Abuse, or NIDA, in a Health Affairs blog post this week. Volkow also noted that the Covid-19 pandemic has highlighted the large racial health disparities in America, and that Black Americans have experienced worse outcomes during the pandemic, continue to die at a greater rate than White Americans, and also suffer disproportionately from a wide range of other acute and chronic illnesses. “We have known for decades that addiction is a medical condition—a treatable brain disorder—not a character flaw or a form of social deviance,” Volkow wrote. “Yet, despite the overwhelming evidence supporting that position, drug addiction continues to be criminalized,” she continued. “The U.S. must take a public health approach to drug addiction now, in the interest of both population well-being and health equity. Separately this week, an opinion piece in Stat from former Office of National Drug Control Policy (ONDCP) Deputy Director Tom McLellan, Ph.D. and Jacob Crothers, M.D., an addiction medicine physician, proposed that the United States should engage in a rapid response similar to “Operation Warp Speed” (for the Covid-19 vaccine development and rollout) to address the nation’s ongoing opioid crisis. In their observations, McLellan and Crothers wrote the U.S. Drug Enforcement Administration surveillance of providers sends a confusing message about encouraging the use of U.S. Food and Drug Administration-approved addiction medications. They also warned against discharging patients for positive drug tests and prohibitive prior authorization policies, and they suggested extending the Medicare opioid treatment bundle to Medicaid.

NCOA to Host Older Adult Mental Health Awareness Day Symposium on May 6

The National Council on Aging (NCOA), along with the U.S. Administration for Community Living and the Substance Abuse and Mental Health Services Administration (SAMHSA) will host the 4^th Annual Older Adult Mental Health Awareness Day Symposium as a virtual event on Thursday, May 6. Registration is free, and the all-day event for public health practitioners, professionals in the aging networks, mental health providers, healthcare professionals, and others interested in the mental health of older adults will address topics such as access to behavioral health in diverse older adults, latest interventions related to SUDs, and socialization and engagement. Learn more from the program’s agenda and click here to register.

Save the Date: NABH 2021 Annual Meeting

NABH will host its 2021 Annual Meeting from Wednesday, Oct. 6 – Friday, Oct. 8, 2021 at the Mandarin Oriental Washington, DC. The association re-scheduled for this later date in 2021 due to the ongoing Covid-19 pandemic. We hope you can join us! After 2021, NABH will host its subsequent Annual Meetings in June. Please save the date for these future NABH Annual Meetings:

• June 13-15, 2022

• June 12-14, 2023

We look forward to seeing you again in Washington!

Fact of the Week

Nearly a quarter of all child and adolescent admissions to psychiatric hospitals are involuntary, according to a new study in The Lancet. The report also showed children admitted against their will more often had a diagnosis of psychosis, substance misuse, or intellectual disability. For questions or comments about this CEO Update, please contact Jessica Zigmond.