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SAMHSA Proposed Rule Permits Methadone Prescribing for New Patients via Telemedicine

The Substance Abuse and Mental Health Services Administration (SAMHSA) on Tuesday proposed updating federal regulations to permit using audio-visual telehealth services for any new patient treated with methadone in an Opioid Treatment Program (OTP) under specific conditions. In a proposed rule, SAMHSA said federal regulations should be updated to allow using audio-visual telehealth services for patients treated with methadone in OTPs only if a program physician, or an authorized healthcare professional under the supervision of a program physician, determines that an adequate evaluation of the patient can be accomplished via an audio-visual telehealth platform. This change is not extended to using audio-only telehealth platforms and applies only to ordering methadone that an OTP dispenses under existing OTP procedures. In addition, SAMHSA’s proposed changes would update 42 CFR Part 8 by removing stigmatizing or outdated language; supporting a more patient-centered approach to treatment; and reducing barriers to receiving care. SAMHSA’s proposed changes also would revise standards to reflect an OTP accreditation and treatment environment that has evolved since Part 8 became effective in 2001. Consequently, SAMHSA said its proposed revisions reflect evidence-based practice, language that aligns with current medical terminology, effective patient engagement approaches, and the workforce providing services in OTPs, including:
  • expanding the definition of an OTP treatment practitioner to include any provider who is appropriately licensed to dispense and/or prescribe approved medications. The current Part 8 rule defines a practitioner as being: “a physician who is appropriately licensed by the State to dispense covered medications and who possesses a waiver under 21 U.S.C.823(g)(2).” During the Covid-19 public health emergency, this has been formally expanded to align with broader definitions of a practitioner (nurse practitioners, physician assistants, etc.), and OTPs reported that this change was essential in supporting workflow and access;
  • adding evidence-based delivery models of care, such as split dosing, telehealth, and harm-reduction activities;
  • removing such outdated terms as “detoxification”;
  • updating criteria for provision of take-home doses of methadone;
  • strengthening the patient-practitioner relationship through promoting shared and evidence-based decision-making;
  • allowing for early access to take-home doses of methadone for all patients, to promote flexibility in creating plans of care that facilitate such every-day needs as employment, while also affording people with unstable access to reliable transportation the opportunity to also receive treatment; likewise, promoting mobile medication units to expand an OTPs geographic reach; and
  • reviewing OTP accreditation standards.
According to SAMHSA, the changes– which are part of President Biden’s National Drug Control Strategy – come at a time when fewer than one out of 10 Americans can access treatment for substance use disorder. SAMHSA will accept public comments on the proposed rule until Feb. 14, 2023.

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CMS Proposes Electronic Prior Authorization for Providers and Payers

The Centers for Medicare & Medicaid Services (CMS) this week released a proposed rule that would require certain providers and payers to implement an electronic prior-authorization process, shorten the timeframe for payers to respond to prior-authorization requests, and work to make the prior-authorization process more efficient and transparent. An announcement from CMS said the proposed requirements would apply to Medicare Advantage (MA) organizations, state Medicaid and Children’s Health Insurance Program (CHIP) agencies, Medicaid managed care plans, CHIP managed care entities, and qualified health plan issuers on the federally facilitated exchanges. The agency estimates that these proposed policies could create efficiencies that would save physician practices and hospitals more than $15 billion over a 10-year period. The rule would automate essential prior-authorization functions related to documentation, requests, and decisions. Also, payers would be required to provide a clear reason for denials and to respond to urgent prior-authorization requests within 72 hours and standard requests within seven days. The proposed electronic platform is the already-established “Patient Access API,” which uses the Health Level 7® format. The rule also would enhance patients’ access to their own information on prior- authorization requests, approvals, and related information by requiring online reporting of certain performance metrics. CMS is seeking information from stakeholders on the following topics:
  • How to standardize data on patients’ social risk factors (e.g., housing instability, food insecurity) that influence patient health and health care utilization;
  • How to advance electronic data exchange among behavioral health providers;
  • How to improve the exchange of medical documentation between and among providers/suppliers and patients (for the purpose of care coordination);
  • How to enable the connection of health information networks to advance cross-organization interoperability, such as the prior-authorization improvements in this rule, including incentives for payers; and
  • Evidence-based policies that CMS could pursue to leverage health IT, data sharing, and interoperability to improve maternal health outcomes.
NABH will address these and the rule’s other key provisions in the association’s formal comments. CMS will publish the rule in the Federal Register on Dec. 13, 2022 and accept comments through March 13, 2023.

Biden Administration Launches Opioid Overdose Dashboard

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

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

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

MedPAC Discusses Draft Recommendations for 2024 Physician Payment Increases

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

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

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

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

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

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

Thank you to all members who have submitted data to NABH’s denial-of-care portal. Your data will help NABH highlight problems in the field related to health plan denials and timeliness. Several policymaking entities are interested in these data, which could support advocacy for expanded access to care. For new participants, please e-mail Emily Wilkins, NABH’s administrative coordinator, for support.

Save the Date for the NABH 2023 Annual Meeting!

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

Fact of the Week

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

Biden Administration Launches Opioid Overdose Dashboard

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

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

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

HHS Releases Proposed Rule to Revise 42 CFR Part 2 Regulations

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

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

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

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

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

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

Thank you to all members who have submitted data to NABH’s denial-of-care portal. Your data will help NABH highlight problems in the field related to health plan denials and timeliness. Several policymaking entities are interested in these data, which could support advocacy for expanded access to care. For new participants, please e-mail Emily Wilkins, NABH’s administrative coordinator, for support.

Save the Date for the NABH 2023 Annual Meeting!

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

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

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

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

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

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

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

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

Thank you to all members who have submitted data to NABH’s denial-of-care portal. Your data will help NABH highlight problems in the field related to health plan denials and timeliness. Several policymaking entities are interested in these data, which could support advocacy for expanded access to care. For new participants, please e-mail Emily Wilkins, NABH’s administrative coordinator, for support.

Save the Date for the NABH 2023 Annual Meeting!

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

Fact of the Week

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

Happy Thanksgiving from NABH!

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

CEO Update 217

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

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

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

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

CMS Releases Medicaid and CHIP Access Data Brief

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

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

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

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

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

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

Thank you to all members who have already submitted your data to NABH’s denial-of-care portal. Your data will help NABH highlight problems in the field related to health plan denials and timeliness. Several policymaking entities are interested in these data, which could support advocacy for expanded access to care. For new participants, please e-mail Emily Wilkins, NABH’s administrative coordinator, for support.

Save the Date for the NABH 2023 Annual Meeting!

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

Fact of the Week

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

NABH Board of Trustees Dinner and Meeting: November 14-15, 2022

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NABH Board of Trustees Meeting:

Nov. 14 – 15, 2022 Waldorf Astoria Washington, DC[/vc_column_text][/vc_column][/vc_row][vc_row][vc_column width=”1/2″][vc_column_text]

NABH Board of Trustees Dinner

Monday, Nov. 14, 2022 6 p.m. – 6:30 p.m. — Board Reception: Franklin Study 6:30 p.m. – 8:30 p.m. — Board Dinner: Franklin Study[/vc_column_text][/vc_column][vc_column width=”1/2″][vc_column_text]

NABH Board of Trustees Meeting

Tuesday, Nov. 15, 2022 9 a.m. — Board Meeting: Lincoln Library Breakfast will be served. Noon — Adjournment[/vc_column_text][/vc_column][/vc_row][vc_row][vc_column][vc_separator][vc_column_text]

Agenda

[/vc_column_text][/vc_column][/vc_row][vc_row][vc_column width=”1/3″][vc_column_text]NABH Board of Trustees Meeting Tuesday, Nov. 15, 2022 9 a.m. – Noon ET Lincoln Library[/vc_column_text][/vc_column][vc_column width=”1/3″][vc_column_text]Waldorf Astoria 1100 Pennsylvania Avenue, NW Washington, DC 20004 202-695-1100[/vc_column_text][/vc_column][vc_column width=”1/3″][vc_column_text]Wi-Fi: hiltonhonorsmeeting Password: nabh2022[/vc_column_text][/vc_column][/vc_row][vc_row][vc_column][vc_separator][vc_column_text][widgetkit id=”8″][/vc_column_text][/vc_column][/vc_row]

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CMS Releases Final Physician Fee Schedule and OPPS Rules for 2023 

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

SAMHSA to Host Webinar About CCBHC Certification Criteria Next Week

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

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

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

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

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

Enhanced NABH Denial-of-Care Portal is Now Available

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

Save the Date for the NABH 2023 Annual Meeting!

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

Fact of the Week

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

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

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

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

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

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

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

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

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

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

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

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

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

Enhanced NABH Denial-of-Care Portal is Now Available

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

Fact of the Week

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

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

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

SAMHSA Announces $15 Million in Early 2023 for CCBHCs

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

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

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

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

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

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

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

Enhanced NABH Denial-of-Care Portal is Now Available

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

Save the Date for the NABH 2023 Annual Meeting!

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

Fact of the Week

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

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NABH 2023 Board Position Nominations Due Today!

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

Becerra Extends Covid-19 PHE for Another 90 Days

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

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

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

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

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

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

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

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

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

Enhanced NABH Denial-of-Care Portal is Now Available

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

Save the Date for the NABH 2023 Annual Meeting!

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

Fact of the Week

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

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NABH Seeking Candidates for 2023 Board Positions

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

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

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

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

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

HRSA Previews Behavioral Health Training Opportunities for Primary Care Residents

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

Enhanced NABH Denial-of-Care Portal is Now Available

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

Save the Date for the NABH 2023 Annual Meeting!

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

Fact of the Week

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

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House to Vote Friday on Senate-Approved Stopgap Spending Measure

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

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

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

House Passes Bill to Bolster Mental Health Parity Protections for Workers

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

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

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

Former ONDCP Leaders Pen Opinion Piece on Increasing Recovery Services

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

Enhanced NABH Denial-of-Care Portal is Now Available

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

Save the Date for the NABH 2023 Annual Meeting!

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

Fact of the Week

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

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

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

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

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

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

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

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

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

Enhanced NABH Denial-of-Care Portal is Now Available

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

Save the Date for the NABH 2023 Annual Meeting!

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

Fact of the Week

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

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

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

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

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

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

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

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

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

Enhanced NABH Denial-of-Care Portal is Now Available

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

Save the Date for the NABH 2023 Annual Meeting!

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

Fact of the Week

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

CEO Update 208

NABH Welcomes Rochelle Archuleta as Executive Vice President for Government Relations and Public Policy

Rochelle Archuleta has joined NABH as executive vice president for government relations and public policy, effective Sept. 6. Rochelle brings to NABH 30 years of experience in the health policy, healthcare delivery system, and legislative arenas. During her 20-year tenure as a policy director for the American Hospital Association (AHA), Rochelle led AHA’s post-acute care policy team. In this role, Rochelle partnered with providers, policymakers, and leading trade associations on issues pertaining to the home health, skilled nursing facility/nursing home, inpatient rehabilitation facility, and long-term care hospital sectors. These advocacy efforts expanded to include issues of common concern to all post-acute care providers and their hospital partners, including issues pertaining to Medicare Advantage and commercial insurers, as well as the Medicare program’s effort to create a new, unified payment system to reimburse the aforementioned, post-acute care settings. “We are pleased to welcome Rochelle to our team,” said Shawn Coughlin, president and CEO at NABH. “Rochelle’s extensive work in healthcare policy, as well as her strong relationships with partner associations, will enhance NABH’s advocacy efforts—both with legislators and regulators.” Rochelle is a research fellow in the Georgetown University McCourt School of Public Policy and is a former David Winston Health Policy Fellow. She earned a master of science in health administration and a master of business administration from the University of Alabama at Birmingham School of Health Professions and a bachelor of arts in political science from the University of Colorado at Boulder.

NABH Submits Comments on CMS’ Proposed Medicare Physician Fee Schedule for 2023

NABH this week sent comments and recommendations to the Centers for Medicare & Medicaid Services (CMS) regarding the agency’s proposed Medicare physician fee schedule for fiscal year 2023. In its nine-page letter, NABH proposed revisions to the “Incident to” regulations and offered a range of recommendations related to the 2023 conversion factor, telehealth, opioid treatment services, coding and payment mechanisms, adjustments to the rate-setting methodology for behavioral health, and more.

HHS-OIG Report Shows Medicare Telehealth Fraud Was Rare During Covid-19 Pandemic

A new report from HHS’ Office of Inspector General (OIG) found a very small fraction of provider claims for Medicare telehealth services during the Covid-19 pandemic may have indicated fraud, waste, or abuse of those services.   The OIG’s offices analyzed Medicare fee-for-service claims data and Medicare Advantage encounter data from March 1, 2020 to Feb. 28, 2021 and focused on about 742,000 providers who billed for a telehealth services. Examining seven measures on different types of billing, investigators identified 1,1714 providers whose billing for telehealth services during the first year of the pandemic posed a high risk to the Medicare program. Those providers billed for telehealth for about half a million beneficiaries and received a total of about $127.7 million in Medicare fee-for-service payments, according to the report.   Each of these 1,714 providers had concerning billing on at least 1 of 7 measures we developed that may indicate fraud, waste, or abuse of telehealth services,” the report noted. “All of these providers warrant further scrutiny. For example, they may be billing for telehealth services that are not medically necessary or were never provided.”

NABH Annual Membership Updates Are Due Next Friday, Sept. 16!

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

Sound the Alarm for Kids to Host Virtual Roundtable on Friday, Sept. 16

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

Enhanced NABH Denial-of-Care Portal is Now Available

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

Save the Date for the NABH 2023 Annual Meeting!

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

Fact of the Week

A recent study of 175,778 Medicare beneficiaries found that receipt of opioid use disorder-related telehealth services during the Covid-19 pandemic was associated with improved medications for opioid use disorder (MOUD) retention and lower odds of medically treated overdose, JAMA Psychiatry reports. For questions or comments about this CEO Update, please contact Jessica Zigmond.

Rochelle Archuleta Joins NABH as Executive Vice President for Government Relations and Public Policy

Rochelle Archuleta has joined the National Association for Behavioral Healthcare (NABH) as executive vice president for government relations and public policy, effective Sept. 6. Rochelle brings to NABH 30 years of experience in the health policy, healthcare delivery system, and legislative arenas. During her 20-year tenure as a policy director for the American Hospital Association (AHA), Rochelle led AHA’s post-acute care policy team. In this role, Rochelle partnered with providers, policymakers, and leading trade associations on issues pertaining to the home health, skilled nursing facility/nursing home, inpatient rehabilitation facility, and long-term care hospital sectors. These advocacy efforts expanded to include issues of common concern to all post-acute care providers and their hospital partners, including issues pertaining to Medicare Advantage and commercial insurers, as well as the Medicare program’s effort to create a new, unified payment system to reimburse the aforementioned, post-acute care settings. “We are pleased to welcome Rochelle to our team,” said Shawn Coughlin, president and CEO at NABH. “Rochelle’s extensive work in healthcare policy, as well as her strong relationships with partner associations, will enhance NABH’s advocacy efforts—both with legislators and regulators.” Rochelle is a research fellow in the Georgetown University McCourt School of Public Policy and is a former David Winston Health Policy Fellow. She earned a master of science in health administration and a master of business administration from the University of Alabama at Birmingham School of Health Professions and a bachelor of arts in political science from the University of Colorado at Boulder.

CEO Update 207

September is National Recovery Awareness Month

This week kicked off National Recovery Month, a national observance every September since 1989 intended to promote and support new evidence-based treatment and recovery practices, the nation’s recovery community, and the dedication of service providers and community leaders who make recovery possible. During this past week’s Overdose Awareness Week, which concludes tomorrow, President Biden issued a National Recovery Month proclamation in which he acknowledged the more than 20 million Americans recovering from substance use disorder and highlighted his administration’s efforts to support recovery. “This year, we secured nearly $22 billion from the Congress to support drug prevention, treatment, harm reduction, and recovery support services, with a focus on underserved communities,” the president said in his proclamation. “With the additional $4 billion investment from our American Rescue Plan, my administration is expanding recovery community organizations, recovery high schools, collegiate recovery programs, and recovery residences.” For more information about National Recovery Month, please visit the Substance Abuse and Mental Health Administration’s (SAMHSA) website, and please remember to follow NABH @NABHbehavioral and on LinkedIn at the National Association for Behavioral Healthcare. HHS Announces $47.6 Million in New Grant Funding for School-Based Mental Health The U.S. Health and Human Services Department (HHS) this week announced $47.6 million in new grant funding opportunities through this Bipartisan Safer Communities Act to support mental health programs in schools. Of that amount, $37.6 million is allocated for Project Advancing Wellness and Resiliency in Education, or AWARE, which is meant to develop a sustainable infrastructure for school-based mental health programs and services that promote the healthy social and emotional development of school-aged youth and prevent youth violence in schools. The remaining $10 million is for the Resiliency in Communities after Stress and Trauma (ReCast) grant program, which helps assist high-risk youth and families by promoting resilience and equity in communities that have recently experienced civil unrest, community violence, and/or collective trauma through evidence-based, violence prevention, and community youth engagement programs, as well as connections to trauma-informed behavioral health services.

Nonfatal Opioid-Involved Overdoses in Emergency Departments Are Rising

The rate of nonfatal, opioid-involved overdose emergency medical services (EMS) encounters increased by an average of 4% quarterly from January 2018 – March 2022, according to new research from the Centers for Disease Control and Prevention (CDC). The findings also reported that rates increased across most sociodemographic and county characteristics. Researchers noted that monitoring nonfatal, opioid-involved overdose trends in EMS data in near real time can help identify where overdose affects communities disproportionately and direct equitable response and prevention efforts, such as increased access to harm-reduction services and connections to care and treatment. Click here to read the full CDC report.

Reminder: HRSA Announces Funding for 2023 Rural Health Network Development Program

Both not-for-profit and for-profit organizations are eligible to apply for the Health Resources and Services Administration’s (HRSA) Federal Office of Rural Health Policy’s (FORHP) 2023 Rural Health Development Program, a four-year program to support integrated healthcare networks to improve outcomes and strengthen the nation’s rural healthcare system. The FORHP will make 44 awards of up to $300,000 each as part of the program, which focuses on four domains: improving access by addressing gaps in care, workforce shortages, better workflows and/or improving the quality of healthcare services; expanding capacity and services by creating effective systems through the development of knowledge, skills, structures, and leadership models; enhancing outcomes by improving patient and/or network development outcomes through expanding or strengthening the network’s services, activities or interventions; and establishing sustainability by positioning the network to prepare for sustainable health programs through value-based care and population health management. FORHP will hold a webinar for applicants on Wednesday, Sept. 7, 2022 from 2 p.m. to 3:30 P.M. ET. Click here for more information about the grants and here for next month’s webinar link.

NABH Submits Medicare Advantage Program Recommendations to CMS

NABH this week responded to a request for information from the Centers for Medicare & Medicaid Services (CMS) about the Medicare Advantage (MA) program and behavioral health. In its letter, NABH cited a recent study that found MA networks included only 23% of psychiatrists in a county on average — lower than all other medical specialties. “Not surprisingly, MA enrollees with depressive symptoms report more difficulty accessing needed treatment and rated their experience with the MA plans as worse than in traditional Medicare,” the letter said. The association provided information and outlined recommendations related to advancing health equity, expanding access, encouraging innovation to promote patient-centered care, and engaging partners.

Extended Deadline: NABH Annual Membership Updates Are Due Friday, Sept. 16

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

Enhanced NABH Denial-of-Care Portal is Now Available 

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

Save the Date for the NABH 2023 Annual Meeting!

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

Fact of the Week

Since October, the use of hashtags related to self-harm – such as “#shtwt, short for Self-Harm Twitter – has increased roughly 500%, averaging tens of thousands of mentions per month, according to a new study from the Network Contagion Research Institute and Rutgers University. For questions or comments about this CEO Update, please contact Jessica Zigmond

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Extended Deadline: NABH Annual Membership Updates Are Due Friday, Sept. 16

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

NABH and Partner Groups Ask HHS Secretary Becerra to Integrate Mental and Physical Health Within ASPR

NABH and more than 50 other advocacy organizations this week sent a letter to U.S. Health and Human Services Department (HHS) Secretary Becerra that urged the Biden administration to integrate mental and physical health within the Administration for Strategic Preparedness and Response (ASPR). Last month HHS announced that Becerra had elevated the then-existing Office of the Assistant Secretary for Preparedness and Response from a staff division to an operating division—taking the new name of the Administration for Strategic Preparedness and Response—in an effort to elevate ASPR to a standalone agency with the department, similar to the Centers for Disease Control and Prevention (CDC), Food and Drug Administration (FDA), and Substance Abuse and Mental Health Services Administration (SAMHSA). HHS’ announcement said the change would allow ASPR to mobilize a coordinated national response more effectively and efficiently during future disasters and emergencies. This week, NABH was one of many organizations that called on HHS to use this opportunity to integrate mental and physical health when forming a national response to such events. “Therefore, with the elevation of ASPR within HHS, the Biden administration must seize this important opportunity to integrate our mental and physical health response in order to truly ensure ASPR is able to fulfill its mission to prepare and respond to health crises,” the organizations wrote in their letter to Becerra. “Needed steps include having senior positions within ASPR dedicated to ensuring the integration of mental health and substance use into all of ASPR’s work, as well as broader staff training to ensure personnel have sufficient background on why mental health is so important to emergency preparedness and response.” Click here to read the entire letter.

CEO Alliance for Mental Health Releases Updated Unified Vision for Transforming Mental Health and Substance Use Car

The CEO Alliance for Mental Health—of which NABH is a member organization— this week released an update Unified Vision for Transforming Mental Health and Substance Use Care for 2022. Please read the updated vision, which includes information related to the national 988 behavioral health crisis line that launched last month. Also, please remember to follow us @NABHbehavioral and on LinkedIn at the National Association for Behavioral Healthcare to share our posts about the vision.

HRSA Announces Funding for 2023 Rural Health Network Development Program

Both not-for-profit and for-profit organizations are eligible to apply for the Health Resources and Services Administration’s (HRSA) Federal Office of Rural Health Policy’s (FORHP) 2023 Rural Health Development Program, a four-year program to support integrated healthcare networks to improve outcomes and strengthen the nation’s rural healthcare system. The FORHP will make 44 awards of up to $300,000 each as part of the program, which focuses on four domains: improving access by addressing gaps in care, workforce shortages, better workflows and/or improving the quality of healthcare services; expanding capacity and services by creating effective systems through the development of knowledge, skills, structures, and leadership models; enhancing outcomes by improving patient and/or network development outcomes through expanding or strengthening the network’s services, activities or interventions; and establishing sustainability by positioning the network to prepare for sustainable health programs through value-based care and population health management. FORHP will hold a webinar for applicants on Wednesday, Sept. 7, 2022 from 2 p.m. to 3:30 P.M. ET. Click here for more information about the grants and here for next month’s webinar link.

Coalition on Physician Education in Substance Use Disorders Extends Submission Deadline for Curriculum Innovation Challenge

The Coalition on Physician Education in Substance Use Disorders (COPE), a partner organization to the Opioid Response Network, has extended the deadline for its Innovative Learning and Teaching About Substance Use/Opioid Use Disorders Curriculum Innovation Challenge to next Wednesday, Aug. 31 at 11:59 p.m. ET. The challenge is intended to support teams of medical school faculty and students in integrating addiction medicine/psychiatry content into core clerkship rotations. It is designed to foster engagement and collaboration between addiction medicine experts, medical school faculty (clerkship directors or the equivalent), and medical students using cutting-edge concepts and training tools. Through a series of virtual conferences, winning teams will be led in developing addiction medicine/psychiatry curriculum and planning subsequent implementation based on the needs of their school. Click here to learn more and apply.

Marijuana and Hallucinogen Use Among Young Adults Reached All-Time High in 2021

Marijuana and hallucinogen use reported by young adults 19 to 30 years old increased significantly in 2021 compared with five and 10 years ago, reaching historic highs in this age group since 1988, according to statistics released this week from the National Institute on Drug Abuse. The findings came from the Monitoring the Future panel study, which also reported that rates of past-month nicotine vaping, which have been gradually increasing in young adults for the past four years, also continued a general upward trend in 2021, despite leveling off in 2020. Past-month marijuana vaping, which had significantly decreased in 2020, rebounded to pre-pandemic levels in 2021. Click here to learn more.

Enhanced NABH Denial-of-Care Portal is Now Available

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

Save the Date for the NABH 2023 Annual Meeting!

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

Fact of the Week

About 6% of behavioral health providers and 29% of substance use treatment centers use electronic health record (EHR) technology, compared with more than 80% of hospitals that use EHRs, according to the Medicaid and CHIP Advisory Committee’s June report to Congress (see p. 84). For questions or comments about this CEO Update, please contact Jessica Zigmond

CEO Update 205

CMS Releases ‘Roadmap’ for Providers to Prepare for End of Covid-19 PHE

The Centers for Medicare & Medicaid Services this week released a series of fact sheets and resources to help the nation’s healthcare providers prepare for the end of the Covid-19 public health emergency (PHE), which will also end many of the flexibilities the agency offered during the global pandemic. A blog post from three CMS leaders noted that the agency learned from providers, facilities, insurers, and other stakeholders about what worked well—and didn’t—in relation to the agency’s waivers and other temporary measures. “Expanding telehealth is an example of a congressional change,” said the blog post from Jonathan Blum, CMS’ chief operating officer and principal deputy administrator; Carol Blackford, director of the agency’s hospital and ambulatory policy group; and Jean Moody-Williams, deputy director of the Center for Clinical Standards and Quality. “The Consolidated Appropriations Act, 2021 expanded access to telehealth services for the diagnosis, evaluation, or treatment of mental health disorders after the end of the PHE,” the authors continued. “These services have been so important to the health and well-being of Americans affected by Covid-19.” The post also noted that U.S. Health and Human Services Department (HHS) Secretary Xavier Becerra will give the healthcare community 60 days’ notice before the PHE ends. Providers can refer to a host of fact sheets and resources from CMS in links at the end of the blog post to help prepare as the PHE winds down.

CMS Rule Proposes Requiring Behavioral Health Quality Data Reporting

CMS on Thursday released a proposed rule that would require annual state reporting for three quality measure sets, including the behavioral health measures in the Core Set of Adult Health Care Quality Measures for Medicaid. The Behavioral Health Core Set includes 13 measures: a depression measure under the Primary Care Access and Preventive Care domain; four measures related to individuals with substance use disorders including one related to medication assisted treatment; two related to the prescribing of opioids; and six measures related to individuals with mental disorders. These core sets are designed to measure the overall national quality of care for beneficiaries, monitor performance at the state level, improve the quality of health care, and provide a national view of quality. CMS has proposed that reporting these measures—currently a voluntary practice—become mandatory in fiscal year 2024. Data reported in 2024 will reflect care delivered in calendar year 2023. “The Medicaid and CHIP Core Sets of quality measures for children, adults, and health home services are key to promoting health equity,” CMS Administrator Chiquita Brooks-LaSure said in an announcement. “They will allow us not only to identify health disparities but also to implement interventions based on the very data that make those disparities clear.” In addition to the Child and Adult Core Sets, CMS has proposed establishing reporting requirements for states that elect to implement one or both of the optional Medicaid health home benefits under sections 1945 or 1945A of the Social Security Act, which will measure healthcare quality for states that choose to establish “health homes.” Public comments about the proposed rule are due Oct. 21, 2022. The rule will be published in the Federal Register on Monday, Aug. 22.

New JAMA Study Shows Pervasiveness of Methamphetamine Use in Rural America

Findings from a JAMA Network Open study released this week show that nearly four of five people taking drugs in rural areas across 10 states used methamphetamine in the past 30 days. Meanwhile, non-fatal overdoses in the past six months were higher among people using both methamphetamines and opioids (22%), compared with opioids alone (14%), or methamphetamines alone (6%). “The challenge is compounded in rural communities that often lack buprenorphine prescribers: more than one-half of U.S. counties (53.4%) do not have a buprenorphine prescriber, leaving 30 million people in those counties without access to treatment,” the researchers wrote. “Similarly, rural opioid treatment programs are rare, leading to long driving times to access methadone,” they continued, adding that educational interventions are needed to train primary care physicians, who are essential providers of opioid use disorder treatment in rural America. “For example,” they wrote, “contingency management training interventions could be adapted to support rural primary care practitioners.”

NABH Annual Membership Updates Are Due Today

The deadline to submit changes about your organization for the online-only NABH 2022 Membership Directory is today, Friday, Aug. 19. Last month NABH sent its system members a message with a link to the association’s membership-update tool. To help ensure we have the most accurate information on our members, please use this tool to verify your system’s information. NABH has added several new categories this year. The answers to these questions will help us provide a more accurate description of our diverse membership to policymakers, regulators, partner organizations, and the media. Please be sure to enter information for all your system’s facilities so that we have a better picture of our diverse membership. If you need assistance, please contact Maria Merlie at maria@nabh.org. Thank you!

Enhanced NABH Denial-of-Care Portal is Now Available

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

Save the Date for the NABH 2023 Annual Meeting!

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

Fact of the Week

A new study in The Lancet Psychiatry shows that up to two years after Covid-19 infection, the risk of developing conditions such as psychosis, dementia, brain fog, and seizures is still higher than after other respiratory infections; however, the findings also showed that while anxiety and depression are more common soon after a Covid-19 diagnosis, the mood orders are transient, becoming no more likely after the two months than following similar infections, such as the flu. To learn more, read this story in STAT. For questions or comments about this CEO Update, please contact Jessica Zigmond

CEO Update 204

CMS Requests Comments to Strengthen Medicare Advantage

On Monday, July 28, 2022, CMS published a request for information on Medicare Advantage to strengthen the program in ways that better align with the Vision for Medicare and the CMS Strategic Pillars. Comments are requested on advancing health equity, strengthening beneficiary access (including telehealth, network adequacy, and prior authorization), promoting person-centered care, affordability and sustainability, and engaging partners. “Medicare Advantage is a critical part of CMS’ vision to advance health equity; expand access to affordable coverage and care; drive high quality, person-centered care; and promote affordability and sustainability of Medicare,” said CMS Administrator Chiquita Brooks-LaSure. Comments are due August 31, 2022.

John Oliver Provides Visibility to the Mental Health Treatment Crisis

On Sunday, July 31, Last Week Tonight with John Oliver discussed the mental health crisis in the United States. The well-informed piece covered workforce issues, pay-parity, telehealth, ghost networks, poor prosecution of insurance companies that violate parity laws, and the reversal of Wit v. UBH.  The Kennedy Forum collaborated with producers of the segment and produced a Wit v. UBH Partner toolkit.

National Academy Publishes Proceedings on Methadone Regulations

In July, the National Academies of Sciences, Engineering, and Medicine released the prepublication document Methadone Treatment for Opioid Use Disorder: Improving Access Through Regulatory and Legal Change: Proceedings of a Workshop. These proceedings are not a consensus document, but rather summarizes the presentations and discussions of the Methadone Treatment for Opioid Use Disorder: Examining Federal Regulations and Laws, a workshop that was held in March 2022. The workshop and proceedings were funded by the White House Office of National Drug Control Policy.

NABH Annual Membership Update: 2022 Membership Directory

NABH is developing its online-only 2022 Membership Directory, an essential member benefit that helps the association in its advocacy efforts. Last week, NABH sent its system members a separate message that includes a link to the association’s membership-update tool. To help ensure we have the most accurate information on our members, please use the link to our membership-update tool and verify your system’s information. NABH has added several new categories this year. The answers to these questions will help us provide a more accurate description of our diverse membership to policymakers, regulators, partner organizations, and the media. Please be sure to enter information for all of your system’s facilities so that we have a better picture of our diverse membership. The deadline to submit your changes to NABH is Friday, Aug. 19, 2022. If you need assistance, please contact Maria Merlie at maria@nabh.org. Thank you!

Enhanced NABH Denial-of-Care Portal is Now Available!

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

Fact of the Week

In a study conducted over a 22-year period, concerns expressed by participants about the dangerousness posed to others by individuals with schizophrenia increased 13 percentage points from a little more than half in 1996 to almost 70% in 2018. The study results also indicate a substantial increase in the public acceptance of the biomedical causes of mental illness, suggesting that education and public health campaigns may not change public attitudes.

CEO Update 203

Final 2023 IPF-PPS Rule Calls for 2.5% Payment Increase to IPFs in 2023

In a final rule released Thursday, the Centers for Medicare & Medicaid Services (CMS) said total estimated payments to inpatient psychiatric facilities (IPFs) are estimated to increase by 2.5%, or $90 million, in fiscal year 2023 relative to IPF payments in 2022. This is larger than the 1.5% payment increase the agency proposed this spring. For 2023, CMS is updating the IPF prospective payment system (PPS) rates by 3.8%, based on the final IPF market basket update of 4.1% minus a 0.3 percentage point productivity adjustment. CMS is also updating the outlier threshold so that estimated outlier payments remain at 2% of total payments. The agency estimates this will result in a 1.2% decrease to aggregate payments, due to updating the outlier threshold. CMS noted that due to rounding, the 3.8% increase to payment rates and the 1.2% decrease to outlier payments yield a 2.5% overall increase in IPF payments. A fact sheet from CMS highlights the final rule’s major provisions, including a permanent 5% cap policy to ease the impact of year-to-year changes in IPF payments related to decreases in the IPF wage index. Finally, CMS did not make final any changes for the IPF Quality Reporting Program in the 2023 final rule. Gov. Phil Murphy Announces ‘Strengthening Youth Mental Health Care’ as NGA Chair’s Initiative Incoming National Governors Association (NGA) Chair Gov. Phil Murphy (D-N.J.) announced “Strengthening Youth Mental Health Care” is his chair’s initiative as he leads the organization from 2022-2023. “We are all aware of the youth mental health crisis in our country,” Murphy said during the closing session of the NGA’s summer meeting in Portland, Maine. “It is a crisis that the pandemic did not create but exposed more fully,” he added. “It is one that we must tackle together, and tackle now.” Murphy also acknowledged access-to-care problems and highlighted the four pillars of his chair’s initiative: prevention and resilience building; increasing awareness and reducing stigma; access and affordability of quality treatment and care; and caregiver and educator training and support. Click here to read more about Murphy’s initiative. Opioid Response Network & National Association of Counties Offer Guidance on Managing Opioid Litigation Funds    The Opioid Response Network (ORN) and the National Association of Counties (NACo) have partnered to strengthen the association’s new Opioid Solutions Initiative and resource center, which offers guidance to U.S. counties about how to use funding from litigation between states and opioid manufacturers and distributors. The support center provides guidance on managing opioid litigation funds, information about effective substance use prevention, treatment and recovery approaches that are approved uses of settlement funds, case studies on evidence-based practices, and  — with help from the ORN — free, on-demand education and training. Click here to read more about NACo’s Opioid Solutions Center and click here to submit requests for free education and training. NABH Annual Membership Update: 2022 Membership Directory NABH is developing its online-only 2022 Membership Directory, an essential member benefit that helps the asssociation in its advocacy efforts. Earlier this week, NABH sent its system members a separate message that includes a link to the association’s membership-update tool. To help ensure we have the most accurate information on our members, please use the link to our membership-update tool and verify your system’s information. NABH has added several new categories this year. The answers to these questions will help us provide a more accurate description of our diverse membership to policymakers, regulators, partner organizations, and the media. Please be sure to enter information for all of your system’s facilities so that we have a better picture of our diverse membership. The deadline to submit your changes to NABH is Friday, Aug. 19, 2022. If you need assistance, please contact Maria Merlie at maria@nabh.org. Thank you! Enhanced NABH Denial-of-Care Portal is Now Available! NABH recently made enhancements to its Denial-of-Care Portal that are intended to make the portal easier for members to use. A year ago, NABH developed the Denial-of-Care Portal to collect specific data on insurers who deny care—often without regard to parity or the effects on patients. Now the association has updated this resource to make it more user-friendly for members and also more aligned with what regulators need to identify parity violations. The updated portal includes fewer questions, which will require less time for members to complete. In addition, all questions are now optional. NABH hopes this will make it more likely for members to share the data they have. Lastly, NABH has added a checklist of “red flags” that were included in the 2022 MHPAEA Report to Congress from the U.S. Health and Human Services, Labor, and Treasury Departments in January. “We know the best way to advocate for parity enforcement with 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 these new changes will make it easier—and faster—for our members to use so that we can gather that critical data.” Please e-mail Emily Wilkins, NABH’s administrative coordinator, if you have questions about the portal. Save the Date for the NABH 2023 Annual Meeting! Please mark your calendars and plan to join us in Washington, DC from June 12-14, 2023 for next year’s NABH Annual Meeting! Fact of the Week Calls to the new, national 988 behavioral health crisis hotline increased by 45% during the week after it transitioned to a three-digit number from a longer one. For questions or comments about this CEO Update, please contact Jessica Zigmond

CEO Update 202

ONDCP Director Identifies Gaps and Proposes Better System for Tracking Nonfatal Overdoses

In a recent JAMA commentary, the head of the White House Office of National Drug Control Policy (ONDCP) said the lack of real-time data for both fatal and nonfatal drug overdoses in the United States undermines the ability to respond accountably and restricts the potential to understand the effects of actions and investments. ONDCP Director Rahul Gupta, M.D., M.B.A., M.P.H., and David Holtgrave, Ph.D., also of ONDCP, argued that it’s essential to build the national data system while taking actions to prevent overdoses and save lives in the near term. “Once established, this national system should rapidly yield higher-quality, more complete, more timely, and more actionable data to inform increasingly effective policy making to prevent and treat overdose occurrences and build health equity,” the authors wrote. “Doing so will require the partnership of many, but there is not a moment to lose.”

Uniform Law Commission Agrees to Propose a Bill to State Legislatures That to Create More Consistency in Telehealth Laws

Politico reported this week that the influential Uniform Law Commission agreed to propose legislation to state legislatures that would try to create more consistency in telehealth laws and expand access to care across state lines. The commission nearly unanimously approved the model legislation after two years of deliberations and guidance from the American Medical Association, Federal Trade Commission, state medical boards, and telehealth groups. “It’s unclear how many states will move to create new laws around telehealth — or use the Uniform Law Commission’s model — but legislatures have embraced past proposals on issues ranging from regulation of organ donation to taxation of people who work in multiple states,” the story noted.

HRSA Payment Program for Rural Health Clinic Buprenorphine-Trained Providers Still Open

The nation’s rural health clinics (RHCs) still have an opportunity to apply for funding from the Health Resources and Services Administration’s (HRSA) program that pays providers who are waivered to prescribe buprenorphine, a medication used to treat opioid use disorder. Launched in 2021, HRSA’s program has about $1.2 million in program funding still available, and RHCs may apply for a $3,000 payment on behalf of each provider who trained to obtain the necessary waiver. HRSA said funds will be paid on a first-come, first-served basis until funds are exhausted. Please direct any questions to DATA2000WaiverPayments@hrsa.gov. In addition, the American Osteopathic Academy of Addiction Medicine and the Providers Clinical Support System are offering a free online course for waiver-eligibility training. Click here for more information.

Enhanced NABH Denial-of-Care Portal is Now Available!

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

Save the Date for the NABH 2023 Annual Meeting!

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

Fact of the Week

Sixty-four percent of dual-eligible beneficiaries have a mental health diagnosis, according to a recent profile from research firm. ATI Advisory. For questions or comments about this CEO Update, please contact Jessica Zigmond

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

The National Association for Behavioral Healthcare is pleased to announce enhancements to its Denial-of-Care Portal that are intended to make the portal easier for members to use. A year ago, NABH developed the Denial-of-Care Portal to collect specific data on insurers who deny care—often without regard to parity or the effects on patients. Now the association has updated this resource to make it more user-friendly for members and also more aligned with what regulators need to identify parity violations. The updated portal includes fewer questions, which will require less time for members to complete. In addition, all questions are now optional. NABH hopes this will make it more likely for members to share the data they have. Lastly, NABH has added a checklist of “red flags” that were included in the 2022 MHPAEA Report to Congress from the U.S. Health and Human Services, Labor, and Treasury Departments in January. “We know the best way to advocate for parity enforcement with 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 these new changes will make it easier—and faster—for our members to use so that we can gather that critical data.” Please e-mail Emily Wilkins, NABH’s administrative coordinator, if you have questions. As always, thank you for all you do each day to support and advance NABH’s mission and vision!

CEO Update 200

CMS Proposes to Modernize Coverage for Behavioral Health Services in 2023 Physician Fee Schedule Rule

The Centers for Medicare & Medicaid Services (CMS) on Thursday proposed new policies to update coverage for behavioral health services in the agency’s physician fee schedule proposed rule for 2023. In the rule, CMS proposes to address the behavioral healthcare workforce shortage by allowing licensed professional counselors (LPCs), marriage and family therapists (LMFTs), and other types of behavioral health practitioners to provide behavioral health services under general, rather than direct, supervision. CMS also proposes to pay for clinical psychologists and licensed clinical social workers to provide integrated behavioral health services as part of a patient’s primary care team. In addition, the rule proposes to bundle certain chronic pain management and treatment services into new monthly payments to help improve patient access to team-based, comprehensive, chronic pain treatment. And the agency is proposing to cover opioid treatment and recovery services from mobile units, such as vans, to increase access to services for people who are homeless or live in rural areas. Meena Seshamani, M.D., Ph.D., director for the Center for Medicare at CMS, and Douglas Jacobs, M.D., M.P.H., chief transformation officer at the Center for Medicare, co-authored a blog post Thursday about the behavioral health changes in the proposed rule.

Federal Health Officials Recommend ‘Preaddiction’ to Treat SUDs

Directors at the National Institutes of Health and the founder of the Treatment Research Institute this week recommended that the DSM-5 diagnostic categories “mild to moderate SUD” be a starting definition for the term preaddiction, a term they said could generate greater attention to the risks associated with early state substance use disorder (SUD) and help direct policies and resources to support preventive and early intervention measures. Nora Volkow, M.D., director of the National Institute on Drug Abuse, George Koob, Ph.D., director of the National Institute on Alcohol and Abuse and Alcoholism, and Tom McClellan, founder of the Treatment Institute wrote a commentary in JAMA Psychiatry this week that pushed for using the term preaddiction and highlighted lessons learned from Type 2 Diabetes and the role of “prediabetes” in their argument. As the authors explained, the American Diabetes Association in 2001 suggested the term prediabetes (defined by elevated scores on two laboratory tests: impaired glucose tolerance and impaired fasting glucose) to leverage public motivation to avoid serious diabetes. “Intervening early is not a new concept, nor is it easy to implement,” the authors wrote. “The diabetes field likely succeeded owing to a broad, well-organized, and sustained strategy applied concurrently at the clinical, public, and policy levels,” they said, adding that if an analogous approach is to be effective in the SUD field, it will require similarly integrated efforts in three areas: measures to define and detect preaddiction; engaging, effective interventions for preaddiction; and public and clinical advocacy. “The diabetes example illustrates why a similar strategy has not yet happened in the SUD field: poor integration into the rest of mainstream healthcare, lack of a prominent advocacy group demanding clinical and policy changes, and little reimbursement for interventions with less severe SUDs,the authors noted. “Nonetheless, the diabetes example shows that an early intervention approach can work given a comprehensive, sustained effort. That example also suggests the potential impact from a parallel strategy to reduce addiction problems by more aggressive efforts to identify and reverse preaddiction.” Volkow discussed the issue further in her blog on July 6.

HUD Announces $365 Million Package to Address Unsheltered Homelessness and Homeless Encampments

The U.S. Housing and Urban Development Department (HUD) recently announced $322 million for permanent housing, supportive services, and other costs, and $43 million to fund about 4,000 new incremental housing choice vouchers. The Initiative for Unsheltered and Rural Homelessness through HUD promotes partnerships with healthcare organizations, public housing authorities and mainstream housing providers, and people with lived experience and expertise of homelessness. “President Biden is following through on his promise to unite our country by delivering funding for healthcare and services that support individuals who are unhoused,” Rahul Gupta, M.D., director of the White House Office of National Drug Control Policy, said in an announcement. “As a physician I have seen firsthand how important it is to address the social and economic conditions of a person’s life in order for them to realize the health and well-being every American deserves.” Click here to learn more in the full HUD announcement.

SAMHSA Releases Advisory on Peer Supports Services in Crisis Care

The Substance Abuse and Mental Health Services Administration (SAMHSA) has released an advisory that discusses the role of peer support workers and models that are available to help individuals in crisis. The 17-page resource includes information about the evidence base for peer support services in crisis care, what peer support workers should do, how the recovery process looks different for everyone, and more.

Reminder: National Academies’ Forum on Mental Health and SUD to Host Workshop Next Week

The National Academies’ Forum on Mental Health and Substance Use Disorders will host a public workshop that focuses on early intervention for psychosis, current data on the epidemiology and outcomes for people at high risk for psychosis and those who have experienced a first psychosis, and ways to improve care for these patients. Sessions will provide an overview of the epidemiology for people with psychosis, discuss what services are available and highlight successful models of care, and examine policy solutions and strategies that the most effective for coordinated specialty services. The workshop will be held on Monday, July 11 from 11 a.m. to 5 p.m. ET. Click here to register.

Reminder: 2022 Annual Meeting Evaluation

If you attended the 2022 Annual Meeting in Washington, please take a few moments to complete this evaluation via Survey Monkey. Your feedback will help inform our future programs. Thank you.   Fact of the Week Comparing the Public Health Emergency (PHE) period (March 2020 to January 2022) with the pre-PHE period, mental health services for children covered by Medicaid has declined about 23%, according to preliminary data from CMS. For questions or comments about this CEO Update, please contact Jessica Zigmond

CEO Update 199

SAMHSA to Host Webinar on 42 CFR Part 2 Compliance Next Week

The Substance Abuse and Mental Health Services Administration (SAMHSA) will host a 90-minute webinar for business managers and compliance officers on July 7 to help ensure their organizations comply with SAMHSA’s 42 CFR Part 2 regulations. The lesson will highlight the latest updates released in January 2018; examine multiple scenarios and frequently asked questions related to SAMHSA’s mental health, substance abuse, and alcohol abuse records; and address proper ways to secure and/or release this information. SAMHSA urges practice managers, business associates who work with health records, compliance officers, physicians, and other medical professionals to attend the webinar on Thursday, July 7 at 1 p.m. ET. Click here to register.

White House Maternal Health Blueprint Aims to Increase Access to Behavioral Health Services

In its new White House Blueprint for Addressing the Maternal Health Crisis, the Biden administration has recommended 50 actions that more than a dozen federal agencies will take to improve maternal care in the United States, including some related to behavioral health. Released in June, the 68-page blueprint outlines five goals, starting with Goal #1: Increase Access to and Coverage of Comprehensive High-Quality Maternal Health Services, Including Behavioral Health Services. “We will continue to invest in maternal behavioral health by launching a 24/7 national support hotline for pregnant individuals and new mothers facing mental health challenges and improving provider education,” the blueprint noted in this first goal. “We will also strengthen access to perinatal addiction services by partnering with hospitals and community-based organizations to implement evidence-based practices,” it continued. “Congress must also take critical steps to bolster access to and coverage of maternal health services.” Other behavioral health-related action items include strengthening supports and access to perinatal addiction services for individuals with substance use disorder by partnering with hospitals and community-based organizations to implement evidence-based interventions, and appointing a dedicated associate administrator for women’s services at SAMHSA to lead its efforts in promoting positive mental health during pregnancy and in the postpartum period.

NABH Responds to AHRQ’s RFI About CAHPS Survey for Inpatient Mental Healthcare Settings

NABH this week responded to the Agency for Healthcare Research and Quality’s (AHRQ) request for information (RFI) regarding potential Consumer Assessment of Healthcare Providers and Systems (CAHPS) for Inpatient Mental Healthcare Settings. AHRQ’s detailed RFI seeks to identify the highest priority aspects patient experiences to include in measures and surveys, the benefits of collecting information about a patient’s experience from family members and caregivers, the challenges that exist in collecting this information, and much more. “During inpatient stays, patients are typically experiencing an increase in psychiatric symptomatology, including, but not limited to, hallucinations, paranoia, delusions, emotional lability, and fragmented cognitive processes,” NABH’s letter said in response to a question about the challenges in administering measures and surveys in mental healthcare settings. “Patients may thus be limited in their ability to express thoughts and feelings, to comprehend written material, or sustain their attention to complete a survey,” the letter continued. “For these reasons, we suggest limiting surveys to 20-25 questions, or 8-10.”

Reminder: National Academies’ Forum on Mental Health and SUD to Host Summer Workshop on Early Intervention for Psychosis on July 11

The National Academies’ Forum on Mental Health and Substance Use Disorders will host a public workshop that focuses on early intervention for psychosis, current data on the epidemiology and outcomes for people at high risk for psychosis and those who have experienced a first psychosis, and ways to improve care for these patients. Sessions will provide an overview of the epidemiology for people with psychosis, discuss what services are available and highlight successful models of care, and examine policy solutions and strategies that the most effective for coordinated specialty services. The workshop will be held on Monday, July 11 from 11 a.m. to 5 p.m. ET. Click here to register.

Reminder: 2022 Annual Meeting Evaluation

If you attended the 2022 Annual Meeting in Washington, please take a few moments to complete this evaluation via Survey Monkey. Your feedback will help inform our future programs. Thank you.

Fact of the Week

The United States requires about 6,600 new mental health practitioners to meet demand in regions the federal government has identified as health professional shortage areas, according to data from the Kaiser Family Foundation.

The NABH staff wishes you, your teams, and your families a happy and safe Independence Day weekend!

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

CEO Update 198

Senate Passes Gun-Control Bill with Mental Health Provisions

The Senate on Thursday passed the most significant gun-control legislation since the mid-1990s in a bill that includes about $15 billion in mental health and school security funding. The House is expected to vote today, June 24, on the measure. The Bipartisan Safer Communities Act expands the existing Medicaid Certified Community Behavioral Health Clinic (CCBHC) demonstration program to all states; helps states to implement, enhance, and expand school-based health programs under Medicaid through updated guidance, technical assistance, and state planning grants; requires the Centers for Medicare & Medicaid Services (CMS) to provide guidance to states on how they can increase access to behavioral health services through telehealth under Medicaid and CHIP; appropriates $150 million to help implement the upcoming 988 behavioral health crisis hotline; provides $500 million through the School-Based Mental Health Services Grant Program to increase the number of qualified mental health service providers that provide school-based mental health services to students in school districts with demonstrated need; and more. President Biden said he intends to sign the bill into law. “Last month, President Biden spent hours with the family members whose lives were forever changed by the recent shootings at a grocery store in Buffalo, New York and an elementary school in Uvalde, Texas,” said a Statement of Administration Policy from the Office of Management and Budget. “The family members delivered a simple message, which the president then relayed to the American people: do something. Do something to stop the carnage of gun violence that leaves behind grief and trauma in communities, both big and small, across the country.” The statement added that the bill advances President Biden’s agenda to expand access to mental health services and address the trauma of gun violence affecting so many communities. Click here to read the legislation.

House Passes Mental Health Bill to Reauthorize Funds for SAMHSA & HRSA

In a 402-20 vote Wednesday, the House of Representatives passed H.R. 7666, the Restoring Hope for Mental Health and Well-Being Act, which would reauthorize essential Substance Abuse and Mental Health Services (SAMHSA) and Health Resources and Services Administration (HRSA) programs to address the nation’s mental health and substance use crises. The bill would reauthorize and modify several programs, including the Community Mental Health Services Block Grant, the Substance Abuse Prevention and Treatment Block Grant, and grants related to suicide prevention and the behavioral health workforce. In remarks on the House floor, House Majority Leader Steny Hoyer (D-Md.) applauded the House Energy and Commerce Committee and all House members whose legislation was included in the package. “I hope this strong vote today will help move these critical policies through the Senate and see them quickly enacted into law,” Hoyer added. On Tuesday, the Biden administration said it supported the bill in a Statement of Administrative Policy.

World Health Organization Releases First World Mental Health Report Since 2001

The World Health Organization (WHO) has released its largest review of world mental health since it released World Health Report 2001: Mental Health: New Understanding, New Hope. The latest iteration, Transforming Mental Health for All, provides a roadmap for governments, academics, health professionals, and others to support the world in transforming mental health. “As the world comes to live with, and learn from, the far-reaching effects of the Covid-19 pandemic, we must all reflect on one of its most striking aspects – the huge toll it has taken on people’s mental health,” the nearly 300-page report noted. “Rates of already-common conditions such as depression and anxiety went up by more than 25% in the first year of the pandemic, adding to the nearly one billion people who were already living with a mental disorder,” it continued. “At the same time, we must recognize the frailty of health systems attempting to address the needs of people with newly-presenting as well as pre-existing mental health conditions.” The report also said that since 2001, countries worldwide have formally adopted international frameworks that guide them to act for mental health. And, it continued, WHO member states have adopted the Comprehensive Mental Health Action Plan 2013-2030, which commits them to meeting 10 global targets for improved mental health. Categorized in eight sections, the report examines principles and drivers in public mental health, assesses world mental health today, argues for investment in mental health, considers promotion and prevention strategies for change, and explores how to restructure and scale up care.

MACPAC Examines How Medicaid Policy Can Support Adopting Behavioral Health IT

In its June report to Congress, the Medicaid and CHIP Payment and Access Commission (MACPAC) analyzed how Medicaid policy can be used to support adopting health information technology among behavioral healthcare providers. The report highlighted that Medicaid programs play a critical role in financing behavioral health services and that those programs are focused on ways to provide behavioral health in more integrated settings. Therefore, the Commission recommended, “…that CMS issue guidance to help states use Medicaid authorities and other federal resources to promote behavioral health IT adoption, and that the Office of the National Coordinator for Health Information Technology and the Substance Abuse and Mental Health Services Administration work together to develop voluntary standards that would encourage health IT uptake appropriate for behavioral health.” See chapter 4 of the report, Encouraging Health Information Technology Adoption in Behavioral Health: Recommendations for Action, to learn more.

CDC Introduces Tool to Check Drinking and Create a Plan to Drink Less

The Centers for Disease Control and Prevention (CDC) has launched an alcohol-screening tool for adults to check their drinking, identify barriers to drinking less frequently, and create a personalized plan to make healthier drinking choices—all anonymously. The resource is part of the Atlanta-based agency’s new Drink Less, Be Your Best campaign that highlights the harmful effects of alcohol and provides resources to help adults drink less. CDC noted in its announcement that the tool is not intended for medical diagnosis or treatment.

‘Hiding in Plain Sight: Youth Mental Illness’ Documentary to Air June 27 and 28

Award-winning filmmaker Ken Burns presents Hiding in Plain Sight: Youth Mental Illness, a two-part documentary film by Erik Ewers and Christopher Loren Ewers on Monday and Tuesday, June 27 and 28 at 9 p.m. ET on PBS. Click here to see a preview of the film, which includes a brief introduction from Burns.

2022 Annual Meeting Presentations Available Online

Please visit our Annual Meeting homepage to view available slide presentations from this year’s Annual Meeting. NABH will post recorded presentations on a later date.   And if you attended the 2022 Annual Meeting in Washington, please take a few moments to complete this evaluation via Survey Monkey. Your feedback will help inform our future programs. Thank you.

Reminder: National Academies’ Forum on Mental Health and SUD to Host Summer Workshop on Early Intervention for Psychosis Next Month

The National Academies’ Forum on Mental Health and Substance Use Disorders will host a public workshop this summer that focuses on early intervention for psychosis, current data on the epidemiology and outcomes for people at high risk for psychosis and those who have experienced a first psychosis, and ways to improve care for these patients. Sessions will provide an overview of the epidemiology for people with psychosis, discuss what services are available and highlight successful models of care, and examine policy solutions and strategies that are the most effective for coordinated specialty services. The workshop will be held on Monday, July 11 from 11 a.m. to 5 p.m. ET. Click here to register.

Save the Date for the 2023 Annual Meeting!

Please save the date for NABH’s next Annual Meeting: June 12-14, 2023 at the Mandarin Oriental Washington, DC.

Fact of the Week

In 2019, nearly a billion people – including 14% of the world’s adolescents – were living with a mental disorder, the World Health Organization reports. For questions or comments about this CEO Update, please contact Jessica Zigmond

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NABH Annual Meeting Kicks Off on Monday!

We’re pleased to devote this week’s edition of CEO Update to details about our Annual Meeting that starts on Monday, June 13! Our theme this year is Shaping the Future of Behavioral Healthcare, and our speakers—including HHS Secretary Xavier Becerra— will address topics that affect our industry today and in the years ahead. From parity and access to care, to the Biden’s administration’s behavioral health and drug control strategies, to the 2022 midterm elections, to workforce challenges and solutions, to the upcoming 988 behavioral health crisis hotline, this year’s program is one you won’t want to miss. On Monday, please be sure to look for an Annual Meeting Alert, which will include a link to our mobile app that contains important details about sessions, events, committee meeting room assignments, exhibitors and sponsors, our priorities for the 117th Congress, restaurant recommendations in the Washington area, and more. We’ll open our meeting on Monday with two dynamic speakers: Ben Nemtin will discuss his personal battle with clinical depression and how to thrive personally and professionally, and journalist Sam Quinones will share his experiences writing his most recent book, The Least of Us: True Tales of America and Hope in the Time of Fentanyl and Meth. Sam will sign copies of his book after his presentation. As with previous Annual Meetings, we will post presentations on our website after the meeting ends. Registration opens on Monday at noon, and our first session kicks off in the Mandarin Oriental’s Grand Ballroom at 2:30 p.m. I hope to see you there! -Shawn Coughlin, President and CEO

HHS Secretary Becerra to Address Attendees on Tuesday, June 14

HHS Secretary Xavier Becerra, the 25th secretary of the U.S. Health and Human Services Department and the first Latino to hold that office, will address Annual Meeting attendees on Tuesday, June 14 at 8:30 a.m. in the Grand Ballroom. Secretary Becerra will offer brief remarks and then engage in a question-and-answer session with NABH President and CEO Shawn Coughlin. Previously Secretary Becerra was California’s attorney general and before that served for 12 terms in the U.S. House of Representatives, where he was the first Latino to serve as a member of the powerful House Ways and Means Committee. He also served as chairman of his party’s caucus and as the ranking member of both the Ways and Means Subcommittee on Health and Ways and Means Subcommittee on Social Security. Secretary Becerra will discuss the Biden administration’s comprehensive strategy to address America’s mental health crisis, which includes promoting the well-being of the nation’s frontline healthcare workforce, piloting new approaches to training behavioral health paraprofessionals, strengthening the country’s crisis care and suicide prevention infrastructure, integrating mental health and substance use treatment into primary care, expanding and strengthening parity, and more.

ONDCP Director Rahul Gupta, M.D., M.B.A., FACP to Present on Tuesday, June 14

Following Secretary Becerra’s presentation on Tuesday, Office of National Drug Control Policy (ONDCP) Director Rahul Gupta, M.D., M.B.A., FACP will provide a presentation at 9:30 a.m. in the Grand Ballroom. Dr. Gupta is the first medical doctor to serve as director and lead ONDCP, a component of the Executive Office of the President. ONDCP coordinates the nation’s $40 billion drug budget and federal policies, including prevention, harm reduction, treatment, recovery support, and supply reduction. Through his work as a physician, a state and local leader, an educator, and a senior leader of a national nonprofit organization, Dr. Gupta has dedicated his career to improving public health and public safety. He is also a buprenorphine-waivered practitioner, who has provided medication-assisted treatment for people with opioid use disorder. The son of an Indian diplomat, Dr. Gupta was born in India and grew up in the suburbs of Washington, D.C. At age 21, he completed medical school at the University of Delhi and later completed subspecialty training in pulmonary medicine. Dr. Gupta earned a master’s degree in public health from the University of Alabama-Birmingham and a global master’s of business administration degree from the London School of Business and Finance.

Panel to Examine Ways to Address Behavioral Healthcare Workforce Challenges

Workforce shortages have challenged NABH members for years before the pandemic worsened the problem. For this year’s Annual Meeting, NABH has developed a panel to discuss potential solutions. Please join us in the Grand Ballroom on Tuesday, June 14 at 11 a.m. to learn from panelists Megan Baird of the Office of Apprenticeship in the U.S. Labor Department’s Employment and Training Administration; Malissa Lewis, LL.M of the Health Resources and Services Administration; and David Long of Pinnacle Treatment Centers, an NABH member organization. NABH Director of Quality and Addiction Services Sarah Wattenberg, L.C.S.W. will moderate a discussion that will highlight apprenticeships, loan repayment programs, and more.

Political Commentator Amy Walter to Discuss 2022 Midterm Elections

Be sure to attend this year’s Annual Meeting Luncheon at noon on Tuesday, June 14 in the Oriental Ballroom to learn from political commentator Amy Walter, who will preview this fall’s midterm election season. Walter, editor in chief of the Cook Political Report with Amy Walter and a political commentator for the PBS NewsHour, provides analysis of the issues, trends, and events that shape the political environment. She is also a regular Sunday panelist on NBC’s Meet the Press and CNN’s Inside Politics and appears frequently on Special Report with Bret Baier on Fox News Channel. From 2017 until early 2021, Walter was the host of the weekly nationally syndicated program “Politics with Amy Walter” on The Takeaway from WNYC and PRX. She’s also the former political director of ABC News.

Learn Details about the Wit v. UBH Case During Wednesday’s Policy Breakfast

Join us on Wednesday morning, June 15 to hear from Meiram Bendat, J.D., founder and president of Psych Appeal and consultant to NABH, who will discuss details of the Wit v. UBH case.   The policy breakfast will begin at 8 a.m. on Wednesday and the Annual Meeting will adjourn at 10 a.m.     The NABH team wishes everyone a safe trip to Washington, and we look forward to seeing you soon! For questions or comments about this CEO Update, please contact Jessica Zigmond

CEO Update 196

White House Releases Fact Sheet on Strategy to Address Nation’s Mental Health Crisis

The Biden Administration concluded Mental Health Month this week by announcing new actions to advance President Biden’s mental health strategy in three previously announced objectives: strengthening system capacity, connecting more Americans to care services, and creating a continuum of support. The White House noted that America’s mental health crisis is unprecedented, as two in five American adults report symptoms of anxiety and depression, and more than half of U.S. parents express concern about their children’s mental well-being. Meanwhile, the announcement continued, more than 40% of teenagers report they struggle with persistent feelings of sadness and hopelessness. “These growing demands have exposed longstanding cracks in our care infrastructure while compounding many other challenges, from criminal justice to homelessness to the labor shortage,” the White House announcement said. In a new fact sheet, the Biden Administration outlined applicable action steps to address the crisis, such as promoting the well-being of the healthcare workforce, piloting new approaches to training behavioral health paraprofessionals, bolstering the nation’s crisis care and suicide prevention infrastructure, building capacity for long-term care facilities to deliver behavioral health services, making care affordable across all types of health insurance coverage, integrating mental health services in ways that reduce stigma and access barriers, and more.

HHS’ Office on Women’s Health Announces Grant Program to Reduce Maternal Deaths Due to SUD

HHS’ Office on Women’s Health is accepting applications for projects designed to strengthen the perinatal (from conception to birth) and postnatal (up to 12 months after birth) to support structures for patients with substance use disorder (SUD) and reduce deaths during those two time periods. Applicants who receive funding will be expected to partner with hospital and community-based organizations to implement evidence-based interventions that strengthen perinatal and postnatal support structures for patients with SUD; create a technologically innovative education and outreach products to provide support accessible to perinatal and postpartum patients with SUD at home and on the go to reduce triggers, decrease stress, and increase feelings of support; and improve health outcomes and reduce deaths among perinatal and postpartum patients associated with SUD. Both for-profit and not-for-profit organizations are eligible to apply. Click here to learn more and apply.

National Academies’ Forum on Mental Health and SUD to Host Summer Workshop on Early Intervention for Psychosis

The National Academies’ Forum on Mental Health and Substance Use Disorders will host a public workshop this summer that focuses on early intervention for psychosis, current data on the epidemiology and outcomes for people at high risk for psychosis and those who have experienced a first psychosis, and ways to improve care for these patients. Sessions will provide an overview of the epidemiology for people with psychosis, discuss what services are available and highlight successful models of care, and examine policy solutions and strategies that are most effective for coordinated specialty services. The workshop will be held on Monday, July 11 from 11 a.m. to 5 p.m. ET. Click here to register.

NABH Working to Enhance Denial-of-Care Portal

NABH’s Denial-of-Care Portal is temporarily unavailable as the association works to enhance features of this member-only resource. NABH developed the portal so members could submit individual examples of claim denials or upload multiple entries via Excel. It also includes sections on appeals and physician participation and is intended to help the association in its advocacy efforts with policymakers and regulators. NABH will inform members when the updated portal is ready to use.

Learn About Our 2022 Annual Meeting Speakers!

The NABH 2022 Annual Meeting is fewer than two weeks away. Please be sure to learn more about this year’s speakers here on our Annual Meeting homepage. And please be sure to register for the meeting, if you have not done so yet. We look forward to seeing you soon in Washington!

Fact of the Week

A new study in JAMA Psychiatry found that after sustaining a mild traumatic brain injury (mTBI), some individuals—on the basis of education, race/ethnicity, history of mental health problems and cause of injury—were at substantially increased risk of post-traumatic stress disorder (PTSD) and/or major depressive disorder (MDD). For questions or comments about this CEO Update, please contact Jessica Zigmond

NABH Board of Trustees Meeting: June 13, 2022

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Agenda

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HHS Leaders Encourage States to Prioritize Efforts to Support Children’s Mental Health   Following Tuesday’s shooting at Robb Elementary School in Uvalde, Texas—the deadliest U.S. school shooting in 10 years in which a gunman killed 19 children and two teachers—U.S. Health and Human Services Department (HHS) agency leaders sent a joint letter to states, tribes, and jurisdictions urging them to maximize and prioritize their efforts to strengthen children’s mental health and well-being. According to the National Survey of Children’s Health, the number of children ages 3-17 years diagnosed with anxiety grew by 29% and those with depression by 27% between 2016 and 2020. Meanwhile, there was a 21% increase in children diagnosed with behavioral or conduct problems between 2019-2020. The letter provided a list of existing opportunities, partnerships, grants, and programs that states, tribes, and jurisdictions can access to support children’s mental health. Including HHS Secretary Xavier Becerra, leaders from the Administration for Children and Families, Administration for Community Living, Centers for Disease Control and Prevention, Centers for Medicare & Medicaid Services, Health Resources and Services Administration, and the Substance Abuse and Mental Health Services Administration (SAMHSA) signed the letter on May 25.

U.S. Surgeon General Releases Advisory on Health Worker Burnout

U.S. Surgeon General Vivek Murthy, M.D., M.B.A. this week released Addressing Health Worker Burnout, a 76-page advisory intended to draw the American people’s attention to an urgent public health issue and provide recommendations about how to manage it. In a video accompanying the advisory, Murthy noted that 54% of the nation’s physicians and nurses were experiencing burnout before the pandemic began, eight out of 10 health workers have experienced workplace violence, and 66% of U.S. nurses have considered resigning. “Healthcare systems, health insurance companies, and government must prioritize health worker well-being,” Murthy said in his recorded message. “This means increasing access to mental health services; reducing workplace burdens to prioritize time with patients; and protecting the health and safety of all health workers.” The advisory includes separate categories describing what healthcare organizations, federal, state, local, and tribal governments, insurers and payers, healthcare technology companies, academic institutions, clinical training programs, and accreditation bodies can do to help address health worker burnout.

George Washington University & Health Landscape Create Mental Health-SUD Workforce Database

With support from a SAMHSA grant, the George Washington University Fitzhugh Mullan Institute for Health Workforce Equity and data research firm Health Landscape have developed a national database on the country’s mental health and substance use disorder workforce to provide evidence-based support for creating policy and targeting resources appropriately. The new Behavioral Health Workforce Tracker is a comprehensive national database that identifies almost 1.2 million behavioral health providers, including more than 600,000 behavioral health specialists, including psychiatric and addiction medicine specialists, psychologists, counselors, and therapists; about 400,000 primary care physicians and advanced practice providers who provided 11 more behavioral health medications, and an additional 173,556 physician specialists who also wrote more than 11 behavioral health medications. Click here to learn more about the database.

National Academies’ Forum on Mental Health and SUD to Host Workshop on Early Intervention for Psychosis

The National Academies’ Forum on Mental Health and Substance Use Disorders will host a public workshop this summer that focuses on early intervention for psychosis, current data on the epidemiology and outcomes for people at high risk for psychosis and those who have experienced a first psychosis, and ways to improve care for these patients. Sessions will provide an overview of the epidemiology for people with psychosis, discuss what services are available and highlight successful models of care, and examine policy solutions and strategies that are most effective for coordinated specialty services. The workshop will be held on Monday, July 11 from 11 a.m. to 5 p.m. ET. Click here to register.

NABH Working to Enhance Denial-of-Care Portal

NABH’s Denial-of-Care Portal is temporarily unavailable as the association works to enhance features of this member-only resource. NABH developed the portal so members could submit individual examples of claim denials or upload multiple entries via Excel. It also includes sections on appeals and physician participation and is intended to help the association in its advocacy efforts with policymakers and regulators. NABH will keep members apprised of when the updated portal is ready to use.

NABH 2022 Annual Meeting Hotel Reservation Cutoff Date is Wednesday, June 1

The Mandarin Oriental Washington, DC has extended the hotel reservation cutoff date for the 2022 NABH Annual Meeting this coming Wednesday, June 1, 2022. Please be sure to reserve your hotel room today! 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 

There has been a 213% increase in the death rate of Black men from drug overdoses from 2015 to 2020, the American Psychological Association reports. Before 2015, Black men were considerably less likely than both White men and American Indian or Alaska Native men to die from drug overdoses. Since then, the death rate among Black men has more than tripled.   For questions or comments about this CEO Update, please contact Jessica Zigmond

CEO Update 194

NABH and Other Healthcare Groups Request Review of Three-Judge Panel’s Ruling in Wit v. UBH

NABH last week requested that the full 9th U.S. Circuit Court of Appeals review a recent ruling from a three-judge panel that erroneously reversed a trial court’s landmark decision last year in the mental health class action, Wit v. United Behavioral Health.   NABH filed an amicus brief to request a “rehearing en banc.” If granted, a rehearing could vacate the appellate panel’s deeply flawed ruling. The American Hospital Association, American Psychological Association, American Association for the Treatment of Opioid Dependence, California Hospital Association, Federation of American Hospitals, National Association of Addiction Treatment Providers, National Council for Mental Wellbeing, and REDC added their organization names to the amicus brief. “Unfortunately, the likely consequence of the panel decision is that the gains achieved as a result of the district court’s rulings will be wiped out as even further restrictions are placed on the care patients receive for treatment of mental illness,” the amicus brief states. “Instead of medical necessity determinations based on GASC developed by non-profit expert bodies, the decision-making power will be left to the discretion of for-profit insurers such as UBH.”   Click here to read the news release that NABH distributed on Monday, May 16.

SAMHSA Introduces First ‘Behavioral Health Recovery Innovation Challenge’

The Substance Abuse and Mental Health Services Administration (SAMHSA) this week introduced its first “Behavioral Health Recovery Challenge” to identify innovations that peer-run or community-based organizations—and entities that partner with them, including hospitals and health systems—have developed to advance recovery. SAMHSA defines recovery as “a process of change through which individuals improve their health and wellness, live self-directed lives, and strive to reach their full potential.” SAMHSA’s announcement noted that the agency encourages participants to share details about the practices they use to advance recovery and also demonstrate how these practices have: 1) expanded on SAMHSA’s definition of recovery, or 2) helped them overcome challenges in incorporating recovery into their behavioral health services or systems. “By using this vehicle, we hope to gain a better understanding of effective and innovative recovery practices from a very diverse field,” HHS Assistant Secretary for Mental Health and Substance Use Miriam E. Delphin-Rittmon, Ph.D., said in an announcement. Delphin-Rittmon also leads SAMHSA. “We aim to take what works for a small group and scale up to a larger population.” Click here to learn more from SAMHSA’s Recovery Innovation Challenge webpage.

SAMHSA Announces Funding Opportunity to Establish Center of Excellence on Social Media and Wellbeing

SAMHSA this week announced a funding opportunity that will award $2 million per year up to five years to establish a national Center of Excellence (CoE) that will develop and disseminate information, guidance, and training on the effects of children and youth’s social media use, including both its risks and benefits. SAMHSA’s grant announcement noted that the new CoE will pay particular attention to the potential risks social media platforms pose to the mental health of children and youth, as well as the clinical and societal interventions that could be used to address those risks. Eligible applicants include states, political divisions of states, Indian tribes or tribal organizations, health facilities, programs operated by or in accordance with a grant contract with the Indian Health Service, or other public of private, not-for-profit entities. The deadline to apply is Monday, July 18. Click here to learn more.

SAMHSA Announces $1.5 billion for State Opioid Response Program

SAMHSA this week said the agency’s State Opioid Response Program grant will fund up to $1,439,500,000 in fiscal year 2022 to 59 states and territories, including a set-aside for states with the highest opioid use disorder-related mortality rates. Grant funds may be used on contingency management to treat stimulant use disorder.   In announcement about the grant funding, Office of National Drug Control Policy Director Rahul Gupta, M.D., M.P.H., M.B.A., FACP said that fewer than one out of 10 people in the United States who need addiction care receive it.   “That is why President Biden released a National Drug Control Strategy to beat the overdose epidemic by going after its drivers: untreated addiction and drug trafficking,” Gupta said in the announcement. “Today we are delivering on key parts of our Strategy through this new funding, which will expand access to treatment for substance use disorder and prevent overdoses, while we also work to reduce the supply of illicit drugs in our communities and dismantle drug trafficking.” The use of contingency management for the treatment off stimulant use disorder is a permitted use of grant funds. The application process opened on Thursday, May 19 and will remain open through Monday, July 18. Click here to learn more.

NABH Working to Enhance Denial-of-Care Portal

NABH’s Denial-of-Care Portal is temporarily unavailable as the association works to enhance features of this member-only resource. NABH developed the portal so members could submit individual examples of claim denials or upload multiple entries via Excel. It also includes sections on appeals and physician participation and is intended to help the association in its advocacy efforts with policymakers and regulators. NABH will keep members apprised of when the updated portal is ready to use.

NABH 2022 Annual Meeting Hotel Reservation Cutoff Date Extended Until June 1

The Mandarin Oriental Washington, DC has extended the hotel reservation cutoff date for the 2022 NABH Annual Meeting to Wednesday, June 1, 2022. Please be sure to reserve your hotel room today! 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

In a recent Cigna survey of 1,000 parents, 80% said their children are struggling with mental health, and nearly one-fifth (18%) say their child’s needs are negatively affecting their job performance and productivity. For questions or comments about this CEO Update, please contact Jessica Zigmond

CEO Update 193

CDC Predicts U.S. Overdose Deaths Surpassed 107,000 in 2021

More than 107,000 Americans died of drug overdoses in 2021, according to provisional data from the Centers for Disease Control and Prevention (CDC) released this week. The troubling statistic—the CDC predicts the total to be 107,622 lives lost— hit a new record, as the number of predicted overdose deaths in 2021 reflects a 15-percent increase in the previous record set in 2020. “It is unacceptable that we are losing a life to overdose every five minutes around the clock,” the Office of National Drug Control Policy Director Rahul Gupta, M.D., M.P.H., M.B.A., FACP, said in a White House statement. “That is why President Biden’s new National Drug Control Strategy signals a new era of drug policy centered on individuals and communities, focusing specifically on the actions we must take right now to reduce overdoses and save lives.” Separately this week, the United States Drug Enforcement Administration (DEA) recognized the first Fentanyl Awareness Day on Monday, May 9. The DEA reports that the synthetic opioid fentanyl is about 50 times more potent than heroin and 100 times more potent than morphine. It is also inexpensive, widely available, and highly addictive. DEA Administrator Anne Milgram released a video announcement about the dangers of fentanyl and the need for urgent action.

HRSA Extends Deadline to Submit for Extenuating Circumstances Request to May 18

HHS’ Health Resources and Services Administration (HRSA) this week announced it has extended the deadline for providers to request to submit a late Provider Relief Fund (PRF) Reporting Period 2 (RP2) report to Wednesday, May 18 at 11:59 p.m. ET. According to HRSA, providers may submit a request if certain extenuating circumstances prevented them from submitting their RP2 report by the initial deadline of March31. All requests must be completed through the PRF Reporting Portal.

Center for Connected Health Policy Releases Bi-Annual Summary of State Telehealth Policy Changes

The Center for Connected Health Policy (CCHP) this week released a summary of state telehealth policy changes for Spring 2022. Covering state telehealth policy updates between January and April 2022, the 11-page summary examines state laws and reimbursement policies, private payors, online prescribing, and more. The resource also includes a state summary chart and an infographic of CCHP’s essential findings.

NABH Working to Enhance Denial-of-Care Portal

NABH’s Denial-of-Care Portal is temporarily unavailable as the association works to enhance features of this member-only resource. The portal was developed so NABH members could submit individual examples of claim denials or upload multiple entries via Excel. It also includes sections on appeals and physician participation and is intended to help the association in its advocacy efforts with policymakers and regulators. NABH will keep members apprised of when the updated portal is ready to use.

NABH 2022 Annual Meeting Preliminary Program Now Available!

The NABH 2022 Annual Meeting online preliminary program is now available. Unless noted otherwise, meeting sessions are open to all Annual Meeting attendees. Please remember to register for the Annual Meeting and reserve your hotel room today, if you haven’t done so yet. We look forward to seeing you next month in Washington!

Fact of the Week

Adolescent female youth who attempted suicide had an elevated risk of substance use disorders up to three decades later, according to a new study in JAMA Psychiatry.   For questions or comments about this CEO Update, please contact Jessica Zigmond.

ONDCP Releases Plan to Reduce Methamphetamine Supply and Save Lives

The White House Office of National Drug Control Policy (ONDCP) on Monday released the Biden administration’s plan to reduce the supply of methamphetamine and save lives as meth-related overdose deaths are rising in the United States. Designed to reduce meth use and prevent meth-involved overdoses, the 25-page plan is also intended to expand access to evidence-based treatment and reduce the trafficking and supply of meth. “The tragic rise in methamphetamine-involved overdose deaths requires immediate action,” ONDCP Director Rahul Gupta, M.D., M.P.H., M.B.A., FACP said in his agency’s announcement. “This bold, new action plan builds on the president’s National Drug Control Strategy by expanding access to evidence-based prevention, treatment, and harm reduction strategies, as well as reducing the supply of methamphetamine and other illicit drugs by going after drug trafficking organizations,” Dr. Gupta continued. “This comprehensive and forward-looking action plan will help make our communities healthier and safer.” The plan applies a public health and safety approach that emphasizes treatment services, harm-reduction services, prevention in schools nationwide, training and education, domestic law enforcement coordination, federal oversight of pill press equipment, international partnerships to disrupt trafficking, and expanded training for domestic and international law enforcement agencies involved in disrupting meth distribution. NABH participates in the Motivational Incentives Policy Workgroup that has met with ONDCP about broadly implementing the evidence-based treatment practice of contingency management, which the new plan highlights. You can learn more about the Biden administration’s National Drug Control Strategy at the NABH 2022 Annual Meeting, when Dr. Gupta will address attendees on Tuesday, June 14 at 9:30 a.m. ET in the Grand Ballroom at the Mandarin Oriental Washington, DC.

CEO Update 192

ASPE Report Studies Pandemic’s Effects on Hospital and Clinician Workforce

A comprehensive report from HHS’ Assistant Secretary for Planning and Evaluation (ASPE) examines the Covid-19 pandemic’s effects on the nation’s healthcare workforce and offers several recommendations, including removing barriers to practicing to the top of one’s license/certification, retaining Covid-19 flexibilities as appropriate, funding for scholarships, and more.   The nearly 30-page report, Impact of the COVID-19 Pandemic on the Hospital and Outpatient Clinician Workforce, found that total employment in the healthcare industry declined during the early months of the pandemic but gradually recovered during the summer of 2020. Many hospitals reported critical staffing shortages during the course of the pandemic—especially when Covid case numbers were high—and during the recent Omicron surge in January and February 2022, the seven-day average of hospitals reporting critical staffing shortages peaked at 22% during mid-January 2022, the report noted. The report acknowledged that several provider types, including behavioral health providers, experienced staffing shortages before the pandemic began. “Even after the pandemic, many of the effects the pandemic has had on the health care workforce will likely persist,” the report noted. “Addressing these impacts as well as the underlying challenges that pre-dated the pandemic can help build a stronger and more resilient health care system for the future.”

Joint Commission’s Covid-19 Staff Vaccination Standard Takes Effect July 1

The Joint Commission said it has approved its new Infection Prevention and Control standard and its elements of performance as a response to the interim final rule from the Centers for Medicare & Medicaid Services (CMS) late last year. According to the Joint Commission, the accrediting organization began surveying to the Omnibus Covid-19 Health Care Staff Vaccination interim final rule—which was released on Nov. 5, 2021—on Jan. 27 this year. “While changes to Joint Commission standards requirements were under review by CMS, findings related to the COVID-19 staff vaccination regulatory requirements have been scored at Leadership (LD) Standard LD.04.01.01, EP 2, along with the applicable Medicare Conditions of Participation/Conditions for Coverage for each of the deemed programs,” the Joint Commission said in an announcement. “This scoring process will continue until June 30, 2022. Click here to learn more.

SAMHSA Senior Medical Advisor John Palmieri, M.D., M.H.A. to Address Attendees at Annual Meeting 

NABH will welcome John Palmieri, M.D., M.H.A., senior medical advisor at the Substance Abuse and Mental Health Services Administration (SAMHSA) and acting director for the 988 behavioral health crisis hotline and Behavioral Health Crisis Coordinating Office, at the 2022 Annual Meeting in Washington on Tuesday, June 14. Prior to his arrival at SAMHSA, Dr. Palmieri was the division chief for behavioral healthcare at the Arlington County (Virginia) Department of Human Services. Dr. Palmieri is a licensed physician in Virginia and is board certified in adult psychiatry. He graduated from Brown University Medical School and completed his adult psychiatry residency at Massachusetts General Hospital. Please click here to learn about our 2022 Annual Meeting speakers.

National Prevention Week is May 8-14

SAMHSA’s National Prevention Week starts Sunday, May 8, and the agency will commemorate the 18th annual National Prevention Day on Monday, May 9. Click here for an agenda of the day’s events. The week-long commemoration is part of Mental Health Awareness Month, which kicked off on Sunday, May 1. The White House issued a proclamation honoring Mental Health Awareness Month, and Mental Health America (MHA)—which established the monthly observance in 1949—is recognizing the 2022 observance with the theme “Back to Basics.” The campaign is intended to provide what MHA has referred to as “foundational knowledge” about mental health, mental health conditions, and information about what people can do if their mental health is cause for concern. Please remember to follow NABH on Twitter @NABHbehavioral and on LinkedIn at the National Association for Behavioral Healthcare throughout the month to learn what NABH members, federal agencies, and advocacy organizations are doing to promote Mental Health Month.

NABH Working to Enhance Denial-of-Care Portal

NABH’s Denial-of-Care Portal is temporarily unavailable as the association works to enhance features of this member-only resource. The portal was developed so NABH members could submit individual examples of claim denials or upload multiple entries via Excel. It also includes sections on appeals and physician participation and is intended to help the association in its advocacy efforts with policymakers and regulators. NABH will keep members apprised about the updated portal is ready to use.

Please Visit the NABH 2022 Annual Meeting Exhibitors & Sponsors Page!

 NABH appreciates the generous support from its exhibitors and sponsors each year at the association’s Annual Meeting. To learn who is exhibiting and sponsoring NABH in 2022, please visit the Exhibitors & Sponsors page on our Annual Meeting homepage. The page also includes general information, tips for exhibitors, and details about shipping materials to the Mandarin Oriental Washington, DC. And please remember to register for the Annual Meeting and reserve your hotel room today, if you haven’t done so yet. We look forward to seeing you next month in Washington!

Fact of the Week

Audio-only visits were the leading telehealth modality for primary care and behavioral health throughout the full pandemic study period of February 2019 through August 2021, according to a new research report from RAND. At the end of the study period, however, audio-only visits were eclipsed by in-person visits for primary care, but not for behavioral health, the study showed.   For questions or comments about this CEO Update, please contact Jessica Zigmond.

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CMS Behavioral Health Strategy Aims to Strengthen Equity, Improve Quality, and Provide Outreach to Beneficiaries

The Centers for Medicare & Medicaid Services (CMS) recently released The CMS Behavioral Health Strategy, a five-goal plan that aims to remove barriers to care and services and also adopt a data-informed approach to evaluate the agency’s behavioral health programs and policies. Noting that the strategy “will strive to support a person’s whole emotional and mental well-being and promotes person-centered behavioral healthcare,” CMS set the following five goals: 1) strengthen equity and quality in behavioral healthcare, 2) improve access to substance use disorders treatment, prevention, and recovery services, 3) ensure effective pain treatment and management, 4) improve access and quality of mental healthcare and services, and 5) utilize data for effective actions and impact on behavioral health. Click here to learn about the objectives in each of those goals.

SAMHSA Announces New Director of the Center for Substance Abuse Treatment

The Substance Abuse and Mental Health Services Administration (SAMHSA) this week named Yngvild Olsen, M.D., M.P.H. as the new director of the agency’s Center for Substance Abuse Treatment. An addiction medicine specialist and general internist, Olsen began her career as the medical director for the outpatient substance use treatment services while serving as a full-time assistant professor in the department of medicine at the Johns Hopkins School of Medicine. From 2011 to 2021, Olsen served as medical director for the Institutes for Behavior Resources/REACH Health Services, a comprehensive outpatient substance use disorder treatment program in Baltimore City.

ONDCP Director Rahul Gupta to Address Attendees at NABH Annual Meeting

NABH is pleased to announce that Director of National Drug Control Policy Rahul Gupta, M.D., M.P.H., M.B.A., FACP will address attendees at the 2022 Annual Meeting on Tuesday, June 14. Dr. Gupta is the first medical doctor to serve as director and lead the Office of National Drug Control Policy (ONDCP), a component of the Executive Office of the President. ONDCP coordinates the nation’s $40 billion drug budget and federal policies, including prevention, harm reduction, treatment, recovery support, and supply reduction. Through his work as a physician, a state and local leader, an educator, and a senior leader of a national nonprofit organization, Dr. Gupta has dedicated his career to improving public health and public safety. He is also a buprenorphine-waivered practitioner, who has provided medication-assisted treatment for people with opioid use disorder. The son of an Indian diplomat, Dr. Gupta was born in India and grew up in the suburbs of Washington, D.C. At age 21, he completed medical school at the University of Delhi and later completed subspecialty training in pulmonary medicine. Dr. Gupta earned a master’s degree in public health from the University of Alabama-Birmingham and a global master’s of business administration degree from the London School of Business and Finance. If you have not done so yet, please visit our Annual Meeting homepage and register today. We look forward to seeing you in Washington!

In Case You Missed It: Kennedy Forum Parity Webinar Recording Now Available

NABH President and CEO Shawn Coughlin participated in a webinar about mental health and substance use disorder treatment parity on Tuesday, April 26 with federal health officials and healthcare organization leaders. Coughlin joined fellow presenters HHS Secretary Xavier Becerra, Assistant Secretary for Mental Health and Substance Use Miriam Delphin-Rittmon, Ph.D., The Kennedy Forum founder and former U.S. Rep. Patrick J. Kennedy (D-R.I.), and American Medical Association President Patrice Harris, M.D. to discuss the Biden administration’s commitment to ensuring parity implementation, the recent Wit v. United Behavioral Health ruling, and ongoing problems with parity compliance. David Lloyd, senior policy advisor at The Kennedy Forum, moderated the event. During the webinar, Delphin-Rittmon, who serves as administrator of SAMHSA, discussed three parity resources that SAMHSA has developed to help patient families, providers, and policymakers understand parity: Know Your Rights, Understanding Parity: A Guide to Resources for Families and Caretakers, and The Essential Aspects of Parity: A Training Tool for Policymakers. NABH was the lead sponsor for this webinar and live Tweeted during the event. Click here to watch the recorded broadcast.

BPC to Host Webinar Monday on Combating the Opioid Crisis with Smarter Federal Spending

The Bipartisan Policy Center (BPC) will host a webinar on Monday, May 2 about new recommendations centered on enhancing federal spending and improving the federal response to America’s ongoing opioid crisis. Participants include Office of National Drug Control Policy Director Rahul Gupta, M.D., M.P.H., M.B.A., FACP; Sen. Joe Manchin (D-W.Va.); American Medical Association President Patrice Harris, M.D.; former U.S. Surgeon General Jerome Adams, M.D.; and former HHS Secretary Donna Shalala. The hour-long webinar will begin at 1 p.m. ET. Click here to register. 

Mental Health Awareness Month Starts Sunday!

Mental Health Month kicks off this Sunday, May 1 to raise awareness about mental health in America. Mental Health America (MHA), which established the monthly observance in 1949, will commemorate Mental Health 2022 with the theme “Back to Basics” to provide what MHA has referred to as “foundational knowledge” about mental health, mental health conditions, and information about what people can do if their mental health is cause for concern. SAMHSA’s National Prevention Week is May 8-14 and the agency will commemorate the 18th annual National Prevention Day on Monday, May 9. Click here for an agenda of the day’s events. And please remember to follow NABH on Twitter @NABHbehavioral and on LinkedIn at the National Association for Behavioral Healthcare throughout the month to learn what NABH members, federal agencies, and advocacy organizations are doing to promote Mental Health Month.

NABH Working to Enhance Denial-of-Care Portal

NABH’s Denial-of-Care Portal is temporarily unavailable as the association works to enhance features of this member-only resource. The portal was developed so NABH members could submit individual examples of claim denials or upload multiple entries via Excel. It also includes sections on appeals and physician participation and is intended to help the association in its advocacy efforts with policymakers and regulators. NABH will keep members apprised when the updated portal is ready to use.

Fact of the Week

Mental health, developmental disorders, and substance use disorders collectively accounted for 48% of all telehealth claims, according to a new report from FAIR Health, a national, not-for-profit organization that produces data products and consumer resources about transparency in healthcare costs and health insurance.   For questions or comments about this CEO Update, please contact Jessica Zigmond.

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President Biden Sends National Drug Control Policy to Congress

President Biden on Thursday sent his administration’s inaugural National Drug Control Policy to Congress with the goal of using a whole-of-government approach to combat the nation’s overdose crisis. The comprehensive strategy focuses on the main drivers of the crisis—untreated addiction and drug trafficking—as it directs federal agencies to take actions that will expand access to evidence-based prevention, harm reduction, treatment, and recovery services, while also reducing the supply of drugs. The plan comes as the nation continues to produce grim statistics: for the first time in America’s history, the country has passed the milestone of 100,000 deaths resulting from drug overdoses in a 12-month period. Meanwhile, since 1999, drug overdoses have killed approximately 1 million Americans. A message from President Bident to Congress at the beginning of the strategy explains the Office of National Drug Control Policy led the effort to produce the strategy in close collaboration with the 18 national drug control agencies. In addition, the Biden administration involved more than 2,000 leaders and stakeholders, including Congress, all 50 Governors, and advocates representing public safety, public health, community groups, local governments, and Tribal communities. An important component of the strategy is its emphasis on harm reduction, an approach that works with people who use drugs to prevent overdose and infectious disease transmission; improve the physical, mental, and social wellbeing of those served; and offer flexible options for accessing substance use disorder treatment and other health care services. “We are changing how we help people when it comes to drug use, by meeting them where they are with high-impact harm reduction services and removing barriers to effective treatment for addiction,” Rahul Gupta, M.D., M.P.H., M.B.A., director of National Drug Control Policy, said in the document, “while addressing the underlying factors that lead to substance use disorder head on.”

The Kennedy Forum to Host Parity Webinar on Tuesday, April 26

NABH President and CEO Shawn Coughlin will join HHS Secretary Xavier Becerra and other healthcare leaders in a webinar about expanding access to mental health and addiction treatment coverage on Tuesday, April 26. The webinar will also feature Assistant Secretary for Mental Health and Substance Use Miriam Delphin-Rittmon, Ph.D., former U.S. Rep. Patrick J. Kennedy, and American Medical Association President Patrice Harris, M.D. Click here to learn more and register for the hourlong webinar, which will start at 2 p.m. ET.

NABH Sends Comments to CMS About Access to Coverage in Medicaid & CHIP

NABH this week responded to a request for information from the Centers for Medicare & Medicaid Services (CMS) regarding access to coverage for Medicaid and the Children’s Health Insurance Program (CHIP). In the letter, NABH emphasized that inadequate access to acute care has led to a strong reliance on hospital emergency rooms to treat people with serious mental illness, even though these settings are not well-suited to address those particular patient needs. NABH also emphasized how the Covid-19 pandemic has heightened the already-increased need for mental health and addiction services. NABH outlined a series of recommendations, including strengthening network adequacy for the full continuum of mental health and addiction treatment; requiring Medicaid programs and plans to implement parity compliance documentation requirements in Medicaid and CHIP; improving Medicaid reimbursement for mental health and addiction treatment providers; and more.

CMS Opens Federal Independent Dispute Resolution Process for Providers

CMS late last week opened the Federal Independent Dispute Resolution (IDR) process for healthcare providers, facilities, health plans, and issuers to resolve payment disputes for certain out-of-network charges. According to CMS, an initiating party will need the following in order to start a dispute: information to identify the qualified IDR items or services; dates and location of items or services; type of items or services such as emergency services and post-stabilization services; codes for corresponding service and place-of-service; attestation that items or services are within the scope of the Federal IDR process; and the initiating party’s preferred certified IDR entity. A list of certified entities is available here. After the 30-business-day open negotiation period ends, initiating parties will have four business days to initiate a dispute via the portal.

BJA Accepting Applications for Variety of Behavioral Health-Related Grant Opportunities

The U.S. Justice Department’s Bureau of Justice Assistance (BJA) is accepting applications for a range of grant programs—eligible to both for-profit and not-for-profit organizations— that seek to improve outcomes for people with mental health and substance use disorders. BJA’s Residential Substance Abuse Treatment (RSAT) for State Prisoners Training and Technical Assistance Program offers funding to provide training and technical assistance (TTA) to grantees and practitioners to improve correctional substance use disorder treatment programming and post-release outcomes for individuals who are incarcerated. Of the four grant opportunities noted in this news item, this grant is the only one for which for-profit organizations other than small businesses are eligible. The Connect and Protect: Law Enforcement Behavioral Health Response Program is seeking applications for funding to support law enforcement-behavioral health cross-system collaboration to improve public health and safety responses and outcomes for people with mental health and substance use disorders. BJA is also accepting applications for its Improving Substance Use Disorder Treatment and Recovery Outcomes for Adults in Reentry for funding to establish, expand, and improve treatment and recovery support services for people with substance use disorders during their incarceration and upon reentry into the community. And the department is accepting applications for its Justice and Mental Health Collaboration Program to support cross-system collaboration to improve public safety responses and outcomes for individuals with mental health disorders or co-occurring mental health and substance use disorders who come into contact with the justice system. Please click on the hyperlinks above for more information and grant deadlines. Political Analyst Amy Walter to Address Attendees at 2022 Annual Meeting Luncheon NABH is pleased to welcome on-air political analyst Amy Walter as the association’s Annual Meeting Luncheon keynote speaker in Washington on Tuesday, June 14. For more than 20 years, Amy Walter has built a reputation as an accurate, objective, and insightful political analyst with unparalleled access to campaign insiders and decision-makers. Known as one of the best political journalists covering Washington, she is the publisher and editor-in-chief of the non-partisan Cook Political Report with Amy Walter, where she provides analysis of the issues, trends, and events that shape the political environment. As a contributor to the PBS NewsHour, Ms. Walter provides weekly political analysis for the popular “Politics Monday” segment. She is also a regular Sunday panelist on NBC’s Meet the Press and CNN’s Inside Politics and appears frequently on Special Report with Bret Baier on Fox News Channel. Please plan to join us for this year’s Annual Meeting luncheon. And if you haven’t done so yet, please remember to register for the meeting and reserve your hotel room today. We look forward to seeing you in Washington! Fact of the Week People with schizophrenia made up a lower proportion of telehealth encounters relative to in-person visits (1.7% versus 2.7%), while those with anxiety and fear-related disorders accounted for a higher proportion (27.5% versus 25.5%), according to a new study published in the April edition of Health Affairs. Researchers concluded the findings highlight the importance of broadening access to services through new modalities without supplanting necessary in-person care for certain groups. For questions or comments about this CEO Update, please contact Jessica Zigmond.

President Biden Sends National Drug Control Policy to Congress

[vc_row][vc_column][vc_column_text]President Biden on Thursday sent his administration’s inaugural National Drug Control Policy to Congress with the goal of using a whole-of-government approach to combat the nation’s overdose crisis. The comprehensive strategy focuses on the main drivers of the crisis—untreated addiction and drug trafficking—as it directs federal agencies to take actions that will expand access to evidence-based prevention, harm reduction, treatment, and recovery services, while also reducing the supply of drugs. The plan comes as the nation continues to produce grim statistics: for the first time in America’s history, the country has passed the milestone of 100,000 deaths resulting from drug overdoses in a 12-month period. Meanwhile, since 1999, drug overdoses have killed approximately 1 million Americans. A message from President Bident to Congress at the beginning of the strategy explains the Office of National Drug Control Policy led the effort to produce the strategy in close collaboration with the 18 national drug control agencies. In addition, the Biden administration involved more than 2,000 leaders and stakeholders, including Congress, all 50 Governors, and advocates representing public safety, public health, community groups, local governments, and Tribal communities. An important component of the strategy is its emphasis on harm reduction, an approach that works with people who use drugs to prevent overdose and infectious disease transmission; improve the physical, mental, and social wellbeing of those served; and offer flexible options for accessing substance use disorder treatment and other health care services. “We are changing how we help people when it comes to drug use, by meeting them where they are with high-impact harm reduction services and removing barriers to effective treatment for addiction,” Rahul Gupta, M.D., M.P.H., M.B.A., director of National Drug Control Policy, said in the document, “while addressing the underlying factors that lead to substance use disorder head on.”[/vc_column_text][/vc_column][/vc_row]

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U.S. Preventive Services Task Force Issues Draft Recommendations on Screening for Anxiety, Depression, and Suicide Risk in Children and Adolescents

In a set of draft recommendations this week, the U.S. Preventive Services Task Force (USPTF) recommended screening children 12 and older for depression and children 8 and older for anxiety. “There is not enough evidence to recommend for or against screening for anxiety and depression in younger children and screening for suicide risk in all youth,” the USPTF announced in a bulletin on April 12. Both the American Academy of Pediatrics (AAP) and the American Foundation for Suicide Prevention (AFSP) expressed serious concerns about the panel’s conclusion that there is insufficient evidence to weigh the benefits and harms of screening asymptomatic children and adolescents for suicide risk. The AAP is urging clinicians to screen all adolescents for suicide risk despite the panel’s finding that more research is needed. “Youth may keep suicidal thoughts to themselves and will not bring up the topic unless directly asked,” May Lau, M.D., M.P.H., a member of the AAP Section on Adolescent Health Executive Committee and a lead author of the Blueprint for Youth Suicide Prevention from AAP/AFSP, said in an article in AAP News. “By screening all youth for suicide, we can identify those that are at risk and connect them with the services they need.” Meanwhile, Christine Moutier, M.D., chief medical officer at the AFSP, told the Associated Press this week that the report “may actually set the field back.” “We have grave concerns that the recommendation citing ‘insufficient evidence’ to implement routine screening for suicide risk for any age youth is 1) flawed due to the incomplete data sources included in their review, and 2) may confuse the field just as major steps are being taken,” Moutier wrote in an e-mail message to NABH. Moutier added that the Blueprint for Youth Suicide Prevention recommends screening for youth ages 12 and older and outlines evidence-based care steps to take for youth who screen positive. A public comment period for the USPTF’s draft recommendations is open until May 9. Click here for details.

HRSA Announces More Than $1.75 Billion in Provider Relief Fund Phase 4 Distribution Payments

HHS’ Health Resources and Services Administration (HRSA) said it is making available more than $1.75 billion in Provider Relief Fund (PRF) Phase 4 General Distribution payments to more than 3,680 providers nationwide this week. According to HRSA, on April 13 providers received an email notification if their application was among those processed in this latest round, and the agency is working to process all remaining applications as quickly as possible. Also this week, HHS Secretary Xavier Becerra extended the PHE for an additional 90 days after the current PHE expires on April 16.

HRSA Announces it Will Offer ‘Extenuating Circumstances’ Option to Providers for PRF Reporting Period 2

HRSA this week said healthcare providers will have the opportunity to submit a “Request to Report Late Due to Extenuating Circumstances for Reporting Period 2” if applicable. Last week, HRSA announced the “extenuating circumstances” option for Reporting Period 1, which lasts from April 11 through April 22. The agency said providers will receive a notification regarding the process to submit a request for Reporting Period 2 in the coming weeks. For more information, visit the Request to Report Late Due to Extenuating Circumstances webpage, or call the Provider Support Line at (866) 569-352 from 9 a.m. to 11 p.m. CT, Monday through Friday.

The Kennedy Forum to Host Parity Webinar Featuring Leaders from HHS, SAMHSA, NABH, & AMA

NABH President and CEO Shawn Coughlin will join HHS Secretary Xavier Becerra and other healthcare leaders in a webinar about expanding access to mental health and addiction treatment coverage later this month. The webinar on Tuesday, April 26 will also feature Assistant Secretary for Mental Health and Substance Use Miriam Delphin-Rittmon, Ph.D., former U.S. Rep. Patrick J. Kennedy, and American Medical Association President Patrice Harris, M.D. Click here to learn more and register for the hour-long webinar, which will start at 2 p.m. ET.

AHA & IAHSS Release Toolkit to Help Mitigate Violence in Healthcare Settings

The American Hospital Association (AHA) and the International Association for Healthcare Security and Safety (IAHSS) have developed a toolkit for hospitals and health systems to establish procedures to prevent violence at all levels. Creating Safer Workplaces is an 11-page resource that provides a framework to build a safer workplace environment; outlines what leaders should consider to promote physical safety and teamwork; highlights how leaders can mitigate risk; describes the role of hospitals in violence intervention; and more.

NPR Story Reports Most State Medicaid Programs Won’t Text Enrollees Despite Urgency to Renew Coverage

A National Public Radio (NPR) story this week cited a recent Kaiser Family Foundation report that found just 11 states said they would use text messaging to alert Medicaid recipients about the end of the Covid public health emergency, while 33 states will use the U.S. Postal Service and at least 20 will rely on individual or automated phone calls. “It’s frustrating that texting is a means to meet people where they are and that this has not been picked up more by states,” Jennifer Wagner, director of Medicaid eligibility and enrollment for research group the Center on Budget and Policy Priorities, said in the story. NPR also noted that officials at the Centers for Medicare & Medicaid Services (CMS) have told states they should consider texting—along with other methods of communication—when trying to contact enrollees about the end of the public health emergency (PHE), but many states don’t have the technology or information about enrollees to do so.

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. 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. Deadline for 2022 NABH Exhibitor & Sponsor Guide Ads is Next Week The deadline to submit an ad in NABH’s 2022 Exhibitor and Sponsor Guide is Tuesday, April 19. Be sure your organization is included in this year’s edition! Please click here for details about advertising options, requirements, payment, and more. We hope to see you in Washington in June!

Fact of the Week 

A recent National Institute of Mental Health-funded study showed that Stepped Care Trauma-Focused (TF) Cognitive Behavioral Therapy (CBT)—in which step one is a parent-led therapist-assisted treatment and step two provides therapist-led TF-CBT for children who did not benefit from step one and require more intensive treatment—can reduce costs by nearly 54%. For questions or comments about this CEO Update, please contact Jessica Zigmond.

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HRSA Announces ‘Extenuating Circumstances’ Option for Provider Relief Fund Reporting

HHS’ Health Resources and Services Administration (HRSA) this week said it will allow healthcare providers to submit a Request to Report Late Due to Extenuating Circumstances for the Provider Relief Fund (PRF) Reporting Period 1 if one or more certain extenuating circumstances apply to their situations. Starting Monday, April 11 and continuing through Friday, April 22 at 11:59 p.m. ET, providers who did not submit their PRF Period 1 report by the required deadline may request to submit a late Reporting Period 1 report, via a DocuSign form, if the following extenuating circumstances exist:
  • Severe illness or death: if a severe medical condition or death of a provider or key staff member responsible for reporting hindered the organization’s ability to complete the report during the reporting period
  • Impacted by natural disaster: if a natural disaster occurred during or in proximity to the end of the reporting period and damaged the organization’s records or information technology
  • Lack of receipt of reporting communications: if an incorrect email or mailing address on file with HRSA prevented the organization from receiving instructions prior to the reporting period deadline
  • Failure to click “submit”: if the organization registered and prepared a report in the PRF Reporting Portal, but failed to take the final step to click “submit” prior to deadline
  • Internal miscommunication or error: if an internal miscommunication or error regarding the individual who was authorized and expected to submit the report on behalf of the organization and/or the registered point of contact in the PRF Reporting Portal
  • Incomplete Targeted Distribution payments: if the organization’s parent entity completed all General Distribution payments, but a Targeted Distribution(s) was not reported on by the subsidiary
According to HRSA, requests to report late due to extenuating circumstances must indicate and attest to a clear and concise explanation, although the agency will not require supporting documents. If HRSA approves an organization’s request, the organization will receive a notification to proceed with completing the Reporting Period 1 report. Providers will have 10 days from the date they receive the notification to submit a report in the PRF Reporting Portal. Click here to learn more about reporting requirements, or call the Provider Support Line at (866) 569-3522 between 9 a.m. to 11 p.m. ET for additional information.

CMS Releases Two Sets of FAQ About ‘No Surprises Act’ Requirements

The Centers for Medicare & Medicaid Services (CMS) this week released two sets of frequently asked questions (FAQ) regarding requirements enacted in the No Surprises Act. CMS issued an FAQ on April 6 that provides additional explanation about the law’s requirements and prohibitions, as well as clarification regarding the independent dispute resolution process and associated fees. A day earlier, CMS released an FAQ with additional information about developing good-faith estimates for uninsured or self-pay patients.

Thorn Run Partners Memo Highlights Medicare & Medicaid Flexibilities During the PHE

Thorn Run Partners, a bipartisan lobbying firm that works with NABH, recently highlighted a host of flexibilities in the Medicare and Medicaid programs during the ongoing Covid-19 public health emergency (PHE). The 14-page memo includes information about recent guidance from CMS, PHE extensions, PHE-related policies in the $1.5 trillion omnibus spending package that President Biden recently signed into law, and more. Click here to read the memo.

NABH Supports ‘Behavioral Health Information Technology Now Act’

NABH is pleased to support the Behavioral Health Information Technology Now Act, a new bill that would offer financial incentives to behavioral healthcare providers for health information technology adoption. Reps. Doris Matsui (D-Calif.) and Markwayne Mullin (R-Okla.) introduced the bill in an effort to coordinate care between physical and mental healthcare—and also include behavioral healthcare providers from a key resource that they have been excluded from for years. “The National Association for Behavioral Healthcare applauds Reps. Matsui and Mullin for recognizing that for far too long, behavioral healthcare providers have not received health information technology funding that other providers have benefited from,” NABH President and CEO Shawn Coughlin said in a news release about the legislation on April 6. “Their legislation would enable behavioral healthcare providers to coordinate care across behavioral healthcare service systems, primary care facilities, and specialty medicine providers more efficiently.” Specifically, the bill would:
  • Finance behavioral health information technology (IT) adoption at $250 million
  • Condition funding allocations to providers based on: 1) acquisition of health IT systems that comply with 2015 certification standards, and 2) attestation of provider compliance with Trump Administration Interoperability and Data Blocking regulations
  • Direct the Office of the National Coordinator for Health Information Technology and the Substance Abuse and Mental Health Services Administration to develop voluntary behavioral health IT standards.

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. 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 2022 Annual Meeting!

NABH will host its 2022 Annual Meeting—Shaping the Future of Behavioral Healthcare—from June 13-15 at the Mandarin Oriental Washington, DC. Please remember to register for the meeting and reserve your hotel room today!

Fact of the Week

Veterans who take medications for opioid use disorder (OUD) for at least 15 days have more than a 50% decreased risk of dying by suicide compared with those not taking OUD medications, according to a study in the April issue of the American Journal of Psychiatry. For questions or comments about this CEO Update, please contact Jessica Zigmond.

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CMS Proposes 2.7% Increase to Inpatient Psychiatric Facilities in 2023

The Centers for Medicare & Medicaid Services (CMS) on Thursday proposed increasing payment rates to the nation’s inpatient psychiatric facilities by 2.7% in fiscal year (FY) 2023, reflecting a 1.5% increase in payments, or about $50 million, relative to FY 2022. According to the agency’s inpatient psychiatric facility prospective payment system (IPF PPS) proposed rule for FY 2023, the IPF PPS federal, per-diem base rate would increase to $856.80 from $832.94 and the electroconvulsive therapy payment rate would increase to $368.87 per treatment from $358.60 per treatment. CMS said the increase is based on the proposed IPF market basket update of 3.1% less a 0.4% percentage point productivity adjustment. For FY 2023 and subsequent years, CMS has proposed to apply a 5% cap on decreases in the IPF PPS wage index in order to mitigate instability in IPF PPS payments due to significant wage index decreases that may affect providers in any given year. CMS did not propose any changes for the IPF Quality Reporting Program for FY 2023. Meanwhile, the agency is seeking comments via a request for information (RFI) about what CMS should consider when advancing the use of measurement and stratification as tools to address healthcare disparities and advance healthcare equity. Specifically, CMS would like comments related to goals and approaches for measuring disparities and using measure stratification across CMS Quality Reporting Programs; guiding principles for selecting and prioritizing measures for disparity reporting; principles for social risk factor and democratic data selection and use; identification of meaning performance differences; guiding principles for reporting disparity measures; and measures related to health equity. CMS is considering and requesting comment about applying the following measures of health equity in the Inpatient Psychiatric Facility Quality Reporting Program: Health Equity Summary Score (HESS) and a structural measure assessing the degree of hospital leadership engagement in health equity performance data. Both of these measures are under consideration for the Medicare Inpatient Quality Reporting Program. Please send any comments that your organization may have to Kirsten Beronio, NABH’s director of policy and regulatory affairs.

President Biden’s 2023 Budget Seeks to Transform U.S. Behavioral Healthcare Delivery

President Biden proposed new, mandatory investments totaling $51.7 billion over 10 years to enhance behavioral healthcare in America in the fiscal year (FY) 2023 budget proposal that he released on March 28. Among the budget blueprint’s most notable behavioral health provisions is the president’s request of $697 million for the Substance Abuse and Mental Health Services Administration (SAMHSA) to ensure that 100% of contacts are answered for the new 988 behavioral health crisis hotline that will begin to operate in July. This is an increase of $590 million from what was enacted for fiscal year 2022. Another significant provision is the president’s proposal for a new, $7.5 billion Mental Health System Transformation Fund through Medicaid to increase access to mental health services through workforce development and service expansion, including the development of non-traditional health delivery sites, the integration of quality mental health and substance use care into primary care settings, and the dissemination of evidence-based practices. NABH is pleased to see President Biden’s 2023  budget proposal calls for improving compliance with behavioral health parity standards by requiring plans and issuers to use medical necessity criteria for behavioral health services that are consistent with the criteria developed by not-for-profit medical specialty associations. The proposal would also place limits on the consideration of profit in determinations of medical necessity. The president’s budget would authorize the secretaries of the U.S. Health and Human Services, Labor, and Treasury Departments to regulate behavioral health network adequacy, and to issue regulations on a standard for parity in reimbursement rates based on the results of comparative analyses submitted by plans and issuers at a cost of $720 million over 10 years. To learn more, please read the NABH Analysis that the association sent to members earlier this week.

Senate Finance Committee Releases ‘Mental Health Care in the United States: The Case for Federal Action’

In a bipartisan report released this week, the Senate Finance Committee concluded that “overwhelmingly, access to affordable, reliable, and high-quality behavioral health care escapes Americans when they need it most” and offered some potential solutions to address the nation’s myriad behavioral healthcare challenges. The 36-page report is divided into eight chapters and examines behavioral health definitions, prevalence, and spending; workforce; children, adolescents, and young adults; access, integration, and coordination; mental health and substance use disorder (SUD) parity; telehealth; and next steps. “As Chairman of the Senate Finance Committee, I am partnering with Ranking Member Mike Crapo on a major bipartisan effort to bring behavioral health care to the forefront of the U.S. health system by leveraging the programs under this Committee’s jurisdiction, including Medicare, Medicaid, and the Children’s Health Insurance Program,” Senate Finance Committee Chairman Ron Wyden (D-Ore.) said in a letter at the start of the report. Wyden added that 10 members of this committee, including five Democrats and five Republicans, are working on policy areas that Wyden deemed “vital for a path forward.”

The Center of Excellence for Protected Health Information Video Offers Guidance about SUD Personnel and 42 CFR Part 2

The Center of Excellence for Protected Health Information (CoE-PHI) has released a video that offers guidance about when identified SUD personnel within a general medical facility must follow the federal privacy protections for SUD treatment known as 42 CFR Part 2. The Substance Abuse and Mental Health Services Administration funds CoE-PHI to help people and organizations understand and apply federal health privacy laws and regulations at work that are specific to certain tasks and roles. CoE-PHI also works to help patients and families understand their rights when seeking treatment for SUD and mental health.

MHA, American Psychological Association, and American Psychiatric Association to Host Webinar on Digital Therapeutics in Mental Health and SUD

Mental Health America, the American Psychological Association, and the American Psychiatric Association will host a webinar next Wednesday, April 6 that examines the role digital therapeutics have in addressing America’s mental health and SUD crises. Participants will learn from Meena Seshamani, M.D., Ph.D., director of the Center for Medicare at CMS; Bakul Patel, director of the Digital Health Center of Excellence at the U.S. Food and Drug Administration; and other experts in the field. The hourlong webinar will begin 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. 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 2022 Annual Meeting!

NABH will host its 2022 Annual Meeting—Shaping the Future of Behavioral Healthcare—from June 13-15 at the Mandarin Oriental Washington, DC. Please remember to register for the meeting and reserve your hotel room today!

Fact of the Week 

Of the approximately 5.9 million adults living with severe bipolar disorder in the United States in 2020, about 51%, or 3 million adults, were untreated at any given time, the Treatment Advocacy Center reports. For questions or comments about this CEO Update, please contact Jessica Zigmond.

President Biden’s 2023 Budget Seeks to Transform U.S. Behavioral Healthcare Delivery

[vc_row][vc_column][vc_column_text]President Biden is proposing new, mandatory investments totaling $51.7 billion over 10 years to enhance behavioral healthcare in America in the fiscal year (FY) 2023 budget proposal he released Monday. Among the budget blueprint’s most notable behavioral health provisions is the president’s request of $697 million for the Substance Abuse and Mental Health Services Administration (SAMHSA) to ensure that 100% of contacts are answered for the new 988 behavioral health crisis hotline that will begin to operate in July. This is an increase of $590 million from what was enacted for fiscal year 2022. Another significant provision is the president’s proposal for a new, $7.5 billion Mental Health System Transformation Fund through Medicaid to increase access to mental health services through workforce development and service expansion, including the development of non-traditional health delivery sites, the integration of quality mental health and substance use care into primary care settings, and the dissemination of evidence-based practices. President Biden’s budget also provides an investment of $397 million for the Health Resources and Services Administration’s (HRSA) Behavioral Health Workforce Development Programs, which is $235 million above FY 2022 enacted level. This funding is intended to increase training of new behavioral healthcare providers, including a track for health support workers such as peers and community health workers. The program also places an emphasis on team-based care. This investment is meant to promote inclusive and equitable behavioral healthcare for youth and focus on the knowledge and understanding of children, adolescents, and youth at risk for a mental health disorder, serious emotional disturbance, or substance use disorder (SUD). The budget also includes increases in primary care training and enhancement and nurse education, practice, and retention to expand behavioral health services into primary care. The FY 2023 budget provides $4.6 billion for SAMHSA’s mental health activities, an increase of $2.5 billion above the FY 2022 enacted level. These investments would provide a historic investment in the Behavior Health Crisis Services; expand access to crisis services; ensure access to early intervention and prevention services to the nation’s vulnerable populations; and invest in children’s mental health. NABH is pleased to see President Biden’s budget calls for improving compliance with behavioral health parity standards by requiring plans and issuers to use medical necessity criteria for behavioral health services that are consistent with the criteria developed by not-for-profit medical specialty associations. The proposal would also place limits on the consideration of profit in determinations of medical necessity. The budget would authorize the secretaries of the U.S. Health and Human Services, Labor, and Treasury Departments to regulate behavioral health network adequacy, and to issue regulations on a standard for parity in reimbursement rates based on the results of comparative analyses submitted by plans and issuers at a cost of $720 million over 10 years. The budget proposes requiring all plans and issuers to cover three behavioral health visits and three primary care visits each year without charging a copayment, co-insurance or deductible-related fee.  And it would provide $125 million in mandatory funding over five years for grants to states to enforce mental health and SUD parity requirements.  Any funds not expended by states at the end of five fiscal years would remain available to the HHS secretary to make additional mental health parity grants. It also proposes to eliminate the ability of self-insured non-federal governmental plans to opt out of parity, affording state and municipal employees the same consumer protections that apply to other employees with private health insurance. In Medicare, the president’s budget would eliminate the 190-day lifetime limit and would require Medicare to cover up to three behavioral health visits per year without cost-sharing. Also related to the Medicare program, current law requires the Centers for Medicare & Medicaid Services (CMS) to terminate psychiatric hospital participation in Medicare after six months of non-compliance with conditions of participation, even if the deficiency does not jeopardize patient health and wellbeing.  This provision does not apply to any other provider category. The president’s proposal would give CMS flexibility to allow a psychiatric hospital to continue receiving Medicare payments when deficiencies are not considered to immediately jeopardize the health and safety of its patients and where the facility is actively working to correct the deficiencies identified in an approved Plan of Correction.  This provision is considered budget-neutral and would not have cost implications. Among other provisions, the White House budget proposal would also establish a Medicare benefit category for licensed professional counselors and marriage and family therapists that authorizes direct billing and payment under Medicare for these practitioners; remove limits on the scope of services for which Medicare can pay clinical social workers, licensed professional counselors, and marriage and family therapists; and allow these practitioners to bill Medicare directly for their mental health services for covered Part A qualifying Skilled Nursing Facility stays. And the proposal would ensure that mental health and SUD benefits under Medicare do not face greater limitations on reimbursement or access to care relative to medical and surgical benefits.  The Medicare Payment Advisory Commission (MedPAC) would be required to issue a report to identify existing gaps in mental health and substance use disorder benefits to be addressed in the Medicare statute. Specifically for SUD, President Biden has proposed $519 million, more than double the 2022 enacted level, for the Family Violence Prevention and Services program. This is the primary federal funding stream dedicated to the support of emergency shelter and related assistance for victims of domestic violence and their children. The funding represents an increase of $292 million over FY 2022 enacted for the base program’s shelters and supportive services. This funding provides services to an estimated 1.3 million children and families to prevent family violence, domestic violence, and dating violence. This includes $250 million in cash assistance for domestic violence survivors and $30 million for the Safe Recovery Together demonstration grants. The demonstration grants will support families affected by domestic violence at the intersection of substance-use coercion, housing instability, and child welfare involvement. President Biden’s FY 2023 budget also proposes:
  • $413 million to SAMHSA in FY 2023, and $4.1 billion over 10 years, for community health centers
  • A $238 million increase above the FY 2022 enacted level in funding for Certified Community Behavioral Health Center Expansion Grants
  • An increase in the amount of Mental Health Block Grant funds reserved for crisis intervention services to 10% from 5%
  • An investment of $11.4 billion, including $10.8 billion in discretionary funding, in programs addressing opioids and overdose-related activities across HHS.
After President Biden kicked off the federal budget process on Monday with his budget proposal, Office of Management and Budget Director Shalanda Young testified Tuesday before the House Budget Committee. Director Young will take more questions from the Senate Budget Committee on Wednesday. Meanwhile, congressional appropriators will begin their work soon, starting with a House Appropriations Committee hearing this Thursday that will feature U.S. Health and Human Services Department (HHS) Secretary Xavier Becerra.[/vc_column_text][/vc_column][/vc_row]

CEO Update 186

Three-Judge Panel in 9th U.S. Circuit Court of Appeals Overturns Wit v. United Behavioral Health

In a blow to parity, a three-judge panel of the 9th U.S. Circuit Court of Appeals this week overturned a trial court’s Wit v. United Behavioral Health (UBH) decision, asserting that UBH’s interpretation that health insurance plans do not require consistency with generally accepted standards of care (GASC) “was not unreasonable.” On Thursday, NABH sent its members an NABH Issue Brief that highlighted the following main points of the earlier decision from the trial court and the three-judge panel’s reversal of that decision in its seven-page ruling:
  • The original Witdecision determined that patients’ health and safety are protected when clinicians provide services consistent with GASC that are established by not-for-profit, professional associations, rather than insurance companies whose financial incentives often conflict with what is best for patients.
  • The three-judge panel said it is “not unreasonable” for health insurers’ coverage determinations to be inconsistent with GASC; however, the trial court’s decision, including two 100-page decisions, described how UBH made medical coverage decisions based on financial interests.
  • In its ruling, the appellate court’s three-judge panel did not cite one holding or one fact that the trial court concluded, despite the trial court’s exhaustive trial findings.
  • The trial court’s decision explained UBH’s misrepresentation to regulators that UBH used American Society of Addiction Medicine (ASAM) criteria when, in fact, the company modified and ultimately undercut the actual ASAM criteria.
  • The appellate court’s three-judge panel ruled that UBH is not obligated to cover treatment consistent with GASC if the treatment is not a covered benefit; however, the plaintiffs did not argue that UBH was obligated to cover all services consistent with GASC. Instead, the plaintiffs argued that if services—such as outpatient, intensive outpatient, and residential treatment—are covered benefits, UBH must make medical necessity determinations that are consistent with GASC.
This flawed ruling has the potential to worsen America’s mental health and addiction crises as the critical need for mental health and addiction treatment services continues to rise during the ongoing Covid-19 pandemic. NABH will continue to fight for true mental health addiction treatment parity and expanded access to care for all who need it.

DEA Expands Access to Medication-Assisted Treatment for People with SUD

The U.S. Drug Enforcement Administration (DEA) on Wednesday announced a new option intended to broaden access for medication-assisted treatment (MAT) for people suffering from substance use disorder (SUD). The new option applies to DEA-registered practitioners working in hospitals, clinics, or emergency rooms, and also for DEA-registered hospitals and clinics that allow practitioners to operate under their registration number. Under this new option, the DEA will grant requests for an exception to the one-day supply limitation in 21 CFR 1306.07(b) to allow for the dispensing of up to a three-day supply of narcotic drugs, including buprenorphine and methadone, “to a person for the purpose of relieving acute withdrawal symptoms when necessary while arrangements are being made for referral for treatment.” Adhering to The Further Continuing Appropriations Act of 2021 and Other Extensions Act, DEA will grant such exception requests while it works to amend 21 CFR 1306.07(b) that the law directs. As part of this effort to save lives in the opioid overdose crisis, the DEA also announced that it is working to make permanent its Covid-19 public health emergency temporary regulations that allow for the initiation of buprenorphine to treat opioid use disorder via telemedicine. Finally, the DEA said it is partnering with the U.S. Health and Human Services Department (HHS) to engage “in regular outreach with pharmacists and practitioners to express support for the use of medication-assisted treatment for those suffering from substance use disorder.”

Provider Relief Fund Reporting Period 2 Deadline is Next Week

The Health Resources and Services Administration’s (HRSA) Provider Relief Fund (PRF) reporting portal remains open for healthcare providers who need to report their use of PRF funds in Reporting Period 2 (RP2) by the deadline next Thursday, March 31. According to HRSA, providers who received one or more payments totaling greater than $10,000 in the aggregate during a Payment Received Period must use the funds by the deadline and report for each application reporting period. HRSA’s announcement also said that providers who received PRF payments exceeding $10,000 in the aggregate between July 1, 2020 and Dec. 2020 and who do not submit a report on use of the funds by 11:59 p.m. ET on March 31, 2022 will be required to return all funds. HRSA said it will not grant grace periods or extensions. Click here to read HRSA’s PRF Reporting Non-Compliance fact sheet. 

BJA Announces Adult Drug Court Discretionary Grant Program Funding Opportunity

The U.S. Justice Department’s Bureau of Justice Assistance (BJA) is seeking applications to plan, implement, and enhance drug court services, including service coordination, management of drug court participants, and recovery support services. Adult drug courts integrated evidence-based SUD treatment, mandatory drug testing, incentives, and sanctions, and transitional services in judicially supervised criminal court setting that have jurisdiction over persons with SUD treatment needs to reduce recidivism, increase access to treatment and support, and prevent overdoses. City or township governments, county governments, federally recognized Native American tribal governments, special district governments, and state governments, and others are eligible to apply for this grant opportunity. The deadline to apply is Friday, May 20. Click here to learn more and apply.

Commonwealth Fund Podcast Examines Closing the Mental Healthcare Gap for Black Teens

In its podcast The Dose, the Commonwealth Fund this week featured Boston Children’s Hospital psychiatrist Kevin Simon, M.D., who discussed how providers can work with families to help address the mental healthcare gap for Black and brown teenagers in America. The Commonwealth Fund notes that in the current overwhelming demand for behavioral health services, the unmet need for Black and brown teenagers stands out. One reason is they are not getting the care they need due to a shortage of child and adolescent mental health providers—especially providers of color—in the United States. Worsening the problem are the racial stereotypes that exist in how school officials, healthcare providers, and others perceive Black and brown teens. Simon suggests that the country diversify the mental healthcare provider workforce to correct the problem in the long term. In the short term, he adds, providers can work with families and teachers to strengthen the system and start by demonstrating “cultural humility” and a genuine curiosity about the lived experiences of Black and brown youth.

 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. 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 2022 Annual Meeting!

NABH will host its 2022 Annual Meeting—Shaping the Future of Behavioral Healthcare—from June 13-15 at the Mandarin Oriental Washington, DC. Please remember to register for the meeting and reserve your hotel room today!

Fact of the Week

Only 20% of U.S. adults received mental health treatment since the start of the Covid-19 pandemic, but 80% of those agreed they benefited from this care, the America Psychological Association reports. For questions or comments about this CEO Update, please contact Jessica Zigmond.

NABH Issue Brief: Details About 9th U.S. Circuit Court of Appeals Ruling to Overturn Wit v. United Behavioral Health Decision

[vc_row][vc_column][vc_column_text]In a blow to parity this week, a three-judge panel of the 9th U.S. Circuit Court of Appeals overturned a trial court’s Wit v. United Behavioral Health (UBH) decision, asserting that UBH’s interpretation that health insurance plans do not require consistency with generally accepted standards of care (GASC) “was not unreasonable.” This NABH Issue Brief highlights brief background on the earlier decision from the trial court, as well as the main points of the three-judge panel’s reversal of that decision this week in its seven-page ruling:
  • The original Wit decision determined that patients’ health and safety are protected when clinicians provide services consistent with GASC that are established by not-for-profit, professional associations, rather than insurance companies whose financial incentives often conflict with what is best for patients.
  • The three-judge panel said it is “not unreasonable” for health insurers’ coverage determinations to be inconsistent with GASC; however, the trial court’s decision, including two 100-page decisions, described how UBH made medical coverage decisions based on financial interests.
  • In its ruling, the appellate court’s three-judge panel did not cite one holding or one fact that the trial court concluded, despite the trial court’s exhaustive trial findings.
  • The trial court’s decision explained UBH’s misrepresentation to regulators that UBH used American Society of Addiction Medicine (ASAM) criteria when, in fact, the company modified and ultimately undercut the actual ASAM criteria.
  • The appellate court’s three-judge panel ruled that UBH is not obligated to cover treatment consistent with GASC if the treatment is not a covered benefit; however, the plaintiffs did not argue that UBH was obligated to cover all services consistent with GASC. Instead, the plaintiffs argued that if services—such as outpatient, intensive outpatient, and residential treatment—are covered benefits, UBH must make medical necessity determinations that are consistent with GASC.
The deeply flawed ruling from the three-judge panel of the 9th U.S. Circuit Court of Appeals has the potential for worsening America’s mental health and addiction crises as the critical need for mental health and addiction treatment services continues to rise during the ongoing Covid-19 pandemic. NABH will continue to fight for true mental health addiction treatment parity and expanded access to care for all who need it.[/vc_column_text][/vc_column][/vc_row]

CEO Update 186

CEO Alliance for Mental Health Announces Rollout to Prepare for 988 Hotline Launch

The CEO Alliance for Mental Health this week announced the start of coordinated effort to help prepare state and municipal officials for the nationwide 988 behavioral crisis hotline that will launch on July 16. NABH is a member of the CEO Alliance, a collaborative of 15 of the nation’s leading mental health professional organizations, advocacy groups, and funders that will push for leaders to adopt A Consensus Approach and Recommendations for the Creation of a Comprehensive Crisis Response System, a roadmap that outlines seven “pillars” for transforming mental health and substance use care in the United State. These are: early identification and prevention; emergency and crisis response; equity and inclusion; integration and partnership; fair and equivalent coverage; standards for care; and workforce capacity. The Alliance released the roadmap last November. The Alliance’s outreach efforts leading to the 988 hotline launch this summer include a social media campaign intended to direct state and municipal elected officials, civic leaders, policymakers, and advocates to the roadmap. In his State of the Union address earlier this month, President Biden announced his administration’s mental health strategy, of which the 988 hotline is a critical component.

Provider Relief Fund Reporting Period 2 Deadline is March 31

The Health Resources and Services Administration’s (HRSA) Provider Relief Fund (PRF) reporting portal remains open for healthcare providers who need to report their use of PRF funds in Reporting Period 2 (RP2) by the deadline on Thursday, March 31. According to HRSA, providers who received one or more payments totaling greater than $10,000 in the aggregate during a Payment Received Period must use the funds by the deadline and report for each application reporting period. HRSA’s announcement also said that providers who received PRF payments exceeding $10,000 in the aggregate between July 1, 2020 and Dec. 2020 and who do not submit a report on use of the funds by 11:59 p.m. ET on March 31, 2022 will be required to return all funds. HRSA said it will not grant grace periods or extensions. Click here to read HRSA’s PRF Reporting Non-Compliance fact sheet.

SAMHSA Announces $25.6 Million in MAT Grant Programs

The Substance Abuse and Mental Health Services Administration (SAMHSA) this week announced two grant programs totaling $25.6 million intended to expand access to medication-assisted treatment (MAT) for opioid use disorder and prevent the misuse of prescription drugs. One is the Strategic Prevention Framework for Prescription Drugs program, which provides funding for state agencies, territories, and tribal entities that have completed a Strategic Prevention Framework State Incentive Grant plan—or similar state plan—to target prescription drug misuse. This program is intended to raise awareness about the dangers of sharing medications, fake or counterfeit pills sold online, and over-prescribing. This grant will fund a total of $3 million over five years for up to six grantees. Applications for this grant are due by Monday, April 25. The other is the Medication-Assisted Treatment-Prescribing Drug and Opioid Addiction grant program, which provides resources to help expand and improve access to medications for opioid use disorder. This program is intended to increase the number of individuals with opioid use disorder receiving medications for opioid use disorder and decrease illicit opioid use and prescription drug opioid misuse. This grant will fund a total of $22.6 million over five years for up to 30 grantees. According to SAMHSA, no less than $11 million will be awarded to Native American tribes, tribal organizations, or consortia. Applications for this program are due by Friday, April 29.   DOJ Announces ‘Second Chance Act Pay for Success Initiative’ The U.S. Justice Department’s Bureau of Justice Assistance (BJA) is seeking applications to fund state, local, and tribal governments to either enhance or implement performance-based programs that reduce recidivism and address substance use disorders (SUD) that affect people who have been incarcerated. Specifically, the funds will be used in contracts with reentry, permanent supportive housing, or recovery housing providers in this effort. The Pay for Success Initiative is a performance-based and outcomes-based program that ties payment for services to reaching agreed-upon goals. Click here for more information.

O’Neil Institute Releases ‘Maximizing the Impact of Opioid Litigation to Address the Overdose Crisis’

The O’Neill Institute for National and Global Health Law at Georgetown University Law Center this week released Maximizing the Impact of Opioid Litigation to Address the Overdose Crisis, a five-page issue brief that describes the themes discussed during the Opioid Litigation Summit held at Georgetown Law Center in September 2021. The resource emphasizes that opioid litigation settlement proceeds must be used to advance a public health response to the nation’s opioid crisis. It also explains how the country can learn from its own history in this regard. “The tobacco litigation settlements of the 1990s evince the need for a comprehensive strategy of oversight and accountability to distribute and manage opioid litigation proceeds,” the issue brief states. “Despite the intent of the settling states’ Attorneys General that funds be used primarily for tobacco-related health initiatives, the lack of specificity in the settlement agreements led to less than 10% of the $206 billion award funding tobacco-related public health strategies.” According to the brief, these five themes emerged from last year’s opioid litigation summit: intentional collaboration leads to actionable policy; community needs should be reflected when distributing proceeds; existing opioid-related funding should be supplemented, not supplanted; oversight should be sustained; and other sources of funding should be maximized and coordinated to create a comprehensive plan to address SUDs.

Senate HELP Committee to Host Mental Health Hearing Next Week

The Senate Health, Education, Labor & Pensions (HELP) Committee will examine how to improve federal mental health and SUD programs in a hearing next week. Senators will hear from Assistant Secretary for Mental Health and Substance Use Miriam Delphin-Rittmon, Ph.D.; Joshua Gordon, M.D., Ph.D., director of the National Institute of Mental Health; Carole Johnson, administrator at the Health Resources and Services Administration; and Nora Volkow, M.D., director of the National Institute on Drug Abuse. Delphin-Rittmon addressed attendees at the 2021 NABH Annual Meeting last October. The hearing, “Strengthening Federal Mental Health and Substance Use Disorder Programs: Opportunities, Challenges, and Emerging Issues,” will be held Wednesday, March 23 at 10 a.m. ET.

National Drug and Alcohol Facts Week Starts Monday

National Drug and Alcohol Facts Week is from March 21-27, and The National Institute on Drug Abuse (NIDA) invites organizations to participate in the national observance meant to empower teens and young adults about making informed decisions about drugs, alcohol, and addiction. NIDA has developed five steps to hosting a NDAFW event and created lesson plans and other materials for educators, counselors, and prevention specialists. Please click here to learn how to register your organization’s event online.

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. 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 2022 Annual Meeting!

NABH will host its 2022 Annual Meeting—Shaping the Future of Behavioral Healthcare—from June 13-15 at the Mandarin Oriental Washington, DC. Please remember to register for the meeting and reserve your hotel room today!

Fact of the Week

Telehealth represented less than 1% of outpatient care before the Covid-19 pandemic for both mental health and substance use and other concerns. At its pandemic peak, telehealth represented 40% of mental health and substance use outpatient visits and 11% of other visits (during the March- August 2020 period), according to research from the Kaiser Family Foundation. For questions or comments about this CEO Update, please contact Jessica Zigmond.

CEO Update 185

Provider Relief Fund Reporting Period 2 Deadline is March 31

The Health Resources and Services Administration’s (HRSA) Provider Relief Fund (PRF) reporting portal remains open for healthcare providers who need to report their use of PRF funds in Reporting Period 2 (RP2) by the deadline on Thursday, March 31. According to HRSA, providers who received one or more payments totaling greater than $10,000 in the aggregate during a Payment Received Period must use the funds by the deadline and report for each application reporting period. HRSA’s announcement also said that providers who received PRF payments exceeding $10,000 in the aggregate between July 1, 2020 and Dec. 2020 and who do not submit a report on use of the funds by 11:59 p.m. ET on March 31, 2022 will be required to return all funds. HRSA said it will not grant grace periods or extensions. Click here to read HRSA’s PRF Reporting Non-Compliance fact sheet.

NABH Submits Comments to CMS about Network Adequacy in Medicare Advantage

NABH this week submitted comments to the Centers for Medicare & Medicaid Services (CMS) regarding the agency’s proposed rule about technical changes to the Medicare Advantage (MA) and Medicare Prescription Drug Benefit programs for the contract year 2023. In a letter to CMS Administrator Chiquita Brooks-LaSure, NABH described how MA plans can increase the number of behavioral healthcare providers and facilities in their networks and improve access to mental health and addiction treatment. “Unfortunately, Medicare beneficiaries do not have adequate access to mental health and addiction treatment,” NABH’s noted. “According to a CMS Data Brief, ‘[b]eneficiaries with depression, regardless of age, were more likely to report having trouble getting healthcare, obtaining prescription medicines, and not seeing doctors than those without depression.’ In addition, Medicare ‘[b]eneficiaries with depression regardless of age, were more likely to report that they have no usual source of care due to high cost.’ These difficulties accessing behavioral healthcare undoubtedly result from MA plans disproportionately lacking in-network behavioral healthcare providers,” NABH’s letter continued. “A recent study found that MA networks included only 23% of psychiatrists in a county on average — lower than all other medical specialties. Not surprisingly, MA enrollees with depressive symptoms report more difficulty accessing needed treatment and rated their experience with the MA plans as worse than in traditional Medicare.” NABH also provided a series of recommendations, such as establishing specific network adequacy standards for the full continuum of mental health and addiction treatment and requiring those standards be met prior to approval for participation in Medicare; requiring MA plans to demonstrate reimbursement rates for behavioral healthcare providers are comparable with rates for other similar healthcare services; and requiring MA plans to comply with parity requirements and use generally accepted standards of care for utilization management.

OSHA Launches Program to Protect Healthcare Workers at Facilities that Treat Covid-19 Patients

The U.S. Labor Department’s Occupational Safety and Health Administration (OSHA) has launched an initiative to protect healthcare workers who work in hospitals and skilled nursing facilities that treat or handle patients with Covid-19. An announcement from OSHA said the goal is to expand its presence to ensure “continued mitigation to control the spread of Covid-19 and future variants of the SARS-CoV-2 virus” and to protect the health and safety of healthcare workers. OSHA also said it will initiate focused inspections to emphasize monitoring for current and future readiness to protect workers from Covid-19 and will conduct follow-up inspections at sites that previously received citations. “OSHA intends to expand its presence in targeted high-hazard healthcare facilities during a three-month period from March 9, 2022 to June 9, 2022,” the announcement said. “Through this focused enforcement initiative, the agency will verify and assess hospital and skilled nursing care employers’ compliance actions taken, including their readiness to address any ongoing or future Covid-19 surges.” 

Congressional Addiction, Treatment, and Recovery Caucus to Host Webinar on Opioid Crisis  Next Week

The Congressional Addiction, Treatment, and Recovery Caucus will host a webinar titled “The Changing Landscape & New Challenges of the Opioid Epidemic” next Thursday, March 17 at 3 p.m. ET. Presenters include award-winning actor Michael Keaton; Beau Kilmer, Ph.D., director of RAND’s Drug Policy Research Center; and Arnold Alier Martinez, Ed.D., NRP, director of the division of pre-hospital medicine research and overdose prevention at the South Carolina Department of Health and Environment Control. Click here to register.

The Joint Commission to Host Webinar About Behavioral Health and Human Services Accreditation on March 22

The Joint Commission will host a complimentary webinar about behavioral health and human services accreditation on Tuesday, March 22 from 10 am. – 12:30 p.m. ET. In a live executive training, the Joint Commission will address the process, cost, requirements, and resources for assistance and will also leave time for questions. The Joint Commission’s announcement also said attendees will leave with a free, 90-day trial of the Joint Commission’s requirements and a copy of the webinar’s slides. Click here to register.

Register for National Drug and Alcohol Facts Week: March 21-27, 2022

National Drug and Alcohol Facts Week is approaching, and The National Institute on Drug Abuse (NIDA) invites organizations to participate in the national observance meant to empower teens and young adults about making informed decisions about drugs, alcohol, and addiction. NIDA has developed five steps to hosting a NDAFW event and created lesson plans and other materials for educators, counselors, and prevention specialists. Please click here to learn how to register your organization’s event online.

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.

Advertise in the 2022 NABH Exhibitor and Sponsor Guide!

NABH will distribute the 2022 NABH Exhibitor and Sponsor Guide to all registrants at the Annual Meeting from June 13–15, 2022 at the Mandarin Oriental Washington, D.C. Be sure your organization is included in it! All ads are due by April 19, 2022. Please click here for details about advertising options, requirements, payment, and more. NABH will also post the 2022 NABH Exhibitor and Sponsor Guide on the association’s website after the Annual Meeting. If you haven’t done so yet, please register for the Annual Meeting and reserve your hotel room today!

Fact of the Week

Between April 2021 and October 2021, the highest rates of telehealth visits were among those with Medicaid (29.3%) and Medicare (27.4%), Black individuals (26.8%), and those earning less than $25,000 (26.7%), according to data from HHS’ Assistant Secretary for Planning and Evaluation. For questions or comments about this CEO Update, please contact Jessica Zigmond.