Author: Administrator

HHS to Host Hospital Data Reporting Webinar on Nov. 13

Written by Administrator on November 12, 2020. Posted in Alerts.

The U.S. Health and Human Services Department (HHS) will host a webinar on Friday, Nov. 13 at 1 p.m. ET to review the updated guidance for hospital data reporting requirements during the Covid-19 pandemic. This webinar is the fourth webinar HHS has hosted to provide guidance to the nation’s healthcare providers on this topic and will include a question-and-answer period. Click here to register and here for the webinar slide deck.

CEO Update 124

Written by Administrator on November 6, 2020. Posted in CEO Updates.

Former U.S. Rep. Jim Ramstad (R-Minn.), Addiction Recovery Champion, Dies at 74

Former U.S. Rep. Jim Ramstad (R-Minn.), a champion for addiction recovery, died Thursday at the age of 74. Ramstad, who had been ailing from Parkinson’s Disease, channeled his personal battle with addiction to become a strong advocate for recovery. He represented Minnesota’s third district in the U.S. House of Representatives for nine terms before he retired in 2009. The Minnesota Republican was the chief sponsor for the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008, the bill that opened access to treatment for millions of Americans suffering from mental illness or chemical addiction. News outlets reporting Ramstad’s death described how the former congressman’s personal battle with alcoholism spurred him to help others battling addiction. The stories also mentioned Ramstad’s arrest for disorderly conduct while he served in the Minnesota state legislature, the event that caused him to give up drinking. “If I had not wound up in that jail cell, I would not have sought treatment,” Ramstad told The New York Times in 2006. Ramstad celebrated his 39^th year of sobriety at his death, according to news reports.

Federal Court Orders Class-Wide Remedies in Wit v. United Behavioral Health

NABH legal consultant and psychotherapist Meiram Bendat, Ph.D., J.D., sent the following summary to NABH this week regarding the remedies in the Wit v. United Behavioral Health case: In its 99-page ruling, the court explained the need for: (1) a 10-year injunction requiring UBH to exclusively apply medical necessity criteria developed by non-profit clinical specialty associations; (2) appointment of a special master; (3) training of UBH in the proper use of court-ordered medical necessity criteria; and (4) reprocessing of nearly 67,000 mental health and substance use disorder benefit claims denied during the class period. Today’s ruling stems from two consolidated class actions, Wit et al. v. United Behavioral Health. and Alexander et al. v. United Behavioral Health, brought by Psych-Appeal, Inc. and Zuckerman Spaeder LLP under the Employee Retirement Income Security Act of 1974 (“ERISA”) in 2014, certified in 2016, and tried in October 2017. While nearly 50,000 ERISA insureds will be eligible for class-wide relief in this case, non-ERISA insureds (such as governmental employees) adversely impacted by UBH’s defective guidelines must rely on state and federal regulators to intervene on their behalf. I trust that you recognize the significance of today’s ruling as much as we do. -Meiram Bendat, Ph.D., J.D., Founder and President, Psych Appeal

DEA Publishes Regulations to Implement the Controlled Substances Act and the Preventing Drug Diversion Act

The Drug Enforcement Administration (DEA) this week published regulations to implement amendments that the 2018 SUPPORT Act made to the Controlled Substances Act. The regulations became effective on Friday, Oct. 30 and appeared in the Federal Register on Nov. 2. The updated regulations:

Allow a practitioner to treat up to 100 patients if a practitioner meets additional credentialing requirements, or if the practitioner provides covered medications (MAT) in a qualified practice setting, and up to 275 patients if the practitioner meet specific additional requirements (42 CFR 8.610-8.655);
Permanently include nurse practitioner or physician assistant in the definition of ”qualifying other practitioner,” and temporarily expand the definition (until Oct. 1, 2023) to include a clinical nurse specialist, certified registered nurse anesthetist, or a certified nurse midwife who meets certain qualifications;
Provide an additional option for a physician to be considered a ”qualifying physician” if the physician graduates in good standing from an accredited school of allopathic medicine or osteopathic medicine in the United States five years prior to notifying HHS of his or her intention to dispense narcotic drugs for maintenance or detoxification treatment. This does not eliminate the SUPPORT Act’s eight-hour opioid training requirement; rather, it permits the training to be completed in medical school or residency, not just through post-residency continuing medical education; and
Permit pharmacies to deliver a controlled substance to a prescribing practitioner’s location for the purpose of administering the medication (through implantation or injection) to the patient or research subject, as previously permitted under a DEA exception. This permits administration directly in the provider’s office without requiring a trip to the pharmacy.

In separate rulemaking, the DEA proposed its intention to amend the Preventing Drug Diversion Act of 2018 related to the identifying and reporting of suspicious orders by DEA registrants. The proposal offers a two-option framework for reporting suspicious orders, establishes a centralized database for reporting, defines four terms: “due diligence,” “order,” “order received under suspicious circumstances,” and “suspicious order,” and requires registrants to design and operate privacy-law-compliant systems. The provisions are intended to clarify procedures for registrants and address a lack of uniformity in reporting suspicious orders. Comments are due by Monday, Jan. 4, 2021.

HHS Extends Compliance Deadline for Information Blocking and Health IT Certification

The U.S. Health and Human Services Department (HHS) recently released an interim final rule that gives healthcare providers and vendors an additional five months to comply with healthcare information blocking and interoperability regulations by April 5, 2021. In March, HHS’ Office of the National Coordinator for Health IT (ONC) released a 21^st Century Cures Act final rule that established exceptions to the Cures Act’s information blocking provision and adopted new health information technology (health IT) certification requirements to improve patients’ smartphone access to their health information at no cost through application programming interfaces. The new interim final rule extends dates in the information blocking provisions—including a November compliance deadline for providers—as well as dates for the Conditions and Maintenance of Certification provisions that require electronic health records platforms to be interoperable. This is the second time HHS has extended the compliance deadline due to the Covid-19 pandemic. “We are hearing that while there is strong support for advancing patient access and clinician coordination through the provisions in the final rule, stakeholders also must manage the needs being experienced during the current pandemic,” Don Rucker, M.D., national coordinator for health IT, said in an announcement. “To be clear, ONC is not removing the requirements advancing patient access to their health information that are outlined in the Cures Act final rule,” he continued. “Rather, we are providing additional time to allow everyone in the health care ecosystem to focus on Covid-19 response.” The rules require that various types of clinical notes be shared with patients, although the rules do not apply to “psychotherapy notes recorded in any medium by a healthcare provider who is a mental health professional documenting or analyzing the contents of a conversation during a private counseling session or a group, joint, or family counseling session and that are separate from the rest of the individual’s medical record,” according to a summary.

Reminder: DOL’s Rural Healthcare Workforce Training Grant Applications Due Nov. 13

The U.S. Labor Department’s Employment and Training Administration (ETA) will accept applications for its H-1B Rural Healthcare Grant Program until next Friday, Nov. 13. Earlier this fall, ETA announced $40 million in available grant funding for employment and training programs in healthcare occupations—including behavioral and mental healthcare—that serve rural populations. According to the announcement, employment and training programs through this funding can propose a wide range of models, including Registered Apprenticeship Programs and Industry-Recognized Apprenticeship Programs. Pre-apprenticeships are permitted only “as on-ramps” to apprenticeship programs proposed as a response to the funding notice and must lead to apprenticeships during the life of the grant. Click here to learn more about the training programs and here to learn how to apply for the funding.

Bipartisan Policy Center to Host Telehealth Webinar Next Week

Sen. Angus King (I-Maine), Maine healthcare providers, and Bipartisan Policy Center experts will lead a webinar about the future of telehealth next Friday, Nov. 13 at noon ET. The webinar will address the investments and changes that both policymakers and healthcare providers need to make to sustain access to quality healthcare through telehealth. Click here to learn more and to register.

NABH to Host Next Annual Meeting in October 2021

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

June 13-15, 2022
June 12-14, 2023

Thank you for all you do to advance NABH’s mission and vision. We look forward to seeing you in Washington next year! Fact of the Week Individuals with a serious mental illness have an average life expectancy 10 to 25 years lower than the rest of the population. For questions or comments about this CEO Update, please contact Jessica Zigmond.

CEO Update 123

Written by Administrator on October 30, 2020. Posted in Uncategorized.

Provider Relief Fund Phase 3 Distribution Applications Due Next Week

The Department of Health and Human Services (HHS) will continue to accept applications for the Provider Relief Fund (PRF) Phase 3 Distribution through next Friday, Nov. 6. HHS announced in early October that an additional $20 billion is available from the PRF for healthcare providers to recover Covid-19-related financial losses and changes in operating expenses. HHS highlighted behavioral healthcare providers in its announcement and encouraged these providers to apply for this latest round of funding. HHS has developed a list of behavioral healthcare providers who are now eligible for funding, such as addiction counseling centers, mental health counselors, and psychiatrists. Eligible providers include behavioral healthcare providers who had previously not been eligible (presumably because they did not participate in Medicare or Medicaid); providers who had already received PRF payments; and providers who began practicing in 2020 and were therefore not eligible to apply previously. Providers who apply will be considered first for the 2% of patient care revenue that has already been made available. If they have not yet received payments from the PRF amounting to 2% of patient care revenue, they will receive funding to reach that amount. In addition, those who apply will receive an add-on payment above the 2% from the $20 billion allocation based on the following criteria:

Change in operating revenues from patient care;
Change in operating expenses from patient care, including expenses incurred related to the coronavirus; and
Payments already received through the prior PRF distributions

All providers receiving PRF funding will be required to accept the associated terms and conditions including reporting requirements.

NIMH Extends Deadline on RFI to Improve Mental Health Outcomes Among Minority and Health Disparities Populations

The National Institute of Mental Health (NIMH) has extended its request-for-information (RFI) deadline on research priorities to improve mental health outcomes among minority and health disparities populations in the United States to Friday, Dec. 11. In the RFI, the NIMH listed a range of possible comment areas, including suggestions on ways in which research on factors such as social determinants, cultural traditions, religion and spirituality, and historical trauma can be used to understand, prevent, or treat mental illnesses among minority and health disparities populations; ideas about systems-level or cross-systems factors that may contribute to or reduce disparate mental health outcomes among minority and health disparities groups; and thoughts about prevention interventions to address racism and discrimination at the individual, family, and/or community level to reduce risk for mental disorders and improve mental health. Click here to learn more about the RFI and how to submit comments.

Please Complete the 2020 NABH Annual Survey Today!

The 2020 NABH Annual Survey closes tomorrow, Saturday, Oct. 31. NABH members should have received personalized links to the survey from consulting firm Dobson DaVanzo. If you have not received a link, please click here and follow the instructions to submit your survey today. Your feedback will help inform and improve NABH’s advocacy efforts. Thank you for your time!

NABH to Host Next Annual Meeting in October 2021

June 13-15, 2022

June 12-14, 2023

Thank you for all you do to advance NABH’s mission and vision. We look forward to seeing you in Washington next year!

Fact of the Week

The Substance Abuse and Mental Health Services Administration reports that more than $11.4 billion was spent in Fiscal Year 2019 on operating inpatient state psychiatric hospitals, accounting for 28% of the total state mental health agency expenditures. For questions or comments about this CEO Update, please contact Jessica Zigmond.

CEO Update 122

Written by Administrator on October 26, 2020. Posted in Uncategorized.

HHS Releases Revised Guidance on Provider Relief Fund Reporting Requirements

In new guidance Thursday, the U.S. Health and Human Services Department (HHS) offered some flexibility on how providers may use Provider Relief Funds (PRF) to recoup lost revenues related to the coronavirus this year. NABH sent a letter to HHS early this month that urged the department to rescind the changes HHS made in its Sept. 19 guidance and instead rely on requirements that HHS issued in June. The association is pleased with the changes announced this week. “Recipients may apply PRF payments toward lost revenue, up to the amount of the difference between their 2019 and 2020 actual patient care revenue,” HHS’ latest guidance noted. “If recipients do not expend PRF funds in full by the end of calendar year 2020, they will have an additional six months in which to use remaining amounts toward expenses attributable to coronavirus but not reimbursed by other sources, or to apply toward lost revenues in an amount not to exceed the difference between 2019 and 2021 actual revenue.” In September, the department’s said “Recipients may apply PRF payments toward lost revenue, up to the amount of their 2019 net gain from healthcare related sources. Recipients that reported negative net operating income from patient care in 2019 may apply PRF amounts to lost revenues up to a net zero gain/loss in 2020. If recipients do not expend PRF funds in full by the end of calendar year 2020, they will have an additional six months in which to use remaining amounts toward expenses attributable to coronavirus but not reimbursed by other sources, or to apply toward lost revenues in an amount not to exceed the 2019 net gain.” HHS’s directive this week also said additional provider types—including residential treatment facilities—are eligible for the Phase 3 Provider Relief Fund distribution. “We have worked closely with stakeholders across the healthcare system to ensure that the Provider Relief Fund reaches all American healthcare providers that have been impacted by the pandemic,” HHS Secretary Alex Azar said in a news release on Oct. 22. “Today, we are expanding the pool of eligible providers to include a broader array of practices, such as residential treatment facilities, chiropractors, and vision care providers that may not have already received payments.”

NASHP Releases Care Coordination for Standards for Children and Youth with Special Needs

The National Academy for State Health Policy (NASHP) has released The National Care Coordination Standards for Children and Youth with Special Health Care Needs to help state officials and other stakeholders develop and improve high-quality care coordination for children. According to NASHP, the study’s goals are to identify and assess the need for coordinated care, engage families in the care-coordination process, build a strong care-coordination workforce, and develop team-based communication process to better serve children and families. The association also released a blog post from NASHP staff to accompany the report, which noted that historically, care coordination researchers and policymakers have focused primarily on adult populations.

JAMA Examines Alcohol Use in U.S. Adults Before and During Covid-19 Pandemic

New research from JAMA that examines the consequences associated with alcohol use in U.S. adults from before to during the Covid-19 pandemic found that excessive alcohol use may lead to or exacerbate mental health problems. According to the letter, Nielsen reported a 54% increase in national sales of alcohol for the week ending March 21, 2020 compared with the year-earlier period. Online sales, meanwhile, increased by 262% from 2019. JAMA’s findings showed that, on average, alcohol was consumed one day more per month by three of four adults. Meanwhile, for women, there was also a significant increase of .18 days of heavy driving from a 2019 baseline of .44 days, reflecting an increase of 41% over baseline. “These data provide evidence of changes in alcohol use and associated consequences during the Covid-19 pandemic,” the research letter said. “In addition to a range of negative physical health associations, excessive alcohol use may lead to or worsen existing mental health problems, such as anxiety or depression, which may themselves be increasing during Covid-19.”

Manatt Analysis Highlights Medicaid Telehealth Policies States Can Make Permanent to Ensure Access for Children and Families

Consulting firm Manatt has published an analysis of Medicaid telehealth policies that states can implement permanently to ensure access to care for children and families. Developed in table format, the analysis offers a “policy domain,” such as video visits, and then provides some background information and a policy opportunity post-Covid. The Robert Wood Johnson Foundation and the Lucile Packard Foundation for Children’s Health funded the study. Separately this month, the Congressional Research Service published a brief paper, Medicaid Telehealth Policies in Response to Covid-19, which includes a summary of certain emergency-related authorities under Medicaid Disaster Relief State Plan Amendments.

Please Complete the 2020 NABH Annual Survey!

The 2020 NABH Annual Survey will close on Saturday, Oct. 31. NABH members should have received personalized links to the survey from consulting firm Dobson DaVanzo. If you have not received a link, please click here and follow the instructions to submit your survey today. Your feedback will help inform and improve NABH’s advocacy efforts. Thank you for your time!

Fact of the Week

Nearly one third of millennials have a behavioral health condition, and rates are rising by double digits, according to a new report from The Blue Cross Blue Shield Association. For questions or comments about this CEO Update, please contact Jessica Zigmond.

CEO Update 121

Written by Administrator on October 16, 2020. Posted in CEO Updates.

Presidential Executive Order Establishes Coronavirus Mental Health Working Group

The White House last week issued an executive order to create a Coronavirus Mental Health Working Group that is expected to develop a plan that addresses Covid-19’s mental health effects on Americans and calls for agencies to maximize support for behavioral healthcare treatment. President Trump’s Saving Lives Through Increased Support for Mental—and Behavioral-Health Needs executive order notes that the working group’s efforts will consider the mental and behavioral health conditions of the vulnerable populations that the pandemic has affected, including minorities, seniors, veterans, small business owners, children, individuals potentially affected by domestic violence or physical abuse, persons living with disabilities, and individuals with substance use disorder (SUD). “We know that the Covid-19 pandemic has created or exacerbated serious behavioral health challenges for many Americans, both adding new stresses and disrupting access to treatment,” U.S. Health and Human Services (HHS) Secretary Alex Azar said in a statement. “The president’s executive order is a welcome opportunity to increase efforts to address the mental health effects of the pandemic, which have already included hundreds of millions of dollars in grants and historic flexibilities to ensure Americans can continue to receive treatment for mental illness and substance use disorders.” Azar will co-chair the new working group with Brooke Rollins, acting director of the U.S. Domestic Policy Council.

U.S. Congress Joint Economic Committee Examines Covid-19’s Toll on Americans’ Mental Health

The United States Congress Joint Economic Committee has released a report that examines how Covid-19’s health and economic repercussions have led to “an unprecedented mental health crisis” in America. The 13-page report summarizes earlier surveys and studies that have found two-thirds of Americans fear that they or their loved ones will be exposed to the virus; more than 12 million Americans are unemployed, and, since February, more than 5 million have given up looking for work; and that nearly one-third of adult Americans are having trouble paying for typical household expenses. “There is yet no clear end in sight for the coronavirus pandemic, which will continue to have devastating effects on public health and on the economy,” the report said. “The Institute of Health Metrics and Evaluation projects more than 360,000 deaths by the end of 2020 under current circumstances, and upward of 430,000 if mandates continue to be eased,” it continued. “The Federal Reserve expects the unemployment rate to remain above pre-pandemic levels until at least the end of 2021. These intense stresses likely will have a growing and lasting impact on Americans’ mental health.

CMS Corrects Announcement to Say Providers Cannot Use PRF When Repaying Medicare Loans

The Centers for Medicare & Medicaid Services (CMS) corrected a misstatement in its Oct. 8 news release to say the nation’s healthcare providers and suppliers cannot use Provider Relief Funds (PRF) to repay Medicare loans the agency has made during the Covid-19 public health emergency. The correction first appeared in an FAQ on Oct. 9. CMS subsequently corrected its original release.

AAAP Releases Buprenorphine Provider Survey Report to Inform Policymakers

The American Academy of Addiction Psychiatry (AAAP) this week released the findings from a new survey that found 80% of X-waivered physicians, physician assistants, and nurse practitioners who treat patients with opioid use disorder (OUD) want telehealth options to continue after the Covid-19 public health emergency. The X-waiver permits office-based clinicians to prescribe Suboxone (buprenorphine/naloxone) for OUD patients. The AAAP led the project with help from other organizations, including the American Psychiatric Association, the American Society of Addiction Medicine, Boston Medical Center, Boston University, and the Yale Program in Addiction Medicine. According to the survey, 78% of respondents said the Covid pandemic has caused them to put on hold or reduce in-person visits. Meanwhile, 75% of physicians and other healthcare professionals said they have used virtual visits to help maintain medication to treat OUD, and 48% reported they used telehealth to initiate medication to help treat OUD. “During the pandemic, physicians and other health care professionals have adapted to quickly provide high-quality, evidence-based care, but this was only possible due to new flexibilities in telehealth rules,” the survey said.

National Addiction Treatment Week Begins Monday, Oct. 19

Monday kicks off National Addiction Treatment Week to build awareness that addiction is a disease, evidence-based treatment is available, and recovery is possible. The week is also meant to encourage people to enter the field of addiction treatment. The American Society of Addiction Medicine (ASAM) launched National Addiction Treatment Week three years ago with partner organizations. Partners include the National Institute on Drug Abuse, the American Medical Association, and the National Association of Addiction Treatment Providers. Click here for ASAM’s schedule of the week and toolkit. Separately, ASAM released an updated cannabis policy statement on Oct. 10.

Please Complete the 2020 NABH Annual Survey!

Fact of the Week

The rate of domestic violence that women with serious mental illness experience throughout their adulthood was more than double than that of the general population: 69% versus 33%. Men with serious mental illness showed a similar trend when compared with the general population: 49% versus 17%, respectively. For questions or comments about this CEO Update, please contact Jessica Zigmond.

CMS Corrects Announcement to Say Providers Cannot Use PRF When Repaying Medicare Loans

Written by Administrator on October 13, 2020. Posted in Alerts.

The Centers for Medicare and Medicaid (CMS) has corrected a misstatement in its Oct. 8 news release to say the nation’s healthcare providers and suppliers cannot use Provider Relief Funds (PRF) to repay Medicare loans the agency has made during the Covid public health emergency. The correction first appeared in an FAQ on Oct. 9. CMS subsequently corrected its original news release

CEO Update 120

Written by Administrator on October 9, 2020. Posted in CEO Updates.

CMS Gives Medicare Part A & B Providers One More Year to Repay AAP Loans

The Centers for Medicare & Medicaid Services (CMS) said Thursday it will give Medicare Part A and B providers and suppliers an additional year to repay loans the agency made to them during the Covid-19 public health emergency (PHE). CMS had advanced payments to Medicare Part A and B providers and suppliers through the Accelerated and Advance Payment (AAP) program to help cover costs as the PHE disrupted healthcare services this year. Initially CMS had required providers to start making repayments in August 2020. “CMS’ advanced payments were loans given to providers and suppliers to avoid having to close their doors and potentially causing a disruption in service for seniors,” CMS Administrator Seema Verma said in an announcement. “While we are seeing patients return to hospitals and doctors providing care we are not yet back to normal,” she added. According to the agency’s new terms, after that first year, CMS will automatically recoup 25% of Medicare payments otherwise owed to the provider or supplier for 11 months. After that period, CMS will increase the recoupment amount to 50% for another six months. CMS said it will send letters to providers who have any outstanding balances after the entire period—a total of 29 months— informing them that repayment will be subject to a 4% interest rate. Those letters will also include guidance on how to request an Extended Repayment Schedule (ERS) due to financial hardship. The agency’s announcement urged providers and suppliers to contact their Medicare Administrative Contractor for information about how to request an ERS. An ERS will allow a provider or supplier to repay these debts over the course of three to five years. CMS also said providers and suppliers may use Provider Relief Funds to repay these Medicare loans. CMS said it will communicate with each provider and supplier about the amount they owe and all applicable terms in the coming weeks.

New CMS Guidance Requires Psychiatric Hospitals to Report Covid-19 Data Weekly

CMS has released guidance that requires Medicare- and Medicaid-participating psychiatric hospitals to report Covid-19 data to the agency on a weekly basis. CMS published an interim final rule in early September that said hospitals would be required to submit Covid-19 data during the public health emergency in a frequent, standardized way that the U.S. Health and Human Services Department (HHS) secretary specified. This week’s awaited guidance makes it clear that the nation’s psychiatric hospitals—along with rehabilitation hospitals—need to report their data weekly, and not on a daily basis as other hospital types are required to do. NABH advocated for CMS to lessen the reporting frequency for psychiatric hospitals and is pleased with the change. The agency listed the required data in new guidance and also developed an infographic that highlights when the agency plans to alert hospitals about gaps in reporting and compliance. These materials are also available on NABH’s Covid-19 resources webpage.

HRSA Releases Provider Relief Fund Phase 3 Distribution Guide and Fact Sheet

HHS’ Health Resources and Services Administration (HRSA) has released a 12-page provider guide and separate fact sheet to help the nation’s healthcare providers navigate the third phase of the Provider Relief Fund (PRF) distribution during the Covid-19 pandemic. The guide includes specific details on eligibility requirements, application requirements, and reporting guidelines, while the fact sheet condenses the guide’s information and also provides links. HHS announced an additional $20 billion in additional funding last week and encouraged behavioral healthcare providers to apply. The department also developed a list of providers eligible for the funding, including addiction counseling centers, mental health counselors and psychiatrists. The Phase 3 Distribution application process opened this past Monday, Oct. 5, and the application deadline is Friday, Nov. 6. HRSA has scheduled an informational webinar to learn more about the Phase 3 Distribution process next Thursday, Oct. 15 at 3 p.m. ET. Click here to register. HHS has scheduled a webinar about the Phase 3 Distribution process specifically for behavioral healthcare providers and the associations that represent them for Friday, Oct. 16 at 3 p.m. ET. Click here to register.

NABH Submits Comments to CMS on 2021 Physician Fee Schedule Proposed Rule

NABH on Oct. 2 provided feedback to CMS on the telehealth services and substance use disorder (SUD) provisions in the agency’s 2021 physician fee schedule (PFS) proposed rule. In a letter to CMS Administrator Seema Verma, NABH said it supports the proposed rule’s provisions that would continue some of the expanded Medicare coverage of services provided via telehealth, including provisions to extend permanently Medicare coverage for group psychotherapy and psychological testing. The association also said it supports those provisions clarifying that clinical social workers and clinical psychologists and therapists can furnish online assessment and management services, virtual check-ins, and remote evaluations. “We urge you to continue covering evaluation and management services and behavioral health counseling as well as opioid/addiction treatment program counseling and periodic assessment services provided via audio-only technology, i.e., telephone,” the letter said. “Furthermore, we recommend continuing to pay for these services at the same or comparable rates as in-person care—as well as paying for administrative fees to help cover the costs of this technology.” NABH also provided comments on the Opioid Treatment Program (OTP) bundled payment regulations, emphasizing more equitable reimbursement for naloxone and community education for naloxone, as well as reduced limitations on the frequency of reimbursement to align with medical necessity determinations. In addition, NABH’s letter said the association supports continued coverage of periodic telehealth assessments beyond the PHE (including audio-only), and to be reimbursed every 60-90 days, consistent with many state requirements to perform such assessments. The association encouraged CMS to continue the simple, one-bundle structure that has been used successfully to date and reiterated NABH’s recommendation from last year that CMS provide a 17% adjustment to encourage the development of rural OTPs. And NABH underscored the importance of continuing to permit greater flexibility in take-home medications, as well identifying the need to permit reimbursement for OTPs who are under a Substance Abuse and Mental Health Services-provisional certification. Finally, NABH supported the agency’s proposal to expand the PFS bundled payments for Opioid Use Disorder to all SUDs.

U.S. Labor Department to Provide $40 Million in Rural Healthcare Workforce Training Grants

The U.S. Labor Department’s Employment and Training Administration has announced about $40 million in available grant funding for employment and training programs in healthcare occupations—including behavioral and mental healthcare—that serve rural populations. According to the announcement, employment and training programs through this funding can propose a wide range of models, including Registered Apprenticeship Programs and Industry-Recognized Apprenticeship Programs. Pre-apprenticeships are permitted only “as on-ramps” to apprenticeship programs proposed as a response to the funding notice and must lead to apprenticeships during the life of the grant. The deadline to apply is Friday, Nov. 13. Click here for additional information and how to apply.

U.S. Justice Department to Develop Guidelines to Manage Substance Withdrawal in Jail-based Settings

The U.S. Justice Department’s Bureau of Justice Assistance (BJA) and the National Institute of Corrections is seeking feedback to develop evidence-based, clinical guidelines and protocols that will help jail administrators, correctional officers, and jail-based clinicians identify and safely manage substance withdrawal in jail-based settings. According to an announcement, the guidelines will address a host of issues, including, but not limited to, rapid withdrawal from opioids, benzodiazepines, alcohol, methamphetamine, and cocaine individually or in combination, including specification of persons who exhibit withdrawal symptoms or report histories or information from other sources that indicate the necessity of immediate referral to medical facilities outside of the jail; screening for risk of suicide, specifically opioid withdrawal-potentiated suicides; and medication maintenance for entering detainees with prescriptions for opioid or antipsychotic medications. The BJA will select one applicant for a 10-month award to create a document that outlines the guidelines and protocols. Applications are due by Wednesday, Oct. 28. Click here for more information.

Joint Commission to Host Virtual Behavioral Health Care and Human Services Conference

The Joint Commission will host its Behavioral Health Care and Human Services conference in a virtual format on Friday, Oct. 28. This year, attendees will have the option to choose from two tracks: Track A, designed for organizations accredited under the Behavioral Health Care Accreditation Manual, and Track B, intended for those accredited under the Hospital Accreditation Manual and supplemented with the Behavioral Health Care Manual. Click here for more information and to register.

Today is the Deadline to Submit Recommendations for the 2021 NABH Board of Trustees

The deadline is today, Friday, Oct. 9, to submit nominees for NABH’s Board Chair-Elect and three NABH Board of Trustees seats that will become available in 2021. NABH’s Selection Committee is particularly interested in identifying senior managers who represent broad diversity within the NABH membership, including various levels of care, organizational structures, and size. If you have not done so yet, please download a nomination form to share your recommendations of individuals you would like to see included in the single-slate ballot for 2021. Please be sure to attached a curriculum vitae (CV) for each individual you recommend, which will help the Selection Committee in its deliberations. You are welcome to recommend yourself. Please send your completed form and all candidate CVs to NABH Director of Operations Maria Merlie. Thank you for your time!

Please Complete the 2020 NABH Annual Survey!

The 2020 NABH Annual Survey opened in late August and NABH members should have received personalized links to the survey from consulting firm Dobson DaVanzo. If you have not received a link, please click here and follow the instructions to submit your survey today. Your feedback will help inform and improve NABH’s advocacy efforts. The survey closes on Saturday, Oct. 31. Thank you for your time!

Fact of the Week

In the first half of 2019, just more than one in 10 adults (11%) reported symptoms consistent with a diagnosable anxiety or depressive disorder. By July 2020, during the Covid-19 pandemic, that number had increased to 40%. For questions or comments about this CEO Update, please contact Jessica Zigmond.

CMS Gives Medicare Part A & B Providers One More Year to Repay AAP Loans

Written by Administrator on October 9, 2020. Posted in Alerts.

New CMS Guidance Requires Psychiatric Hospitals to Report Covid-19 Data Weekly

Written by Administrator on October 7, 2020. Posted in Alerts.

The Centers for Medicare & Medicaid Services (CMS) has released guidance that requires Medicare- and Medicaid-participating psychiatric hospitals to report Covid-19 data to the agency on a weekly basis. CMS published an interim final rule in early September that said hospitals would be required to submit Covid-19 data during the public health emergency in a frequent, standardized way that the U.S. Health and Human Services Department (HHS) secretary specified. This week’s awaited guidance makes it clear that the nation’s psychiatric hospitals—along with rehabilitation hospitals—need to report their data weekly, and not on a daily basis as other hospital types are required to do. The agency listed the required data in new guidance and also developed an infographic that highlights when the agency plans to alert hospitals about gaps in reporting and compliance. Links to these new materials are also available our Covid-19 resources webpage.

NABH Comments on the CY 2021 Physician Fee Schedule and other Changes to Part B Payment Policies Proposed Rule

Written by Administrator on October 4, 2020. Posted in Letters.

NABH Comments on CY 2021 PFS Proposed Rule

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CEO Update 119

Written by Administrator on October 2, 2020. Posted in Uncategorized.

HHS Includes Behavioral Healthcare Providers in Provider Relief Fund Phase 3 Distribution

The Department of Health and Human Services (HHS) on Thursday announced an additional $20 billion is available from the Provider Relief Fund (PRF) for healthcare providers to recover Covid-19-related financial losses and changes in operating expenses. HHS highlighted behavioral healthcare providers in its announcement and encouraged these providers to apply for this latest round of funding. HHS has developed a list of behavioral healthcare providers who are now eligible for funding, such as addiction counseling centers, mental health counselors, and psychiatrists. “Our behavioral health providers have shouldered the burden of responding and confronting this expanded challenge triggered by the pandemic,” HHS said in the announcement. “When traditional face-to-face counseling was restricted and new telehealth flexibilities were put in place in response to the pandemic, many behavioral health providers invested in and adopted telehealth technologies to continue providing patient care.” Providers are encouraged to apply early. Be sure to apply between Monday, Oct. 5 through Friday, Nov. 6, 2020. Eligible providers include behavioral healthcare providers who had previously not been eligible (presumably because they did not participate in Medicare or Medicaid); providers who had already received PRF payments; and providers who began practicing in 2020 and were therefore not eligible to apply previously. Providers who apply will be considered first for the 2% of patient care revenue that has already been made available. If they have not yet received payments from the PRF amounting to 2% of patient care revenue, they will receive funding to reach that amount. In addition, those who apply will receive an add-on payment above the 2% from the $20 billion allocation based on the following criteria:

Change in operating revenues from patient care;
Change in operating expenses from patient care, including expenses incurred related to the coronavirus; and
Payments already received through the prior PRF distributions

All providers receiving PRF funding will be required to accept the associated terms and conditions including reporting requirements. HHS said it plans to hold webinars to assist with the application process.

HHS Provider Relief Fund Reporting Requirements Change Terms for Recovering Lost Revenue

The Department of Health and Human Services (HHS) has issued guidance that contradicts the department’s June FAQ about calculating lost revenue from Covid-19 that may be recovered through the Coronavirus Aid, Relief, and Economic Security Act’s (CARES) Provider Relief Fund (PRF). In the June FAQ, HHS said hospitals could “use any reasonable method of estimating the revenue during March and April 2020 compared to the same period had Covid-19 not appeared.” This latest guidance defines lost revenue that may be recovered as being limited to “a negative change in year-over-year net patient care operating income.” The guidance further specifies that providers generally will only be able to apply their PRF payments to lost revenue up to a facility’s net patient operating income for 2019. As HHS announced previously, providers who have received more than $10,000 from the PRF are required to submit a report by Feb.15, 2021, on the use of those funds through Dec. 31, 2020, and, if necessary, a second and final report by July 31, 2021. The PRF funding provided through the CARES Act and subsequent legislation was intended to reimburse eligible providers for healthcare-related expenses and lost revenues attributable to Covid-19. HHS had included a general commitment to reporting on the use of the PRF funds in the terms and conditions that PRF fund recipients agreed to for the funding. Previously HHS said it would issue detailed reporting instructions by Aug. 17, 2020 and the reporting system would be available Oct. 1. The reporting system is not yet available. “We urge you to rescind the changes included in the Sept. 19 guidance regarding how lost revenue may be calculated,” NABH President and CEO Shawn Coughlin wrote in a letter to HHS Secy. Alex Azar on Oct. 1. “Please clarify that providers may continue to rely on the June guidance as an alternative and equally valid approach to calculating lost revenue attributable to Covid-19 and eligible for reimbursement with funding from the PRF.” Please contact your U.S. senators and representatives today and ask them to urge the White House and HHS to reinstate the Covid-19 PRF reporting requirements that HHS outlined in June. Providers must be able to use these funds to recover any revenue lost due to Covid-19, rather than be limited by these new details from HHS.

NABH Sends 2021 OPPS Rule Comment Letter to CMS

NABH this week submitted comments to the Centers for Medicare & Medicaid Services (CMS) concerning partial hospitalization program (PHP) provisions in the agency’s 2021 outpatient prospective payment system (OPPS) proposed rule. In a letter to CMS Administrator Seema Verma, NABH President and CEO Shawn Coughlin said NABH supports provisions in the rule that continue using the geometric mean per diem cost methodology to set the rates for PHPs. The association also supports maintaining a separate cost floor for the Community Mental Health Center PHPs and the Hospital-based PHPs, the letter noted. “We agree that it is important that the per diem rates not fluctuate too greatly from year to year to provide stability for PHP providers,” Coughlin wrote in the letter. “In order to ensure stability in future rates, we recommend that CMS consider incorporating an annual adjustment to the cost floor in order to ensure that it reflects updated cost information and continues to help minimize the impact of significant changes in the median costs.” NABH’s letter also expressed concerns about the decrease in the rate for ambulatory payment classification (APC) 5822 Level 2 Health and Behavior Services, and urged the agency to consider continuing telehealth coverage for PHP services and coverage for associated facility fees so individuals with serious behavioral health conditions can continue to access critical services.

SAMHSA Releases ‘My Mental Health Crisis Plan” Mobile App

The Substance Abuse and Mental Health Services Administration (SAMHSA) this week released “My Mental Health Crisis Plan,” a new mobile app that allows individuals with serious mental illness (SMI) to create a plan to help guide their treatment during a mental health crisis. A SAMHSA announcement said the app was developed through SMI Adviser, a project that SAMHSA administers with funding from the American Psychiatric Association. The new resource provides a step-by-step process for individuals to create and share a psychiatric advance directive (PAD), a legal document that includes a list of instructions and preference that the individual wishes to be followed during a mental health crisis if the person is unable to make his or her own decisions. My Mental Health Crisis Plan also allows individuals to state clearly which medications to use and not to use, preferences for hospitals and mental health professionals, the names of trusted persons who can act on their behalf, and more. The mobile app is available in the Apple App Store and Google Play.

JAMA Study Examines PTSD Risk Factors Among First Responders in a Crisis

First responders in a major crisis may be most likely to experience post traumatic stress disorder (PTSD) if they are older and affected personally by the disasters, a new JAMA study has concluded. For the study, researchers studied data from more than 56,000 first responders after a 9.0 magnitude earthquake that struck Japan in March 2011 that led to nearly 16,000 deaths. The responders were surveyed several times during a six-year period, and researchers found that although only 7% of the study group likely had PTSD overall, being personally affected by the disaster meant a 96% increase in likelihood of PTSD. “Given these findings, in the future, first responders’ PTSD symptoms might be mitigated by shortening deployment length, avoiding post-deployment overtime work, and paying special attention to the needs of personal experience of the disaster or older age,” the study said. “Efforts to alleviate responders’ initial symptoms will be required.”

Please Complete the 2020 NABH Annual Survey!

Fact of the Week

Researchers from the University of Washington used data from the National Survey of Drug Use and Health to identify risk factors for suicide among individuals with mental health challenges who had criminal justice system involvement. They found that while there was a higher frequency of suicide attempts in all populations that had been involved with the criminal justice system, those who had been recently arrested were at the highest risk for suicide compared with those on parole or probation. The results suggest that prioritizing suicide prevention and mental health services after arrest could have significant impacts on this population. For questions or comments about this CEO Update, please contact Jessica Zigmond.

NABH Letter on HHS Provider Relief Fund Reporting Requirements

Written by Administrator on October 2, 2020. Posted in Letters.

HHS Provider Relief Fund Reporting Requirements

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HHS Includes Behavioral Healthcare Providers in Provider Relief Fund Phase 3 Distribution

Written by Administrator on October 2, 2020. Posted in Alerts.

Change in operating revenues from patient care;
Change in operating expenses from patient care, including expenses incurred related to the coronavirus; and
Payments already received through the prior PRF distributions

HHS Provider Relief Fund Reporting Requirements Change Terms for Recovering Lost Revenue

Written by Administrator on October 2, 2020. Posted in Alerts.

The Department of Health and Human Services (HHS) has issued guidance that contradicts the department’s June FAQ about calculating lost revenue from Covid-19 that may be recovered through the Coronavirus Aid, Relief, and Economic Security Act’s (CARES) Provider Relief Fund (PRF). In the June FAQ, HHS said providers could “use any reasonable method of estimating the revenue during March and April 2020 compared to the same period had Covid-19 not appeared.” This latest guidance defines lost revenue that may be recovered as being limited to “a negative change in year-over-year net patient care operating income.” The guidance further specifies that providers generally will only be able to apply their PRF payments to lost revenue up to a facility’s net patient operating income for 2019. As HHS announced previously, providers who have received more than $10,000 from the PRF are required to submit a report by Feb.15, 2021, on the use of those funds through Dec. 31, 2020, and, if necessary, a second and final report by July 31, 2021. The PRF funding provided through the CARES Act and subsequent legislation was intended to reimburse eligible providers for healthcare-related expenses and lost revenues attributable to Covid-19. HHS had included a general commitment to reporting on the use of the PRF funds in the terms and conditions that PRF fund recipients agreed to for the funding. Previously HHS said it would issue detailed reporting instructions by Aug. 17, 2020 and the reporting system would be available Oct. 1. The reporting system is not yet available. Please contact your U.S. senators and representatives today and ask them to urge the White House and HHS to reinstate the Covid-19 PRF reporting requirements that HHS outlined in June. Providers must be able to use these funds to recover any revenue lost due to Covid-19, rather than struggling to once again change course to respond to shifting guidance from HHS.

NABH Comments on FY 2021 OPPS Rule

Written by Administrator on October 1, 2020. Posted in Letters.

NABH Comments on FY 2021 OPPS Rule

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NABH Board of Trustees Meeting Oct. 5-6, 2020

Written by Administrator on October 1, 2020. Posted in Board Member.

[vc_row][vc_column width=”1/2″][vc_column_text] Monday, Oct. 5, 2020 6 p.m. – 6:30 p.m. Board Reception 6:30 p.m. – 8:30 p.m. Dinner Guest Speaker: Nathan L. Gonzales, Editor and Publisher, Inside Elections with Nathan L. Gonzales [/vc_column_text][/vc_column][vc_column width=”1/2″][vc_column_text] Tuesday, Oct. 6, 2020 8 a.m. Board Meeting Noon Lunch 1 p.m. Adjournment [/vc_column_text][/vc_column][/vc_row][vc_row][vc_column][vc_separator][vc_row_inner][vc_column_inner][vc_column_text]

Agenda

NABH Board of Trustees Meeting Tuesday, Oct. 6, 2020 8:30 a.m. – 1 p.m. ET The Top of the Hay Room The Hay-Adams Hotel, Washington, DC 20006 800 16th Street, NW, Washington, DC Hotel phone: 202-638-6600 [/vc_column_text][/vc_column_inner][/vc_row_inner][vc_row_inner][vc_column_inner width=”1/2″][vc_column_text]

BOT Agenda 10-6-2020

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Remote Participation Best Practices

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CEO Update 118

Written by Administrator on September 25, 2020. Posted in Uncategorized.

Congress Passes National Suicide Hotline Designation Act The House of Representatives this week passed a Senate-approved bill designating ‘988’ as the three-digit phone number for a national suicide prevention lifeline. In a voice vote Monday, the House passed the National Suicide Hotline Designation Act, which amends the Communications Act to designate 988 as the universal dialing code for the National Suicide Prevention Lifeline. The legislation allows states to impose a 988 surcharge on phone bills to help fund the call centers, a practice states follow to support 911. The bill has moved to the White House for President Trump’s signature. After it becomes law, the Federal Communications Commission requires all phone service providers to transition to 988 by July 16, 2022. FDA Requires Strong Warning Labels for Benzodiazepines The U.S. Food and Drug Administration (FDA) on Wednesday said it is requiring class-wide labeling changes for benzodiapines to include the risks of abuse, misuse, addiction, physical dependence, and withdrawal reactions to help improve their safe use. According to the FDA, an estimated 92 million benzodiapine prescriptions were dispensed from U.S. outpatient pharmacies in 2019, with alprazolam (38%) being the most common, followed by clonazepam (24%) and lorazepam (20%). Meanwhile, an estimated 50% of patients dispensed oral benzodiapines—commonly used to treat anxiety, insomnia, seizures, and panic disorders—received them for two months or longer, the agency noted. “While benzodiazepines are important therapies for many Americans, they are also commonly abused and misused, often together with opioid pain relievers and other medicines, alcohol and illicit drugs,” FDA Commissioner Stephen M. Hahn, M.D., said in a news release. “We are taking measures and requiring new labeling information to help healthcare professionals and patients better understand that while benzodiazepines have many treatment benefits, they also carry with them an increased risk of abuse, misuse, addiction and dependence.” CDC’s National Center for Health Statistics Releases Reports on Mental Health and Treatment The Centers for Disease Control and Prevention’s (CDC) National Center for Health Statistics (NCHS) has released three new reports that examine anxiety disorder, depression, and treatment among U.S. adults in 2019. The findings showed that more than 15% of U.S. adults experienced symptoms of anxiety and 18.5% of U.S. adults had symptoms of depression that were “mild, moderate, or severe in the past two weeks.” The studies also showed women were more likely than men to have received any mental health treatment, and the percentage of adults who received any mental treatment varied by age group and urbanization level. HHS-OIG Report Says CMS Should Pursue Strategies to Boost the Number of At-Risk Medicaid Beneficiaries Acquiring Naloxone A new report from the U.S. Department of Health and Human Services’ (HHS) Office of Inspector General (OIG) concluded that the Centers for Medicare & Medicaid Services (CMS) should pursue strategies to increase the number of at-risk beneficiaries acquiring community-use versions of naloxone through Medicaid. The study notes that, on average, 130 people in the United States die every day from an opioid overdose, and the drug naloxone “plays a critical role in saving the lives of those who abuse or misuse opioids.” As one review of emergency data found that, when given naloxone, 94% of people survived their overdose. In 2018, the U.S. Surgeon General issued an advisory that said increasing naloxone’s availability and targeted distribution is a “critical component” of efforts to reduce opioid-related overdose deaths. For the report, the OIG’s office used state-reported Medicaid data to determine how total utilization for naloxone changed in the Medicaid program between 2014 and 2018. By using manufacturer-reported sales data, the researchers determined the proportion of all naloxone distributed nationwide. “Access to naloxone for Medicaid beneficiaries has expanded significantly, with the program paying for 21 times more doses in 2018 than in 2014,” the OIG report said. “Despite this growth, Medicaid paid for only 5% of all naloxone distributed in the United States in 2018,” it continued. “This figure is especially concerning given that (1) Medicaid covers almost 40% of nonelderly adults with opioid use disorder (OUD) and (2) some States with extremely high overdose mortality rates paid for relatively little naloxone under Medicaid.” Treatment Advocacy Center Releases New Analysis on State Involuntary Treatment Laws New research from the Treatment Advocacy Center shows that whether or not a person receives timely, appropriate treatment for acute psychiatric crisis or chronic psychiatric disease is almost entirely dependent on the state in which he or she is living when the crisis occurs. Grading the States: An Analysis of U.S. Psychiatric Treatment Laws offers a detailed evaluation of each state’s treatment laws compared with other states, and it also identifies specific statutory changes that states can make to improve access to care for this population. According to the report, 10 states earned an “A” grade while eight states earned an “F.” Meanwhile, six states—Alabama, Delaware, Georgia, Oklahoma, Pennsylvania, and Tennessee—still have an outdated requirement that harm to self or others be imminent for a person to qualify for inpatient commitment, and seven states—Georgia, Ohio, Oklahoma, Oregon, Rhode Island, Wisconsin, and Wyoming—require harm from failing to meet basic needs to be imminent to intervene. “The U.S. mental health system is not one single broken system, but many,” the study said. “Responsibility for making needed reform is in the hands of the states and thousands of local governments,” it continued. “Each has a unique set of laws, regulations, policies and budget priorities that, collectively, make up our national mental health system.” September is National Recovery Month & National Suicide Prevention Month There are a few days remaining in National Recovery Month and National Suicide Prevention Month, commemorated every September to educate Americans about services, treatment, and resources available to those with mental health and substance use disorders and to promote suicide prevention. SAMHSA has hosted a webinar series throughout the month that featured topics including supported employment, communities supporting recovery, and the importance of integrating recovery support services. Meanwhile, the National Action Alliance (Action Alliance) for Suicide Prevention has developed several resources to help build awareness about suicide prevention. Please see the Action Alliance’s #BeThere activities and use the hashtag #BeThere to educate your organization’s social media followers. And please remember to follow NABH on Twitter and LinkedIn to learn what NABH members, federal agencies, and other organizations are doing to honor National Recovery Month and National Suicide Prevention Month. Please Complete the 2020 NABH Annual Survey! The 2020 NABH Annual Survey opened in late August and NABH members should have received personalized links to the survey from consulting firm Dobson DaVanzo. If you have not received a link, please click here and follow the instructions to submit your survey today. Your feedback will help inform and improve NABH’s advocacy efforts. The survey closes on Saturday, Oct. 31. Thank you for your time! Fact of the Week Emerging literature shows a connection between air pollution and anxiety and depression: “It’s thought that the change in the nervous system that seems to be stimulated by air pollution, and perhaps the vascular system changes, can affect brain function and lead people into a more depressive state,” Michael Jerrett, Ph.D. of the Center for Healthy Climate Solutions at UCLA’s Fielding School of Public Health told Kaiser Health News. For questions or comments about this CEO Update, please contact Jessica Zigmond.

CEO Update 117

Written by Administrator on September 11, 2020. Posted in Uncategorized.

NABH Sends CMS Comments on Covid-19 Reporting Requirements

NABH this week urged the Centers for Medicare & Medicaid Services (CMS) to exempt psychiatric hospitals and psychiatric units in inpatient hospitals from the Covid-19 reporting requirements the agency added to the Conditions of Participation (CoP) and announced in an interim final rule. In a letter to CMS Administrator Seema Verma, NABH President and CEO Shawn Coughlin asked that if the agency does not exempt psychiatric hospitals and units, that it at least modify the requirements to remove the ones that are not relevant to psychiatric facilities. These requirements relate to supplies and use of Remdesivir, intensive care unit beds, ventilators and ventilator supplies and medications, and the use of emergency department or overflow locations for Covid-19 patients while those patients wait for an inpatient bed. “Furthermore, we ask that you modify the interim final rule to lessen the frequency of reporting,” Coughlin wrote in the letter. “The rule does not explain why this very burdensome reporting must be done every day, seven days a week. It is especially unclear why this daily reporting is necessary for facilities that are not focused on treating Covid-19. The staffing information is particularly arduous to submit on a daily basis.” The letter also highlights that guidance on data elements incorporated in the interim final rule indicate that some hospitals may report to their state agencies, which will report to the federal government on their behalf. But it’s unclear how hospitals will know whether their states have been certified to conduct that reporting. “In addition, the status of each state’s certification may change, and states may be permitted to report for some of their hospitals, but not all,” the letter noted. “It is not clear how hospitals will know whether they should report this information to their state agencies or to the federal government, especially because a state’s certification may change over time.”

SAMHSA Proposes Establishing Guidelines to Include Hair Specimens in Federal Workplace Drug Testing Programs

The Substance Abuse and Mental Health Services Administration (SAMHSA) is proposing to establish scientific and technical guidelines to include hair specimens in the Mandatory Guidelines for Federal Workplace Drug Testing Programs using Hair (HMG). In a recent notice, SAMHSA said the HMG will allow federal executive branch agencies to collect and test a hair specimen as part of their drug testing program within the limitation that hair specimen be used for pre-employment and random testing. A federal agency that chooses to test hair specimens must authorize collection and testing of at least one other specimen type (i.e., urine or oral fluid) that is authorized under the Mandatory Guidelines for Federal Workplace Drug Testing Programs and provide procedures in which the alternate specimen is used in cases when a donor is unable to provide a sufficient amount or length of hair. SAMHSA has requested public comments on this notice through Monday, Nov. 9. Click here to learn more about the guidelines and how to submit comments.

CMS Issues Covid-19 Reporting Guidance for Labs and Long-term Care Facilities

CMS has issued new surveyor guidance for Covid-19 laboratory test reporting for Clinical Laboratory Improvement Amendments-certified laboratories. These labs are expected to adhere to the new requirements no later than Wednesday, Sept. 23 and will be subject to civil monetary penalties if they do not comply.

New Report Highlights Harmful Effects of Eating Disorders on Individuals, Families, and Society

About 9% of the U.S. population, or approximately 28.8 million Americans, will have an eating disorder in their lifetime, says a new report from the Strategic Training Initiative for the Prevention of Eating Disorders, or STRIPED. Working with the Academy for Eating Disorders and Deloitte Access Economics, STRIPED spent a year gathering evidence on the effects of eating disorders on individuals, families, and societies; analyzing the direct costs for treatment; and reporting other economic costs, such as informal caregiving, productivity, and estimated substantial losses in wellbeing. Researchers found that eating disorders cost the U.S. about $64.7 billion a year, including $48.6 billion in productivity losses, $6.7 billion in informal caregiving, $4.8 billion in efficiency losses, and $4.6 billion throughout the country’s health system. Eating disorders affect everyone, the report found, but people of color with eating disorders are half as likely to be diagnosed or to receive treatment. Meanwhile, females are twice as likely to have an eating disorder than males. CMS to Host Open Door Forum on Hospital IPPS and OPPS Rules Next Week CMS will host an Open Door Forum on Thursday, Sept. 17 to provide an update and answer questions about the agency’s 2021 Hospital Inpatient Prospective Payment System final rule and 2021 Outpatient Prospective Payment System proposed rule. The hourlong event will begin at 2 p.m. ET, and CMS has requested that participants dial in 15 minutes before the call begins. This is a conference call only. Click here for details.

September is National Recovery Month & National Suicide Prevention Month

September is National Recovery Month and National Suicide Prevention Month, which are intended to educate Americans about services, treatment, and resources available to those with mental health and substance use disorders and to promote suicide prevention. SAMHSA will host a webinar series throughout Recovery Month that will feature a different topic every Thursday. Upcoming topics include supported employment, communities supporting recovery, and the importance of integrating recovery support services. Meanwhile, the National Action Alliance (Action Alliance) for Suicide Prevention has developed several resources to help build awareness about suicide prevention. Please see the Action Alliance’s #BeThere activities and use the hashtag #BeThere to educate your organization’s social media followers. And please remember to follow NABH on Twitter and LinkedIn to learn what NABH members, federal agencies, and other organizations are doing to honor National Recovery Month and National Suicide Prevention Month.

Please Complete the 2020 NABH Annual Survey!

The 2020 NABH Annual Survey opened late last month and NABH members should have received personalized links to the survey from consulting firm Dobson DaVanzo. If you have not received a link, please click here and follow the instructions to submit your survey today. Your feedback will help inform and improve NABH’s advocacy efforts. Thank you for your time!

Fact of the Week

Calls to the National Eating Disorders Association’s helpline are up 70% to 80% in recent months. For questions or comments about this CEO Update, please contact Jessica Zigmond.

NABH Letter on Covid-19 Reporting Requirements

Written by Administrator on September 8, 2020. Posted in Letters.

NABH Comments on COP Reporting Requirements on Covid-19

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CEO Update 116

Written by Administrator on September 4, 2020. Posted in Uncategorized.

September is National Recovery Month & National Suicide Prevention Month

This past week began National Recovery Month and National Suicide Prevention Month, which are intended to educate Americans about services, treatment, and resources available to those with mental health and substance use disorders and to promote suicide prevention. Elinore McCance-Katz, M.D., Ph.D, assistant secretary for mental health and substance use at the Substance Abuse and Mental Health Services Administration (SAMHSA), helped kick off the month-long observances in a video message celebrating those in recovery and the recovery community’s work in the fight against addiction in the United States. SAMHSA will host a webinar series throughout Recovery Month that will feature a different topic every Thursday. Upcoming topics include supported employment, communities supporting recovery, and the importance of integrating recovery support services. Meanwhile, the National Action Alliance (Action Alliance) for Suicide Prevention has developed several resources to help build awareness about suicide prevention. Please see the Action Alliance’s #BeThere activities and use the hashtag #BeThere to educate your organization’s social media followers. In addition, the group will host National AI/AN Hope for Life Day on Sept. 10. That event falls during Suicide Prevention Week from Sept. 6-12. Please see the Hope for Life Day toolkit and visit the Action Alliance’s #BeThere webpage for more information. And please remember to follow NABH on Twitter and LinkedIn to learn what NABH members, federal agencies, and other organizations are doing to honor National Recovery Month and National Suicide Prevention Month.

AHRQ Seeks Comment on Strategies for Opioid Use and Misuse in Older Adults in Primary Care

The Agency for Healthcare Research and Quality (AHRQ) is working on a project to assess and describe the current prevalence, awareness, and management of opioid use, misuse, and abuse in older adults and identify gaps and areas of needed research. The new project will support primary care practices in both developing and testing innovative strategies, approaches, and/or tools for opioid management within learning collaboratives and will culminate in a “Compendium of Strategies” for opioid management in older adults in primary care settings. AHRQ mapped out its data collection method in the agency’s project description and is seeking public comments about that process. The notice was posted on Aug. 26, and AHRQ will accept comments for 30 days after that publication date. Anthem-Affiliated Health Plans More than Doubled the Number of Consumers Receiving Whole-Person Treatment for OUD After committing four years ago that it would ensure more consumers would receive both drug therapy and counseling treatment, health insurer Anthem announced this week that it increased the combined percentage of consumers in employer-based, individual, and Medicaid plans with opioid use disorder (OUD) to 36% from 18% in 26 plans nationwide. The Indianapolis-based insurer released the announcement at the start of National Recovery Month and added that Medicaid plans alone increased to 55% from 24%. Greg Williams, a national recovery advocate who helped launch the Surgeon General’s report Facing Addiction in America and who co-founded The Alliance for Addiction Payment reform, applauded Anthem for its efforts and said it’s more important than ever for health insurers to take on this leadership role. “Medication for certain substance use disorders has the potential to save lives, but medication alone is not a panacea for long-term outcomes,” Williams said in a news release from Anthem. “The best way to promote sustained recovery is to combine the use of medication in treatment with evidence-based behavioral therapies and recovery support services.” Click here to read Anthem’s Sept. 2 announcement.

JAMA Article Examines OUD Therapies in Residential Treatment Programs

A new article in JAMA explores the findings of research that investigated the OUD treatment that the nation’s residential treatment programs offer. Published Aug. 25, the research letter notes that residential treatment programs are “a common, costly setting for treating opioid use disorder and are frequently promoted in policy proposals to improve access to care.” But concerns have arisen about the quality of care and a low use of evidence-based opioid agonist treatment in these settings. Because data on these programs are based primarily on self-reported surveys, the researchers simulated patients calls to audit the treatments that these programs offer. Click here to read the research letter.

Georgetown Offers New Master’s Program in Addiction Policy and Practice

Georgetown University is offering a new master’s program in addiction policy and practice that is intended to build a national policy workforce that will respond to the chronic health condition of addiction. The program will draw from the faculty and resources of the university’s schools, including the Graduate School of Arts and Science, the O’Neill Institute for National and Global Health Law at Georgetown University Law Center, Georgetown University Medical Center, the McCourt School of Public Policy, and the basic and social science departments of Georgetown College. Applications for the one-year program will open this fall and the first class is scheduled to begin in July 2021. Click here to learn more.

Fact of the Week A prevalence of depression symptoms in the United States was more than three-fold higher during Covid-19 compared with before the pandemic.

CEO Update 115

Written by Administrator on August 28, 2020. Posted in Uncategorized.

2020 NABH Annual Survey Opens Today!

Data collection for the 2020 NABH Annual Survey starts today, Friday, Aug. 28. Your participation in this survey will help NABH continue to provide an accurate, up-to-the-minute picture of the U.S. behavioral healthcare industry. This year NABH has added a few new questions related to substance use to help us better measure our membership’s activities. NABH’s contractor, Dobson DaVanzo & Associates, will conduct the NABH Annual Survey again this year. Dobson DaVanzo & Associates brings extensive data-analysis experience and data-security expertise to this project. The firm has analyzed data for the last several NABH Annual Surveys. Dobson DaVanzo will send personalized links to the survey instrument via e-mail directly to the CEOs of all NABH-member organizations. If you receive a request to participate in the survey, please respond as soon as possible. The 2020 online entry form will provide a personalized, secure e-mail link for each facility. You will be able to enter, save, and review data— and review that data internally with others in your organization who have completed the survey—until you click “Done” on the survey’s last page. After you click “done,” you may not make changes. The survey data are used in dozens of ways to help protect mental health and addiction treatment benefits; ensure fair and adequate payments; improve patient care; and communicate trends to the media, payers, benefit consultants, and the public. Within your organization, you can also use the NABH aggregate data you will receive to measure how your facility compares with national trends. Because the survey collects the most current information about the field, it can provide a valuable perspective for administrative and clinical operations. The NABH Annual Survey Report is an invaluable strategic planning tool as well as a reference document every behavioral healthcare organization should have. If you have any questions or suggestions about this survey, please contact Shawn Coughlin or Kirsten Beronio. Thank you for your time. We appreciate your help in making us stronger advocates for you and your teams!

HHS Extends Provider Relief Fund Phase 2 General Distribution Deadline to Sept. 13

The Department of Health and Human Services (HHS) has extended the deadline to apply for Phase 2 General Distribution Funding for Medicaid, Medicaid managed care, Children’s Health Insurance Program, dental providers, and certain Medicare providers until Sunday, Sept. 13. This funding is through the Provider Relief Fund, which the federal government established in this year’s Coronavirus Aid, Relief, and Economic Security Act (CARES) and Paycheck Protection Program and Health Care Enhancement Act. These payments do not need to be repaid to the government if providers comply with terms and conditions. HHS has extended this Phase 2 General Distribution Funding deadline before, with the latest deadline scheduled for Friday, Aug. 28. Providers now have a few extra weeks to apply. Click here to read HHS’ six steps to applying for the Phase 2 General Distribution.

CMS Makes Covid-19 Data Collection a Requirement in Conditions of Participation

The Centers for Medicare & Medicaid Services (CMS) is requiring Covid-19 data collection and reporting as a condition of participation (CoP) for hospitals participating in the Medicare and Medicaid programs, including psychiatric facilities. CMS added the requirement with other provisions in an interim final rule and said it will accept comments for 60 days. The rule noted the requirement will become effective when it is published in the Federal Register, although it did not list a specific date. Under the new requirement, hospitals will need to report daily data, including—but not limited to—the number of confirmed or suspected Covid-19 positive patients, intensive care unit beds occupied, and the availability of supplies and equipment, such as ventilators and personal protective equipment. CMS warned in the rule that if a hospital fails to comply with this new CoP, it could face possible termination from the federal healthcare programs.

NABH Supports ‘Eliminating the Provider Relief Fund Tax Penalties Act’

NABH is one of 29 healthcare advocacy organizations this week to support the Eliminating the Provider Relief Fund Tax Penalties Act, a bill that would offer some financial relief to healthcare providers during the Covid-19 pandemic. Congress’ allocation of $175 billion in financial support to healthcare professionals through this year’s Public Health and Social Services Emergency Fund (PHSSEF) has done much to help the healthcare community provide critical services to patients. At the same time, PHSSEF assistance is taxable, which results in a reduction of 21% or more to the benefit for taxpaying healthcare professionals, compared with non-taxpaying healthcare professionals. “This negative impact penalizes those who care for our nation’s most vulnerable,” the organizations wrote in a letter to House and Senate lawmakers. “The passage of H.R. 7819/S. 4525 would remove the negative tax implications for PHSSEF recipients by ensuring that all Provider Relief Fund assistance is not taxable, while maintaining that expenses tied to this assistance are tax-deductible.”

Urban Institute Study Examines Naloxone Products and Pricing in Medicaid, 2010-2018

Medicaid enrollees’ naloxone options will remain limited—and could potentially worsen the nation’s overdose crisis—without new federal policies that regulate prices and/or promote robust price competition, according to new research from the Urban Institute. For the study, researchers tracked changes in Medicaid spending from 2010-2018 on naloxone, its price per unit, and Medicaid-covered naloxone prescriptions for generic naloxone products, the brand-name Narcan nasal spray, and the Evzio autoinjector. “We find dramatic increases in Medicaid prescriptions for and spending on naloxone between 2010 and 2018,” Senior Research Associate Lisa Clemans-Cope and her team concluded in the study. “This may partially owe to the new naloxone formulations that offer advantages in administration,” the study’s authors wrote, adding that needle-free naloxone nasal spray is highly effective and easy to use, while the quick-acting autoinjector naloxone works for people with nasal abnormalities, which make up a substantial share of those with opioid use disorder. “Ideally, prescribers could write naloxone prescriptions suited to each Medicaid patient’s circumstances,” the researchers wrote. “However, we find that the autoinjector formulation was not offered in any state Medicaid program in 2018, likely because of their very high and variable prices per prescription in years prior and lack generic equivalents.”

SAMHSA Accepting Applications for Disaster Response State Grant Program

The Substance Abuse and Mental Health Services Administration (SAMHSA) is accepting applications for its Disaster Response State Grant Program, which is meant to provide mental and substance use disorder treatment, crisis counseling, and other related supports for adults and or school-aged children affected by hurricanes, typhoons, wildfires, and earthquakes during 2018. The agency said it plans to issue about 17 grants of up to $7 million per year for one year and will accept applications through Wednesday, Sept. 2. Click here to learn more.

SAMHSA Helpline Offers 24/7 Crisis Counseling Services

As Americans withstand the effects of Hurricane Laura and California’s wildfires, NABH reminds all members that SAMHSA’s Disaster Distress Helpline provides crisis counseling services 24 hours a day, seven days a week, 365 days a year. NABH thanks its members for providing essential behavioral healthcare services in the nation’s disaster areas during an already difficult time.

Looking Ahead: September is Suicide Prevention Month

The National Action Alliance (Action Alliance) for Suicide Prevention has developed several resources to help build awareness about suicide prevention during Suicide Prevention Month in September. To help in the effort, please see the Action Alliance’s #BeThere activities and use the hashtag #BeThere to educate your organization’s social media followers. In addition, the group has scheduled a #BeThere Twitter chat on Tuesday, Sept. 1 at 2 p.m. ET and will host National AI/AN Hope for Life Day on Sept. 10. That event falls during Suicide Prevention Week, which is Sept. 6-12. Click here for the Hope for Life Day toolkit and visit the Action Alliance’s #BeThere webpage for more information. Fact of the Week In April, 64% of the U.S. population reported feeling “nervous on several or more days.” That increased by five percentage points to 69% by July, according to a Census Bureau survey. For questions or comments about this CEO Update, please contact Jessica Zigmond.

CMS Makes Covid-19 Data Collection a Requirement in Conditions of Participation

Written by Administrator on August 26, 2020. Posted in Alerts.

NABH and Other Healthcare Groups Support Eliminating the Provider Relief Fund Tax Penalties Act

Written by Administrator on August 26, 2020. Posted in Letters.

Letter Support the Elimination of the Provider Relief Fund Tax Penalties Act

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HHS Extends Phase 2 General Distribution Deadline to Sept. 13

Written by Administrator on August 26, 2020. Posted in Alerts.

The Department of Health and Human Services (HHS) has extended the deadline to apply for Phase 2 General Distribution Funding for Medicaid, Medicaid managed care, Children’s Health Insurance Program, dental providers, and certain Medicare providers until Sunday, Sept. 13. This funding is through the Provider Relief Fund, which the federal government established in this year’s Coronavirus Aid, Relief, and Economic Security Act (CARES) and Paycheck Protection Program and Health Care Enhancement Act. These payments do not need to be repaid to the government if providers comply with terms and conditions. HHS has extended this Phase 2 General Distribution Funding deadline before, with the latest deadline scheduled for this Friday, Aug. 28. Providers now have a few extra weeks to apply. Click here to read HHS’ six steps to applying for the Phase 2 General Distribution.

2020 NABH Annual Survey Starts Aug. 28!

Written by Administrator on August 24, 2020. Posted in Alerts.

Data Collection for the 2020 NABH Annual Survey Starts this Week! I am pleased to announce that data collection for the 2020 NABH Annual Survey will begin on Friday, Aug. 28. Your participation in this survey will help us continue to provide an accurate, up-to-the-minute picture of the U.S. behavioral healthcare industry. Please note that we have added a few new questions related to substance use. This will help us better measure our membership’s activities. Look for a Message from Consulting Firm Dobson DaVanzo & Associates, LLC Our contractor, Dobson DaVanzo & Associates, will conduct the NABH Annual Survey again this year. Dobson DaVanzo & Associates brings extensive data-analysis experience and data-security expertise to this project. The firm has analyzed data for the last several NABH Annual Surveys. Dobson DaVanzo will send personalized links to the survey instrument via e-mail directly to the CEOs of all NABH-member hospitals and residential treatment centers. If you receive a request to participate in the survey, please respond as soon as possible. Submit Your Data Online The 2020 online entry form will provide a personalized, secure e-mail link for each facility. You will be able to enter, save, and review data— and review that data internally with others in your organization who have completed the survey—until you click “Done” on the survey’s last page. You may not make changes after you have submitted your data. You will receive complete instructions with the survey instrument. Your Participation in Essential! The survey data are used in dozens of ways to help protect mental health and addiction treatment benefits; ensure fair and adequate payments; improve patient care; and communicate trends to the media, payers, benefit consultants, and the public. Within your organization, you can also use the NABH aggregate data you will receive to measure how your facility compares with national trends. Because the survey collects the most current information about the field, it can provide a valuable perspective for administrative and clinical operations. The NABH Annual Survey Report is an invaluable strategic planning tool as well as a reference document every behavioral healthcare organization should have. If you have any questions or suggestions about this survey, please feel free to contact me directly at Shawn@nabh.org or contact Kirsten Beronio at Kirsten@nabh.org. Thank you for your time. We appreciate your help!

CEO Update 114

Written by Administrator on August 21, 2020. Posted in Uncategorized.

HHS Sets New OUD Target in ‘Healthy People 2030’ Public Health Plan The Health and Human Services Department (HHS) this week released Healthy People 2030, the federal government’s 10-year plan to address the nation’s most critical public health priorities and problems. In it, HHS features 355 core, or “measurable,” objectives with 10-year targets, including one to reduce the proportion of persons with opioid use disorder (OUD) in the past year. Specifically, the plan notes a baseline of 0.7% of persons aged 12 years and older who reported an OUD (heroin or prescription pain reliever) in the 12 months of 2018. Healthy People 2030 sets a new target of 0.5%. A federal advisory committee of 13 external leaders and a workgroup of subject matter experts from more than 20 federal agencies contributed to Health People 2030, which also incorporated public comments during the development process. EEOC Releases Guidance for Healthcare Providers to Help Opioid Patients Stay Employed The U.S. Equal Employment Opportunity Commission (EEOC) has released a fact sheet to help explain the healthcare provider’s role under the American with Disabilities Act of 1990 when a patient who uses opioids needs a reasonable accommodation or when questions surface about a patient’s ability to perform a job safely. As the EEOC noted in its announcement, this information is not new; instead, it applies to principles established in the 30-year-old law and previously issued guidance. The new publication is meant to provide clarity under all existing requirements. In the publication, the EEOC recommends medical documentation be written using plain language that explains the provider’s professional qualifications and details regarding the nature and length of the relationship with the employee; the nature of the employee’s medical condition; the extent to which the employee’s opioid use would limit a “major life activity” (such as walking, lifting, sleeping, or concentrating) without treatment; the need for reasonable accommodation; and suggested accommodations “without overstating the need for any one particular accommodation in case an alternative is necessary.” Click here to learn more. NABH Participates in CMS Stakeholder Listening Session NABH members and staff participated in a call about OUD during the public health emergency with leaders of the Centers for Medicare & Medicaid Services (CMS) this week. Kimberly Brandt, principal deputy administrator for policy and operations at CMS, hosted the call and NABH President and CEO Shawn Coughlin represented the association. Joe Pritchard, CEO of Pinnacle Treatment Centers, and Greg Marotta, CEO of CleanSlate, also participated. During the call, CMS reviewed previous Trump administration activities and asked stakeholders to comment on outstanding issues related to expanding access to treatment for individuals with opioid use disorders. The topics discussed included streamlining provider credentialing, collaborating with the Substance Abuse and Mental Health Services Administration (SAMHSA) and the Drug Enforcement Administration (DEA) on telemedicine rules, making all Covid telehealth flexibilities permanent; permitting methadone induction through telehealth, supporting state licensure reciprocity, covering services for incarcerated individuals prior to reentering the community, covering contingency management as an evidence-based practice for individuals with stimulant disorders, and targeting specific funds to behavioral healthcare providers. For more information, please contact Sarah Wattenberg, NABH’s director of quality and addiction treatment services. Atrium Health’s Behavioral Health to Host Webinar on Virtual Care Model Next Week NABH member Atrium Health’s Behavioral Health will host the first webinar in its series “Delivering Behavioral Health Services in a Pandemic Environment” next Wednesday, Aug. 26 at 1 p.m. ET. The webinar, Transitioning Outpatient Services to a Virtual Care Model, is open to all. Click here to join the meeting. Looking Ahead: September is Suicide Prevention Month The National Action Alliance (Action Alliance) for Suicide Prevention has developed several resources to help build awareness about suicide prevention during Suicide Prevention Month in September. To help in the effort, please see the Action Alliance’s #BeThere activities and use the hashtag #BeThere to educate your organization’s social media followers. In addition, the group has scheduled a #BeThere Twitter chat on Tuesday, Sept. 1 at 2 p.m. ET and will host National AI/AN Hope for Life Day on Sept. 10. That event falls during Suicide Prevention Week, which is Sept. 6-12. Click here for the Hope for Life Day toolkit and visit the Action Alliance’s #BeThere webpage for more information. #BeThere activities and created a Hope for Life Day toolkit. Fact of the Week Among U.S. adults aged 18 and older, 5.1% engaged in heavy drinking, or the consumption of an average of more than 14 alcoholic drinks per week for men or more than 7 drinks per week for women. For questions or comments about this CEO Update, please contact Jessica Zigmond.

CEO Update 113

Written by Administrator on August 14, 2020. Posted in Uncategorized.

HHS Releases Provider Relief Fund Step-by-Step Guide and Stakeholder Toolkit

The U.S. Health and Human Services Department (HHS) this week hosted a webinar to clarify issues related to the Coronavirus Aid, Relief, and Economic Security Act’s (CARES) Provider Relief Fund and released materials for providers navigating the system to receive federal funding during the Covid-19 pandemic. On Thursday, HHS’ Health Resources and Services Administration (HRSA) hosted the webinar about the Provider Relief Fund’s Phase 2 General Distribution, in which providers may receive up to 2% of their reported revenue from patient care. The agency later released the presentation slides, as well as a step-by-step guide about the fund and a stakeholder toolkit. These and other pandemic-related materials are posted to NABH’s Covid-19 resources page.

Milliman Study Shows Individuals with Behavioral and Physical Health Conditions Drive High Total Healthcare Costs

Individuals with behavioral health conditions in addition to physical health conditions drive high total healthcare costs even though spending for behavioral healthcare treatment among these patients is a small portion of that total spending. That is the conclusion of a new study from actuarial and consulting firm Milliman, Inc. this week that analyzed claims data for 21 million commercially insured individuals. The Path Forward for mental health and substance use, a private-sector initiative to spur market-based improvements in behavioral health treatment, commissioned the study. The initiative receives funding from the Mental Health Treatment and Research Institute LLC, a tax-exempt subsidiary of The Bowman Family Foundation. According to the report, 5.7% of the entire study population—high-cost patients with both behavioral and physical health conditions—accounted for 44% of all healthcare spending. Meanwhile 50% of patients with behavioral health conditions had less than $68 of total annual spending for behavioral treatment. “This is a tragedy,” Henry Harbin, M.D., a psychiatrist and advisor to The Path Forward, said in news release about the study’s findings. “And now we know this population accounts for more than half of our total healthcare spending,” he continued. “Tremendous savings and improved outcomes are achievable if these individuals who deserve care are identified early and provided with prompt evidence-based behavioral treatment.” The report is intended to provide a baseline for estimating the effects of Covid-19 on behavioral healthcare.

CDC Report Shows 93,000 Americans Died from Excessive Alcohol Use from 2011-2015

An average of 255 Americans die from excessive drinking every day, shortening their lives by an average of 29 years, according to the Centers for Disease Control and Prevention (CDC). A recent Mortality and Morbidity Weekly Report, or MMWR, from the federal public health agency showed excessive alcohol use was responsible for about 93,000 deaths and 2.7 million “YPLL,” or years of potential lives lost, during 2011-2015. The majority of these alcohol-attributable deaths involved males, and about four in five deaths among adults aged 65 or older was nearly double that among adults aged 20-34 years, the findings showed. The report noted some recommendations from the Community Preventive Services Task Force that could reduce both alcohol-attributable deaths and YPLL, such as increasing alcohol taxes and regulating the number and concentration of alcohol outlets.

GAO Examines Medicaid Coverage for SUD Peer Support Services and Eating Disorders in the Military

A recent study from the Government Accountability Office (GAO) found that 37 states covered peer support services for adults with substance use disorders (SUDs) in their Medicaid programs in 2018. GAO researchers analyzed Medicaid and Children’s Health Insurance Program (CHIP) Payment and Access Commission data for the report. The findings noted that officials from the three states GAO reviewed—Colorado, Missouri, and Oregon—reported that their Medicaid programs offered peer support services as a complement, rather than an alternative, to clinical treatment for SUD. Separately, GAO also released a report on eating disorders in the U.S. military, which reviewed how the U.S. Defense Department (DOD) screens and provides treatment for eating disorders. That report showed that with DOD health coverage, service members and their dependents can receive specialized care for eating disorders through civilian providers working in 166 eating disorder facilities across 32 states. Of those facilities, more than three-quarters provide treatment to both adult and child and adolescent populations.

Manatt Health Releases Tracking Tool for Telehealth Coverage After Public Health Emergency

Manatt Health this week released a federal and 50-state tracking tool that highlights policy, regulatory, and legal changes related to telehealth during the Covid-19 pandemic. The research firm released this resource a week after the Centers for Medicare & Medicaid Services (CMS) announced in its physician fee schedule proposed rule that certain Medicare telehealth flexibilities during the pandemic would be made permanent, while others would be temporary. Manatt’s tracking tool includes a complete list of services that the proposed rule addresses.

RTI International Tracks Addiction Treatment Quality Across Time and States

A recent RTI International study found improvements in quality on most measures for addiction treatment between 2007 and 2017 but concluded that “performance on several measures remained low.” The North Carolina-based research and technical services firm said the study’s objective was to track trends in the signs of higher-quality addiction treatment based on definitions from the National Institute on Drug Abuse, the National Institute on Alcohol Abuse and Addiction, and the Substance Abuse and Mental Health Services Administration. According to the report, a greater percentage of U.S. addiction treatment facilities had attributes indicating higher quality in 2017 than in 2007, with most of the improvement occurring between 2011 and 2017. “Nonetheless, in 2017 fewer than 50 percent of facilities offered medications for opioid use disorder; testing for hepatitis C, HIV, and STDs; self-help groups; employment assistance; and transportation assistance,” the study said.

JAMA Article Explores Outpatient Mental Health Services for Youth After Psychiatric Hospitalization

A new JAMA study found that mental health follow-up received within seven days of discharge was associated with a reduced risk of suicide among children and adolescents during the eight to 189 days after hospital discharge. Researchers examined a cohort study of 139,694 child and adolescent inpatients in the Medicaid program and concluded that “shorter hospital stay, lack of prior mental healthcare, managed care, Black race, older age, and medical comorbidities were associated with delayed follow-up care.”

National Association of Mental Health Program Directors to Host Webinar Next Week

The National Association of Mental Health Program Directors will hold a two-part webinar series titled “Establishing and Building Bed Registry Systems” next week. Part One will focus on understanding the essential elements of an effective statewide registry, while Part Two will highlight three different models for success in establishing and building statewide crisis service and bed registries. Click here to register for Part One on Wednesday, Aug. 19 from 1:30 p.m. to 3 p.m. ET, and here to register for Part Two on Thursday, Aug. 20, also from 1:30 p.m. to 3 p.m. ET.

Fact of the Week

About 25% of young adults between the ages of 18 and 24 reported they have seriously considered suicide during the Covid-19 pandemic. For questions or comments about this CEO Update, please contact Jessica Zigmond.

Milliman Release: “Study Reveals Individuals with Behavioral Health Conditions in Addition to Physical Conditions Drive High Total Healthcare Costs; Small Portion Spent on Behavioral Treatment, Vast Majority Spent on Physical Treatment”

Written by Administrator on August 13, 2020. Posted in News Releases.

Milliman Report on High Cost of Behavioral Healthcare

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HHS to Host Provider Relief Fund Webinar on Thursday, Aug. 13

Written by Administrator on August 11, 2020. Posted in Alerts.

The Health and Human Services Department (HHS) will host an informational webinar for healthcare providers about applying to the CARES Act Provider Relief Fund this Thursday, Aug. 13 at 3 p.m. ET. Please click here to register. HHS announced on July 31 that certain Medicare-participating providers would have another opportunity to receive additional Provider Relief Fund payments. These are the providers who missed an early June deadline to apply for additional funding equal to 2% of their total patient care revenue from the $20 billion portion of the $50 billion phase 1 General Distribution, including many Medicaid, Children’s Health Insurance Program (CHIP), and dental providers with low Medicare revenues. These eligible providers may now submit their application for possible funding by Friday, Aug. 28. HHS has also extended the deadline to Aug. 28 for providers who participate in Medicaid and CHIP to apply for up to 2% of their total patient care revenue from a separate funding distribution for Medicaid providers. To be eligible for this funding, providers must not have received any funding from the Medicare focused distribution of funding from the Provider Relief Fund. Providers can access the same portal to apply for both Medicare-based and Medicaid-based funding. HHS has hosted a series of webinars to address questions from providers throughout the application process, and Thursday’s webinar is the next provider and provider organization webinar in this series.

CEO Update 112

Written by Administrator on August 7, 2020. Posted in Uncategorized.

CMS Announces 2.2% Increase in Base Payment Rate for IPFs and Scope-of-Practice Changes for 2021

The Centers for Medicare & Medicaid Services (CMS) will update the Medicare base payment rate for the Inpatient Psychiatric Facilities Prospective Payment System (IPF PPS) by 2.2% in Fiscal Year (FY) 2021, the agency announced in a final rule. In its April proposed rule, CMS had estimated a 2.4% payment rate update for IPFs next year. The agency included its updated estimates and calculations in a fact sheet accompanying the final rule. The agency said in the final rule that it estimates the 2021 update will increase total IPF payments to providers by 2.3%, or about $95 million. The agency included its calculations in a fact sheet accompanying the final rule. CMS said in the final rule that it will allow advanced practice providers, including physician assistants, nurse practitioners, psychologists, and clinical nurse specialists, to operate within the scope of practice allowed by state law by documenting progress notes in the medical record of patients for whom they are responsible, receiving services in psychiatric hospitals. NABH has advocated for this policy change and is pleased the agency made this update. CMS also finalized its proposal to adopt revised Office of Management and Budget statistical area delineations resulting in wage index values that the agency said are “more representative of the actual costs of labor in a given area.” CMS is finalizing its proposed policy that any decline in a provider’s wage index value from its FY 2020 wage index, regardless of the circumstance causing the decline, will be capped at a 5 percent decrease for FY 2021.

CMS Proposes Expanding Medicare Telehealth Benefits and Scope of Practice Beyond Pandemic

CMS is proposing to maintain—either permanently or temporarily— many of the Medicare telehealth benefits and workforce flexibilities authorized during the Covid-19 pandemic, according to the fiscal year 2021 Medicare physician fee schedule proposed rule the agency released Monday. In issuing these proposed changes, CMS referred to President Trump’s Aug. 3 Executive Order on improving rural health and telehealth access that directs the Health and Human Services (HHS) secretary to propose regulations to extend flexibilities provided during the Covid-19 public health emergency (PHE) as appropriate. Please click here to read the full NABH Analysis about this rule. Also this week, NABH was one of 20 organizations that sent a letter to federal lawmakers supporting the Telehealth Response for E-prescribing Addiction Therapy Services (TREATS) Act. Please click here to read the full letter.

HHS Extends Deadline for Provider Relief Fund Until Aug. 28

HHS has extended the deadline to Friday, Aug. 28 from Monday, Aug. 3 for healthcare providers who participate in Medicaid and CHIP to apply to the Provider Relief Fund established in the Coronavirus Aid, Relief, and Economic Security (CARES) Act. HHS had previously extended this deadline to Aug. 3 from July 20. HHS said it plans to issue a simplified application form soon. In addition, HHS said it is re-opening the portal for Medicare-participating providers to apply for funding set aside from the Provider Relief Fund. The previous deadline to apply for this distribution was June 3. Providers will now have until Aug. 28 to apply for the balance of funding up to 2% of their annual patient revenue. HHS is re-opening this application process after learning that many providers, including many Medicaid and CHIP providers, did not apply to the prior Medicare-based distribution because they had relatively low Medicare revenues. HHS also announced it is working on another funding distribution from the Provider Relief Fund focused on providers who have not received any of this funding including those who only bill commercially or do not directly bill for the services they provide to Medicare and Medicaid beneficiaries. Information about how to apply for the various Provider Relief Fund distributions is on the HHS website.

CMS and SAMHSA Add Kentucky and Michigan to CCBHC Demonstration

CMS and SAMHSA have chosen Kentucky and Michigan as additional participants in the Certified Community Behavioral Health Clinic (CCBHC) demonstration that the CARES Act requires, CMS announced this week. The demonstration is part of a broader effort to integrate behavioral healthcare with physical healthcare, increase evidence-based practices on a consistent basis, and improve access to high quality care for people with mental health and substance use disorders. Although the Protecting Access to Medicare of 2014 created this demonstration for a two-year period, the program has been extended several times. Kentucky and Michigan join the original participants selected in 2016.

Wit v. UnitedHealthcare Hearing Delayed to Wednesday, Sept. 2

The remedies hearing in the Wit v. UnitedHealthcare case that had been scheduled for this week has been delayed to Wednesday, Sept. 2. NABH has learned that U.S. Chief Magistrate Judge Joseph Spero has re-scheduled the hearing due to meetings related to Covid-19. Members of the public and press are welcome to join the webinar, and NABH will send an updated Zoom link when it becomes available.

Fact of the Week

A new study shows 55% of patients who have survived Covid-19 were diagnosed with at least one psychiatric disorder. For questions or comments about this CEO Update, please contact Jessica Zigmond.

Coalition Letter In Support Of TREATS Act

Written by Administrator on August 7, 2020. Posted in Letters.

TREATS Act Medicine Letter

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NABH Analysis: CMS Proposes Expanding Medicare Telehealth Benefits and Scope of Practice Changes Beyond Pandemic

Written by Administrator on August 4, 2020. Posted in Analysis.

CMS Proposes Expanding Medicare Telehealth Benefits and Scope of Practice Changes Beyond Pandemic The Centers for Medicare & Medicaid Services (CMS) is proposing to maintain—either permanently or temporarily— many of the Medicare telehealth benefits and workforce flexibilities authorized during the Covid-19 pandemic, according to the fiscal year 2021 Medicare physician fee schedule proposed rule the agency released Monday. In issuing these proposed changes, CMS referred to President Trump’s Aug. 3 Executive Order on “Improving Rural Health and Telehealth Access” that directs the Health and Human Services secretary to propose regulations to extend flexibilities provided during the Covid-19 public health emergency (PHE) as appropriate. Proposed Extensions of Medicare Coverage of Telehealth On a permanent basis, CMS proposes to continue Medicare coverage for these telehealth services authorized during the PHE:

		Home visits for the evaluation and management of an established patient: less complex and last typically 25 minutes,
		Certain types of visits for patients with cognitive impairments,
		Group psychotherapy,
		Neurobehavioral status exams,
		Care planning for patients with cognitive impairment,
		Less complex domiciliary, rest home, or custodial care services, and
		Prolonged evaluation and management (E/M) services.

CMS has requested public feedback on other services to add to this list of permanent Medicare-covered, telehealth services. CMS is also proposing to extend Medicare coverage on a temporary basis for telehealth delivery of the following services until the end of the calendar year when the PHE ends:

		Psychological and neuropsychological testing,
		Emergency department visits,
		Home visits to address moderate to severe issues, typically lasting 60 minutes,
		More complex domiciliary, rest home, or custodial care services, and
		Nursing facilities discharge day management.

CMS has also requested comments on this list of telehealth services that the agency proposes to cover temporarily in Medicare. CMS said it intends these temporary extensions of coverage to allow time for the agency to consider whether these services should be extended permanently. In the proposed rule, CMS clarified that licensed clinical social workers, clinical psychologists, (as well as physical therapists, occupational therapists, and speech-language pathologists) can furnish the brief online assessment and management services via telehealth as well as virtual check-ins and remote evaluation services. In addition, CMS has clarified that telehealth rules do not apply when the beneficiary and the practitioner are in the same location even if audio/video technology assists in providing a service. CMS has not proposed to continue separate payments for audio-only evaluation and management services beyond the end of the PHE. Instead, the agency has requested comment on whether to develop coding and payment for a service similar to virtual check-in but for a longer unit of time with a higher value. CMS is seeking feedback on duration of services and resources required to furnish this service and also whether Medicare coverage of this audio-only service should be extended temporarily or permanently. Meanwhile, CMS is proposing to allow direct supervision to be provided using real-time, interactive audio and video technology (excluding telephone that does not also include video) through Dec. 31, 2021. The agency is requesting comments on this proposal, including guardrails that should be in place and risks to patient safety and concerns about waste, fraud, and abuse. CMS also included a number of clarifications about Medicare coverage for remote physiologic monitoring codes and new payment rates for immunization administration.

Updates to Evaluation and Management Codes

In this proposed rule, CMS has proposed revaluing a number of code sets that rely on or are analogous to E/M visits including psychiatric diagnostic evaluations and psychotherapy services. CMS has also proposed simplified coding and billing requirements for E/M visits to take effect in January 2021.

Proposed Changes to Scope of Practice Rules and Related Issues

CMS has also proposed changes to allow healthcare professionals to practice up to the top of their professional training and to continue some of the workforce flexibilities allowed during the PHE, including:

		Allowing nurse practitioners, clinical nurse specialists, physician assistants, and certified nurse-midwives (instead of only physicians) to supervise others performing diagnostic tests consistent with state law and licensure, providing that they maintain the required relationships with supervising/collaborating physicians as required by state law,
		Clarifying that physicians and nonphysician practitioners, including therapists, can review and verify documentation entered into the medical record by members of the medical team for their own services that are paid under the Medicare physician fee schedule,
		Accordingly, in the inpatient psychiatric facility prospective payment system final rule issued July 31, CMS also confirmed as final, changes to the special conditions of participation rules for psychiatric facilities allowing non-physician practitioners, or advanced practice providers (including physicians assistants, nurse practitioners, psychologists, and clinical nurse specialists) to document progress notes in accordance with state laws and scope-of-practice requirements.
		Clarifying that therapy students, and students of other disciplines, working under a physician or practitioner who furnishes and bills directly for their professional services to the Medicare program, may document in the record so long as it is reviewed and verified (signed and dated) by the billing physician, practitioner, or therapist, and
		Requesting comment on whether to continue temporarily or permanently Medicare coverage for services of residents that are provided outside of the scope of their approved GME programs and furnished to inpatients of a hospital in which they have their training program as separately billable physicians’ services.

Proposed Changes to Opioid Treatment Program Benefit CMS has proposed making several changes to claiming rules and payment codes for the new Medicare Part B benefit for opioid use disorder services, including medications and services furnished by opioid treatment programs. Of note, add-on codes for nasal naloxone and auto-injector naloxone are proposed along with clarification on periodic assessment add-on code requirements. SUD Screening in Medicare Initial and Wellness Visits CMS is implementing a new requirement that the Medicare Initial Preventive Physical Examination and Annual Wellness Visit include screening of beneficiaries for potential substance use disorders, including a review of any current opioid prescriptions, as well as referral for specialty treatment, as appropriate. This new requirement was enacted in the SUPPORT Act. Electronic Prescribing of Controlled Substances CMS said it is implementing another SUPPORT Act provision that requires prescriptions of Schedule II, III, IV, or V controlled substances for Medicare Part D beneficiaries to be electronic. CMS issued a request for information on July 30 requesting feedback on whether to include exceptions to this requirement and whether CMS should impose penalties. Public comments on this proposed rule are due by Monday, Oct. 5.

HHS Extends Deadline for Provider Relief Funding Until Aug. 28

Written by Administrator on August 3, 2020. Posted in Alerts.

The Department of Health and Human Services (HHS) extended the deadline to Friday, Aug. 28 from Monday, Aug. 3 for healthcare providers who participate in Medicaid and CHIP to apply to the Provider Relief Fund established in the Coronavirus Aid, Relief, and Economic Security (CARES) Act. HHS had previously extended this deadline to Aug. 3 from July 20. HHS said that it plans to issue a simplified application form soon. In addition, HHS is re-opening the portal for Medicare-participating providers to apply for funding set aside from the Provider Relief Fund for Medicare providers. The previous deadline to apply for this distribution was June 3. Providers will now have until Aug. 28 to apply for the balance of funding up to 2% of their annual patient revenue. HHS is re-opening this application process after learning that many providers, including many Medicaid and CHIP providers, did not apply to the prior Medicare-based distribution because they had relatively low Medicare revenues. HHS also announced it is working on another distribution of funding from the Provider Relief Fund focused on providers who have not received any of this funding, including those who only bill commercially or do not directly bill for the services they provide to Medicare and Medicaid beneficiaries. Information on how to apply for the various Provider Relief Fund distributions is on HHS’ website.

Wit v. UnitedHealthcare Hearing Delayed to Wednesday, Sept. 2

Written by Administrator on August 3, 2020. Posted in Alerts.

The remedies hearing in the Wit v. UnitedHealthcare case scheduled for this week has been delayed to Wednesday, Sept. 2. NABH has learned that U.S. Chief Magistrate Judge Joseph Spero has re-scheduled the hearing due to meetings related to Covid-19. Members of the public and press are welcome to join the webinar, and NABH will send an updated Zoom link when it becomes available.

CMS Announces 2.2% Payment Update and Scope-in-Practice Changes for 2021

Written by Administrator on August 3, 2020. Posted in Alerts.

The Centers for Medicare & Medicaid Services (CMS) will update the Medicare payment rate for the Inpatient Psychiatric Facilities Prospective Payment System (IPF PPS) by 2.2% in Fiscal Year (FY) 2021, the agency announced in a final rule late Friday. In its April proposed rule, CMS had estimated a 2.4% payment rate update for IPFs next year. The agency included its updated estimates and calculations in a fact sheet accompanying Friday’s final rule. According to the rule, CMS will allow advanced practice providers, including physician assistants, nurse practitioners, psychologists, and clinical nurse specialists, to operate within the scope of practice allowed by state law by documenting progress notes in the medical record of patients for whom they are responsible, receiving services in psychiatric hospitals. NABH has advocated for this policy change and is pleased the agency made this update. CMS also finalized its proposal to adopt revised Office of Management and Budget (OMB) statistical area delineations resulting in wage index values that the agency said are “more representative of the actual costs of labor in a given area.”

CEO Update 111

Written by Administrator on July 31, 2020. Posted in CEO Updates.

NABH and Other Healthcare Advocacy Groups Provide Feedback on Latest Covid-19 Legislation

NABH this week weighed in on issues specific to behavioral healthcare providers in the $1 trillion Covid-19 stimulus package that Senate Majority Leader Mitch McConnell (R-Ky.) released on Monday, July 27. Referred to collectively as the HEALS Act, the legislation includes a total of eight bills from Senate Republicans. For detailed information on this latest Covid-19 bill, please see this section-by-section summary from the law firm Brownstein Hyatt Farber Schreck. On Thursday, NABH joined the American Hospital Association, the Federation of American Hospitals, the Catholic Health Association of the United States, the Children’s Hospital Association, the Association of American Medical Colleges, Premier Healthcare Alliance, and Vizient, Inc. in a letter regarding surprised medical billing. “Legislative proposals that would dictate a set payment rate for unanticipated out-of-network care are neither market-based nor equitable, and do not account for the myriad inputs that factor into payment negotiations between insurers and providers,” the organizations noted in the letter. “These proposals will only incentivize insurers to further narrow their provider networks and would also result in a massive financial windfall for insurers,” it continued. “As such, we oppose the setting of a payment rate in statute and are particularly concerned by proposals that would undermine hospitals and front-line caregivers during the Covid-19 pandemic.” And on Tuesday, NABH joined a handful of other advocacy groups—including Advocates for Opioid Recovery, the American Association for Opioid Dependence, Inc., and the MAT Leadership Council—in sending a letter to congressional leaders that calls for a total of $400 million in federal funding to support opioid treatment programs (OTPs) and recovery support services. “To ensure that the 450,000 OTP patients around the country continue to have access to this lifesaving care, we request that $300 million be included in the next COVID-19 stimulus package for opioid treatment programs,” the organizations said in the letter, adding later, “We also request that Congress set aside an additional funding stream of $100 million for recovery support services. Recovery support services can cover myriad types of programming including online and call-in All Recovery Meetings that support multiple pathways to recovery, peer support services, and evidence-supported programs that teach life skills and/or job skills and training for those in recovery or who are involved in the criminal justice system.” NABH will continue to keep members apprised of congressional developments on the latest coronavirus stimulus package.

CMS Approves DNV GL Healthcare USA as a Psychiatric Accreditation Program

The Centers for Medicare and Medicaid Services (CMS) announced in a final rule that it has approved an application from DNV GL Healthcare USA for initial recognition as an accrediting organization for psychiatric hospitals that wish to participate in Medicare or Medicaid. According to the rule, CMS has approved DNV GL as a national accrediting organization for these facilities effective July 30, 2020 through July 30, 2024. CDC Releases New Covid-19 Guidance for Behavioral Healthcare New guidance from the Centers for Disease Control and Prevention (CDC) this week clarified that the federal agency’s infection prevention and control guidance applies to all settings where healthcare is delivered, which includes psychiatric hospitals or other behavioral health facilities. The guidance also included challenges and potential solutions specific to behavioral health settings, such as group therapy sessions, cloth face coverings, alcohol-based hand sanitizer, and smoking.

HHS Joins Other Federal Agencies to Form Covid-19 Insights Partnership

HHS has joined the U.S. Veterans Affairs Department (VA) and the U.S. Energy Department to form the Covid-19 Insights Partnership to coordinate and share health data as well as expertise and research to fight against the coronavirus. “The volume and quality of the data HHS has on COVID-19 has advanced by leaps and bounds in recent months,” HHS Secretary Alex Azar said in an announcement about the partnership. “The Department of Energy’s world-class resources will help us derive new insights from the data we gather to help patients and protect our country.” The Covid-19 Insights Partnership’s research and analysis will focus on vaccine and therapeutic development and outcomes, virology, and other critical scientific topics to understand Covid-19 better. HHS and VA will provide additional updates and information on research projects as it becomes available.

MACPAC Responds to Covid-19 and Systemic Racism with New Resources

The Medicaid and CHIP Payment and Access Commission (MACPAC) has added a new section to its website and released a new issue brief to highlight the nation’s two public health crises: Covid-19 and systemic racism. An announcement from MACPAC noted that elevated rates of infection and mortality from Covid-19 are having a disproportionate effect on Black, Hispanic, and Native American communities. A new section of the commission’s website describes how Medicaid is using different legal authorities to respond to the deadly coronavirus, while a new issue brief highlights what MACPAC refers to as a “countercyclical role” responding to this current crisis as well as previous economic and public health emergencies.

Commonwealth Fund Releases Analysis on How States Can Address Mental Health

A new analysis from the Commonwealth Fund shows that 13.4% of adults 18 and older reported symptoms of serious psychological distress in April 2020, compared with 3.9% in April 2018. The findings also projected that deaths from suicide and alcohol or drug misuse could increase by an additional 75,000 before the U.S. economy recovers from Covid-19. In the report, researchers examine states’ mental health responses to Covid-19 by Medicaid and other insurers. The analysis also maps out effective strategies. “While no state has yet provided a comprehensive response, all have implemented measures to address the issue, providing a wealth of ideas and promising practices,” researchers K. Bryant Smalley and Jacob C. Warrant noted in the analysis released this week. “These strategies largely fall into five categories: telemental health, licensure and scope of practice, insurance changes, establishment of new services, and visibility and durability of efforts.”

Wit v. UnitedHealthcare Hearing Open to Public Via Webinar on Thursday, Aug. 6

Members of the public and press are welcome to join a webinar next week that will feature the remedies hearing in the Wit v. UnitedHealthcare case. Click here to follow the hearing via Zoom on Thursday, Aug. 6 at 12:30 p.m. ET/ 9:30 a.m. PT. For important information and guidance on technical preparation for the webinar, please click here.

Reminder: NABH Telehealth Survey Due Today, Friday, July 31

If you haven’t done so already, please fill out this survey about how expanded telehealth coverage during the Covid-19 pandemic has helped maintain and/or improve access to behavioral healthcare. This information will help us advocate for continued expanded telehealth coverage after the public health emergency ends. Please e-mail Kirsten Beronio, NABH’s director of policy and regulatory affairs, with any questions.

Fact of the Week

Three of the 20 most expensive conditions during hospital stays with an expected payer of Medicaid were related to mental and substance use disorders: schizophrenia spectrum and other psychotic disorders, depressive disorders, and alcohol-related disorders. For questions or comments about this CEO Update, please contact Jessica Zigmond.

NABH Signs Letter to Congress Regarding Surprise Medical Billing

Written by Administrator on July 30, 2020. Posted in Letters.

HALO letter on surprise billing

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NABH Signs Letter Calling For Access to OUD Treatment and RSS During Covid-19

Written by Administrator on July 29, 2020. Posted in Letters.

RSS Treatment Funding during Covid-19

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CEO Update 110

Written by Administrator on July 24, 2020. Posted in Uncategorized.

HHS Extends Coronavirus Public Health Emergency On Thursday, July 23, HHS Secretary Alex Azar extended the public health emergency determination regarding Covid-19. Public health emergencies last for 90 days. As a result, emergency authorities are extended to late October. HHS Extends Medicaid/CHIP Provider Relief Deadline and Announces Additional Hotspot Funding HHS extended to Monday, August 3, the deadline for providers that participate in Medicaid and CHIP to apply for $15 billion from the Provider Relief Fund authorized in the Coronavirus Aid, Relief, and Economic Security (CARES) Act to support healthcare providers affected by Covid-19.To be eligible, providers must not have received a payment from the earlier Medicare-based distributions from the Fund. For details see updated HHS fact sheet on eligibility and how to apply for the Medicaid and CHIP Provider Distribution. HHS is also holding a webinar on Monday, July 27, 3-4 p.m. EST to go over the application process for the Medicaid and CHIP provider funding. Click on this link to register. Not as many providers as expected have applied for the Medicaid and CHIP provider funding, and HHS held focus groups this week to gather feedback on the process, as highlighted in an NABH Alert. HHS has posted a set of FAQs regarding the Medicaid and CHIP provider funding and has established a provider support line for application inquiries at (866) 569-3522. HHS also announced last Friday, July 17, that it would distribute an additional $10 billion to hospitals in areas heavily impacted by Covid-19. HHS is basing these distributions on data submitted by hospitals on Covid-19 positive inpatient admissions for the period January 1 to June 10, 2020. In May, HHS distributed $12 billion from the Provider Relief Fund in the first round of funding for hotspot areas. HHS Changes Reporting Requirement for Provider Relief Fund Recipients Healthcare providers that received more than $10,000 from the Provider Relief Fund will have to report how they spent these funds by February 15, 2021, according to an HHS notice. Providers with unexpended funds as of December 31, 2020, will be required to submit a second and final report by July 31, 2021. HHS had previously announced that providers would not have to submit quarterly reports. HHS stated it would release detailed reporting instructions by August 17, 2020, and that the reporting system would become available on October 1, 2020. Court Upholds Medicare Site Neutral Hospital Payments A three-judge panel of the D.C. Court of Appeals unanimously ruled that HHS has the legal authority to reduce Medicare payments to hospital clinics for services typically provided at lower reimbursement rates by independent physician offices. This site-neutral payment policy took effect in January 2019, but was blocked by a district court last summer. The American Hospital Association that led the suit, has not indicated whether it will appeal the ruling. NABH Requests Data from Members to Help Advocate for Expanded Telehealth Coverage NABH issued an alert circulating a short survey, this week, asking members to share data on the impact of expanded coverage of telehealth during the Covid-19 pandemic. This information will help make the case for continued expanded coverage of services provided via telehealth after the public health emergency ends. Please provide requested information at this survey site as soon as possible and by next Friday, July 31, at the latest. CMS Shortens Approval Cycle of Joint Commission The Centers for Medicare and Medicaid Services (CMS) approved the Joint Commission’s program for accrediting hospitals for only two years, until mid-July 2022. CMS may approve accrediting organizations that survey healthcare facilities for participation in Medicare and Medicaid for up to six years. CMS stated that the approval was limited to two years because of concerns related to Joint Commission surveyor performance and comparability of the Joint Commission’s survey process with the agency’s process. CMS indicated they expect to carry out more frequent reviews of the Joint Commission’s activities to avoid continued inconsistencies and to ensure requested revisions are implemented. CMS required the Joint Commission to make several changes including requiring additional training for its surveyors related to off-site location standards, reviews of medical records, and the level of detail provided to facilities during briefings. In addition, CMS required changes to the Joint Commission’s process related to leading and probing questions during interviews and more restrictions on interviewing frontline caregivers in the presence of supervisors. HHS Establishes New Covid-19 Data Dashboard and Database HHS restored public access to coronavirus data on Monday with a new system that brings together numerous datasets and a HHS Coronavirus Data Hub that includes, for example, a dashboard on hospital capacity that shows percent of inpatient beds occupied, percent occupied by COVID-19 patients, and percent of ICU beds occupied in each state. AMA Issues Report on Opioid Overdose Epidemic The American Medical Association Opioid Task Force issued a 2020 Progress Report that calls on policymakers to act to remove barriers to evidence-based care for those with pain and those with a substance use disorder. The report highlights health insurance company, pharmacy chain, and pharmacy benefit manager practices as well as state laws that delay and deny access to non-opioid pain care and evidence-based treatment for opioid use disorder. MedPAC Issues 2020 Databook The Medicare Payment Advisory Commission issued its July 2020 Data Book: Health Care Spending and the Medicare Program. The Data Book provides information on national health care and Medicare spending as well as Medicare beneficiary demographics, dual-eligible beneficiaries, quality of care in the Medicare program, and Medicare beneficiary and other payer liability. It also examines provider settings—such as hospitals and post-acute care—and presents data on Medicare spending, beneficiaries’ access to care in the setting, and the sector’s Medicare profit margins, if applicable. In addition, it covers the Medicare Advantage program and prescription drug coverage for Medicare beneficiaries, including Part D.

Fact of the Week

According to Kaiser Health News, a recent analysis from Well Being Trust, a national public health foundation, predicted as many as 75,000 people might die from suicide, overdose or alcohol abuse, triggered by the uncertainty and unemployment caused by the pandemic. For questions or comments about this CEO Update, please contact Kirsten Beronio.

Help Maintain Coverage of Telehealth Expanded During Covid-19

Written by Administrator on July 22, 2020. Posted in Alerts.

NABH is requesting information from our members to show how expanded coverage of telehealth during the Covid-19 pandemic has helped maintain and even improve access to behavioral healthcare. This information will help us advocate for continuation of this expanded coverage of telehealth after the public health emergency ends. Here is a quick survey to share the requested data on the impact of the telehealth expansion. Please submit the survey and any additional information as soon as possible, but no later than Friday, July 31. Please email Kirsten Beronio, Director of Policy and Regulatory Affairs (kirsten@nabh.org) with any questions.

Deadline to Apply for Medicaid / CHIP Provider Relief Extended to Aug. 3

Written by Administrator on July 20, 2020. Posted in Alerts.

Friday, the U.S. Department of Health and Human Services (HHS), announced that it is extending the application deadline for Medicaid and CHIP Provider Relief Fund distribution from today July 20, 2020 to August 3, 2020. In June, HHS announced plans to distribute approximately $15 billion to eligible providers that participate in state Medicaid and CHIP programs who had not yet received a payment from earlier distributions from the Provider Relief Fund. This HHS fact sheet explains the application process. In addition, HHS is holding focus groups tomorrow and Wednesday to identify opportunities to increase application volumes in the current Medicaid/CHIP distribution. The focus group discussion will center on three topics-

Awareness of the PRF program and Medicaid/CHIP distribution
Understanding of program components, such as eligibility
Technical challenges faced during the application process

These sessions will be held on Tuesday, July 21^st from 6:30 – 7:30 pm ET and Wednesday, July 22^nd from 3:00 – 4:00 pm ET. To confirm your participation, please send an email to preston.white@mckinsey.com with your name, email, title, organization and state, and note which session you would like to attend. If you have any questions, please reach out to our Director of Policy and Regulatory Affairs, Kirsten Beronio.

CEO Update 109

Written by Administrator on July 17, 2020. Posted in Uncategorized.

FCC Designates 988 as Three-Digit Number for National Suicide Prevention Hotline

The Federal Communications Commission (FCC) this week adopted rules to establish 988 as the new, nationwide, three-digit phone number for Americans in crisis to connect with suicide prevention and mental health crisis counselors. All phone service providers are required to direct all 988 calls to the existing National Suicide Prevention Lifeline by July 16, 2022. During the transition period, Americans who need help should continue to contact the National Suicide Prevention Lifeline by calling 1-800-273-8255 (1-800-273-TALK) or through online chats. Veterans and U.S. service members may reach the Veterans Crisis Line by pressing 1 after dialing, chatting online at www.veteranscrisisline.net, or texting 838255.

U.S. Drug Overdose Deaths Hit Record High of 71,000 in 2019

Nearly 71,000 Americans died of drug overdoses in 2019, according to preliminary data from the Centers for Disease Control and Prevention this week. The record high number of overdose deaths predates the Covid-19 pandemic, which experts predict will increase the number of overdose deaths even higher. Reports show that fentanyl and similar synthetic opioids—which accounted for about 36,500 overdose deaths—are driving the trend, while deaths involving cocaine and methamphetamine are also rising.

HHS Announces Changes to Covid-19 Daily Data Reporting Process Effective July 15

HHS announced that as of Wednesday, July 15, the CDC’s National Healthcare Safety Network (NHSN) Covid-19 module is no longer an option for hospitals to fulfill the agency’s request for daily data reporting on bed capacity, utilization, personal protective equipment (PPE), and in-house laboratory testing data. Instead, HHS has asked hospitals to use one of these four options to report that information:

If your state has assumed reporting responsibility, submit all data to your state each day and your state will submit on your behalf. Your state can provide you with a certification if they are authorized to submit on your behalf.
Submit data to TeleTracking™. All instructions about the data submission are on that site and the new and updated fields will be ready as of July 15.
Authorize your health information technology (IT) vendor or other third party to share information directly with HHS.
Publish to the hospital or facility’s website in a standardized format, such as schema.org.

For additional details about these options, please see page 9 in HHS’s updated guidance. This information is also posted to NABH’s Covid-19 resources page.

SAMHSA Updates Confidentiality of Patient Records in Final Rule

The Substance Abuse and Mental Health Services Administration (SAMHSA) this week issued a final rule to update the Confidentiality of Substance Use Disorder Patient Records known as 42 CFR part 2 (or “part 2”) regulations, further aligning the regulations with other healthcare delivery rules. Key changes include:

Part 2 programs may share information verbally with a non-part 2 provider without subjecting the non-part 2 record to the requirements of part 2, as long as the non-part 2 provider segregates specific substance use disorder (SUD) records.
Patients may consent to disclosures without naming a specific individual to receive this information; the update provides instructions for disclosures to exchanges and research institutions and provides guidance on disclosures related to care coordination and case management.
Non-part 2 providers are not required to redact information in their medical records and may redisclose information if the patient has signed a written consent, or if the disclosure is otherwise permitted under the regulations.
Written consents expressly allow sharing information with 18 types of payment and healthcare operations, including for care coordination and case management.
Non-opioid treatment providers have access to central registries if they have a treatment relationship to the patient.
Opioid treatment programs have new permissions to disclose information to prescription drug monitoring programs.
During medical emergencies, information may be shared among part 2 programs or other SUD treatment providers during state or federally declared natural and major disasters.
Disclosures for conducting scientific research may be made to non-Health Insurance Portability and Accountability (HIPAA) covered entities and those who are not subject to the Common Rule.
Permits federal, state, and local agencies to conduct audits and evaluations.
Extends to 12 months the period of placement of undercover agents or informants, which may be further authorized by a new court order.

These changes do not include provisions that recently became law in the Coronavirus Aid, Relief and Economic Security Act (CARES Act). CARES Act provisions are effective March 27, 2021. The rule was published in the Federal Register on July 15. For questions about this rule, please contact Sarah Wattenberg, NABH’s director of quality and addiction services, at sarah@nabh.org.

NABH Sends Telehealth Letter to Capitol Hill as Congress Considers Latest Covid-19 Relief Bill

NABH this week sent a letter to congressional health policy staff that highlights the ways telehealth is essential in providing access to critical behavioral health services. “Shortly after the pandemic arose, our members rapidly adjusted their programs and services to implement telehealth technologies so they could continue providing critically needed mental health and addiction treatment services during these incredibly stressful times,” NABH President and CEO Shawn Coughlin said in the letter, which included preliminary data from some NABH members that show how crucial the increased coverage of services through telehealth has been during the Covid-19 pandemic. Separately this week, Manatt released a comprehensive 50-state tracker for policy, regulatory, and legal changes related to telehealth during the Covid-19 pandemic.

JAMA Examines Behavioral Health Parity Efforts Nationwide

Citing SAMHSA data, a new article in JAMA showed that less than two-thirds of patients with schizophrenia, bipolar disorder, or other more serious mental health conditions received care for their illness in 2018, while the same study showed only in five people with an opioid use disorder obtained treatment. The findings attributed the reasons for these statistics to stigma, barriers to care due to cost and clinical resources, and the overall scarcity of clinicians treating patients with mental health and substance use orders. “These factors compound the difficulty of finding a clinician willing to accept patients associated with only “in-network” payments for their services,” the article noted. “A 2014 study using data from the National Ambulatory Medical Care Survey found that in 2009-2010, nearly half of psychiatrists surveyed did not accept network commercial insurance payment or Medicare, and more than half did not accept Medicaid,” it continued, adding that psychiatrists have one of the lowest Medicaid participation rates among medical specialists.

Fact of the Week

According to ProPublica Illinois, more than 1,180 Cook County residents have died or are suspected to have died from opioid-related overdoses this year. Half of the confirmed opioid-related deaths have been among Black people, even though Black residents make up less than a quarter of the county’s population. For questions or comments about this CEO Update, please contact Jessica Zigmond.

NABH Letter on Telehealth: NABH sent a copy of this letter to the House Ways and Means and House Energy and Commerce Committees.

Written by Administrator on July 17, 2020. Posted in Letters.

NABH Letter on Telehealth

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HHS Announces Changes to Covid-19 Daily Data Reporting Process Effective July 15

Written by Administrator on July 14, 2020. Posted in Alerts.

HHS announced that as of Wednesday, July 15, the Centers for Disease Control and Prevention (CDC) National Healthcare Safety Network (NHSN) Covid-19 module will no longer be an option for hospitals to fulfill the agency’s request for daily data reporting on bed capacity, utilization, personal protective equipment (PPE), and in-house laboratory testing data. Instead, HHS is asking hospitals to use one of these four options to report that information:

If your state has assumed reporting responsibility, submit all data to your state each day and your state will submit on your behalf. Your state can provide you with a certification if they are authorized to submit on your behalf.
Submit data to TeleTracking™. All instructions about the data submission are on that site and the new and updated fields will be ready as of July 15.
Authorize your health information technology (IT) vendor or other third party to share information directly with HHS.
Publish to the hospital or facility’s website in a standardized format, such as schema.org.

For additional details about these options, please see page 9 in HHS’s updated guidance. This information is also posted to NABH’s Covid-19 resources page.

CEO Update 108

Written by Administrator on July 13, 2020. Posted in Uncategorized.

HHS Plans to Extend Covid-19 Public Health Emergency

HHS has signaled it will extend the Covid-19 public health emergency before it expires on July 25. The news was reported via Twitter on June 29 from HHS spokesman Michael Caputo, who noted that the department has renewed the public health emergency once before. After it is extended, the public health emergency will remain effective for an additional 90 days. This extension will help providers continue to use waivers and flexibilities that have been issued to help them address the global pandemic.

Kaiser Family Foundation Releases Analysis on Mental Health and SUD

A new analysis from the Kaiser Family Foundation (KFF) on Friday found that 36.5% of adults in the United States report symptoms of anxiety or depressive disorder, up from 11% in 2019. Meanwhile, Louisiana (42.9%), Florida (41.5%), and Oregon (41.3%) have the highest shares reporting these symptoms, while Wisconsin (27.2%), Minnesota (30.5%), and Nebraska (30.6%) have the lowest, the analysis showed. KFF reported the statistics in a series of state facts sheets, which also showed New Mexico, Montana, Wyoming, Alaska, and Idaho are the states with the highest rates of suicide.

Commonwealth Fund Report Says Covid-19 Highlights Gaps in Medicare Mental Health Coverage

A report from the Commonwealth Fund released this week shows gaps that remain in Medicare beneficiaries’ access to mental health services, including the federal healthcare program’s 190-day lifetime limit for inpatient psychiatric stays and limited coverage for telemental health services. The article’s purpose was to offer an overview of Medicare beneficiaries’ needs and benefits, as well as the initiatives to improve both financing and mental health services delivery in Medicare. According to the study, more than 112 million Americans live in areas of the country where healthcare providers are in short supply, and experts predict increasing shortages in psychiatrists, clinical and counseling psychologists, mental health social workers, mental health counselors, and other specialty mental health professionals through 2025. “Policies to expand coverage of telemental health should be rigorously studied and potentially made permanent as a strategy to increase access to mental health services,” researchers noted in the report. Separately, JAMA on July 1 published a new analysis that examines the trends in the prevalence of U.S. adults who screened positive for depression and the proportion who received treatment from 2007 to 2016, with consideration of health insurance coverage.

Today is the Deadline to Register for DOL Discussion on Parity Compliance

The U.S. Labor Department (DOL) will host a 90-minute virtual discussion titled “Parity Compliance: Progress and Challenges” next Thursday, July 16 at 1:30 p.m. ET. As part of DOL’s Fiscal Year 2020 MH/SUD Enforcement Evaluation Program—published in the 2020 DOL MHPAEA Report to Congress— DOL’s Employee Benefits Security Administration (EBSA) announced it would host a listening session to gain feedback on the agency’s interpretive guidance and enforcement program. EBSA also noted that attendees could use the opportunity to comment on the MHPAEA self-compliance tool that EBSA proposed on June 19. The last day to register for the event is today, July 10.

NAMI To Host First Virtual NAMICon Next Week

The National Alliance on Mental Illness (NAMI) has transitioned its in-person NAMICon to a virtual event on July 13 and 14. The event’s plenary session will feature National Institute of Mental Health Director Joshua Gordon, M.D., Ph.D., who will discuss the challenges and opportunities of mental health research. The program will also explore the importance of diversity, inclusion, and cultural competence, and how to address issues such as identity, language, and demographics. Click here to register for the event and here for the program’s two-day schedule.

NNED, SAMHSA to Host Roundtable Next Week on Addressing Covid-19 and Behavioral Health Needs in Communities of Color

The National Network to Eliminate Disparities in Behavioral Health (NNED) and the Substance Abuse and Mental Health Services Administration (SAMHSA) will host a host a virtual roundtable next week to address how the Covid-19 pandemic, the current economic crisis, and civil unrest from incidents of police brutality have worsened disparities in mental health. The event—part of National Minority Mental Health Awareness Month this July—will highlight how faith-based NNED partner organizations are supporting mental health concerns of racial and ethnic minorities and providing opportunities to receive support and connection through faith-based practices and partnerships. Click here to register for the event on Thursday, July 16 at 3 p.m. ET. And please remember to follow NABH on Twitter and LinkedIn for information and events related to National Mental Health Awareness Month.

BPC to Host Webinar on Covid-19’s Effect on Mental Health Access for People of Color

The Bipartisan Policy Center (BPC) will host a webinar titled “Covid-19’s Adverse Impact on Mental Health Access for People of Color” on Tuesday, July 21. The BPC notes that as the Covid-19 pandemic has increased mental health and substance use problems, the situation is even worse for Black, Indigenous, and people of color populations, which have long experienced disparities in access to care. This 90-minute webinar will discuss this trend and how integrating behavioral health services with primary care can benefit these patient populations. Click here to register for the event, which starts at 11:30 a.m. ET.

Fact of the Week

During the initial phase of the Covid-19 crisis in April 2020, the prevalence of serious psychological distress among adults age 55 and older was nearly double pre-COVID levels; among Hispanic and low-income adults, rates were more than triple. For questions or comments about this CEO Update, please contact Jessica Zigmond.

SAMHSA Updates Confidentiality of Patient Records in Final Rule

Written by Administrator on July 13, 2020. Posted in Alerts.

The Substance Abuse and Mental Health Services Administration (SAMHSA) on Monday issued a final rule to update the Confidentiality of Substance Use Disorder Patient Records known as 42 CFR part 2 (or “part 2”) regulations, further aligning the regulations with other healthcare delivery rules. Key changes include:

Part 2 programs may share information verbally with a non-part 2 provider without subjecting the non-part 2 record to the requirements of part 2, as long as the non-part 2 provider segregates specific substance use disorder (SUD) records.
Patients may consent to disclosures without naming a specific individual to receive this information; the update provides instructions for disclosures to exchanges and research institutions and provides guidance on disclosures related to care coordination and case management.
Non-part 2 providers are not required to redact information in their medical records and may redisclose information if the patient has signed a written consent, or if the disclosure is otherwise permitted under the regulations.
Written consents expressly allow sharing information with 18 types of payment and healthcare operations, including for care coordination and case management.
Non-opioid treatment providers have access to central registries if they have a treatment relationship to the patient.
Opioid treatment programs have new permissions to disclose information to prescription drug monitoring programs.
During medical emergencies, information may be shared among part 2 programs or other SUD treatment providers during state or federally declared natural and major disasters.
Disclosures for conducting scientific research may be made to non-Health Insurance Portability and Accountability Act (HIPAA) covered entities and those who are not subject to the Common Rule.
Permits federal, state, and local agencies to conduct audits and evaluations.
Extends to 12 months the period of placement of undercover agents or informants, which may be further authorized by a new court order.

These changes do not include provisions that recently became law in the Coronavirus Aid, Relief and Economic Security Act (CARES Act). CARES Act provisions are effective March 27, 2021. This rule is expected to be published in the Federal Register this Wednesday, July 15, and will become effective within 30 days of its publication. For questions about this rule, please contact Sarah Wattenberg, NABH’s director of quality and addiction services, at sarah@nabh.org.

CEO Update 107

Written by Administrator on June 26, 2020. Posted in Uncategorized.

FCC To Vote Next Month on Designating 988 as National Suicide Hotline Number

Federal Communications Commission (FCC) Chairman Ajit Pai this week presented his team with draft rules to establish 988 as the new, nationwide, three-digit phone number for Americans to connect with suicide prevention and mental health crisis counselors. The Commission is scheduled to adopt the rules at its open meeting on July 16. If adopted, the rules would require all phone service providers to start directing all 988 calls to the existing National Suicide Prevention Lifeline by July 16, 2022. During the transition period, Americans who need help should continue to contact the lifeline by calling 800-273-8255 (TALK). “988 will save lives. Helping Americans in crisis connect to counselors trained in suicide prevention is one of the most important things we can do at the FCC,” Chairman Pai said in a statement this week. “We believe that 988—which has an echo of the 911 number we all know as an emergency number—will help people access mental health services,” he continued. “Establishing this special purpose number will also highlight the urgency of addressing rising suicide rates in America and reduce the stigma too often associated with seeking assistance from suicide prevention and mental health services.”

HHS Announces MENTAL Health Innovation Challenge to Combat Social Isolation and Loneliness

HHS this week said the Administration for Community Living and the Office of the Assistant Secretary for Health launched the MENTAL Health Challenge to fight social isolation and loneliness among older adults, people with disabilities, and veterans. The White House Office of Science and Technology Policy is coordinating the Mobilizing and Empowering the Nation and Technology to Address Loneliness & social isolation (MENTAL) Health Innovation Challenge, and other federal partners include the FCC and the Veterans Affairs Department. A total of $750,000 in prizes will be awarded for developing an easy-to-use online system that offers recommendations for programs, activities, and resources that can help users connect to others and engage in the community, based on their needs, interests, and abilities. HHS’ announcement said the winning system will be announced—and demonstrated—in January 2021 at CES, the Consumer Technology Association’s annual trade show. That winning system will then become the centerpiece of a national public awareness campaign. “We need a multipronged public health approach to change the way we address social isolation, especially among our most at-risk populations,” U.S. Surgeon General VADM Jerome M. Adams, M.D., M.P.H. said in the announcement. “This approach must include the development of innovative solutions to combat the harmful physical and mental health effects of social isolation and the role technology has in promoting better connections for all.” Nearly a quarter of Americans who are 65 or older have few social relationships or infrequent social contact with others, and more than 40% of people 60 and older report feeling lonely, according to HHS. The department also noted that the number of older adults is projected to nearly double by the year 2060, while the population of people with disabilities is growing and 22 veterans die by suicide every day.

CMS Creates Office to Coordinate Administrative Burden Reduction Efforts

The Centers for Medicare & Medicaid Services (CMS) this week announced it created the Office of Burden Reduction and Health Informatics to consolidate the agency’s efforts to reduce regulatory and administrative burden. This new office is part of CMS’ Patients over Paperwork (PoP) initiative to eliminate duplicative, unnecessary, and costly federal requirements and regulations. In addition to efforts that reduce administrative burden, the new office will focus on health informatics, which uses and applies health data and clinical information to provide better healthcare to patients. “Fostering innovation through interoperability will be an important priority, and the office will leverage technology and automation to create new tools that allow patients to own and carry their personal health data with them seamlessly, privately, and securely throughout the health care system,” the agency’s announcement said.

Taskforce on Telehealth Policy Seeks Public Comment Through July 9

The Taskforce on Telehealth Policy is seeking public comments as it develops recommendations for policymakers on how to maximize telehealth services benefits while maintaining high quality and program standards. The Alliance for Connected Care, National Committee for Quality Assurance, and the American Telemedicine Association convened the taskforce, which represents a broad range of providers, consumer advocates, payers, and health quality experts from the public, private, and not-for-profit sectors. Click here to learn more about the taskforce and here to access the portal for submitting comments.

GAO Recommends Steps for U.S. Labor Department to Address SUD

The U.S. Labor Department (DOL) should clarify expectations of state workforce agencies and how funding from the 2014 Workforce Innovation and Opportunity Act (WIOA) can be used to address the needs of people with substance use disorders (SUD) and potential employers, the Government Accountability Office (GAO) recommended in a recent report. DOL has awarded grants to states to address the nation’s opioid crisis after HHS declared the crisis a public health emergency in October 2017. The GAO was asked to investigate how WIOA-funded programs are addressing the employment and training needs of those affected by SUD. For this report, the GAO interviewed officials in four of the 10 states that received DOL grants as of March 2019—Maryland, New Hampshire, Ohio, and Washington—and two that did not—Alabama and Arizona—as well as DOL officials and researchers. “DOL officials said they support SUD-affected communities mainly by providing information to states that apply for and receive targeted grants,” the GAO report noted. “However, officials in two selected states expressed uncertainty about DOL’s expectations of states in serving the needs of SUD-affected job seekers and potential employers.” The GAO noted that DOL agreed with GAO’s recommendations.

House Energy & Commerce Health Subcommittee to Examine Mental Health Bills Next Week

The House Energy and Commerce Health Subcommittee will hold a remote hearing next week to examine several bills intended to improve mental healthcare in the United States. “As we confront a global pandemic, severe economic downturn, and systemic racism, we are faced with increased anxiety and stress,” House Energy and Commerce Chairman Frank Pallone, Jr. (D-N.J.) and Health Subcommittee Chairwoman Anna Eshoo (D-Calif.) said in a joint statement. “Mental health is an essential part of our nation’s health and and it is uniquely important during this time of unprecedented crisis—particularly for those with existing mental health conditions.” The remote hearing will begin at 11 a.m. ET on Tuesday, June 30 and will examine more than 20 mental health-related bills.

Manatt Compares Presidential Campaign Healthcare Policy Positions in New Infographic

Research firm Manatt this week has released an infographic that maps out the healthcare policy positions of President Donald Trump and Democratic presidential candidate and former Vice President Joe Biden during this 2020 election cycle. The category “Increase Access to Treatment” shows President Trump would remove the Institutions for Mental Diseases (IMD) exclusion to allow residential treatment facilities with more than 16 beds to receive Medicaid reimbursements, and it shows former Vice President Biden would expand health insurance coverage, expand funding for mental health services and providers, and enforce mental health parity laws.

Fact of the Week

In 2018, national surveys from the Henry J. Kaiser Family Foundation, AARP, and Cigna examined the prevalence of loneliness, which they estimated to be 22%, 35%, and 47%, respectively. Using the same methodology as for its 2018 survey, in 2020 Cigna reported loneliness among Americans increased to 61% in 2019.

CEO Update Will Publish Next on Friday, July 10

NABH will not publish CEO Update next Friday, July 3 and will publish the next issue on Friday, July 10. The NABH team wishes you and your families a happy and safe Independence Day weekend! For questions or comments about this CEO Update, please contact Jessica Zigmond.

CEO Update: 106

Written by Administrator on June 19, 2020. Posted in CEO Updates.

HHS Temporarily Suspends Quarterly Reports from Provider Relief Fund Recipients

HHS on June 13 updated previous guidance to say recipients of Provider Relief Fund payments do not need submit a separate quarterly report to HHS or the Pandemic Response Accountability Committee. The Coronavirus Aid, Relief, and Economic Security Act (CARES) had included the requirement, but HHS updated a Frequently Asked Questions document and said the agency will develop a report containing all information necessary for recipients of the payment to comply with this provision. HHS also indicated it would require reports in the future. “However, the Terms and Conditions for all Provider Relief Fund payments also require recipients to submit any reports requested by the Secretary that are necessary to allow HHS to ensure compliance with payment Terms and Conditions,” the updated guidance noted. “HHS will be requiring recipients to submit future reports relating to the recipient’s use of its PRF money. HHS will notify recipients of the content and due date(s) of such reports in the coming weeks.”

NABH Sends Youth Education Funding Recommendations to Congressional Committees

NABH this week sent a letter to two congressional committees that recommends how to allocate money from the Elementary and Secondary School Emergency Fund that the CARES Act authorized. In the letter to the Senate Health, Education, Labor & Pensions Committee and the House Committee on Education & Labor, NABH President and CEO Shawn Coughlin asked Congress to clarify that funding for state education agencies from the Elementary and Secondary School Emergency Relief Fund be allocated equitably to both non-profit and for-profit residential and other therapeutic settings, including specialized day schools that provide care for children and adolescents with serious behavioral and/or emotional conditions. In addition, NABH recommended that Congress dedicate funding in any upcoming legislation that addresses the Covid-19 pandemic to provide education services and supports for children and adolescents with these conditions. “An appropriation of $37.5 million for education services in residential and other treatment settings and specialized day schools would ensure these settings are able to provide digital devices, internet access, and online school content to these children and adolescents with special needs,” the letter said. “There are approximately 500 residential facilities serving 25,000 children and adolescents with serious behavioral and/or emotional conditions nationwide, and this would ensure that this population is also included and treated equitably.”

Kaiser Family Foundation Issue Brief Highlights Options for Medicaid Providers During Covid-19

In a new issue brief, the Kaiser Family Foundation provides an overview of how states currently reimburse providers and the challenges for Medicaid providers that have resulted from the Covid-19 pandemic. The brief notes that although Congress enacted legislation with $175 billion in provider relief grants, the initial allocation of funds was “disadvantageous” to Medicaid providers. “HHS recently announced that $15 billion has been set aside to more directly support Medicaid providers, and an unspecified amount has been allocated to reimburse providers for COVID-19 treatment costs for the uninsured,” the issue brief said. “However, it is not clear if the current provider relief fund allocations will be sufficient to meet providers’ needs resulting from the pandemic. Congress will likely continue to debate additional funding for states through Medicaid and for providers. Without additional fiscal relief, states may be limited in their ability to support Medicaid providers and provider relief grants may not be adequate.”

News Report Shows 20% Increase in Drug Overdose Deaths in New Jersey

Drug overdose deaths in New Jersey have increased 20% this year during the Covid-19 pandemic, news outlet NJ.com reported this week. Citing data from NJ Cares, the state’s drug information dashboard, the story reported that 1,330 people in New Jersey died of suspected overdoses in the first five months of 2020, which is 225 more people than the number recorded in the same period last year. May’s figures were especially grim, the story said, when suspected deaths reach a high of 307—nearly 10 people per day. State Police Lt. Jason Piotrowski was quoted in an online town hall saying seven deaths a day has been typical and that he hopes last month’s number proves to be an anomaly.

CMS Chicago Stakeholders to Host Webinar on Covid-19 Relief Funds and Medicaid Next Week

The Centers for Medicare & Medicaid Services (CMS) Chicago Local Engagement and Administration will host a 30-minute webinar about CARES Act Provider Relief Fund distribution in Medicaid on Wednesday, June 24. The event is part of CMS Chicago’s weekly “Real Time” series on Wednesdays at 9 a.m. CT. Click here for more information and to register.

Fact of the Week

A June Health Affairs article reports fewer than half of U.S. mental health treatment facilities provide services for children with autism spectrum disorder (ASD). For questions or comments about this CEO Update, please contact Jessica Zigmond.

NABH Letter: Elementary and Secondary Emergency Relief Fund

Written by Administrator on June 19, 2020. Posted in Letters.

NABH Letter: Elementary and Secondary Emergency Relief Fund

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CEO Update 105

Written by Administrator on June 12, 2020. Posted in Uncategorized.

SAMHSA Offers Guidance and Forms for Medicaid/CHIP Provider Relief Fund Payments

HHS’ Substance Abuse and Mental Health Services Administration (SAMHSA) is providing guidance, instructions, and application forms after HHS announced this week it will distribute $15 billion to eligible Medicaid and Children’s Health Insurance Program (CHIP) providers during the Covid-19 pandemic. HHS said the payment to each provider will be at least 2% of reported gross revenue from patient care. The department also said the final amount each provider receives will be determined after the data is submitted, including information about the number of Medicaid patients providers serve. According to SAMHSA, before applying to the enhanced provider relief portal, applicants should read the Medicaid provider distribution instructions and download the Medicaid provider distribution application form.

Independent Task Force Recommends Screening All Adults for Unhealthy Drug Use

The U.S. Preventive Services Task Force (USPSTF) this week recommended that all adults 18 and older be screened regularly for unhealthy drug use, which is defined as using illegal drugs or taking medications not specified for a medical reason. Previously the agency did not issue a recommendation on the subject, saying there was insufficient evidence to suggest regular screening. This new guidance follows a review of studies that evaluated the sensitivity of screening tools—most of which were moderately or highly accurate in identifying unhealthy drug use. Established in 1984, USPSTF is an independent, volunteer panel of national experts in prevention and evidence-based medicine. The group works to improve the health of all Americans by making evidence-based recommendations about clinical preventive services such as screening, counseling services, and preventive medications. The task force’s views are not meant to be construed as those of HHS or HHS’ Agency for Healthcare Research and Quality (AHRQ).

AHRQ Requests Information on Older Adult Opioid Use and Misuse in Primary Care Settings

AHRQ this week issued a notice requesting public comments on identifying and testing strategies for management of opioid use and misuse in older adults in primary care practices. According to the notice, this project is meant to assess and describe the current prevalence, awareness, and management of opioid use, misuse, and abuse in older adults, and identify the gaps and areas of needed research. “Additionally, this project will support primary care practices in developing and testing innovative strategies, approaches, and/or tools for opioid management within the context of facilitated learning collaboratives, culminating in a compendium of strategies for opioid management in older adults in primary care settings,” the notice said. Click here to learn more about the project and how to submit comments within 60 days of the June 8 notice.

ONDCP to Launch Rural Community Toolbox Website on June 24

The White House Office of National Drug Control Policy and senior Trump Administration officials will virtually launch the Rural Community Toolbox website, a resource for rural communities affected by addiction, on Wednesday, June 24. The Rural Community Toolbox is intended to serve as a clearinghouse for funding and resources in more than a dozen different federal agencies to help rural leaders build healthy, drug-free communities. Click here for more information when it becomes available and to register for the virtual launch, which will begin at 3 p.m. ET.

NABH President and CEO Shawn Coughlin Participates in Project Wake Up Panel Discussion

NABH President and CEO Shawn Coughlin was one of seven panelists to participate in an in-depth panel discussion about mental health stigma and suicide in America. Project Wake Up led the June 11 panel as a follow-up to the world premiere last week of Wake Up, a documentary about suicide, ending mental health stigma, and making sure people who need treatment receive it. Former U.S. Rep. Patrick Kennedy (D-R.I.), Craig Bryan, Psy.D. of the Ohio State University’s psychology department, Morissa Henn of InterMountain Healthcare, and Michael Zibilich, whose son died by suicide in 2012, were among the other panelists.

Fact of the Week

Buprenorphine treatment rates by primary care providers increased from 12.9 people per 10,000 population in 2010 to 27.4 in 2018. For questions or comments about this CEO Update, please contact Jessica Zigmond.

HHS Announces Relief Funding for Medicaid & CHIP Providers, Safety Net Hospitals

Written by Administrator on June 9, 2020. Posted in Alerts.

HHS said Tuesday it expects to distribute about $15 billion through the department’s Health Resources and Services Administration (HRSA) to eligible providers who participate in state Medicaid and CHIP programs and have not received a payment from the Provider Relief Fund General Distribution. HRSA will also distribute about $10 billion from the Provider Relief Fund to the nation’s safety-net hospitals, which is expected to happen this week. HHS said it will launch an enhanced Provider Relief Fund Payment Portal on Wednesday that is intended to allow eligible Medicaid and CHIP providers to report their annual patient revenue, which will be used as a factor for HHS to determine their Provider Relief Fund payment. According to an announcement, the payment to each provider will be at least 2% of reported gross revenue from patient care. HHS said it will determine the final amount that each provider receives after data is submitted, including information about the number of Medicaid patients providers serve. To be eligible for this funding, healthcare providers must not have received payments from the $50 billion Provider Relief Fund General Distribution and either have directly billed their state Medicaid/CHIP programs or Medicaid managed care plans for healthcare-related services between January 1, 2018, to May 31, 2020. On Monday, HHS contacted all hospitals, asking them to update information on their COVID-19 positive-inpatient admissions for the period January 1, 2020, through June 10, 2020. This information will be used to determine a second round of funding to hospitals in COVID-19 hotspots to ensure they are equitably supported in the battle against this pandemic. To determine their eligibility for funding under this $10 billion distribution, hospitals must submit their information by June 15, 2020 at 9:00 PM ET. HHS said close to 1 million healthcare providers may be eligible for these patients. Click here for more information about eligibility and the application process.

CEO Update 104

Written by Administrator on June 5, 2020. Posted in Uncategorized.

Psych Hub Releases Race, Racism & Mental Health Resources During Week of Protests

Mental health educational platform Psych Hub released Race, Racism, & Mental Health Resources for individuals and communities amid a week of national and global protests against racism and police brutality following the death of George Floyd. Psych Hub compiled the list of resources on antiracism and Black mental health that includes links to organizations, online resources, books, and social media. “Experiencing and witnessing racism in any of its forms has traumatic effects that can build up with time and repetition,” the resources page noted. Also this week, NABH President and CEO Shawn Coughlin made a statement on Twitter and LinkedIn that included a link to the Substance Abuse and Mental Health Services Administration’s (SAMHSA) behavioral health equity page. “Racism and all acts of discrimination cause suffering, fear, anxiety, and depression,” Coughlin said. “We must advocate for behavioral health equity: the right to access quality healthcare for all populations, regardless of a person’s race, ethnicity, gender, socioeconomic status, sexual orientation, or geographical location.” NABH joined Psych Hub as a partner this year.

NABH Sends CMS Recommendations on Additional CoP

NABH this week sent a letter to the Centers for Medicare & Medicaid Services (CMS) outlining the association’s concerns with additional conditions of participation (CoP) for behavioral healthcare providers and recommendations to provide some regulatory relief. The letter also urged continued expanded coverage of behavioral healthcare services via telehealth. “The additional Conditions of Participations (CoP) for psychiatric hospitals and accompanying sub-regulatory guidance in the State Operations Manual (known as the B-tags) impose more than $625 million in additional costs annually, according to a recent study,” NABH President and CEO Shawn Coughlin wrote in the letter to CMS Administrator Seema Verma. “The Covid-19 pandemic has added to the strain on these facilities with additional financial losses and unexpected costs, including those related to greatly increased personal protective equipment, screening everyone coming into the facility, additional staffing needs for screening, and other infection control measures, including isolation rooms and units, software and hardware purchases to facilitate telework for administrative staff and telehealth for patients, and lost revenue due to decreased patient volume because of infection concerns and reduced referrals,” he added. NABH’s Covid-19 task force contributed to and reviewed the final letter, which is available on the association’s homepage and Covid-19 resources page.

HRSA Awards $20.3 Million to Expand Addiction Workforce in Underserved Communities

HHS’ Health Resources and Services Administration (HRSA) this week announced it awarded $20.3 million to 44 recipients to increase the number of fellows at accredited addiction medicine and addiction psychiatry fellowship programs. HRSA’s Addiction Medicine Fellowship program is part of the agency’s effort to fight the nation’s ongoing opioid crisis. The awardees will train addiction specialists at facilities in high-need communities that integrate behavioral and primary care services. “The need for physicians with the expertise and skills to provide substance use prevention, treatment, and recovery services is essential,” HRSA Administrator Tom Engels said in a news release. “Addiction specialists can respond to patients’ specific behavioral health needs and help communities that are hit hardest by the opioid epidemic.” Click here to view the list of award recipients.

Health Affairs Study Explores OUD Treatment of Commercially Insured Adults

A research article published in the journal Health Affairs this week explored treatment provided to people with opioid use disorder (OUD), rather than efforts to reduce prescriptions and misuse. Analyzing claims data representing 12 million to 15 million nonelderly adults covered through commercial group insurance during the period 2008-2017, researchers examined rates of OUD diagnoses, treatment patterns, and spending, and they identified three essential patterns. “The rate of diagnosed OUD nearly doubled during 2008-19, and the distribution has shifted toward older age groups; the likelihood that diagnosed patients will receive any treatment has declined, particularly among those ages 45 and older, because of a reduction in the use of medication-assisted treatment (MAT), and despite clinical evidence demonstrating its efficacy; and treatment spending is lower for patients who chose MAT,” the article noted. The researchers noted these patterns suggest that policies supporting MAT use are “critical to addressing the undertreatment of OUD among the commercially insured” and that additional research is needed.

JAMA Commentary Examines Treating Patients with OUD in Their Homes

A late May commentary in JAMA examined an emerging treatment model for OUD in recent years that uses telehealth to provide medication treatment to patients in their homes. The article notes that about 50,000 deaths from OUD overdose occur each year in the United States, and the prevalence of heroin use is increasing. And while more than 2 million people with an OUD need treatment and a rising number of individuals are receiving treatment, still less than 20% receive effective medications such as buprenorphine. According to researchers, some telehealth companies have advertised the convenience of their model in leveraging telehealth services for OUD treatment. Meanwhile, the article suggests another potential benefit. “By minimizing the need to travel and increasing privacy for patients who may not want to be seen seeking care,” the article noted, “these programs also could address the access challenges that are especially problematic for underserved patients.”

NABH System Members: Please Submit Your Annual Dues!

NABH thanks its members for the excellent work they do each day to advance NABH’s mission, most especially during this unprecedented, difficult time in our nation’s history. Our mission has never been more important than it is today. This is a reminder to all NABH system members to please submit their annual dues payments if they have not done so already. NABH members’ active involvement and prompt payment are critical in helping our association achieve its vision and ensure that NABH remains the leading advocate for our nation’s behavioral healthcare providers. As we continue to navigate the Covid-19 pandemic together, we want to be sure you receive information about the work we do and the resources we provide. Please visit our website at www.nabh.org and follow us on Twitter (@NABHbehavioral), LinkedIn, and YouTube. Also, please be sure to visit our Covid-19 webpage for important guidance, external links, and other resources. Please contact NABH Director of Operations Maria Merlie if you have questions about your organization’s dues payment.

Fact of the Week

More than 88,000 additional people have developed anxiety or depression due to the Covid-19 pandemic, according to new data from Mental Health America’s online screening program. For questions or comments about this CEO Update, please contact Jessica Zigmond.

Regulatory Relief to Support Access to Behavioral Healthcare

Written by Administrator on June 5, 2020. Posted in Letters.

CoP Letter

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CEO Update 103

Written by Administrator on May 29, 2020. Posted in Uncategorized.

HHS Extends Compliance Deadline for Providers to Receive Covid-19 Relief Funds

HHS late last week announced a 45-day, compliance deadline extension for healthcare providers who receive payments from the Provider Relief Fund to accept the department’s required terms and conditions. The extension means HHS has granted providers a total of 90 days from the time they receive payments—made available through the CARES Act and the Paycheck Protection Program and Health Care Enhancement Act— until the time they accept the department’s terms and conditions. If providers do not meet the terms and conditions, they must return the funds. Visit HHS’ Provider Relief Fund webpage for more information.

The Joint Commission to Resume Surveys Next Month

The Joint Commission said this week it will resume regular surveys and reviews in June and will contact organizations due for a survey to assess the effects the coronavirus has had on their operations. The Oakbrook Terrace, Ill.-based accrediting organization said it is reviewing a variety of factors and criteria to determine which organizations will be surveyed—including identifying and prioritizing low-risk areas. In its announcement, The Joint Commission said the survey process will include changes to protect safety. For instance, the surveys will limit the number of individuals in group sessions and minimize the number of people who accompany the surveyor on tracer activities. In addition, using masks will be a routine practice, and The Joint Commission said it expects “the organization to provide masks and/or other personal protective equipment to surveyors and reviewers while on-site.” “Our survey will focus on a thorough assessment but will not retroactively review compliance,” the announcement said. “The implementation of an organization’s emergency operations plan will not be the focus of return survey activity considering the Centers for Medicare and Medicaid Services (CMS) waivers and other extensions,” it continued. “Rather, we will work to understand how you have adapted to the pandemic and review your current practices to assure you are providing safe care and working in a safe environment.” Click here to view The Joint Commission’s resources for healthcare staff fighting the Covid-19 pandemic.

Recording of HHS’ Webinar on Ensuring Safety During Covid-19 Available Next Week

HHS’ Assistant Secretary for Preparedness and Response (ASPR) Technical Resources, Assistance Center, and Information Exchange (TRACIE) will host a webinar on Tuesday, June 2 featuring how healthcare providers in the field have planned and implemented operational changes during Covid-19. Registration for the 90-minute webinar is full, so HHS announced that a recording will be available 24 hours after the event. The webinar will include officials from HHS’ Health Resources and Services Administration (HRSA) and Agency for Healthcare Research and Quality (AHRQ), as well as leaders from health systems in Louisiana, Massachusetts, New York, and Washington, D.C. ONDCP Director to Lead Stakeholder Call Next Week on Supporting SUD Care in Rural America James Carroll, director of the White House Office of National Drug Control Policy (ONDCP), and other senior agency officials will host a rural stakeholder call on Tuesday, June 2 at 3 p.m. ET to discuss the changes that have been made to increase access to substance use disorder (SUD) care in rural America during the global pandemic. Leaders from the Centers for Medicare & Medicaid Services, the Substance Abuse and Mental Health Services Administration, the Centers for Disease Control and Prevention, the Department of Agriculture, and other organizations will serve as speakers during the hourlong call. Click here to learn more and to register, as space is limited.

AHRQ to Host Webinar on the Role of Telehealth in Increasing Access to Care on June 9

HHS’ AHRQ will host a 90-minute webinar on Tuesday, June 9 to highlight how telehealth can increase access to care and improve healthcare quality. Presenters—including a clinical professor of psychiatry and behavioral sciences at the University of California at Davis—will discuss their work on the effectiveness of telepsychiatry, the effect of telemedicine on chronic disease management, and the facilitators and barriers to adopting urban telemedicine. Click here to learn more and to register.

Fact of the Week

A joint Census Bureau-National Center for Health Statistics survey during Covid-19 global pandemic found that 24% of Americans are showing clinically significant symptoms of major depressive disorder and 30% are showing symptoms of generalized anxiety disorder. For questions or comments about this CEO Update, please contact Jessica Zigmond.

CEO Update 102

Written by Administrator on May 22, 2020. Posted in Uncategorized.

Healthcare Providers Must Act by June 3 to Receive Additional Relief Fund Payment

Eligible healthcare providers have until Wednesday, June 3 to submit their revenue information and accept all terms and conditions to receive an additional payment from the Provider Relief Fund’s $50 billion general distribution, HHS said this week. HHS’ notice said all providers who automatically received an additional general distribution payment before Friday, April 24 must provide HHS with “an accounting of their annual revenues by submitting tax forms or financial statements.” Providers must also agree to program terms and conditions if they want to keep the funds. The CARES Act and the Paycheck Protection Program and Health Care Enhancement Act provide $175 billion in relief funds to hospitals and other healthcare providers during the Covid-19 global pandemic. Previously HHS said $50 billion of the Provider Relief Fund was allocated for general distribution to facilities and providers who bill Medicare and were affected by Covid-19, based on providers’ net revenue. Of that funding, $30 billion was distributed immediately, proportionate to providers’ share of Medicare fee-for-services reimbursements in 2019. Then HHS began distributing an additional $20 billion on April 24. According to HHS, every healthcare provider who has provided treatment for uninsured Covid-19 patients on or after Feb. 4 can request claims reimbursement through HHS’ Health Resources and Services Administration portal and will be reimbursed at Medicare rates, subject to available funding. The required steps include enrolling as a provider participant, checking patient eligibility and benefits, submitting patient information, submitting claims, and receiving payment via direct deposit. Click here for more information.

GAO Recommends CMS Include Detailed Information About SUD Coverage in “Medicare & You”

A new Government Accountability Office (GAO) report recommends the Centers for Medicare & Medicaid Services (CMS) include “explicit information” on the services Medicare covers for beneficiaries with substance use disorders (SUDs) in the agency’s Medicare & You publication. The GAO’s analysis of Medicare claims data in 2018 shows that almost 5 million beneficiaries used services for behavioral health services, which represented about 14% of the more than 36 million fee-for-services Medicare beneficiaries. About 96% of all behavioral health services accessed in 2018 (the year for which the latest data are available) were for a primary diagnosis in one of the following five behavioral health disorder categories: mood disorders (42%), anxiety and stress-related disorders (22%), schizophrenia and other non-mood, psychotic disorders (15%), disorders due to known physiological conditions (10%), and SUDs (7%). For this study, researchers also examined how CMS provides information to Medicare beneficiaries about coverage for behavioral health services. In doing so, they learned CMS mails Medicare & You—the most widely disseminated source of information on Medicare benefits—to all Medicare beneficiaries every year. “GAO reviewed the fall 2019 and January 2020 editions of Medicare & You,” the study noted. “While the January 2020 edition describes a new coverage benefit for beneficiaries with opioid use disorders, neither edition includes an explicit and broader description of the covered services available for substance use disorders,” it continued. “Both HHS and CMS have stated that addressing substance use disorders is a top priority. Given that coverage for substance use disorders is not explicitly outlined in Medicare’s most widely disseminated communication, Medicare beneficiaries may be unaware of this coverage and may not seek needed treatment as a result.” This finding led the GAO to recommend that CMS include “explicit information” on SUD coverage. “HHS reviewed a draft of this report,” the GAO study said, “and concurred with the recommendation.” Mental Health Survey Analysis Shows How People Worldwide Respond to Depression Treatment A new JAMA study shows that of more than 80,000 respondents surveyed in 16 countries, 68.2% of adults with a lifetime history of major depressive disorder obtained treatment they considered helpful. The findings showed that other patients stopped seeking treatment after early unhelpful treatment. Meanwhile, the findings showed that most patients (93.9%) were helped if they persisted through 10 treatment professionals, but only 21.5% of patients were that persistent. This led researchers to conclude “many more patients with major depressive disorder might obtain helpful treatment if they persist after early unhelpful treatment.”

SAMHSA Covid-19 Emergency Response for Suicide Prevention Grant Applications Due Today

The deadline to apply for the Substance Abuse and Mental Health Services Administration’s (SAMHSA) Covid-19 Emergency Response for Suicide Prevention (Covid-19 ERSP) grants is today, Friday, May 22. The agency said it plans to issue 50 Covid-19 ERSP grants of up to $800,000 per year for 16 months for the program that is meant to support states and communities to prevent suicide and suicide attempts among adults 25 and older during the pandemic. SAMHSA’s announcement noted there are currently 57.8 million Americans living with mental and/or substance use disorders and suicide is the tenth leading cause of death in the United States. “The current national Covid-19 crisis will certainly contribute to the growth in the number of Americans needing urgent care to address mental health needs, including suicidality,” the announcement said. “Americans across the country will struggle with increases in depression, anxiety, trauma, grief, isolation, loss of employment, financial instability and other challenges, which can lead to suicide and suicide attempts.” Click here to for the application materials.

Join the Conversation!

If you have not done so yet, please register today to access our Covid-19 Forum, an interactive comments page for all NABH members on NABH’s Covid-19 resources webpage. The Covid-19 Forum now requires an NABH login to view and post any content. Previously, a login was required only to post new content. So although members of the general public would not be able to post comments, they would be able to view them. This added feature makes it more exclusive to members. To participate you must first create an account and log-in. Your current NABH username and password will not work for this new feature. To help us connect your account to the correct NABH member organization, please use your work e-mail when registering. After you create a new username and password, you will use that information as your new login for all member-only resources at www.nabh.org, including CEO Update. After you have created an account, please visit the section, post information, and comment often. This forum is for you to post questions about issues you and your teams are managing during the coronavirus pandemic and to help provide answers and potential solutions to other NABH members. Please note that in creating this account, you are agreeing to view and post information that all NABH members can access. Our members will generate and share the content in this forum for other NABH members to use. NABH has not created this content; however, NABH staff will review postings regularly and may delete or reproduce posts if necessary. In addition, NABH is not liable to visitors of this site for any posted content. Our members agree to post questions or content that they believe is relevant to other member organizations. NABH may not be held liable for loss or damages that occur by the posting of or action taken on content posted. All content is for educational and informational purposes and is not intended as medical, legal, or other advice. If you have any questions, please contact nabh@nabh.org for assistance.

Follow NABH on Twitter and LinkedIn During Mental Health Month

This Mental Health Month, please remember to follow NABH on Twitter @NABHBehavioral and on LinkedIn at the National Association for Behavioral Healthcare to learn what NABH members and other organizations are doing during the annual national observance.

Fact of the Week

Among all adult discharges from opioid addiction treatment in the period 2015–17, 10.4% used both self-help groups and medications. For questions or comments about this CEO Update, please contact Jessica Zigmond.

CEO Update 101

Written by Administrator on May 15, 2020. Posted in CEO Updates.

NABH Letter to Lawmakers Outlines How to Address Covid-19’s Effects on Behavioral Health

NABH’s Covid-19 task force on Tuesday sent a letter to Vice President Mike Pence and senior congressional leaders that lists behavioral healthcare providers’ top challenges and recommendations as America prepares for a surge in mental health and addiction issues resulting from the Covid-19 pandemic. “Epidemics, even those of lesser magnitude than the Covid-19 pandemic, cause significant detrimental effects on mental health and substance use among affected populations often for years following an outbreak,” the letter noted. “Recent polls have found that half or more of Americans say the coronavirus pandemic is affecting their mental health with many reporting symptoms of anxiety and depression with high degrees of distress.” The letter lists key steps to address the behavioral health effects from Covid-19, including: maintaining and improving expansions of tele-behavioral health; maintaining other coverage expansions critical to improving access to behavioral healthcare; improving access to addiction services; increasing access to urgent and acute care for behavioral health conditions; and improving access to care and education for youth with serious behavioral health conditions. Click here to learn about NABH’s Covid-19 task force and to access behavioral healthcare resources during the pandemic.

United Nations Releases Policy Brief on Covid-19 and Mental Health

United Nations (UN) Secretary-General António Guterres this week said mental health services are an essential part of all government responses to Covid-19 that must be expanded and fully funded. Guterres emphasized that message when he announced the UN’s policy brief on Covid-19 and mental health and urged the international community to do much more to protect all those who face rising mental pressures. “After decades of neglect and underinvestment in mental health services, the Covid-19 pandemic is now hitting families and communities with additional mental stress,” Guterres said in a video message. “Those most at risk are frontline healthcare workers, older people, adolescents and young people, those with pre-existing mental health conditions, and those caught up in conflict and crisis,” he added. “We must help them and stand by them. Even when the pandemic is brought under control, grief, anxiety, and depression will continue to affect people and communities.” Devora Kestel, director of the World Health Organization’s (WHO) Department of Mental Health and Substance Use, reiterated Guterres’s message when she said past economic crises had “increased the number of people with mental health issues, leading to higher rates of suicide for example, due to their mental health condition or substance abuse.” Kestel also said it’s critical to take measures that protect and promote care for the existing situation “so that we can prevent things becoming worse in the near future.”

House to Vote Friday on Latest Coronavirus Stimulus Package

The House on Friday is expected to vote on a nearly $3 trillion coronavirus economic stimulus package that includes several behavioral healthcare provisions. According to a bill summary, the House bill includes $200 million for the National Institute of Mental Health to support research on the mental health consequences of Covid-19, including the effect on the nation’s healthcare providers. The legislation also includes $20 million to establish an emergency mental health and substance use training and technical assistance center at the Substance Abuse and Mental Health Services Administration (SAMHSA), and $50 million for the agency to award grants to states, tribes, and community-based entities to increase capacity for behavioral health services. In Medicaid, the bill would increase Federal Medical Assistance Percentage, or FMAP, payments to state Medicaid programs by a total of 14 percentage points from July 1, 2020 through June 30, 2021. And it would prevent the HHS secretary from finalizing the Medicaid Fiscal Accountability Regulation until the end of the Covid-19 public health emergency. The legislation also includes $175 billion for the public health and social services emergency fund, which breaks down to $100 billion in grants for hospitals and healthcare providers to be reimbursed for expenses or lost revenue resulting from the coronavirus, and $75 billion for Covid-19 testing and contact tracing. The House is expected to approve this bill, although its future is less certain in the Senate. NABH staff is watching the developments in this latest round of negotiations and its implications for behavioral healthcare providers.

Senate Passes Bill to Make National Suicide Prevention Hotline ‘9-8-8’

In a unanimous voice vote, the Senate this week passed the National Suicide Hotline Designation Act, a bill that would make the national suicide prevention hotline a three-digit number. Currently the national suicide prevention hotline is accessible through a 10-digit number, 800-273-8225 (TALK). This legislation would allow a person to dial 9-8-8 to access the hotline, although the current number would still work. The bill now moves to the House for consideration.

SAMHSA Covid-19 Emergency Response for Suicide Prevention Grant Applications Due May 22

SAMHSA this week said it is accepting applications for its Covid-19 Emergency Response for Suicide Prevention (Covid-19 ERSP) grants. The agency said it plans to issue 50 Covid-19 ERSP grants of up to $800,000 per year for 16 months for the program that is meant to support states and communities to prevent suicide and suicide attempts among adults 25 and older during the pandemic. SAMHSA’s announcement noted there are currently 57.8 million Americans living with mental and/or substance use disorders and suicide is the tenth leading cause of death in the United States. “The current national Covid-19 crisis will certainly contribute to the growth in the number of Americans needing urgent care to address mental health needs, including suicidality,” the announcement said. “Americans across the country will struggle with increases in depression, anxiety, trauma, grief, isolation, loss of employment, financial instability and other challenges, which can lead to suicide and suicide attempts.” SAMHSA will accept applications through next Friday, May 22. Click here to learn more.

Follow NABH on Twitter and LinkedIn During Mental Health Month

Fact of the Week

Opioid use during pregnancy caused a 300% increase in neonatal abstinence syndrome (NAS) between 1999 and 2013. For questions or comments about this CEO Update, please contact Jessica Zigmond.

Covid-19 Task Force Letter to Congress

Written by Administrator on May 12, 2020. Posted in Letters.

Covid- 19 Task Force Letter to Congress

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CEO Update 100

Written by Administrator on May 8, 2020. Posted in Uncategorized.

Health Affairs Blog Examines Strategies for Helping Individuals with OUD During Covid-19

A Health Affairs blog post this week outlines specific strategies that the federal government, states, and other stakeholders can apply to help individuals with opioid use disorder (OUD) mitigate the effects of Covid-19. Co-writers Jocelyn Guyer, managing director at Manatt Health, and Karen Scott, president of the Foundation for Opioid Response Efforts, note in the blog post that states and providers should update their approach to OUD treatment and “not only change their policies on paper but also issue clear and authoritative guidance to explain the new options available to help people with OUD through the pandemic.” The article highlights the various federal agencies involved in regulating medications used for OUD and recommends what should come next. “In the longer term, as the Covid-19 crisis eases, it also will be important to evaluate whether any of the temporary policy changes should be adopted on an ongoing basis,” the authors wrote. “These could include, for example, eliminating prior authorization requirements for medications used for OUD; allowing access to medications used for OUD even if someone is not participating in counseling; and using telehealth to ease access to medications used for OUD, peer supports, and individual counseling.”

AHRQ Releases Consent Form for Telehealth Services

HHS’ Agency for Healthcare Research and Quality (AHRQ) has released a consent form for providers to document they had a discussion with a patient about telehealth services and that the patient understood the information discussed. AHRQ said providers should mail or provide an electronic portal to the form so patients have it before the discussion, and they should arrange for a qualified interpreter if the patient does not speak English well. The agency said the form is intended as a checklist to make sure providers cover all important information with patients in easy-to-understand language. Click here to access the form and for tips to follow during the consent discussion. Brookings Releases Report on Removing Barriers to Telehealth Services Research organization The Brookings Institution this week released Removing Regulatory Barriers to Telehealth Before and After Covid-19, a report that concludes state and federal barriers have prevented telehealth services from launching its full capabilities. The report provides a brief overview of the U.S. healthcare system; defines telemedicine, telehealth, and digital health; and examines federal versus state telehealth use implementation. Researchers noted that Covid-19 has shown the world the value of telemedicine, and asserted that telehealth regulations, especially those at the state level, should be written with a “broad eye toward the future,” being as flexible as possible. “While progress was being made before the coronavirus outbreak to adopt telehealth in states,” the study’s researchers wrote, “the pandemic not only demonstrated its worth but also proved it necessary to avert larger meltdowns in hospital systems and among medical professionals—even those whose work was stopped due to social distancing.”

Next Week is National Prevention Week

The Substance Abuse and Mental Health Services Administration’s next National Prevention Week is May 10 through 16. This Mental Health Month, click here to download a toolkit from Mental Health America and here for resources from the National Alliance on Mental Illness.

NABH Joins Psych Hub

NABH recently became a partner with Psych Hub, an online learning platform about mental health, substance use, and suicide prevention. Psych Hub’s free micro-video library hosts more than 100 consumer-facing, animated videos focused on improving mental health literacy and reducing stigma about seeking care. Click here to see all of Psych Hub’s partner organizations.

Fact of the Week

A recent Kaiser Family Foundation tracking poll found that older adults were less likely than adults ages 18 to 64 to report that worry or stress related to the coronavirus has had a negative effect on their mental health: 31% versus 49%, respectively. For questions or comments about this CEO Update, please contact Jessica Zigmond.

CEO Update 99

Written by Administrator on May 1, 2020. Posted in Uncategorized.

CMS Announces Additional Medicare Coverage Flexibility for Behavioral Healthcare Services

The Centers for Medicare & Medicaid Services (CMS) on Thursday announced additional flexibility in Medicare coverage for several behavioral healthcare services during the Covid-19 pandemic, including partial hospitalization. CMS said it will allow payment for certain partial hospitalization services—namely, individual psychotherapy, patient education, and group psychotherapy—that are delivered in temporary expansion locations, including patients’ homes. In addition, hospitals may bill for services provided remotely by hospital-based practitioners to Medicare patients registered as hospital outpatients, including when the patient is at home when the home is serving as a temporary provider-based department of the hospital. Examples of this include counseling and educational service as well as therapy services. This change expands the types of healthcare providers that can provide using telehealth technology. CMS said hospitals may also bill as the originating site for telehealth services that hospital-based practitioners provide to Medicare patients registered as hospital outpatients, including when the patient is located at home. And while CMS announced previously that Medicare would pay for certain services conducted by audio-only telephone between beneficiaries and their doctors and other clinicians, the agency on Thursday broadened that list to include many behavioral health and patient education services. CMS is also increasing payments for these telephone visits to match payments for similar office and outpatient visits. This would increase payments for these services to about $46-$110 from a range of about $14-$41. The payments are retroactive to March 1, 2020. The changes will also allow Opioid Treatment Programs (OTPs) to perform periodic assessments through two-way audio-visual technology and through audio-only telephone calls. This change builds on CMS’ March 31^st guidance, in which the agency said audio-only telephone calls were permitted for therapy, counseling, and counseling add-on codes. In addition, CMS said pharmacists may perform medication management in accordance with state scopes of practice and laws. This modification does not, however, apply to the dispensing of methadone. Thursday’s rule reaffirmed the continuation of methadone dispensing by certified and accredited OTPs, under the supervision of clinicians who have received appropriate training and as required by the Controlled Substances Act. Until now, CMS only added new services to the list of Medicare services that may be provided via telehealth using its rulemaking process. CMS is changing its process during the Covid-19 pandemic and will add new telehealth services on a sub-regulatory basis as it considers practitioner requests. CMS also announced that teaching hospitals, including inpatient psychiatric facilities, can increase temporary beds and admit more patients to alleviate pressure on acute-care hospital bed capacity without facing reduced teaching status payments and reduced payments for indirect medical education.

May is Mental Health Month

May 1 kicks off Mental Health Month, and Mental Health America (MHA) has created a 2020 Mental Health Month Toolkit to commemorate the national observance. MHA and its affiliates nationwide have led this monthly observance since 1949, and this year will promote a “Tools 2 Thrive” theme to provide practical tools to improve mental health. According to MHA, which reports that one in five people will experience a mental illness during their lifetime, some of the tools may need to be adapted due to social-distancing restrictions during the global pandemic.

HRSA Seeks Public Comment on Bureau of Health Workforce Substance Use Evaluation

HHS’ Health Resources and Services Administration (HRSA) announced it is seeking public comment for the next 30 days on its Bureau of Health Workforce Substance Use Evaluation. In September 2017, HRSA’s Bureau of Health Workforce launched a multi-pronged effort to increase the U.S. healthcare system’s workforce capacity to prevent and treat the nation’s deadly opioid crisis. HRSA developed or expanded activities under five programs as part of this effort—including programs such as the National Health Service Corps Loan Repayment Program and the Behavioral Health Workforce Education and Training Program—and is now seeking feedback to assess these program changes. Click here to learn more about the comment submission process.

AHA to Host Webinar Next Week on Outpatient Services Featuring Sheppard Pratt Leaders

The American Hospital Association (AHA) will host a webinar about outpatient behavioral health services during the Covid-19 pandemic featuring leaders from NABH member Sheppard Pratt Health System on Monday, May 4. Harsh Trivedi, M.D., M.B.A., an NABH board member and AHA trustee, along with Sheppard Pratt’s chief medical officer, chief operating officer, and medical director for outpatient services, will discuss the system’s efforts to redesign and adapt innovative treatment programs across the full continuum of outpatient services. This event follows a webinar that AHA hosted last month on Sheppard Pratt’s processes and protocols in the system’s inpatient psychiatric settings during the pandemic. The hourlong webinar will begin on Monday at 3 p.m. ET. Click here to register.

Brookings to Host May 6 Webinar on Telehealth Before and After Covid-19

Research organization Brookings will host an hourlong webinar about telehealth services before and after Covid-19 next Wednesday, May 6 at 2 p.m. ET. In its announcement, Brookings noted that before the global pandemic, federal and state regulations around reimbursement and licensure requirements limited telehealth use, while private insurance programs and Medicaid have historically excluded telehealth services from coverage. “Whether through remote clinical health management or real-time patient monitoring, telehealth will increasingly become a necessity in health care, especially in assessing treatment options prior to any hospital visits,” the webinar announcement said. The Center for Technology at Brookings and the John Locke Foundation will host the webinar to discuss the findings of a forthcoming paper on this issue, as well as the status of regulations and how to support telehealth services in the future. Click here to register.

SAMHSA to Host May 7 Webinar on Combatting Social Isolation for Seniors During Covid-19

The Substance Abuse and Mental Health Services Administration (SAMHSA), the Administration for Community Living, the Veterans Health Administration, and the National Coalition on Mental Health and Aging will host a webinar about combatting social isolation for seniors during the pandemic to commemorate National Older Adult Mental Health Awareness Day on Thursday, May 7. The discussion will include practical ideas to promote connection and recovery for older adults with serious mental illness and substance use disorders during the global pandemic. Click here for more information about the 90-minute webinar, which will begin at 1 p.m. ET.

Fact of the Week

According to the Kaiser Family Foundation, 56% of U.S. adults report that worry or stress related to the coronavirus outbreak has caused them to experience at least one negative effect on their mental health and wellbeing, such as problems with sleeping or eating, increased alcohol use, or worsening chronic conditions. For questions or comments about this CEO Update, please contact Jessica Zigmond.

NABH-The Kennedy Forum Op-Ed

Written by Administrator on April 20, 2020. Posted in Resources.

In January, the Centers for Disease Control and Prevention announced some hopeful news when it reported a slight uptick in U.S. life expectancy following years of decline largely due to historic rates of overdoses and suicides. Sadly, COVID-19 has the potential to reverse serious progress made in addressing our nation’s mental health and addiction crises — particularly around overdose rates — unless policymakers mitigate the pandemic’s serious effects on behavioral health in the next stimulus package. Read More

CEO Update 98

Written by Administrator on April 17, 2020. Posted in CEO Updates.

CMS Expects FY 2021 IPF Payments to Increase by 2.4% The Centers for Medicare & Medicaid Services (CMS) on April 10 said it expects payments to inpatient psychiatric facilities to increase by 2.4% in fiscal year 2021, boosting the federal per diem base rate to $817.59 from $798.55. An announcement about CMS’ proposed inpatient psychiatric facility prospective payment system (IPF-PPS) rule said the agency estimates total IPF payments to increase by $100 million next year. The rule was published in the Federal Register on Tuesday, April 14. According to the proposed rule, CMS will adopt the Office of Management and Budget guidelines regarding geographic delineation of statistical areas, which CMS said should result in wage index values better representing the actual labor costs in a given area. “CMS is proposing that all IPF providers negatively impacted in their wage index, regardless of the circumstance causing the decline, be capped at a 5-percent decrease for FY 2021,” the announcement said. Table 6 at the start of page 57 in the proposed rule shows changes in 2021 from 2020 for different facility types. The agency said it is not making changes to the IPF Quality Reporting Program. NABH is analyzing the proposed rule and will submit comments by the June 9 deadline. HHS Opens CARES Act Emergency Fund Attestation Portal HHS has opened its Coronavirus Aid, Relief, and Economic Security (CARES) Act emergency fund attestation portal for healthcare providers who receive funds from the $100 billion Public Health and Social Services Emergency Fund within 30 days of receipt to attest that they received the funds and agree to payment terms and conditions. HHS began distributing the first $30 billion from the fund on April 10 to reimburse providers for healthcare-related expenses and lost revenue related to Covid-19. New Coalition Launches Initiative to Match PPE Donors with Hospitals A coalition of organizations including the American Hospital Association (AHA), Kaiser Permanente, UPS, and Microsoft has launched the Protecting People Everywhere initiative to support a national exchange that matches personal protective equipment (PPE) donors with the hospitals in greatest need. Powered by the HealthEquip™ app, the initiative is meant to ensure these critical supplies are distributed equitably. Click here to learn more. NABH Sends Urgent OTP Requests to HHS and SAMHSA NABH this week asked HHS and the Substance Abuse and Mental Health Services Administration (SAMHSA) to make changes in telehealth service delivery and payment rates for opioid treatment programs (OTPs) during Covid-19. In a letter to HHS Secretary Alex Azar and SAMHSA Administrator Elinore McCance-Katz, M.D., Ph. D., NABH requested that the Trump administration support an NABH-proposed telehealth service-delivery model for new patients that addresses SAMHSA’s clinical concerns while also protecting patients and physicians. The letter also asked the federal health officials to support OTP providers at a standardized rate during the pandemic period to mitigate the loss in revenue and increase in expenditures for OTPs during Covid-19. Click here to read the letter, which is posted on NABH’s Covid-19 resources page. AHA to Host Behavioral Health Webinar Featuring Sheppard Pratt Leaders Next Week The AHA will host a webinar about behavioral health challenges during Covid-19 on Wednesday, April 22 featuring senior leaders from NABH member Sheppard Pratt Health System. Harsh Trivedi, M.D., M.B.A., an NABH board member and an AHA trustee, along with Sheppard Pratt’s chief medical officer, chief nursing officer, and chief strategy officer, will discuss how the system re-engineered care processes and developed new care protocols for agitated patients during the pandemic. The team will also discuss the system’s efforts to support staff and build resistance during the national emergency. The hourlong webinar will begin at 2 p.m. ET. Click here to register. O’Neill Institute Covid-19 and Addiction Policy Webinar Includes Pinnacle Treatment Centers CEO The O’Neil Institute for National and Global Health Law at Georgetown last week hosted a webinar on Covid-19 and addiction policy that featured Joe Pritchard, CEO of NABH member Pinnacle Treatment Centers and a member of NABH’s Addiction Treatment Committee. Panelists discussed the current state of access to treatment and harm reduction services for people with substance use disorders. Topics included recently waived federal regulations related to medications and telehealth, as well as the availability of harm reduction and recovery support services. Fact of the Week Between 1999 and 2018, suicide rates were lowest among females aged 10-14. The rate for this age group increased to 2.0 in 2018 from 0.5 in 1999. For questions or comments about this CEO Update, please contact Jessica Zigmond

CMS Expects FY 2021 IPF Payments to Increase by 2.4%

Written by Administrator on April 13, 2020. Posted in Alerts.

The Centers for Medicare & Medicaid Services (CMS) on April 10 said it expects payments to inpatient psychiatric facilities to increase by 2.4% in fiscal year 2021, boosting the federal per diem base rate to $817.59 from $798.55. An announcement about CMS’ proposed inpatient psychiatric facility prospective payment system (IPF-PPS) rule said the agency estimates total IPF payments to increase by $100 million next year. The rule will be published in the Federal Register on Tuesday, April 14. According to the proposed rule, CMS will adopt the Office of Management and Budget (OMB) guidelines regarding geographic delineation of statistical areas, which CMS said should result in wage index values better representing the actual labor costs in a given area. “CMS is proposing that all IPF providers negatively impacted in their wage index, regardless of the circumstance causing the decline, be capped at a 5-percent decrease for FY 2021,” the announcement said. Table 6 at the start of page 57 in the proposed rule shows changes in 2021 from 2020 for different facility types. The agency said it is not making changes to the IPF Quality Reporting Program. NABH is analyzing the proposed rule and will submit comments by the June 9 deadline.

CEO Update 97

Written by Administrator on April 10, 2020. Posted in Uncategorized.

HHS Announces $30 Billion in Immediate Covid-19 Relief Funding for Providers

HHS announced on Friday it is distributing $30 billion immediately to healthcare providers fighting the deadly Covid-19 pandemic. The funding is the first portion of the $100 billion allotted to hospitals and other providers as part of the Coronavirus Aid, Relief, and Economic Security (CARES) Act that President Trump signed on March 27. The funding will arrive via direct deposit to eligible providers starting on Friday, April 10. HHS’ announcement said the money is in the form of payments, not loans, so the money will not need to be repaid. Eligible healthcare providers include all facilities and providers that received Medicare fee-for-service reimbursements in 2019. According to HHS, payments to practices that are part of larger medical groups will be sent to the group’s central billing office. Click here to learn how HHS will determine the payments and what eligible providers need to do. To receive funding, providers must agree not to seek to collect out-of-pocket payments from a Covid-19 patient that are greater than what the patient would have otherwise been required to pay if an in-network provider had provided care, HHS said. HHS has created a public website that shows all Covid-19 grant and cooperative agreement awards, which features a U.S. map detailing the amounts awarded by states, graphics highlighting the numbers of awards, amounts awarded by agency, and more.

NABH Sends Latest Covid-19 Recommendations to Vice President Pence and Hill Leaders

NABH on Thursday sent Vice President Mike Pence and top Senate and House leaders a six-page letter outlining critical behavioral healthcare recommendations as lawmakers prepare for the next round of legislation to provide relief during the Covid-19 pandemic. The letter highlights behavioral healthcare provider needs related to payment issues, health information technology, telehealth, parity compliance, medication treatment for opioid use disorder, youth services, and additional emergency funding needs. Please visit NABH’s enhanced Covid-19 resources page for all pandemic-related correspondence, guidance, and external webpage links.

NABH and Other Behavioral Health Organizations Request Emergency Covid-19 Relief

Earlier this week, NABH joined more than 35 other associations on a request for $38.5 billion in emergency funding for behavioral health organizations during Covid-19. The appropriations request calls for the $38.5 billion in emergency supplemental funding for direct payments to behavioral health organizations to ensure they can remain open and operating during the pandemic. A significant portion of the funding would be set aside for behavioral healthcare organizations enrolled in Medicaid. Also this week, NABH also supported a Mental Health Liaison Group letter to HHS Secretary Alex Azar and Centers for Medicare & Medicaid Services (CMS) Administrator Seema Verma that requested CMS immediately expand Medicare coverage of telehealth to allow audio-only communications and waive Medicare’s current requirement for audio-video connecting during the pandemic.

The Joint Commission Releases FAQs on Healthcare Provider Face Masks Brought from Home

The Joint Commission (TJC) this week released frequently asked questions (FAQs) regarding TJC’s position statement on using face masks brought from home. TJC’s Office of Quality and Patient Safety has received many complaints from healthcare workers about inadequate personal protective equipment (PPE), such as a lack of N95 masks for performing aerosolizing procedures or working without routinely wearing a mask when exposed to a large number of patients who could have Covid-19. “If a hospital cannot provide N95 masks for staff performing these procedures or working in the immediate vicinity, staff should be allowed to bring in their own masks,” TJC noted. Click here to read the FAQ document, which is also posted on NABH’s Covid-19 resources page.

CDC Reports National Suicide Rate Increased 35% Between 1999 and 2018

The Centers for Disease Control and Prevention (CDC) this week reported the U.S. suicide rate increased 35% between 1999 and 2018. During that period, suicide rates among females were highest for those between the ages of 45 and 64, while the rates were highest among males for those aged 75 and older. Meanwhile, in 2018, the suicide rate for males was 3.7 times the rate for females. According to the CDC, suicide is the 10^th leading cause of death for all ages in the United States.

Fact of the Week

The U.S. suicide rate increased on average about 1% per year from 1999 to 2006 and then by 2% per year from 2006 through 2018. For questions or comments about this CEO Update, please contact Jessica Zigmond.