NABH Education and Research Foundation to Kick Off Webinar Series Next Week
The
NABH Education and Research Foundation is pleased to host its first webinar,
Redesigning the Present and Future of Behavioral Healthcare, on
Tuesday, Jan. 23, 2024 from 2 p.m. – 3 p.m. ET.
Foundation President Donald Parker, who serves as president of Behavioral Health Care Transformation Services for Hackensack Meridian Health, will co-lead the webinar with workforce consultant Beth Kuhn of
Stonegate Strategies.
Kuhn has more than 30 years of workforce experience – with special interest and expertise in behavioral healthcare workforce development – and has served in both Democratic and Republican administrations, including in her roles as commissioner of the Kentucky Department of Workforce Investment and as director of workforce development at the Vermont Department of Labor. Kuhn’s accomplishments include creating the Strategic Initiative for Transformation Employment, or
SITE, a statewide model designed to bridge the gap between recovery and workforce participation for individuals active in their recovery from substance use issues.
During this interactive webinar, participants are encouraged to ask questions of Kuhn and Parker, who will provide an overview of existing behavioral healthcare workforce challenges; explain why America’s current workforce structure doesn’t meet present or future workforce needs; suggest redesign strategies, present examples of current successes; and offer ideas about how to leverage current options to help providers develop a more robust workforce system.
Please join us and click
here to register for this free webinar!
Congress Clears Stop Gap Funding Extension, Delaying Potential Healthcare Package
Staving off a government shutdown, House and Senate lawmakers passed legislation this week to extend the federal government’s current funding deadlines into March.
The House passed the bill in 314-108 vote hours after the Senate passed the measure 77-18. The legislation extends funding for agencies under four appropriations bills that were scheduled to expire today, Jan. 19 – Agriculture, Rural Development, Food and Drug Administration, and related agencies; Energy and Water Development; Military Construction, Veterans Affairs, and related agencies; and Transportation, Housing and Urban Development, and related agencies – until March 1.
Funding covered under the remaining eight bills that were scheduled to expire Feb. 2 have been extended through March 8. Lawmakers have indicated they expect this is the final stopgap spending measure needed for fiscal year 2024.
Several non-controversial healthcare provisions were included in the March 8 stopgap measure, such as providing continued funding for community health centers, teaching health centers and the National Health Service Corps; funding special diabetes programs; averting steep cuts to hospitals that have a high volume of uninsured and Medicaid patients; and providing continued funding for the Sexual Risk Avoidance Education Program, which aims to limit teen pregnancy and domestic violence.
The bill did not address several expired health programs, including the
SUPPORT Act reauthorization; the global HIV/AIDS program, the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR); the
Pandemic and All-Hazards Preparedness Act; and heath price transparency legislation.
Lawmakers are expected to include those programs in a potential March deal, if Congress doesn’t have to punt again with another spending patch. NABH continues to advocate for
SUPPORT Act reauthorization and to stop the
Modernizing Opioid Treatment Access Act (MOTAA) as part of a broader healthcare package. Health policy leaders in the House and Senate remain in negotiations on a final package.
CMS Increases Prior Authorization Timeliness and Transparency in Final Rule
The Centers for Medicare & Medicaid Services (CMS) this week finalized a
rule that takes concrete steps to shorten the prior authorization process, which physicians and providers use to request health plan coverage for medical treatments and services that a physician has prescribed for a patient.
In part, this rule responds to recent government audits that found that many government-contracted health plans were denying coverage inappropriately for services that actually were covered. The rule mostly takes effect for managed contracts in 2026 and beyond for insurers who contract with Medicare, Medicaid, and the Children’s Health Insurance Program, but not private insurance. Specifically, health plans will be required to make prior authorization coverage decisions within seven days and 72 hours for urgent requests.
The rule also requires health plans to provide a specific reason for denying a prior-authorization request, which will help facilitate the correction of fixable claims as well as denial appeals. These payers also will be required to report their clinical and/or policy basis publicly for prior-authorization denials.
Finally, to further reduce administrative burden, payers will now be required to conduct prior authorizations using a common electronic interface for transactions and data exchange, using Health Level 7 and other applications.
Overall, CMS estimates that the final rule will reduce federal healthcare expenditures by approximately $15 billion over 10 years. Click
here to learn more in the agency’s fact sheet.
CMS Announces Model to Test Approaches for Advancing Integration in Behavioral Health
CMS on Thursday introduced its Innovation in Behavioral Health (IBH) model to improve the care quality and outcomes for adults with Medicare and Medicaid who have mental health conditions and/or substance use disorder (SUD) by connecting them with the physical, behavioral, and social supports they need.
The CMS Innovation Center will test the new IBH model, under which community-based behavioral healthcare practices will form interprofessional care teams composed of behavioral and physical health providers, as well as community-based supports. This new model supports President Biden’s mental health strategy and implements an action item in the HHS
Roadmap for Behavioral Health Integration.
“The Biden-Harris administration will continue to explore innovative ways to help people with mental health conditions and/or substance use disorder,” HHS Secretary Xavier Becerra said in an announcement. “Put simply, mental health is health—and by expanding access to the high-quality care that people need, we are changing lives.”
CMS’ announcement said through the interprofessional care teams, people will experience an integration of services that will bridge the gaps between physical and behavioral health. The model enables a “no wrong door” approach, meaning that regardless of how patients enter care, they will have access to all available services. Through this practice, IBH also aims to reduce overall program expenditures.
The model will launch in Fall 2024, and CMS said it expects it to operate for eight years in up to eight states. CMS will release a notice of funding opportunity for the model in Spring 2024. Click
here to learn more.
SAMHSA Releases Updated 988 Partner Toolkit
The Substance Abuse and Mental Health Services Administration (SAMHSA) has released an updated 988 Partner Toolkit that the agency says is designed to help users better navigate the bank of materials available to promote the lifeline in communities.
The toolkit has the same video PSAs, social media promotions, FAQs, and print materials, and is now available to search by target audience, population, language, and resource type.
Click
here to access the toolkit.
Reminder: NABH’s Enhanced Denial-of-Care Portal is Now Available
NABH thanks all members who have submitted data to the association’s
Denial-of-Care Portal. You have provided critical information that expands the portal and helps NABH strengthen its advocacy efforts related to erroneous prior-authorization denials.
With guidance from our members, NABH has improved the portal by adding two elements:
- Time-based data on the number of days between a request for coverage and a plan’s denial, which improves our ability to assess and compare health plan responsiveness.
- The gap between days of provided care versus days of covered care to quantify and compare uncompensated days per health plan.
We strongly encourage all NABH members to submit their denial-of-care data in the portal. If you need help starting, or if you have other questions, please e-mail NABH Associate Manager for Congressional Affairs
Emily Wilkins.
Save the Date for the NABH 2024 Annual Meeting!
Please plan to join us at the Salamander Washington, DC from
May 13-15, 2024 for this year’s Annual Meeting,
The Future of Behavioral Healthcare. Registration will open in February.
Fact of the Week
SAMHSA’s
Food and Mood Project aims to promote emotional wellness and reduce the impact of mental health and substance use conditions among the nation’s K-12 population by implementing strategies that address the intersection among behavioral health, food/nutrition security, and cultural food diversity.
For questions or comments about this CEO Update, please contact Jessica Zigmond.
