Author: Shelby Liebler
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NABH Responds to HHS Request for Information on Behavioral Health
NABH last week submitted a response to the HHS Request for Comment on Chronic Disease of Addiction, which solicited ideas on “research, policy, and strategies to improve the prevention, treatment, recovery of chronic disease of addiction and mental illness and how to promote the Great American Recovery Initiative.”
NABH’s response offers three recommendations: (1) expand Medicaid coverage of Institutions for Mental Diseases via changes to the in lieu of service authority, (2) work with the Drug Enforcement Administration to streamline regulatory requirements for Opioid Treatment Program mobile medication units, and (3) promote access to contingency management for substance use disorders.
States Sue CMS Over Community Engagement Requirement
Democratic attorneys general and governors in 25 states and DC filed a lawsuit on June 29 in the U.S. District Court for the District of Massachusetts against CMS for the Community Engagement Requirement Interim Final Rule (IFR).
The lawsuit alleges that through CMS’ development and issuance of the IFR, the agency:
- Violated H.R. 1, specifically with (1) the requirement for a health condition under the medically frail exclusion to significantly impair an individual’s functioning, (2) the limitation on the optional short-term hardship exception for declared emergencies to affect individuals’ ability to participate in community engagement activities, and (3) the restrictions imposed on beneficiary self-attestation for exclusions and certain exceptions;
- Was arbitrary and capricious by providing contradictory information to states, departing from prior guidance without adequate justification, and imposing unreasonable requirements; and
- Did not provide clear notice of the conditions that states must meet to implement the community engagement requirement because of ambiguity in the IFR and because states could not have reasonably anticipated many conditions based on statutory language and prior CMS guidance.
It is unclear what effect this lawsuit will have on the implementation of the community engagement requirement, which expansion states must incorporate into their Medicaid eligibility requirements by January 1, 2027. NABH will continue to monitor this litigation and keep members informed.
CMS Releases CY 2027 OPPS Proposed Rule
On Thursday, July 2, the Centers for Medicare & Medicaid Services (CMS) issued the Calendar Year 2027 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Proposed Rule (CMS-1850-P), which includes updates to Medicare payment rates for behavioral health intensive outpatient programs (IOPs) and partial hospitalization programs (PHPs). CMS also released a rule summary.
The proposed IOP and PHP rates are a 9.4% increase from FY 2026 for programs providing 3 services per day and an 11.1% increase from FY 2026 for programs providing 4 or more services per day.
| Proposed FY 2027 Rates | CMHCs | Hospital-based |
| Intensive Outpatient (3 services) | $139.81 | $349.52 |
| Intensive Outpatient (4 or more services) | $185.98 | $464.99 |
| Partial Hospitalization (3 services) | $139.81 | $349.52 |
| Partial Hospitalization (4 or more services) | $185.98 | $464.99 |
NABH will closely review the OPPS proposed rule for PHP and IOP payment methodology and rate concerns, as well as other policy issues that might impact members. We will provide comments to CMS on the proposed rule, which are due August 31, 2026. Contact Sarah Steverman, VP of Quality and Regulatory Affairs, with questions.
House Ways & Means Committee Bill Markup
The House Ways & Means Committee last Wednesday held a markup and advanced multiple bills out of committee, including the Tax Exempt Hospital Transparency Act introduced by Reps. Greg Murphy (R-NC) and Lloyd Smucker (R-PA). The bill aims to establish additional IRS reporting requirements for nonprofit hospitals.
NABH is actively monitoring this legislation and will provide updates to members as they become available.
Upcoming Webinars on Changes to Medicaid
Please note these two upcoming virtual events discussing the new Community Engagement Requirement and other changes to Medicaid:
- The Centers for Medicare & Medicaid Services (CMS) and the National Academy for State Health Policy will hold a webinar on Wednesday, July 22 at 12:30 p.m. ET to discuss the Community Engagement Requirement Interim Final Rule (IFR). During this webinar, CMS staff will explain the new Medicaid requirements, walk through the Interim Final Rule and answer audience questions. Please note that this webinar was rescheduled from its original date, July 9. Click here to register.
- KFF and States Newsroom will hold a virtual event on Thursday, July 23 at noon ET entitled “Medicaid and the Road Ahead: Spending Cuts, Work Requirements and What’s Next for States, Providers and Families.” The conversation will focus on the broad impacts of the new Medicaid Community Engagement Requirement and other federal policy changes. Click here to register.
Reminder: Mark Your Calendars for These Upcoming Behavioral Healthcare Events
Please remember to save the date for the NABH 2027 Annual Meeting from March 1-3, 2027, at The Ritz-Carlton Washington, DC.
In the near term, here are some upcoming behavioral healthcare-related virtual and in-person events:
- CMS will host a virtual Connectathon to share updates about patient assessment reporting programs, including the proposed Inpatient Psychiatric Facility Patient Assessment Instrument (IPF-PAI). Alongside other general sessions, the IPF-PAI track will provide a preview of new patient assessment data collection tools. A kickoff call was held on June 22, but registration is still open for informational and demonstration sessions from July 14-16. Click here to register.
- The Association of Clinicians for the Underserved annual conference will focus on expanding access to care from July 26-29, 2026, in Washington, D.C
- The American Psychological Association will host its annual conference Aug. 6-8, 2026, in Washington, DC.
Fact of the Week
A new forecast from Vizient projects that behavioral health outpatient volumes will grow 22% over the next decade, more than seven times the 3% increase predicted by population trends alone.
For questions or comments about this CEO Update, please contact NABH Operations Coordinator Shelby Liebler.
CMS Releases CY 2027 OPPS Proposed Rule with IOP and PHP Rates
The previous NABH alert on the OPPS proposed rule published on July 2, 2026 included the wrong per diem rates for IOP and PHP. This version published on July 6, 2026 updates those numbers to the current rates from Appendix A of the CY 2027 OPPS proposed rule.
On Thursday, July 2, the Centers for Medicare & Medicaid Services (CMS) issued the Calendar Year 2027 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Proposed Rule (CMS-1850-P), which includes updates to Medicare payment rates for behavioral health intensive outpatient programs (IOPs) and partial hospitalization programs (PHPs). CMS also released a rule summary.
NABH will closely review the OPPS proposed rule for PHP and IOP payment methodology and rate concerns, as well as other policy issues that might impact members. We will provide comments to CMS on the proposed rule, which are due August 31, 2026. Contact Sarah Steverman, VP of Quality and Regulatory Affairs, with questions.
PHP and IOP Per Diem Rates
Intensive Outpatient (3 services) CMHCs Hospital-based
2027 Rate $139.81 $349.52
2026 Rate $127.74 $319.38
Intensive Outpatient (4 or more services) CMHCs Hospital-based
2027 Rate $185.98 $464.99
2026 Rate $167.38 $418.45
Partial Hospitalization (3 services) CMHCs Hospital-based
2027 Rate $139.81 $349.52
2026 Rate $127.74 $319.38
Partial Hospitalization (4 or more services) CMHCs Hospital-based
2027 Rate $185.98 $464.99
2026 Rate $167.38 $418.45
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NABH Medicaid Community Engagement Requirement Webinar
Last Thursday, NABH hosted a webinar to discuss the new Medicaid Community Engagement Requirement Interim Final Rule, with a focus on implications for beneficiaries with behavioral health conditions. The slides from the presentation can be accessed here.
The recording of the webinar is now available, click here to access the video. The webinar is only accessible via this direct link, but members should feel free to share it.
CMS Issues Request for Information on Essential Health Benefits
CMS is requesting information on the Essential Health Benefits (EHB) framework and the requirement for EHB benefits to equal the benefits provided under a typical employer plan.
The Affordable Care Act included a requirement for non-grandfathered individual and small group (except fully-insured) private health plans, as well as Medicaid Alternative Benefit Plans, to cover 10 benefit categories, known as EHB. One EHB is “mental health and substance use disorder services, including behavioral health treatment.” States select an EHB benchmark plan, which serves as the basis for EHB design across applicable plans offered in the state.
The request for information (RFI) includes questions specific to behavioral health benefits, as well as broader topics that relate to behavioral health.
NABH is considering whether to submit comments in response to the RFI. Please reach out to NABH Vice President of Public Policy, Dan Schwartz, by Thursday, July 2 if you have specific information or perspectives that you would like NABH to relay.
MOTAA 2.0 Introduced in the Senate
On Thursday, June 25, Senators Ed Markey (D-MA) and Rand Paul (R-KY) introduced the Modernizing Opioid Treatment Access Act 2.0 (MOTAA 2.0), which differs from the previous version of the legislation. The new version empowers the Department of Health & Human Services to authorize additional providers to prescribe methadone without the need for additional legislation.
NABH is actively monitoring this legislation and will update members as more information becomes available. Please contact NABH Vice President of Public Policy, Dan Schwartz, with any questions.
Reminder: Mark Your Calendars for These Upcoming Behavioral Healthcare Events
Please remember to save the date for the NABH 2027 Annual Meeting from March 1-3, 2027, at The Ritz-Carlton Washington, DC.
In the near term, here are some upcoming behavioral healthcare-related virtual and in-person events:
- CMS will host a virtual Connectathon to share updates about patient assessment reporting programs, including the proposed Inpatient Psychiatric Facility Patient Assessment Instrument (IPF-PAI). Alongside other general sessions, the IPF-PAI track will provide a preview of new patient assessment data collection tools. A kickoff call was held on June 22, but registration is still open for informational and demonstration sessions from July 14-16. Click here to register by June 30.
- The Association of Clinicians for the Underserved annual conference will focus on expanding access to care from July 26-29, 2026, in Washington, D.C.
- The American Psychological Association will host its annual conference Aug. 6-8, 2026, in Washington, DC.
Fact of the Week
July marks the 4th anniversary of the 988 Suicide & Crisis Lifeline’s nationwide launch. The 988 Lifeline has routed more than 26 million calls, texts, and chats since 2022.
Happy Independence Day from NABH!
Please note that NABH will not publish CEO Update on Friday, July 3and will resume on Friday, July 10.
The NABH team wishes you, your families, and your teams a happy and safe weekend celebrating our nation’s 250th Independence Day!
For questions or comments about this CEO Update, please contact NABH Operations Coordinator Shelby Liebler.
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NABH Webinar on Medicaid Community Engagement Requirement Interim Final Rule
NABH held a webinar yesterday on the new Medicaid Community Engagement Requirement Interim Final Rule, providing an overview of key provisions in the interim final rule, including exclusions for people with behavioral health conditions.
Thank you to all who attended the webinar. Click here to access the slides presented.
SAMHSA Announces $700 Million in Funding Opportunities
The Substance Abuse and Mental Health Services Administration (SAMHSA) announced this week more than $700 million in potential funding for grants and cooperative agreements. The notices of funding opportunity (NOFOs) include a new $96 million initiative, the Safety Through Recovery, Engagement, and Evidence-based Treatment and Support (STREETS) program, along with $612 million in funding opportunities for additional behavioral health programs.
SAMHSA announced that the new STREETS program will provide eight communities with up to $3 million per year for four years to “develop multisector, state-of-the-art care systems for people who are homeless and have substance use disorders, serious mental illness, or co-occurring disorder.”
SAMHSA also released NOFOs to establish new Certified Community Behavioral Health Clinics (CCBHCs), enhance services at established CCBHCs, and several other programs, including grants to support 988/crisis services, suicide prevention, and substance use treatment and recovery services.
CMS Issues Final Rule on Oversight of Accrediting Organizations
The Centers for Medicare & Medicaid Services (CMS) on June 12 issued a final rule revising how the agency conducts oversight of accrediting organizations (AOs) that ensure healthcare providers are in compliance with the Medicare Conditions of Participation. The final rule phases out the use of “look-back” validation surveys, replacing them with direct validation surveys conducted by both AOs and state agencies. The rule also implements several policies intended to improve consistency in the survey process. These changes will take effect on June 16, 2027.
Click here to read the final rule.
New Medicaid Reimbursement Analysis from AJMC
The American Journal of Managed Care (AJMC) on June 12 released a new analysis comparing healthcare resource utilization and costs for Medicaid patients with serious mental illness between states with low and high reimbursement rates for psychiatric services. The study found that higher state Medicaid reimbursement rates were associated with reduced healthcare resource utilization and cost.
Read the full analysis here.
Reminder: Mark Your Calendars for These Upcoming Behavioral Healthcare Events
Please remember to save the date for the NABH 2027 Annual Meeting from March 1-3, 2027 at The Ritz-Carlton Washington, DC.
In the near term, here are some upcoming behavioral healthcare-related virtual and in-person events:
- CMS will host a virtual Connectathon to share updates about patient assessment reporting programs, including the proposed Inpatient Psychiatric Facility Patient Assessment Instrument (IPF-PAI). Alongside other general sessions, the IPF-PAI track will provide a preview of new patient assessment data collection tools. A kickoff call will be held on June 22, followed by informational and demonstration sessions from July 14-16. Click here to register.
- A webinar presented by the National Training and Technical Assistance Center (NTAC) at CMS will be held on Thursday, June 25 at 3 p.m. E.T., designed for state Medicaid staff and others involved in state-level crisis service initiatives. Click here to register.
- The Association of Clinicians for the Underserved annual conference will focus on expanding access to care from July 26-29, 2026 in Washington, D.C.
- The American Psychological Association will host its annual conference Aug. 6-8, 2026 in Washington, DC.
Honoring Juneteenth
Today we honor Juneteenth, recognizing the day in 1865 that the final enslaved Americans were freed. At NABH, we remain committed to advancing and expanding access to quality, accountable behavioral healthcare for all. Learn more about the history of Juneteenth by clicking here.
Fact of the Week
From 2019 to 2024, the percentage of American adults seeking mental health counseling rose by almost 5%, the CDC reports.
For questions or comments about this CEO Update, please contact NABH Operations Coordinator Shelby Liebler
NABH Community Engagement Requirement Webinar Slides
Slides presented at the NABH ” Medicaid Community Engagement Requirement Interim Final Rule: Implications for Beneficiaries with Behavioral Health Conditions” webinar on Thursday, June 18, 2026.
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Upcoming NABH Webinar on Medicaid Community Engagement Requirements Interim Final Rule
On Thursday, June 18 from 12-1 p.m. ET, NABH will host a webinar for members on the new Medicaid Community Engagement Requirements Interim Final Rule. We will provide an overview of key provisions in the interim final rule, including exclusions for people with behavioral health conditions.
Click here to register for the webinar.
NABH Submits Comments on FY27 IPPS Proposed Rule to CMS
NABH this week submitted comments and recommendations to the Centers for Medicare & Medicaid Services (CMS) about the agency’s Fiscal Year 2027 Inpatient Prospective Payment Systems (IPPS) proposed rule. In the IPPS rule, CMS asked for information regarding the appropriateness of including the Emergency Care Access and Timeliness eCQM (electronic clinical quality measure) in the Inpatient Quality Reporting Program. The letter addresses the association’s concern that the measure does not account for the complexity of staffing and operating an inpatient unit serving patients with behavioral healthcare needs.
Read the full letter here.
CMS Connectathon Featuring IPF-PAI Reporting Tool
The Centers for Medicare & Medicaid Services (CMS) will host a virtual Connectathon to share updates about patient assessment reporting programs, including the proposed Inpatient Psychiatric Facility Patient Assessment Instrument (IPF-PAI). As CMS explores using Fast Healthcare Interoperability Resources (FHIR) for statutory quality reporting, the Connectathon will showcase the Patient Assessment Reporting Interoperability Tool (PARIT), a FHIR-based web application designed to support standardized collection and submission of patient assessment data.
Alongside other general sessions, the IPF-PAI track will provide a preview of PARIT and demonstrate the collection and submission of patient data. A kickoff call will be held on June 22, followed by informational and demonstration sessions from July 14-16. Click here to register.
Please contact Sarah Steverman, Vice President of Quality and Regulatory Affairs, with questions.
CMS NTAC Webinar: Medicaid and Mobile Crisis Response in Rural Areas
CMS will host a National Training and Technical Assistance Center (NTAC) webinar on Thursday, June 25 at 3 p.m. ET. Designed for state Medicaid staff and others involved in state-level crisis service initiatives, the webinar will discuss leveraging Medicaid policy and scaling services for Mobile Crisis Response in rural areas. Click here to register.
Reminder: Mark Your Calendars for These Upcoming Behavioral Healthcare Events
Please remember to save the date for the NABH 2027 Annual Meeting from March 1-3, 2027 at The Ritz-Carlton Washington, DC.
In the near term, here are some upcoming behavioral healthcare-related events:
- The American Mental Health Counselors Association annual event for professionals will be held June 23–26, 2026 in Portland, Ore.
- The Association of Clinicians for the Underserved annual conference will focus on expanding access to care from July 26-29, 2026 in Washington, D.C.
- The American Psychological Association will host its annual conference Aug. 6-8, 2026 in Washington, DC.
Fact of the Week
35% of US teens are extremely or very concerned about the mental health of their peers, according to the Pew Research Center.
For questions or comments about this CEO Update, please contact NABH Operations Coordinator Shelby Liebler.
CMS Issues Interim Final Rule on Medicaid Community Engagement Requirements
CMS issued the interim final rule (IFR), Medicaid Program: Community Engagement Requirement for Certain Individuals, after the market closed on Monday, June 1.
This IFR implements Sec. 71119 of H.R. 1 (also known as the One Big Beautiful Bill Act and the Working Families Tax Cut legislation), which conditioned Medicaid eligibility on completing 80 hours per month of community engagement activities (i.e., work, community service, or educational activities).
Statutory exceptions to community engagement requirements include people who are medically frail, which includes having a substance use disorder (SUD) or disabling mental disorder (DMD). The IFR does not define either SUD or DMD, but rather indicates that states will need to adopt lists of qualifying conditions and implement a process for individuals to request an exemption due to a condition excluded from the list. Importantly, the IFR clarifies that people with SUDs would only qualify for the SUD exemption if they have been in recovery for fewer than five years, and active treatment participation is not needed to qualify.
States are required to prioritize assessing exception eligibility using their existing data. For individuals whom states cannot verify as medically frail using their existing data, practitioners can submit documentation to demonstrate eligibility. Otherwise, individuals can self-attest to medical frailty and enroll in Medicaid for six months before information is required to substantiate their attestation. If states grant the medically frail exception, they would need to reassess this exception at least annually.
Congress directed CMS in H.R. 1 to implement community engagement requirements via an IFR, a type of regulation that bypasses a public comment process on a draft version of a rule before it takes effect.
The NABH team will continue to review the IFR, which takes effect on July 31, 2026, the same day public comments are due. However, states do not need to implement the IFR’s provisions until Jan. 1, 2027.
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