CEO Updates

NABH to Host Parity Panel with DOL Official Lisa Gomez and Former U.S. Rep. Patrick Kennedy on Tuesday, June 13

NABH President and CEO Shawn Coughlin will moderate a parity panel discussion with Lisa Gomez, assistant secretary for employee benefits security at the U.S. Labor Department, and former U.S. Rep. Patrick Kennedy (D-R.I.). on Tuesday, June 13, the second day of the 2023 Annual Meeting.
 
Before she was sworn in last October, Gomez was a partner with the law firm Cohen, Weiss and Simon LLP and chair of the firm’s management committee. She has deep technical and practical experience in the field of employee benefits law and spent almost three decades representing various Taft-Hartley and multiemployer pension and welfare plans, single employer plans, jointly administered training program trust funds, a federal employees health benefit plan, and other plans covering employees in a range of industries. Gomez earned her bachelor’s degree at Hofstra University and her law degree at Fordham.

Former Rep. Kennedy is the CEO of The Kennedy Forum, a not-for-profit he founded in 2013 to unite advocates, business leaders, and government agencies to advance evidence-based practices, policies, and programming mental health and addiction. During his time in Congress, Kennedy was the lead author of the Mental Health Parity and Addiction Equity Act. Kennedy is also the founder of Don’tDenyMe.org, an educational campaign that empowers consumers and providers to understand parity rights and connects them to essential appeals guidance and resources, and co-founder of One Mind, an organization that pushes for greater global investment in brain research.

The panel will begin at 9:30 a.m. ET in the Salamander’s Grand Ballroom and will discuss the landmark 2008 parity law and the work that remains to secure the law’s promise.

Please be sure to register for the Annual Meeting and reserve your hotel room today, if you haven’t done so yet. We look forward to seeing you in Washington!

CMS Coverage for PHP Telehealth Services Ends With COVID-19 PHE’s Conclusion

The Centers for Medicare & Medicaid Services (CMS) has shared with NABH and other stakeholders the agency’s plans to end telehealth coverage for partial hospitalization program (PHP) services implemented during the COVID-19 Public Health Emergency (PHE) when the PHE concluded at the end of Thursday, May 11.

In addition, CMS has explained that telehealth coverage will continue through December 2024 for Intensive Outpatient Program (IOP) services that qualify under the outpatient prospective payment system as “remote mental health services.”
 
NABH continues to communicate with key Members of Congress to clarify the legislative intent behind the telehealth coverage extensions that were authorized in the Consolidated Appropriations Act, 2023 last December. The NABH team understands that some Members of Congress intended for the telehealth coverage extension to include PHP services.

Given the persistent confusion on these matters, NABH has urged CMS to issue clarification in writing. NABH will keep members apprised of our efforts to extend telehealth coverage for PHP services.  

DEA Rule to Extend Telemedicine Flexibilities for Prescription of Controlled Substances Effective May 11

The U.S. Drug Enforcement Administration’s (DEA) temporary extension of COVID-19 telemedicine flexibilities for prescription of controlled medications took effect Thursday, May 11.
 
Under the DEA’s rule, the agency has extended the full set of telemedicine flexibilities adopted during the PHE for six months through Nov. 11, 2023. For any practitioner-patient telemedicine relationships that have been or will be established up to Nov. 11, 2023, the full set of telemedicine flexibilities regarding prescription of controlled medications established during the PHE will extend for one year through Nov. 11, 2024.
 
In a letter to DEA on March 31, NABH advocated to remove requirements for in-person medical examinations for Schedule II stimulant medications for ADHD and Schedule III-V mental health medications.

Please contact Sarah Wattenberg, NABH’s director of quality and addiction services, with questions or comments.

SAMHSA and FDA Officials Release Letter to Practitioners to Promote Medication First Model

Officials from the Substance Abuse and Mental Health Services Administration (SAMHSA) and the U.S. Food and Drug Administration (FDA) this week sent a letter to healthcare practitioners noting that although counseling and other services are important parts of treatment plans, they should not be prerequisites for receiving medication.
 
“An often-cited barrier to prescribing buprenorphine for the treatment of OUD is the perception that patients must engage in counseling and other services in order to start or continue receiving the medication,” wrote Miriam Delphin-Rittmon, Ph.D. and Patrizia Cavazzoni, M.D. “This letter serves to clarify the importance of counseling and other services as part of a comprehensive treatment plan, but to also reiterate that the provision of medication should not be made contingent upon participation in such services,” they added.
 
Delphin-Rittmon serves as the assistant secretary for mental health and substance use at SAMHSA and Cavazzoni is the director of the FDA’s Center for Drug Evaluation and Research.

SAMHSA Announces Funding Opportunity for Cooperative Agreements for 988 Suicide and Crisis Lifeline Crisis Center Follow-Up Programs

SAMHSA has announced it anticipates funding a total of $5 million in 10 awards to expand efforts among 988 lifeline centers to support individuals in follow-up programs.
 
Specifically, the money would support individuals post-contact to provide continued support and linkages to decrease suicide risk by 1) ensuring the systematic follow-up of suicidal persons who contact the 988 suicide and crisis lifeline; 2) providing enhanced crisis stabilization coordination, crisis respite, mobile crisis outreach response services, and other services on the crisis continuum of care; 3) reducing unnecessary police engagement; and 4) improving connections for high-risk populations.
 
Click here to learn more.

SAMHSA Distributes Additional Grant Funding for Programs to Combat Overdose and SUD

Also this week, SAMHSA announced awards in four grant programs totaling nearly $11.3 million in additional funding to support the Biden administration’s ongoing efforts nationwide in prevention, treatment, recovery support, and harm reduction.
 
The four grant programs are Screening, Brief Intervention to Referral Treatment (SBIRT) (nearly $6.9 million); Grants to Prevent Prescription Drug/Opioid Overdose-Related Deaths ($2.6 million); Target Capacity to Expansion-Special Projects ($1.1 million); and Provider’s Clinical Support System to universities (more than $725,000).
 
Click here to learn more about the programs

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

Thank you to all members who have submitted data to NABH’s denial-of-care portal!
 
We are still seeking data from additional members to support advocacy on health plan denials and prior-authorization timeliness.
 
If you are a new participant, please e-mail NABH Administrative Coordinator Emily Wilkins for support.

Fact of the Week

The Centers for Disease Control and Prevention reports that overdose deaths increased by 279% for drug overdoses involving fentanyl during the five-year study period to 21.6 per 100,000 standard population in 2021 from 5.7 per 100,000 standard population in 2016.
 
For questions or comments about this CEO Update, please contact Jessica Zigmond.

Please Meet with NABH’s Exhibitors and Sponsors at the 2023 Annual Meeting Next Month!

NABH appreciates the generous support of our exhibitors and sponsors, whose valuable products and services help NABH members deliver quality behavioral healthcare every day to those who need it!

Please make time to visit our exhibitors and sponsors at the Annual Meeting from June 12-14 at the Salamander Washington, DC. Before then, you can view a complete list of our exhibitors and sponsors on our Annual Meeting homepage.

Also, please be sure to register for the Annual Meeting and reserve your hotel room today if you haven’t done so yet. We look forward to seeing you in Washington!

U.S. Labor Department Projects Five Mental Health Jobs Will Grow ‘Much Faster’ than Average from 2021-2031

The U.S. Labor Department’s (DOL) Bureau of Labor Statistics projects these five mental health-related careers will grow “much faster” than average between 2021-2031: mental health and substance abuse social workers; substance abuse, behavioral disorder, and mental health counselors; community health workers; healthcare social workers; and marriage and family therapists.

“Together, they employed about 761,000 workers in 2021 —and they are expected to have more than 91,000 openings on average each year through 2031,” DOL reported in its blog. “The education typically required to enter these occupations ranges from a high school diploma to a master’s degree, and they all pay around or more than the $46,310 median for all occupations in 2022.”

Click here to learn more about growth projection for each position.

CMS Releases Guide for Medicaid School-based Services

The Centers for Medicare & Medicaid Services (CMS) this week released a guide for Medicaid school-based services to make it easier for schools to deliver and receive payment for healthcare services to millions of eligible students.

CMS worked with the U.S. Department of Education to produce the Comprehensive Guide to Medicaid Services and Administrative Claiming, which is a result of the Bipartisan Safer Communities Act.

“With this guide, we are helping states and schools bring health care to kids where they are, rather than the other way around,” CMS Administrator Chiquita Brooks-LaSure said in a statement. “Children spend most of their waking hours in school. We also know that children have suffered serious declines in access to mental and behavioral healthcare services during the COVID-19 pandemic. We’re making it easier for states and schools to maximize Medicaid coverage to grow connections to care.”

Medicaid and CHIP cover more than half of all U.S. children, or more than 41 million children, according to CMS. The guide is intended to help states and schools leverage Medicaid and CHIP, and it maps out how they can build a bridge between education and healthcare, including mental healthcare, to support children enrolled in these programs and help them thrive.

House and Senate Committees Press Insurers for Information on Claims

Two congressional oversight committees this week pressed the nation’s insurers for information regarding denial of claims in one instance and denial of care in Medicare Advantage in the second.

Republicans from the House Energy and Commerce Committee sent a letter to Cigna President and CEO David Cordani asking for clarification after online news source ProPublica released an investigative report that suggested the insurance company’s physicians reject claims without reading them.

Meanwhile, the Senate Homeland Security & Governmental Affairs Committee Permanent Subcommittee on Investigations hosted a hearing about delays and denials of care in Medicare Advantage. That hearing follows an April 2022 report from the HHS Office of Inspector General that found Medicare Advantage insurers have denied some coverage or payment for services that would have been covered under traditional Medicare.

Federally Supported Study Finds More than Half of Physicians Ranked Stigma as Highest Barrier to Treating Patients for OUD

A University of Vermont study of more than 450 clinicians and counselors in rural New England found that more than half (55%) ranked stigma as the highest barrier to treating patients for opioid use disorder (OUD) among other factors that included time and staffing, medication diversion, and organizational/clinic barriers.

Meanwhile, 60% of physicians and 51% of counselors surveyed disagreed that medications for OUD “replace addiction to one kind of drug with another.” However, among clinicians with the ability to prescribe, there was considerable difference in this belief, depending on whether they were currently treating with medications for OUD, or MOUD.

“More than 80% of those currently treating with MOUD believed it is not an addiction replacement; among those not currently treating with OUD, fewer than half felt that way,” the Federal Office of Rural Health Policy (FORHP) announced. FORHP is part of HHS’ Health Resources and Services Administration and supports the Center on Rural Addiction at the University of Vermont, which conducted the study.

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

Thank you to all members who have submitted data to NABH’s denial-of-care portal!

We are still seeking data from additional members to support advocacy on health plan denials and prior-authorization timeliness. If you are a new participant, please e-mail NABH Administrative Coordinator Emily Wilkins for support.

Fact of the Week

The Centers for Disease Control and Prevention reports that more Black Americans died from fentanyl overdoses than from any other drug in 2021 and at far higher rates than whites or Hispanics.

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

NABH to Host Parity Panel with DOL Official Lisa Gomez and Former U.S. Rep. Patrick Kennedy on Tuesday, June 13

NABH President and CEO Shawn Coughlin will moderate a parity panel discussion with Lisa Gomez, assistant secretary for employee benefits security at the U.S. Labor Department, and former U.S. Rep. Patrick Kennedy (D-R.I.). on Tuesday, June 13, the second day of the 2023 Annual Meeting.

Before she was sworn in last October, Gomez was a partner with the law firm Cohen, Weiss and Simon LLP and chair of the firm’s management committee. She has deep technical and practical experience in the field of employee benefits law and spent almost three decades representing various Taft-Hartley and multiemployer pension and welfare plans, single employer plans, jointly administered training program trust funds, a federal employees health benefit plan, and other plans covering employees in a range of industries. Gomez earned her bachelor’s degree at Hofstra University and her law degree at Fordham.

Former Rep. Kennedy is the CEO of The Kennedy Forum, a not-for-profit he founded in 2013 to unite advocates, business leaders, and government agencies to advance evidence-based practices, policies, and programming mental health and addiction. During his time in Congress, Kennedy was the lead author of the Mental Health Parity and Addiction Equity Act. Kennedy is also the founder of Don’tDenyMe.org, an educational campaign that empowers consumers and providers to understand parity rights and connects them to essential appeals guidance and resources, and co-founder of One Mind, an organization that pushes for greater global investment in brain research.

The panel will begin at 9:30 a.m. ET in the Salamander’s Grand Ballroom and will discuss the landmark 2008 parity law and the work that remains to secure the law’s promise.

Please be sure to register for the Annual Meeting and reserve your hotel room today, if you haven’t done so yet. We look forward to seeing you in Washington!

CMS Coverage for PHP Telehealth Services Ends With COVID-19 PHE’s Conclusion

The Centers for Medicare & Medicaid Services (CMS) has shared with NABH and other stakeholders the agency’s plans to end telehealth coverage for partial hospitalization program (PHP) services implemented during the COVID-19 Public Health Emergency (PHE) when the PHE concluded at the end of Thursday, May 11.

In addition, CMS has explained that telehealth coverage will continue through December 2024 for Intensive Outpatient Program (IOP) services that qualify under the outpatient prospective payment system as “remote mental health services.”

NABH continues to communicate with key Members of Congress to clarify the legislative intent behind the telehealth coverage extensions that were authorized in the Consolidated Appropriations Act, 2023 last December. The NABH team understands that some Members of Congress intended for the telehealth coverage extension to include PHP services.

Given the persistent confusion on these matters, NABH has urged CMS to issue clarification in writing. NABH will keep members apprised of our efforts to extend telehealth coverage for PHP services.  

DEA Rule to Extend Telemedicine Flexibilities for Prescription of Controlled Substances Effective May 11

The U.S. Drug Enforcement Administration’s (DEA) temporary extension of COVID-19 telemedicine flexibilities for prescription of controlled medications took effect Thursday, May 11.

Under the DEA’s rule, the agency has extended the full set of telemedicine flexibilities adopted during the PHE for six months through Nov. 11, 2023. For any practitioner-patient telemedicine relationships that have been or will be established up to Nov. 11, 2023, the full set of telemedicine flexibilities regarding prescription of controlled medications established during the PHE will extend for one year through Nov. 11, 2024.

In a letter to DEA on March 31, NABH advocated to remove requirements for in-person medical examinations for Schedule II stimulant medications for ADHD and Schedule III-V mental health medications.

Please contact Sarah Wattenberg, NABH’s director of quality and addiction services, with questions or comments.

SAMHSA and FDA Officials Release Letter to Practitioners to Promote Medication First Model

Officials from the Substance Abuse and Mental Health Services Administration (SAMHSA) and the U.S. Food and Drug Administration (FDA) this week sent a letter to healthcare practitioners noting that although counseling and other services are important parts of treatment plans, they should not be prerequisites for receiving medication.

“An often-cited barrier to prescribing buprenorphine for the treatment of OUD is the perception that patients must engage in counseling and other services in order to start or continue receiving the medication,” wrote Miriam Delphin-Rittmon, Ph.D. and Patrizia Cavazzoni, M.D. “This letter serves to clarify the importance of counseling and other services as part of a comprehensive treatment plan, but to also reiterate that the provision of medication should not be made contingent upon participation in such services,” they added.

Delphin-Rittmon serves as the assistant secretary for mental health and substance use at SAMHSA and Cavazzoni is the director of the FDA’s Center for Drug Evaluation and Research.

SAMHSA Announces Funding Opportunity for Cooperative Agreements for 988 Suicide and Crisis Lifeline Crisis Center Follow-Up Programs

SAMHSA has announced it anticipates funding a total of $5 million in 10 awards to expand efforts among 988 lifeline centers to support individuals in follow-up programs.

Specifically, the money would support individuals post-contact to provide continued support and linkages to decrease suicide risk by 1) ensuring the systematic follow-up of suicidal persons who contact the 988 suicide and crisis lifeline; 2) providing enhanced crisis stabilization coordination, crisis respite, mobile crisis outreach response services, and other services on the crisis continuum of care; 3) reducing unnecessary police engagement; and 4) improving connections for high-risk populations.

Click here to learn more.

SAMHSA Distributes Additional Grant Funding for Programs to Combat Overdose and SUD

Also this week, SAMHSA announced awards in four grant programs totaling nearly $11.3 million in additional funding to support the Biden administration’s ongoing efforts nationwide in prevention, treatment, recovery support, and harm reduction.

The four grant programs are Screening, Brief Intervention to Referral Treatment (SBIRT) (nearly $6.9 million); Grants to Prevent Prescription Drug/Opioid Overdose-Related Deaths ($2.6 million); Target Capacity to Expansion-Special Projects ($1.1 million); and Provider’s Clinical Support System to universities (more than $725,000).

Click here to learn more about the programs

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

Thank you to all members who have submitted data to NABH’s denial-of-care portal!

We are still seeking data from additional members to support advocacy on health plan denials and prior-authorization timeliness.

If you are a new participant, please e-mail NABH Administrative Coordinator Emily Wilkins for support.

Fact of the Week

The Centers for Disease Control and Prevention reports that overdose deaths increased by 279% for drug overdoses involving fentanyl during the five-year study period to 21.6 per 100,000 standard population in 2021 from 5.7 per 100,000 standard population in 2016.

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

Hill Day Returns to NABH Annual Meeting Program!

NABH is excited to welcome its members and guests back to Hill Day during the 2023 Annual Meeting!

This year NABH is working with the firm Advocacy Associates to help schedule Capitol Hill meetings and briefings for interested Annual Meeting attendees during Hill Day on Tuesday, June 13 from 1:30 to 5 p.m. ET.

NABH will help prepare interested attendees by providing materials through a mobile app. To take advantage of this free opportunity, please indicate that you want to participate in Hill Day when you register for the 2023 Annual Meeting, or contact NABH Administrative Coordinator Emily Wilkins.

Please remember to reserve your hotel room at the Salamander Washington, DC, if you haven’t done so yet. We look forward to seeing you next month!

HHS Launches FindSupport.gov During First Week of Mental Health Awareness Month

HHS on Thursday launched FindSupport.gov, a website designed to help the public identify available resources, explore unbiased information about various treatment options, and learn how to find the support they need for problems related to mental health, drugs, or alcohol.

HHS’ Substance Abuse and Mental Health Services Administration (SAMHSA) and the Centers for Medicare & Medicaid Services (CMS) developed the concept for FindSupport.gov as a response to research that people were looking for an unbiased, trustworthy source of information to receive support for mental health and substance use issues. The department also developed a brief video to highlight the new website.

Also Thursday, HHS hosted its Support is Here to Strengthen Mental Health summit, where HHS Secretary Xavier Becerra said the Biden administration is saying to all who are struggling with mental health that support is here. “I am proud that we are changing the way mental health is viewed in this country because mental health is health, period.” Becerra tweeted.

The summit and new website coincide with the first week of Mental Health Awareness Month, which the United States has observed since 1949. The month-long observance is meant to fight stigma, provide support, educate the public, and advocate for policies that support the millions of Americans affected by mental illness.

Click here to learn more, and please remember to follow us @NABHbehavioral and on LinkedIn at the National Association for Behavioral Healthcare.

DEA Extends COVID-19 Telehealth Flexibilities for Prescription of Controlled Medications for Now

The U.S. Drug Enforcement Administration (DEA) on Wednesday said it will extend its COVID-19 telemedicine flexibilities for prescription of controlled medications as the agency works to determine how to move forward in a way that gives Americans access to needed medicine with the appropriate safeguards.

An announcement from DEA noted the agency received a record number of comments on its proposed telemedicine rules, which prompted DEA and the U.S. Health and Human Services Department (HHS) to submit a draft temporary rule to the Office of Management and Budget requesting an extension. NABH submitted comments on this matter (see CEO Update, April 28, 2023).

“Further details about the rule will become public after its full publication in the Federal Register,” the announcement said.

CMS’ Recent Proposed Rule Would Establish Network Adequacy Requirements and Payment Transparency in Medicaid MCOs

CMS’ recent Medicaid managed care proposed rule aims to strengthen standards for more timely access to care for Medicaid and Children’s Health Insurance Program (CHIP) managed care enrollees and establish new payment transparency requirements in fee-for-service and managed care programs.

As NABH reported in last week’s CEO Update, CMS is proposing to establish maximum appointment wait-time standards for outpatient mental health and substance use disorder—adult and pediatric—and other services, including routine primary care.

News reports offered details of a call that CHIP Services Director Daniel Tsai had with reporters, in which Tsai said, “The standards we established are what we call a national floor so a state is welcome to set a standard that is higher than that, [but] they must meet at least the standard that we outlined proposed in the proposed rule,” according to an article in Inside Health Policy, which noted the administration wants to align Medicaid wait-time standards with the two-week requirement for commercial plans.
 
The proposed rule would also require states to employ an independent company to conduct yearly “secret shopper surveys” that confirm a managed care plan is complying with appointment wait-time standards and the insurer’s provider directory is up-to-date.

Regarding payment rates, Tsai was reported as saying that, historically, CMS, advocates, and providers do not have a good way of understanding and benchmarking where Medicaid payment rates are across different state programs.

“So what we do propose is that every state has to make their base rates of payments transparently available and easily accessible, and every state has to benchmark their base rates for Medicaid relative to Medicare payment rates, which is a national standard that allows for
comparison and easy benchmarking across states,” Tsai said.

Joint Commission Seeks Feedback on Proposed Workplace Violence Prevention Requirements for BHC Program

The Joint Commission this week opened its field review to gather feedback from behavioral healthcare organizations about their experiences with workplace violence to help provide the most evidence-based and relevant requirements for its Behavioral Health Care and Human Services (BHC) accreditation program.

In its announcement, the Joint Commission said its field review will ask for comments on the potential new requirements and the larger context of how behavioral healthcare organizations are currently experiencing, preventing, and monitoring workplace violence.

The field review is open through June 9 and takes about 15 to 20 minutes to complete. Click here to complete the questionnaire.
 
HRSA Payment Program for Rural Health Clinic Buprenorphine-Trained Providers Still Active

HHS’ Health Services and Resources Administration (HRSA) has announced that Rural Health Clinics (RHCs) are still eligible to apply for a $3,000 payment on behalf of each provider trained to prescribe buprenorphine between Jan. 1, 2019 and Jan. 25, 2023.

SAMHSA announced in January 2023 that clinicians no longer need a DATA 2000 Waiver to prescribe buprenorphine; however, the payment program to defray earlier training cost is still active. Launched in 2021, the program pays for providers who previously trained for the waiver to prescribe buprenorphine.

HRSA said about $900,000 in program funding remains available for RHCs, which will be paid on a first-come, first-served basis until funds are exhausted. Send question to DATA2000WaiverPayments@hrsa.gov.

NIDA Study Finds Association Between Cannabis Use Disorder and Schizophrenia

A new National Institute of Drug Abuse (NIDA) study has found that young men between 21-30 years of age with a cannabis (marijuana) use disorder have an increased risk of developing schizophrenia.

The findings are notable because they emphasize that cannabis use disorder appears to be a major modifiable risk factor for schizophrenia at the population level. After evaluating more than 6 million people in Denmark for more than five decades, researchers estimated that the percentage of cases of schizophrenia that may have been avoided by preventing cannabis use disorder was as high as 30% among men aged 21-30; 15% among men aged 16-49; and 4% among women aged 16-49.

The study was a collaboration between authors at the Mental Health Services in the Capital Region of Denmark and NIDA at the National Institutes of Health.

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

Thank you to all members who have submitted data to NABH’s denial-of-care portal!

We still seek data from additional members to support advocacy on health plan denials and prior-authorization timeliness.

If you are a new participant, please e-mail NABH Administrative Coordinator Emily Wilkins for support.

Fact of the Week

A new study reports three in 10 Americans say they know someone affected by opioid addiction; within that group, more than half say they know someone who has died from opioid use.
 
For questions or comments about this CEO Update, please contact Jessica Zigmond.

NABH Pleased to Welcome HHS Secretary Xavier Becerra at 2023 Annual Meeting

U.S. Health and Human Services Department (HHS) Secretary Xavier Becerra, J.D. will address attendees at the 2023 NABH Annual Meeting on Monday, June 12 from 2:15 p.m. to 2:45 p.m.

Secretary Becerra is the 25th secretary of HHS and the first Latino in U.S. history to hold the office. Previously Secretary Becerra was California’s attorney general and before that served for 12 terms in the U.S. House of Representatives, where he was the first Latino to serve as a member of the powerful House Ways and Means Committee.

Secretary Becerra also served as chairman of his party’s caucus and as the ranking member of both the Ways and Means Subcommittee on Health and the Ways and Means Subcommittee on Social Security.

Born in Sacramento, Secretary Becerra is the son of working-class parents. He was the first in his family to receive a four-year degree, earning his bachelor’s degree in economics from Stanford University. He earned his law degree from Stanford Law School.

Please register for the Annual Meeting and reserve your hotel room today, if you haven’t done so yet. We look forward to seeing you in Washington!

CMS Releases FAQs About Transition Period Following End of Covid-19 PHE

The Centers for Medicare & Medicaid Services (CMS) has released a fact sheet of frequently asked questions to help providers prepare for the transition period after the Covid-19 public health emergency (PHE) ends on May 11.

Although certain waivers and flexibilities CMS granted during the pandemic are set to expire, others will be permanent or extended due to congressional action. For instance, the Consolidated Appropriations Act, 2023 extended many telehealth flexibilities through Dec. 31, 2024, including: people with Medicare can access telehealth services in any geographic area in the United States, rather than only those in rural areas; people with Medicare can stay in their homes for telehealth visits that Medicare pays for rather than traveling to a healthcare facility; and certain telehealth visits can be delivered audio-only (such as a telephone) if someone is unable to use both audio and video, such as a smartphone or computer.

The fact sheet also noted that Medicare Advantage plans may offer additional telehealth benefits and that individuals should check with their plan about coverage.

“For Medicaid and CHIP, telehealth flexibilities are not tied to the end of the PHE and have been offered by many state Medicaid programs long before the pandemic,” CMS noted in the fact sheet. “Coverage will ultimately vary by state. CMS encourages states to continue to cover Medicaid and CHIP services when they are delivered via telehealth.

DEA Requests Extension on Agency’s Final Rule on Telehealth Prescribing of Controlled Substances

The Drug Enforcement Administration (DEA) has asked the White House for an extension on the release of the DEA’s final rule on telehealth prescribing of controlled substances.

The extra time would permit telehealth services to continue under COVID-19 policies temporarily. NABH’s letter to DEA in late March was among the more than 18,000 comments that DEA received about telehealth services; the agency likely needs additional time to finalize the rule and avert disrupting current telehealth practices after the PHE ends on May 11.

CMS Releases Proposed Rules on Access and Quality in Medicaid & CHIP

CMS late Thursday released notices of proposed rulemaking (NPRMs)—Ensuring Access to Medicaid Services (Access NPRM) and Managed Care Access, Finance, and Quality (Managed Care NPRM) that NABH is reviewing.

To improve access to care, the Managed Care NPRM proposes to establish maximum appointment wait-time standards for outpatient mental health and substance use disorder—adult and pediatric—and other services, including routine primary care (also adult and pediatric).

CMS will accept comments on the proposed rules until Monday, July 3.

NIH Seeks to Expand Peer Reviewer Pool to Ensure Review Committees are Diverse and Inclusive

The National Institutes of Mental Health (NIMH) is seeking to expand its pool of peer reviewers with mental health researchers who can offer diverse perspectives in the peer-review process.

The NIMH peer-review process aims to make certain that scientific experts evaluate grant applications in a manner free from what the National Institutes of Health deems as inappropriate incidences. Peer reviewers provide feedback on the scientific merit of those applications.

Click here to learn more about eligibility requirements for peer reviewers and here to submit an application.

SAMHSA Announces Funding Opportunity to Promote Physical-Behavioral Healthcare Integration

The Substance Abuse and Mental Health Services Administration (SAMHSA) announced it will award a total of about $29 million in a new grant funding opportunity intended to integrate physical healthcare and behavioral healthcare.

The opportunity is not open directly to healthcare providers, but rather to the states. Specifically, states and state agencies—such as the state mental health authority, the single state agency for substance use services, the state’s Medicaid agency, and the state health department—are eligible to apply.

SAMHSA’s announcement said it anticipates awarding 14 grants and the length of the project is five years. Click here to learn more.

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

Thank you to all members who have submitted data to NABH’s denial-of-care portal!

We are still seeking data from additional members to support advocacy on health plan denials and prior authorization timelines. If you are a new participant, please e-mail NABH Administrative Coordinator Emily Wilkins for support.

Fact of the Week

A recent study in JAMA Psychiatry suggests that estimates of long-term exposure to multiple air pollutants were associated with increased risk of depression and anxiety. Researchers concluded that the non-linear associations may have important implications for policymaking in air pollution control. An article this week in Kaiser Health News also explored the connection between anxiety and pollution.
 
For questions or comments about this CEO Update, please contact Jessica Zigmond.

Former DOL Assistant Secretary for Employment and Training John Pallasch to Kick Off
2023 Annual Meeting

NABH is pleased to announce John Pallasch, former Senate-confirmed assistant secretary for employment and training at the U.S. Labor Department (DOL), will kick off the association’s 2023 Annual Meeting with his presentation on Monday, June 12 at the Salamander Washington, DC.
 
Currently Pallasch is the founder and CEO of One Workforce, a workforce consultancy in Aiken, S.C. He served previously as executive director of Kentucky’s Office of Employment and Training, and—in his first stint at DOL—as deputy assistant secretary in the department’s Mine Safety and Health Administration.
 
Pallasch has spent more than 20 years influencing organizational personnel, efficiency, and productivity in the public and private sectors. He will draw from those experiences to help NABH members think more critically about their workforce challenges and more creatively about how to solve them.
 
Pallasch graduated from Ohio State and later earned a law degree from Pepperdine University School of Law. Please help us welcome him in the Salamander’s Grand Ballroom on Monday, June 12 at 2:45 p.m. ET.
 
If you haven’t done so yet, please register for the Annual Meeting and reserve your hotel room today.  We look forward to seeing you in Washington!

CMS Final Rule Establishes Mental Health Facilities and SUD Treatment Centers as Essential Community Providers

In a final rule this week, the Centers for Medicare & Medicaid Services (CMS) expanded access to care for low-income and medically underserved communities by establishing two new essential community provider (ECP) categories for mental health facilities and SUD treatment centers.

The changes came in the Patient Protection and Affordable Care Act (ACA) notice of benefit and payment parameters (NBPP) for 2024. This annual notice administers policy changes for plans on the ACA exchanges and sets rates and risk-model specifications.

The decision to categorize mental health facilities and SUD treatment centers as ECPs is a win for NABH; in late January, NABH advocated for these ECP categories in its comment letter to CMS about the agency’s proposed NBPP rule for 2024.

“NABH strongly supports CMS’ proposal to expand its network adequacy criteria by creating two distinct essential community provider categories for mental health facilities and substance use disorder (SUD) treatment centers,” NABH President and CEO Shawn Coughlin wrote in the association’s letter. “To construct each county-level network, the rule would require insurers on the health exchanges to attempt to contract with at least one SUD Treatment Center and at least one Mental Health Facility.”

The final rule takes effect 60 days after it appears in the Federal Register.

CMS Announces Opportunities to Increase Care Access, Including SUD Treatment, for Incarcerated Individuals

CMS this week announced a new opportunity for states to help increase care for individuals who are incarcerated in the period immediately before their release to help them thrive as they re-enter communities.

The new Medicaid Reentry Section 1115 Demonstration Opportunity would allow state Medicaid programs to cover services that address various health concerns, including substance use disorders and other chronic health conditions.

In an announcement Monday, CMS Administrator Chiquita Brooks-LaSure said the agency reached a milestone in expanding access through Medicaid.

“This guidance outlines a pathway to implement historic changes for individuals who are incarcerated and eligible for Medicaid, she said. “By improving care and coordination prior to release from the justice system, we can help build a bridge back to the community and enhance individual and collective public health and public safety outcomes.”

Click here to read the letter from Daniel Tsai, deputy administrator and director at the Center for Medicaid and CHIP Services, to state Medicaid directors.

NIH Study Shows Prevalence of Stimulant Therapy for ADHD Associated with Higher Rates of Prescription Stimulant Misuse in Teens

Researchers have found a strong link between the prevalence of prescription stimulant therapy for attention-deficit/hyperactivity disorder (ADHD) and rates of prescription stimulant misuse—taken in a way other than directed by a clinician— by students in middle schools and high schools.

The study this week in JAMA Network Open emphasized the need for assessments and education in both schools and communities to prevent medication-sharing among teens.

“This is especially important considering non-medical use of prescription stimulants among teens remains more prevalent than misuse of any other prescription drug, including opioids and benzodiazepine,” NIH noted in a news release about the study.

The National Institutes of Health’s National Institute on Drug Abuse (NIDA) and the U.S. Food and Drug Administration supported the study, which used data between 2005 and 2020 by the Monitoring the Future (MTF) study. The MTF is a large, multicohort survey of legal and illicit drug use among American adolescents in eighth, 10^th, and 12^th grades. NIDA also funds the MTF.

Reminder: Public Comments on SAMHSA’s 2023-2026 Draft Strategic Plan Due April 27

The Substance Abuse and Mental Health Services Administration (SAMHSA) is seeking public comment on the agency’s draft 2023-2026 SAMHSA Strategic Plan that presents a person-centered mission and mission highlighting SAMHSA’s priorities and principles.

SAMHSA’s five priority areas include preventing overdose; enhancing access to suicide prevention and crisis care; promoting resilience and emotional health for children, youth, and families; integrating behavioral and physical healthcare; and strengthening the behavioral healthcare workforce. The agency’s four core principles are equity, trauma-informed approaches, recovery, and commitment to data and evidence.

Comments on the draft plan are due by 5 p.m. ET next Thursday, April 27. Click here to submit comments.

Reminder: 2023 NABH Exhibitor and Sponsor Guide Ad Deadline is Today, April 21

NABH will distribute the 2023 NABH Exhibitor and Sponsor Guide to all registrants at the 2023 NABH Annual Meeting from June 12-14, 2023 at the Salamander Washington, DC. Be sure your organization is included in it!
 
All ads are due today, Friday, April 21, 2023. Please click here for details about advertising options, requirements, payment, and more.

The association also will send the guide to all NABH members after the meeting and post it on the NABH Annual Meeting webpage.

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

Thank you to all members who have submitted data to NABH’s denial-of-care portal. Your data will help NABH highlight problems in the field related to health plan denials and timeliness.

Several policymaking entities are interested in these data, which could support advocacy for expanded access to care. For new participants, please e-mail Emily Wilkins, NABH’s administrative coordinator, for support.

Fact of the Week

The U.S. Drug Enforcement Administration’s (DEA) National Prescription Drug Take Back Day is tomorrow, Saturday, April 22. DEA reflects the agency’s commitment to health and safety, encouraging the public to remove unneeded medications from their homes as a measure of preventing medication misuse and opioid addiction from starting.
 
For questions or comments about this CEO Update, please contact Jessica Zigmond.

CMS Proposes 3% Increase in Payment Rates to Inpatient Psychiatric Facilities for 2024

The Centers for Medicare & Medicaid Services (CMS) is proposing to update Inpatient Psychiatric Facility Prospective Payment System (IPF PPS) payment rates by 1.9% in fiscal year (FY) 2024, or $55 million, relative to current rates.

This update includes a 3.2% market basket increase, a 0.2 percentage point productivity cut, and a 1.0% decrease to outlier payments.

Other notable components of the agency’s proposed IPF PPS rule this week include:

Proposed Modification to the Regulation on Excluded Units Paid Under the IPF PPS:

Responding to increased mental health needs—including the need for available inpatient psychiatric beds—CMS is proposing greater flexibility for hospitals to open and bill Medicare for a new IPF distinct part unit.

Specifically, beginning in FY 2024, CMS would allow hospitals to open a new unit at any time during the cost reporting period, with 30-day advance notice to the CMS regional office and Medicare administrative contractor.

An announcement about the proposed rule said “CMS believes this proposal would alleviate unnecessary burden and administrative complexity placed upon hospitals when opening new psychiatric units, helping to expand access to behavioral healthcare” in line with the agency’s behavioral healthcare strategy.

Proposed Updates to the IPFQR Program

The rule also proposes to adopt three quality measures focused on health equity for the IPFQR Program. First, beginning in FY 2026, a Facility Commitment to Health Equity measure would ask IPFs to attest to its efforts to address health equity across five domains: (1) Equity is a Strategic Priority; (2) Data Collection; (3) Data Analysis; (4) Quality Improvement; and (5) Leadership Engagement.

Second, a Screening for Social Drivers of Health (SDOH) measure would assess the percentage of patients over 17 who are screened for five specific health-related social needs (HRSNs) — food insecurity, housing instability, transportation needs, utility difficulties, and interpersonal safety. Voluntary reporting would begin in the calendar year 2025, with payments affected beginning in FY 2027.

Finally, CMS would adopt a Screen Positive Rate for SDOH measure beginning with voluntary reporting in CY 2024 and payment impact in FY 2027. This process measure assesses the percentage of patients who screen positive for each of the noted HRSNs in this quality measure.

Request for Information (RFI) to Inform the Revisions to the IPF PPS Required by the Consolidated Appropriations Act, 2023 (CAA, 2023):

Meanwhile, CMS noted in the rule that it has continued to analyze more recent IPF cost and claim information in an ongoing effort to refine the IPF PPS. In its FY 2023 IPF PPS proposed rule, CMS issued a technical report and sought comments on the results of the latest refinement analysis in preparation to propose IPF PPS patient-level and non-regression-derived refinements to be effective in FY 2024. Subsequently, new provisions in the CAA, 2023 require CMS to revise payments under the IPF PPS for Rate Year 2025 (or FY 2025 under the IPF PPS) as the U.S. Health and Human Services secretary determines appropriate.

Consequently, CMS has included a request for information (RFI) that will be used to inform future payment revisions.

Also in the proposed rule, CMS has addressed the specific types of data and information that the CAA, 2023 suggests CMS may collect, as well as soliciting comments on additional data and information that could be collected to inform future payment revisions.

CMS will accept public comments on the proposed rule through Monday, June 5.

Final Medicare Advantage Rule for 2024 Addresses Many NABH Priorities

Earlier this week, the Centers for Medicare & Medicaid Services (CMS) issued its contract year 2024 final rule related to the Medicare Advantage (MA) program, which addresses multiple, long-standing concerns of the NABH. In particular, we are pleased with the rule’s extensive improvements related to prior authorization, network adequacy, and quality of care, including measures that:

• Require MA plans to comply with the general coverage and benefit conditions of the Traditional Medicare program, along with national and local coverage determinations (LCD), and related regulations;
• Apply prior authorization approvals to a patient’s full course of treatment for medically reasonable and necessary care, as determined by the treating physician;
• Codify appointment wait time standards for behavioral healthcare and other services;
• Add a 10 percentage point credit to insurers’ network adequacy assessment for the inclusion of clinical psychologists and licensed clinical social workers;
• Exempt emergency behavioral health services from the prior authorization process;
• Require MA organizations to:
  • include behavioral health services in their care coordination programs;
  • base medical necessity determinations on the individual circumstances of a specific patient, rather than on a proprietary algorithm or software;
  • create a utilization management committee that annually reviews coverage policies to ensure that coverage is “no more restrictive than traditional Medicare coverage criteria;’ and
  • include in their advertisements a specific Medicare Advantage plan name and ban the use words or imagery that is “misleading, confusing, or misrepresents the plan.”
• Clarify that insurers may deny care using proprietary criteria, only if traditional Medicare coverage rules are not fully established and the in-house coverage standards are based on “current evidence in widely used treatment guidelines or clinical literature made publicly available to CMS, enrollees, and providers.”

Of concern, is CMS’ exclusion of providers of medication for opioid use disorder from its network adequacy criteria. This proposal was not finalized because the elimination of the x-waiver requirement for buprenorphine providers removed the data source necessary for CMS to track those providers.

The rule also explained that there are too few opioid treatment programs (OTPs) to establish access standards, and reminded MA organizations that they are required to include OTPs as part of their Part B coverage for OTP services or arrange out-of-network care at in-network cost sharing.

New Resource: ‘Using Contingency Management To Combat Stimulant Use Disorder’ Fact Sheet

NABH has produced Using Contingency Management To Combat Stimulant Use Disorder, a brief fact sheet that explains contingency management (CM) and highlights the association’s legislative request for Congress to direct federal agencies to replace the current $75 CM incentive payment limitation with scientifically proven incentive levels.

“Decades of research and peer-reviewed literature validate the effective use of CM, which uses positive reinforcement to encourage abstinence from stimulant use,” NABH’s fact sheet explains. “Positive behavior reinforcement takes the form of predictable and meaningful financial incentives, such as gift cards (with restricted purchase guidelines) or prizes, which can be earned only when specific ‘target behaviors’ are achieved, such as drug-free urine samples.”

The new resource is available on NABH’s homepage under “Latest Content” and also posted on NABH’s “Be an Advocate” page.

Reminder: Please Submit NABH’s Behavioral Health Information Technology Survey by April 12

NABH is seeking feedback from all system members about their experiences with behavioral health information technology as the association urges Congress and the Biden administration to extend incentives to behavioral healthcare organizations for adopting electronic health records.

Please submit this brief survey by Wednesday, April 12. Your responses will help NABH in its advocacy efforts to urge Congress and the Biden administration to extend these incentives to behavioral healthcare organizations.

Please e-mail Rochelle Archuleta if you have questions.

2023 Exhibitor and Sponsor Guide Advertising Deadline is Approaching!

NABH will distribute the 2023 NABH Exhibitor and Sponsor Guide to all registrants at the 2023 NABH Annual Meeting from June 12-14, 2023 at the Salamander Washington, DC. Be sure your organization is included in it!
 
All ads for the guide are due by April 21, 2023. Please click here for details about advertising options, requirements, payment, and more.

The association also will send the guide to all NABH members after the meeting and post it on the NABH Annual Meeting webpage.

2023 ExNABH Annual Meeting Hotel Cut-Off Date is May 11!hibitor and Sponsor Guide Advertising Deadline is Approaching!

Please reserve your hotel room today at the Salamander Washington, DC (formerly the Mandarin Oriental hotel) for the 2023 NABH Annual Meeting from June 12-14, 2023!

The hotel’s cut-off date is Thursday, May 11, 2023. And please visit our Annual Meeting webpage to register for the meeting, if you have not done so yet.

We look forward to seeing you in Washington!

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

Thank you to all members who have submitted data to NABH’s denial-of-care portal. Your data will help NABH highlight problems in the field related to health plan denials and timeliness.

Several policymaking entities are interested in these data, which could support advocacy for expanded access to care. For new participants, please e-mail Emily Wilkins, NABH’s administrative coordinator, for support.

Fact of the Week

A recent Health Affairs study found that the proportion of adult primary care visits that addressed mental health concerns increased to 15.9% by 2016 and 2018 from 10.7% of visits in 2006–07.
For questions or comments about this CEO Update, please contact Jessica Zigmond

NABH Releases 2023 Advocacy Priorities

NABH this week released its 2023 advocacy priorities, which reflect the association’s mission and outline the actions NABH will take to achieve its goals.

Categorized under the headings “Mental Health” and “The Addiction Crisis,” NABH’s 2023 advocacy priorities include securing the promise of parity; persuading lawmakers to provide incentives for behavioral healthcare providers to establish and implement a solid behavioral health information technology infrastructure; advocating Congress to repeal the Institutions for Mental Diseases (IMD) exclusion; pushing the Centers for Medicare & Medicaid Services to ensure payment rates provide adequate and appropriate reimbursement for opioid treatment program services; maintaining tele-behavioral healthcare services, and more.
 
Please review this document and share it with others. If you have questions, please contact nabh@nabh.org.

FDA Approves First Over-the-Counter Naloxone Spray

The U.S. Food and Drug Administration (FDA) on Tuesday approved Narcan, 4 mg. naloxone hydrochloride nasal spray for over-the-counter (OTC), non-prescription use, making it the first naloxone product approved to use without a prescription.

Naloxone is a medication that reverses the effects of opioid overdose rapidly and is the standard treatment for opioid overdose. The FDA’s action clears the way for this life-saving medication to be sold directly to consumers in drug stores, convenience stores, grocery stores, gas stations, and online.

The move comes at a time when the Centers for Disease Control and Prevention released provisional data earlier this month that showed 101,750 reported U.S. fatal overdoses in the 12-month period ending in October 2022, while the predicted number of fatal doses for that period is even higher at 107,669.

“As a physician, I have used Naloxone on people to reverse an opioid overdose hundreds of times and have witnessed firsthand its life-saving effects,” Rahul Gupta, M.D., director of the White House Office of National Drug Control Policy, said in a statement this week. “FDA’s announcement to make Narcan available over-the-counter is an important step to make this medicine accessible to more people at a time when the majority of overdose deaths are being driven by illicit opioids like fentanyl,” he added. “This move will also build on the progress made under the Biden-Harris administration to get more Naloxone into communities, expand access to treatment for substance use disorder, and reduce the supply of illicit drugs, which has resulted in a decline or flattening of overdose deaths for seven months in a row.”

According to the FDA, the manufacturer determines the timeline for availability and price of this OTC product. Click here to learn more.

SAMHSA Warns Providers and Grantees About Xylazine Risks

In a letter this week, the Substance Abuse and Mental Health Services Administration (SAMHSA) alerted providers to the risks of xylazine, a non-opioid agent increasingly found in combination with opioids such as fentanyl.

The letter said xylazine—which the FDA has not approved for use in humans—can cause
severe circulatory changes with devastating effects on human tissue, leading to painful open lesions, necrosis, and potentially limb loss.

“Practitioners must be aware of risks posed by xylazine and prepare to manage patients accordingly, Miriam Delphin-Rittmon, Ph.D., assistant secretary for mental health and substance use, wrote to providers. “SAMHSA’s goal with this alert is to provide information about the consequences of xylazine exposure, what practitioners can do to mitigate harm, and how SAMHSA is responding to this emerging public health challenge.”

Known as “tranq” or “tranq dope” in the illicit drug market, xylazine can cause drowsiness, lethargy, and, in rare instances, apnea and death.

SAMHSA encourages healthcare professionals and patients to report adverse events resulting from possible xylazine exposure to their local health department, poison center, or the American Association of Poison Control Centers at 1-800-222-1222. FDA’s MedWatch Adverse Event reporting may be completed online at www.fda.gov/medwatch.

SAMHSA Announces Three Recovery-Related Funding Opportunities

SAMHSA this week announced it will accept applications through May for three separate funding opportunities to implement and strengthen recovery services in communities.

The programs include the Treatment, Recovery, and Workforce Support grant to implement evidence-based programs to support individuals in substance use disorder (SUD) treatment and recovery to live independently and participate in the workforce; the Recovery Community Services Program-Statewide Network, intended to strengthen community-based recovery organizations, their statewide networks of recovery stakeholders, and specialty and general healthcare systems as key partners in delivering state and local recovery support services; and the Recovery Community Services Program, which would provide peer recovery support services to individuals with SUD or co-occurring substance use and mental disorders, including those in recovery from these disorders.

SAMHSA will accept applications for all three funding opportunities until May 30.

Reminder: SAMHSA Funding Opportunity to Establish or Implement Opioid Recovery Centers

SAMHSA has announced it will grant up to $1.4 million in two awards to establish or implement comprehensive treatment and recovery centers that provide a spectrum of treatment, harm reduction, and recovery support services to address America’s opioid crisis.

Applications are due Tuesday, May 16. Click here to learn more and apply.

Advertise in the 2023 NABH Exhibitor and Sponsor Guide!

NABH will distribute the 2023 NABH Exhibitor and Sponsor Guide to all registrants at the 2023 NABH Annual Meeting from June 12-14, 2023 at the Salamander Washington, DC. Be sure your organization is included in it!
 
All ads are due by April 21, 2023. Please click here for details about advertising options, requirements, payment, and more.

The association also will send the guide to all NABH members after the meeting and post it on the NABH Annual Meeting webpage.

Register and Reserve Your Hotel Room Today for the 2023 NABH Annual Meeting!

Please join us in Washington, DC from June 12-14, 2023 for this year’s NABH Annual Meeting at the Salamander Washington, DC (formerly the Mandarin Oriental hotel).

NABH’s theme this year is Securing the Promise of Parity, which recognizes the Mental Health Parity and Addiction Equity Act’s (MPAEA) 15^th anniversary and that we have more work to do to ensure the landmark law is implemented fully.

Our preliminary program will be available soon. Meanwhile, please visit our Annual Meeting homepage to register, reserve your hotel room, and view our Annual Meeting At-a-Glance.

We look forward to seeing you in Washington!

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

Thank you to all members who have submitted data to NABH’s denial-of-care portal. Your data will help NABH highlight problems in the field related to health plan denials and timeliness.

Several policymaking entities are interested in these data, which could support advocacy for expanded access to care. For new participants, please e-mail Emily Wilkins, NABH’s administrative coordinator, for support.

Fact of the Week

Between 2009 and 2019, the number of pediatric mental health hospitalizations increased by 25.8%, and these hospitalizations accounted for a significantly higher proportion of pediatric hospitalizations, according to a study published in JAMA this week.

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

NABH Responds to Senate HELP Committee RFI About U.S. Healthcare Workforce Shortage

NABH thanks its many members who submitted comments detailing their workforce challenges and potential solutions, which helped form the association’s response to the Senate Health, Education, Labor & Pensions (HELP) Committee’s request for information earlier this week.

In its six-page letter, NABH noted that America’s behavioral healthcare workforce shortage has reached a crisis point, with nearly 58 million adults reporting any mental illness, about 61 million people using illicit drugs, and more than 150 million people living in federally designated mental health professional shortage areas at a time when the U.S. psychiatrist workforce will contract through 2024 to a projected low of 38,821, equal to a shortage of between 14,280 and 31,091 psychiatrists.

A diminished candidate pool, a limited employee pipeline, workplace violence, employee satisfaction in a post-pandemic environment, a highly competitive workforce, over-regulation, and an extremely limited health information technology infrastructure were the leading drivers of the segment’s workforce shortage, the association noted, based on NABH system member responses. The letter then summarized a range of solutions under the categories of reimbursement at parity, additional funding for training programs, and deregulation.

NABH will discuss how to address the behavioral healthcare workforce shortage in two sessions at the 2023 NABH Annual Meeting on Monday, June 12.

NABH Addresses Federal Lawmakers’ Stigmatizing Comments about OTPs

NABH this week sent a letter to federal lawmakers expressing deep disappointment with the congressional leaders’ recent comments that compared the nation’s opioid treatment programs (OTPs) with drug cartels and characterized this behavioral healthcare segment as an industry protecting its profits.

“These comments are highly stigmatizing to the approximately 18,000 staff who work in OTPs and have dedicated their careers to delivering life-saving services to individuals with opioid use disorders (OUD),” NABH wrote in a letter to Rep. Donald Norcross (D-N.J.) and Sen. Edward Markey (D-Mass.) “Your comments also perpetuate the ongoing stigma against medication-assisted treatment (MAT) that plagues our society,” the letter continued. “This stigma is one of the primary reasons that people with OUD do not seek, nor receive, MAT, even though it is the evidence-based, gold standard of care for patients suffering from OUD. We are confident you both agree that with our nation facing an overdose epidemic with one death every five minutes, we cannot afford to lose ground in the battle against stigmatization in addiction care.”

The letter highlights strengths and weaknesses of recent regulatory reforms and current legislation. It also provides a series of recommendations for lawmakers, such as examining the effects of recent efforts to expand access, with a specific focus on understanding the root causes behind incremental overdoses as well as the disproportionate harm that marginalized populations suffer; addressing significant barriers to treatment; and studying the potential impact of leveraging community-based pharmacies in the United States to dispense methadone widely to patients while ensuring that adequate regulatory controls can be established, given the concerning behaviors by pharmacies that recent court proceedings have documented.

NABH Files Amicus Brief on Behalf of Nine Organizations in Wit v. UBH Ruling

NABH has filed an amicus brief that supports a petition for rehearing the ongoing Wit v. United Behavioral Health (UBH) case.

A three-judge panel in the 9^th U.S. Circuit Court of Appeals on Jan. 26 replaced its March 2022 ruling in the Wit v. UBH case with a new opinion that was a major disappointment to both mental health patients and providers.

NABH asserts the latest opinion will materially reduce the benefit of insurance because it does not protect medically necessary treatment based on generally accepted standards of care.

NIH Study Reveals Shared Genetic Markers Underlying SUD

Scientists have identified genes commonly inherited across addiction disorders, regardless of the substance used, according to a study published in Nature Mental Health.

With support from the National Institute on Drug Abuse, the National Institute on Alcohol and Alcoholism, the National Institute of Mental Health, the Eunice Kennedy Shriver National Institute of Child Health and Human Development, and the National Institute on Aging, researchers at Washington University in St. Louis, along with more than 150 coauthors worldwide, analyzed genomic data from more than 1 million people.

Their findings also reinforce the role of the dopamine system in addiction, by showing that the combination of genes underlying addiction disorders was also associated with regulation of dopamine signaling. Click here to learn more.

SAMHSA Announces Funding Opportunity to Establish or Implement Opioid Recovery Centers

The Substance Abuse and Mental Health Services Administration (SAMHSA) announced it will grant up to $1.4 million in two awards to establish or implement comprehensive treatment and recovery centers that provide a spectrum of treatment, harm reduction, and recovery support services to address America’s opioid crisis.

Applications are due Tuesday, May 16. Click here to learn more and apply.

Advertise in the 2023 NABH Exhibitor and Sponsor Guide!

NABH will distribute the 2023 NABH Exhibitor and Sponsor Guide to all registrants at the 2023 NABH Annual Meeting from June 12-14, 2023 at the Salamander Washington, DC. Be sure your organization is included in it!

All ads are due by April 21, 2023. Please click here for details about advertising options, requirements, payment, and more.

The association also will send the guide to all NABH members after the meeting and post it on the NABH Annual Meeting webpage.

Register and Reserve Your Hotel Room Today for the 2023 NABH Annual Meeting!

Please join us in Washington, DC from June 12-14, 2023 for this year’s NABH Annual Meeting at the Salamander Washington, DC (formerly the Mandarin Oriental hotel).

NABH’s theme this year is Securing the Promise of Parity, which recognizes the Mental Health Parity and Addiction Equity Act’s (MPAEA) 15^th anniversary and that we have more work to do to ensure the landmark law is implemented fully.

Please visit our Annual Meeting homepage to register, reserve your hotel room, and view our Annual Meeting At-a-Glance.

We look forward to seeing you in Washington!

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

Thank you to all members who have submitted data to NABH’s denial-of-care portal. Your data will help NABH highlight problems in the field related to health plan denials and timeliness.

Several policymaking entities are interested in these data, which could support advocacy for expanded access to care. For new participants, please e-mail Emily Wilkins, NABH’s administrative coordinator, for support.

Fact of the Week

The National Alliance on Mental Illness (NAMI) reports that research shows the effects of solitary confinement on mental health are often fatal, both during and after incarceration. A recent showed individuals were overall 24% more likely to die in the first year after release, including from suicide (78% more likely) and homicide (54% more likely). They were also 127% more likely to die of an opioid overdose in the first two weeks after release.

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

NABH Remembers Former Board Member Frank Fortunati, Jr., J.D., M.D.

NABH remembers with grateful appreciation Frank Fortunati, Jr., J.D., M.D., 58, who died March 5 after a protracted, courageous battle against prostate cancer.

A psychiatrist, attorney, and pharmacist, Fortunati had served as assistant professor of psychiatry and deputy chair for Yale-New Haven Health System. Since 2016, he was the vice chief and medical director of psychiatry and behavioral health for Yale-New Haven Hospital, where he was also active in the department’s COVID Healthcare Worker Support Task Force and Anti-racism Task Force.

Referred to as a true Renaissance Man, Fortunati was an accomplished musician who played saxophone, guitar, piano, and flute. His obituary noted that one of his great joys was performing with his friends and fellow psychiatrists in their band “Schedule II.” In the car, he enjoyed listening to jazz or classic Rock. He was also an avid gardener, spending hours growing and harvesting tomatoes, peppers, eggplants, grapes, and figs.
 
Fortunati served as a member of the NABH Board of Trustees from 2018-2020 and was also an engaged member of NABH’s Quality Committee, Workplace Violence Prevention Workgroup, and COVID-19 Task Force. His fellow board members and the Washington-based NABH team will remember how he always listened well and offered thoughtful, practical solutions to any topic—and proposed solutions that made life better for patients and the healthcare teams who cared for them.

“Fortunati led by example, often serving in multiple roles (vice chief, section head, inpatient medical director),” the Yale School of Medicine wrote in an announcement about his death. “He earned the respect of everyone who worked with him. His credibility enabled him to drive change and improve quality. He put others ahead of his personal needs, repeatedly declining to complete the paperwork necessary for his own promotion in the service of looking out for others.”

Fortunati is survived by his wife, Karen; children Jenna and Frankie; other family members; and the Fortunati family’s three cherished dogs. Funeral services were held at Saint Mary Church (Precious Blood Parish) in Milford, Conn. on March 11.

NABH Raises Information System Limitations and Prior Authorization Concerns with CMS

NABH this week submitted comments to the Centers for Medicare & Medicaid Services (CMS) about the agency’s electronic prior authorization proposed rule as it pertains to behavioral healthcare patients and providers.

Under the direction of the NABH Managed Care Committee, the association raised concerns that the current limitations of the behavioral healthcare sector’s information system infrastructure are such that, without federal investment in compliant information technology to enable behavioral healthcare connectivity, most behavioral healthcare providers will remain shut out of 1) the interoperable exchange of patient health information, and 2) the electronic prior authorization processes that the rule proposes.

NABH’s letter also strongly supports modifying existing regulation to treat prior authorization approvals as a promise of payment that cannot be retracted, in addition to a determination of whether an item or service is medically necessary.

NABH Opposes Proposed FTC Ban on Non-Compete Clauses

In comments submitted today, NABH asked the Federal Trade Commission (FTC) to withdraw its proposed rule that would ban non-compete clauses.

NABH’s opposition to this proposal was based on three distinct concerns: the rule proposes an overly simplified, one-size-fits-all approach for all employees across all industries; given the workforce disruptions related to the COVID-19 pandemic, now is not the time to upend the healthcare labor markets; and, finally, the FTC lacks the statutory authority to promulgate this wide-reaching regulation.

Members of Congress Request Telehealth Parity Guidance from DOL

A bipartisan group of Members of Congress have sent a letter to the U.S. Labor Department (DOL) urging the department to provide guidance regarding parity enforcement for mental health and substance use disorder (SUD) services delivered via telehealth.

In the letter, House members expressed concern that health plans may be less motivated to cover behavioral healthcare telehealth services after the COVID-19 public health emergency is scheduled to end on May 11.

“Since the onset of the pandemic, telehealth use has risen dramatically, with 41% of MH/SUD care delivered via telehealth by October 2020,” the letter noted. “Mental health conditions continue to be the top claims diagnosis in the commercial market rising from 30% in January 2020 to roughly 65% in November 2022,” it continued. “Given the immense need for MH/SUD services combined with acute behavioral health workforce shortages, we want to ensure insurance plans and issuers understand their responsibility under federal parity law as it relates to behavioral health services delivered via telehealth.”

Click here to read the full letter.

SAMHSA Announces National Strategy for Suicide Prevention Funding Opportunity

The Substance Abuse and Mental Health Services Administration (SAMHSA) this week announced it will grant five awards totaling $2 million to implement suicide prevention and intervention programs for adults that help implement the 2021 Surgeon General’s Call to Action to Implement the National Strategy for Suicide Prevention.
 
With an emphasis on older adults, adults in rural areas, and American Indian and Alaskan native adults, the program is meant to address the Call to Action’s broad-based public health approach to suicide prevention through enhancing collaboration among stakeholders such as county health departments, workplace settings, criminal justice setting, senior-serving organizations, and community firearm stakeholders.

Applications are due Monday, May 15. Click here for more information.

Advertise in the 2023 NABH Exhibitor and Sponsor Guide! 

NABH will distribute the 2023 NABH Exhibitor and Sponsor Guide to all registrants at the 2023 NABH Annual Meeting from June 12-14, 2023 at the Salamander Washington, DC. Be sure your organization is included in it!

All ads are due by April 21, 2023. Please click here for details about advertising options, requirements, payment, and more.

The association also will send the guide to all NABH members after the meeting and post it on the NABH Annual Meeting webpage.

Registration is Open for the 2023 NABH Annual Meeting: Securing the Promise of Parity!

Please join us in Washington, DC from June 12-14, 2023 for this year’s NABH Annual Meeting at the Salamander Washington, DC (formerly the Mandarin Oriental hotel).

NABH’s theme this year is Securing the Promise of Parity, which recognizes the Mental Health Parity and Addiction Equity Act’s (MPAEA) 15^th anniversary and that we have more work to do to ensure the landmark law is implemented fully.

Please visit our Annual Meeting homepage to register, reserve your hotel room, and view our Annual Meeting At-a-Glance.

We look forward to seeing you in Washington!

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

Thank you to all members who have submitted data to NABH’s denial-of-care portal. Your data will help NABH highlight problems in the field related to health plan denials and timeliness.

Several policymaking entities are interested in these data, which could support advocacy for expanded access to care. For new participants, please e-mail Emily Wilkins, NABH’s administrative coordinator, for support.

Fact of the Week

Black and Hispanic adults with co-occurring disorders were less likely to receive mental health or substance use treatment (47% and 43%, respectively) than White adults (64%), according to research from The Pew Charitable Trusts. 

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

President Biden’s FY 2024 Budget Proposal Includes Strong Focus on Behavioral Healthcare Needs

Yesterday, President Biden issued his Fiscal Year 2024 budget proposal, which now goes to Congress for consideration. Key provisions include:
 
Elimination of the 190-day Lifetime Limit on Psychiatric Hospital Services. The proposed budget would rescind the current law limiting Medicare enrollees to a lifetime limit of 190-days inpatient psychiatric care. The purpose of this provision is to increase access to hospital-level care and advance parity between mental health and physical health coverage for patients with serious mental illness. The budget estimates that this item would generate a $2.4 billion cost to Medicare over 10 years.

Greater Psychiatric Hospital Flexibility when Restoring Compliance with Conditions of Participation. In cases where a psychiatric hospital is non-compliant with the Medicare conditions of participation for a deficiency that does not jeopardize patient health and well-being, the proposed budget would give CMS flexibility to continue issuing Medicare payments if the facility is actively working to correct the deficiency, rather than terminate Medicare participation.

Workforce. The proposed budget also includes a $2 billion mandatory Mental Health System Transformation Fund for workforce development and service expansion. In part, this workforce development effort would augment FY 2023 funding already enacted in law to train about 18,000 behavioral health providers— including clinicians, peer support specialists, and others—and increase the number of providers practicing in areas of high demand throughout the country.

Parity. The proposed budget would apply to Medicare Advantage the 2008 Mental Health Parity and Addiction Equity Act, requiring health plans to offer mental health and substance use disorder benefits that are no more restrictive than the medical and surgical benefits they offer. It also requires health plans to use medical necessity criteria for behavioral health developed by nonprofit medical specialty associations, as well as regulation of behavioral health network adequacy, and the creation of a standard for parity in reimbursement. The budget estimates a $760 million cost over 10 years for these parity items.

Learn more about the Biden administration’s FY 2024 budget proposal here.

Study Shows Opioids Cause Half of All Poisonings in U.S. Kids Aged 5 and Under

About 52% of poisoning deaths of U.S. children aged 5 and under in 2018 involved the ingestion of an opioid, according to a study published online this week in the journal Pediatrics.

Researchers also found that opioids accounted for a progressively greater proportion of the substances contributing to poisoning-related deaths during the study period, from 24% in 2005 to 52% in 2018.
 
“As the types of opioids circulating during the current epidemic continue to evolve, policy and programmatic initiatives should focus on children in addition to adults,” the study’s authors wrote.  “Regulatory changes have improved the safety of OTC medications, but a substantial proportion of pediatric fatalities are still associated with this medication class.”

Thank You to Members Who Submitted Comments on Workforce Challenges & Solutions

NABH thanks all members who responded to our request for feedback about their system’s most critical workforce challenges and potential solutions.

The NABH Research and Education Foundation is seeking comments in these two areas to help NABH respond to a request for information (RFI) that the Senate Health, Education, Labor & Pensions (HELP) Committee announced last week. The RFI follows a Feb. 16 hearing the Senate HELP Committee held to examine the root causes of America’s current healthcare workforce shortages and explore potential solutions.
 
If you haven’t sent comments and would like to contribute, please send your feedback as an attachment to foundation@nabh.org by the close of business on Monday, March 13.

Registration is Open for the 2023 NABH Annual Meeting: Securing the Promise of Parity!

Please join us in Washington, DC from June 12-14, 2023 for this year’s NABH Annual Meeting at the Salamander Washington, DC (formerly the Mandarin Oriental hotel).

NABH’s theme this year is Securing the Promise of Parity, which recognizes the Mental Health Parity and Addiction Equity Act’s (MPAEA) 15^th anniversary and that we have more work to do to ensure the landmark law is implemented fully.

Please visit our Annual Meeting homepage to register, reserve your hotel room, and view our Annual Meeting At-a-Glance.

We look forward to seeing you in Washington!

Manatt Telehealth Webinar Recording Now Available

NABH thanks its members who helped the NABH Education and Research Foundation and Manatt produce a joint issue brief, Telehealth is Effectively Augmenting Traditional Partial Hospitalization and Intensive Outpatient Programs last month.

In case you missed it, Manatt led a webinar on March 1 that highlighted the telehealth issue brief’s findings. Click here to submit a brief form to watch the recorded webinar.

NABH is grateful to Abhi Pardeshi from UHS, Dylan Ross from Rogers Behavioral Health, and T.J. Vlavianos from Northwell Health’s Zucker Hillside Hospital for joining NABH President and CEO Shawn Coughlin as the webinar’s panelists.

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

Thank you to all members who have submitted data to NABH’s denial-of-care portal. Your data will help NABH highlight problems in the field related to health plan denials and timeliness.

Several policymaking entities are interested in these data, which could support advocacy for expanded access to care. For new participants, please e-mail Emily Wilkins, NABH’s administrative coordinator, for support.

Fact of the Week

Males make up 25% of people with anorexia. Because they are often diagnosed later than females, they are at higher risk of dying, according to the Center for Discovery.

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

Registration is Open for the 2023 NABH Annual Meeting: Securing the Promise of Parity!

Please join us in Washington, DC from June 12-14, 2023 for this year’s NABH Annual Meeting at the Salamander Washington, DC (formerly the Mandarin Oriental hotel).

NABH’s theme this year is Securing the Promise of Parity, which recognizes the Mental Health Parity and Addiction Equity Act’s (MPAEA) 15^th anniversary and that we have more work to do to ensure the landmark law is implemented fully.

Please visit our Annual Meeting homepage to register, reserve your hotel room, and view our Annual Meeting At-a-Glance.

We look forward to seeing you in Washington!

Please Send Us Your Feedback on Workforce Challenges & Solutions

The NABH Research and Education Foundation is seeking comments from NABH members on 1) the main drivers of your system’s workforce shortages, and 2) your ideas for solutions.

NABH will gather this collective feedback and respond to the request for information (RFI) that the Senate Health, Education, Labor & Pensions (HELP) Committee announced thursday.

The RFI follows a Feb. 16 hearing the Senate HELP Committee held to examine the root causes of America’s current healthcare workforce shortages and explore potential solutions.

Please send your comments as an attachment to foundation@nabh.org by the close of business on Monday, March 13.

Thank you for your help with this critical issue!

DEA Proposes Two Telemedicine Regulations

The Drug Enforcement Administration (DEA) recently published two telemedicine rules that, taken together, largely revert to pre-COVID requirements for an in-person medical evaluation prior to prescribing controlled substances.

DEA’s Notices of Proposed Rulemaking (NPRM) for buprenorphine and telemedicine without an in-person medical evaluation propose permitting the following two scenarios under which a telemedicine prescription can take place:

Scenario A: Permitting a virtual first prescription by the prescribing practitioner without an in-person medical evaluation for an initial 30-days of non-narcotic Schedule III-V or buprenorphine-controlled substances. The NPRM proposes specific processes and documentation requirements for this scenario, such as checking the PDMP and noting ‘telemedicine’ on the face of the prescription.

Scenario B: Permitting a qualified telemedicine referral in which a second DEA-registered practitioner performs an in-person exam and makes a referral to the prescribing practitioner. Under this scenario, Schedule II-V and narcotic substances can be prescribed. The NPRM proposes processes and documentation for these referrals, such as a written referral and transfer of medical records prior to prescribing.

To continue prescribing after 30-days under Scenario A, a one-time in-person medical evaluation is required. The in-person evaluation requirement can be satisfied in three ways:

• Through an evaluation by the telemedicine prescribing practitioner;

• Through an evaluation conducted as a three-way audio-visual exam in which the prescribing practitioner, another DEA-registered referring provider, and the patient participate;

• Through a ‘qualified telemedicine referral’ by another DEA-registered practitioner who has seen the patient in-person and who adheres to specific procedures and documentation for the referral.

Meanwhile, if a telemedicine prescription for a controlled substance was initiated during the public health emergency (PHE), the NPRM proposes a 180-day transition period during which time an in-person medical evaluation must take place. If the NPRM is finalized by May 11, 2023 (the designated end of the PHE), an individual inducted during the PHE would have to have an in-person medical evaluation by November 2023. This extends to all prescriptions for controlled substances II-V initiated during the PHE.

The NPRM do not include the long-awaited special registration rule, which would have allowed certain clinicians to prescribe controlled substances via telemedicine without an in-person evaluation. Moreover, DEA said this NPRM satisfies its obligation to propose rules for a special registration.

In addition, the revisions align with the Centers for Medicare & Medicaid Services’ updated definition of telehealth to include audio-only telemedicine of controlled substances for mental health where states permit it. These instances are both limited and situational.

NABH will provide comments to DEA by the agency’s March 31 deadline. Please send any comments to Sarah Wattenberg at sarah@nabh.org by Friday, March 17.

SAMHSA Releases Report on Long COVID’s Effects on Behavioral Health

A meta-analysis of studies around the world showed that the overall prevalence of depression, anxiety, and sleep disturbances among COVID-19 survivors was 45%, 47%, and 34%, respectively, according to a report released this week from the Substance Abuse and Mental Health Services Administration (SAMHSA).

The Centers for Disease Control and Prevention (CDC) defines Long COVID as “new, returning, or ongoing symptoms that last four or more weeks following acute COVID-19 diagnosis.”

SAMHSA’s report, Overview of the Impacts of Long COVID on Behavioral Health, examines the effects of the deadly virus in a variety of areas, including cognitive and psychiatric symptoms associated with Long COVID, a widening of health disparity gaps, potential long-term implications, and future directions for Long COVID recovery.

“Among the most common symptoms of Long COVID is a gradient of cognitive and psychiatric sequelae (e.g., depression, anxiety, PTSD), which may portend significant consequences for patient functioning and quality of life,” the report noted.

The study also said that in comparison with those not affected, COVID-19 survivors show increased rates of mental health and cognitive problems.

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

Thank you to all members who have submitted data to NABH’s denial-of-care portal. Your data will help NABH highlight problems in the field related to health plan denials and timeliness.

Several policymaking entities are interested in these data, which could support advocacy for expanded access to care. For new participants, please e-mail Emily Wilkins, NABH’s administrative coordinator, for support.

Fact of the Week

Research has shown that, regardless of COVID-19 status, 53% of healthcare workers reported symptoms of at least one mental health condition, including depression (32%), anxiety (30%), PTSD (37%), and suicidal ideation (8%), according to SAMHSA’s Overview of the Impacts of Long COVID on Behavioral Health.

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

Registration is Open for the 2023 NABH Annual Meeting: Securing the Promise of Parity!

Please plan to join us in Washington, DC from June 12-14, 2023 for this year’s NABH Annual Meeting at the Salamander Washington, DC (formerly the Mandarin Oriental hotel).

NABH’s theme this year is Securing the Promise of Parity, which recognizes the Mental Health Parity and Addiction Equity Act’s (MPAEA) 15^th anniversary and that we have more work to do to ensure the landmark law is implemented fully.

Please visit our Annual Meeting homepage to register, reserve your hotel room, and view our Annual Meeting At-a-Glance.

We look forward to seeing you in Washington!

Reminder: NABH-Manatt Telehealth Issue Brief Webinar on Wednesday, March 1

Manatt will host a webinar featuring NABH President and CEO Shawn Coughlin and NABH members as panelists on Wednesday, March 1 at noon ET to highlight findings from the telehealth issue brief that the NABH Education and Research Foundation and Manatt released this month.

The telehealth issue brief is the first resource from the NABH Education and Research Foundation, which worked with NABH members and Manatt to compile and evaluate data to measure the impact that telehealth services have had on access and outcomes. The study showed how telehealth services effectively augment traditional partial hospitalization programs (PHP) and intensive outpatient programs (IOP).

NABH urges its members to read the issue brief and share it with others. The association has also created a social media toolkit with shareable graphics that highlight key research from the study. Members can access the issue brief and social media toolkit on the NABH Education and Research Foundation’s Resources page.

Click here to register for next week’s free webinar.

Biden Administration Will Allow States to Use Medicaid to Cover SUD for Incarcerated Persons

The Biden administration will allow states to use Medicaid funding to cover substance use disorder (SUD) treatment for incarcerated persons at state jails and prisons, news outlets reported this week.

According to Politico, Rahul Gupta, M.D., director of the Office of National Drug Control Policy, said Tuesday that the Centers for Medicare & Medicaid Services (CMS) plans to release guidance this spring that outlines how states could use the program and federal dollars to pay for treatments before people are released.

The story also quoted Gupta as saying the guidance is a “smart move” and that all 112 of the nation’s federal prisons will offer medication-assisted treatment for SUD by this summer.

NIH Trial to Compare Effects of Prescribed Buprenorphine or Methadone in Office Settings

The National Institutes of Health (NIH) will conduct a hybrid effectiveness/implementation trial to compare patients’ ability to remain in treatment when they’re prescribed buprenorphine or methadone in an office-based setting, STAT News reported today.

According to the story, the clinical trial, scheduled for this year, is the first of its kind in the “fentanyl era.”

“While we do have hints from the scientific literature that methadone has better outcomes with respect to retention in treatment and decreases in illicit drug use, we actually don’t have that literature in patients who are primarily using fentanyl,” David Fiellin, M.D., director of Yale Medical School’s Program in Addiction Medicine and the researcher overseeing the trial, said in the story.

Click here for details about the NIH study.

CMS Releases Preliminary Medicaid and CHIP Data Snapshot

CMS this week released Medicaid and CHIP and the Covid-19 Public Health Emergency, a data snapshot that compares healthcare service utilization patterns, including behavioral healthcare services, in Medicaid and the Children’s Health Insurance Program (CHIP) during the Covid-19 pandemic from March 2020 through July 2022.

Section five of the report presents the behavioral healthcare content, including services delivered via telehealth and a breakdown of services for adults and children enrolled in these programs.

More than 137 million Americans—including children, pregnant women, parents, seniors, and individuals with disabilities—were enrolled across each state’s Medicaid or CHIP for at least one day during the public health emergency.

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

Thank you to all members who have submitted data to NABH’s denial-of-care portal. Your data will help NABH highlight problems in the field related to health plan denials and timeliness.

Several policymaking entities are interested in these data, which could support advocacy for expanded access to care. For new participants, please e-mail Emily Wilkins, NABH’s administrative coordinator, for support.

Fact of the Week

Black patients are 1.6 times more likely to experience an involuntary psychiatric hospital admission than non-Black patients, according to a study about racial and ethnic inequities published in Psychiatric Services.
 
For questions or comments about this CEO Update, please contact Jessica Zigmond.

FDA Advisors Recommend Over-the-Counter Use of Narcan

A U.S. Food and Drug Administration (FDA) advisory panel this week voted 19-0 to recommend the agency approve the anti-opioid overdose drug Narcan be made available as an over-the-counter drug.

Narcan is currently available by prescription only, and the change would make it the first opioid overdose reversal drug to be made available over the counter. News reports noted the FDA advisors also asked that the manufacturer make it more clear to users how to administer the product.

The FDA is expected to make a final decision by March 29.

CDC Releases Youth Risk Behavior Survey Data Summary & Trends Report: 2011-2021

Female students were nearly twice as likely to attempt suicide during the past year compared with their male peers, with nearly six in 10 feeling persistently sad or hopeless and more than one in 10 attempting suicide, the Centers for Disease Control and Prevention (CDC) reported in its Youth Risk Behavior Survey Data Summary & Trends Report: 2011-2021 this week.

The data provide a critical view of U.S. adolescent health and well-being related to sexual behavior, substance use, experiences of violence, mental health, and suicidal thoughts and behaviors. This year’s report also includes data on students’ experiences of unstable housing, school connectedness, and parental monitoring to expand understanding of young people’s environments and opportunities to improve them.

In the CDC’s words, the findings “tell a distressing story” about the health and well-being of our country’s young people. According to the report, female students experienced more violence, mental health challenges, suicidal thoughts and behaviors, and substance use than their male peers. For instance, the percentage of female students who had ever experienced forced sex increased for the first time in 10 years, with 14% of female students having this experience.

Meanwhile, attempted suicide was higher among Black students than students from other groups and increased among Black and White students from 2011 to 2021. And LGBQ+ students were nearly four times as likely as their heterosexual peers to attempt suicide during the past year, with more than two in 10 reporting this experience.

CDC Provisional Data Show U.S. Drug Overdose Deaths High but Declining

Provisional data from the CDC this week show the number of U.S. drug overdose deaths, while still high, has declined.

The CDC predicts there were 106,840 drug overdose deaths for the 12-month period ended September 2022 compared with 107,937 predicted drug overdose deaths for the 12-month period ended August 2021. And when comparing month-over-month statistics in 2022, the numbers show a steady decline, starting with 110,317 predicted overdose deaths in March 2022.

In a statement last month, Office of National Drug Control Policy (ONDCP) Director Rahul Gupta, M.D. attributed the progress to the Biden administration’s efforts to remove barriers to treatment and disrupting the supply of illicit drugs.

SAMHSA Releases National Substance Use and Mental Health Services Survey, 2021

More than two-thirds of substance use treatment facilities (69.5%) offered pharmacotherapies as part of their treatment services, with a higher percentage of substance use facilities reporting they used medication-assisted treatment (MAT) for treating opioid use disorder (55.3%) than for treating alcohol use disorder (37.9%).

Those were among the findings of the Substance Abuse and Mental Health Services Administration’s (SAMHSA) National Substance Use and Mental Health Services Survey, 2021 released this week.
 
Researchers gathered data from April 30, 2021 through January 10, 2022 for the 35-page report, which is the most comprehensive national source of data on substance use and mental health treatment facilities, its territories, and Washington, D.C.

NABH Submits Comments to SAMHSA on Opioid Treatment Program Regulations

This week NABH submitted a comment letter to SAMHSA on the Opioid Treatment Program (OTP) regulations 42 CFR part 8.

In it, NABH wrote that the association appreciates SAMHSA’s flexibility to OTPs, including new authority to provide methadone induction via telehealth. NABH was the first organization to advocate for this change when COVID-19 social-distancing measures made it hard for individuals to access methadone treatment.

NABH expressed concerns and called for SAMHSA to remove changes to accreditation standards that would prematurely trigger one-year or non-accreditation status.

Click here to read NABH’s letter.

NABH Submits Comments to CMS on Medicare Advantage

Also this week, NABH submitted comments to the Centers for Medicare & Medicaid Services (CMS) about policy and technical changes to Medicare Advantage (MA) for calendar year 2024.

NABH noted that the association appreciates the proposed rule’s focus on improving access to and quality of care through increasing both the oversight and transparency of insurers. In particular, NABH supports the rule’s proposed improvements related to prior authorization, network adequacy, and quality of care, many of which NABH and its partners have long pursued.

The association outlined a series of recommendations to CMS on topics such as clarifying “Original Medicare” standards as minimum requirements for MA; improving medical necessity; streamlining prior authorization requirements; and, regarding the rule’s proposed reduction of the overpayment window, allowing a reasonable time of about six months for providers to conduct investigations, and, when necessary, process a refund.

Click here to read NABH’s letter.

Reminder: NABH-Manatt Telehealth Issue Brief Webinar on Wednesday, March 1

Manatt will host a webinar featuring NABH President and CEO Shawn Coughlin and some NABH members as panelists on Wednesday, March 1 at noon ET to highlight findings from the telehealth issue brief that the NABH Education and Research Foundation and Manatt released this month.

The telehealth issue brief is the first resource from the NABH Education and Research Foundation, which worked with NABH members and Manatt to compile and evaluate data to measure the impact that telehealth services have had on access and outcomes. The study showed how telehealth services effectively augment traditional partial hospitalization programs (PHP) and intensive outpatient programs (IOP).

NABH urges its members to read the issue brief and share it with others. The association has also created a social media toolkit with shareable graphics that highlight key research from the study. Members can access the issue brief and social media toolkit on the NABH Education and Research Foundation’s Resources page.

Click here to register for next month’s free webinar.

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

Thank you to all members who have submitted data to NABH’s denial-of-care portal. Your data will help NABH highlight problems in the field related to health plan denials and timeliness.

Several policymaking entities are interested in these data, which could support advocacy for expanded access to care. For new participants, please e-mail Emily Wilkins, NABH’s administrative coordinator, for support.

Details Coming Soon for the NABH 2023 Annual Meeting

Please plan to join us in Washington, DC from June 12-14, 2023 for this year’s NABH Annual Meeting at the Salamander Washington, DC (formerly the Mandarin Oriental hotel). Details coming soon.

Fact of the Week

Some data brokers are marketing highly sensitive data on individuals’ mental health conditions on the open market, with seemingly minimal vetting of customers and seemingly few controls on using purchased data, according to a study from Duke University’s Sanford School of Public Policy.

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

Becerra Renews COVID-19 Public Health Emergency Through May 11

U.S. Health and Human Services Department (HHS) Secretary Xavier Becerra on Thursday renewed the nation’s COVID-19 public health emergency (PHE) status for another 90 days through May 11.

“Based on current trends regarding COVID-19, the U.S. Department of Health and Human Services is planning for this to be the final renewal and for the COVID-19 PHE to end on May 11, 2023,” Becerra wrote to the nation’s governors on Feb. 9. “Rather than 60 days’ notice, I am providing 90 days’ notice before the COVID-19 PHE ends to give you and your communities ample time to transition.”

Becerra’s letter also noted that the Biden administration’s whole-of-government approach to combatting the deadly virus has helped transition the country away from the emergency phase. Since Omicron peaked at the end of January 2022, daily COVID-19 reported cases are down 92%; COVID-19 deaths have declined by more than 80%; and new COVID-19 hospitalizations are down nearly 80%, Becerra’s letter noted.

NIMH to Host Webinar Next Week on the Opioid Crisis and HEALing Communities Study

The National Institute on Mental Health (NIMH) will host a webinar next Tuesday to discuss how the HEALing Communities Study (HCS) is testing the prevention and treatment of opioid misuse in communities that the nation’s opioid crisis has hit hardest.

Sharon L. Walsh, Ph.D., professor of behavioral science, psychiatry, pharmacology and pharmaceutical sciences at the University of Kentucky’s Colleges of Medicine and Pharmacy, will describe how the HCS has begun to expand access to evidence-based care, improve data availability and timeliness, address social determinants of health, reduce stigma through public health communications campaigns, and modify relevant policies.

Walsh also serves as director of the Center on Drug and Alcohol Research and the Substance Use Disorder Priority Research Area. She is the principal investigator of the HCS at the University of Kentucky. The HCS tests the integration of prevention, overdose treatment, and medication-based treatment in select communities.

Click here to register for the free webinar, which will begin at 2 p.m. ET on Tuesday, Feb. 14.

SAMHSA Announces Funding Opportunity for Assertive Community Treatment Programs for Youth and Adults with SMI

The Substance Abuse and Mental Health Services Administration (SAMHSA) this week announced it will award more than $5 million to establish or expand and maintain Assertive Community Treatment (ACT) programs for transition-aged youth and adults with serious mental illness (SMI).
 
The program’s purpose is to improve behavioral health outcomes for individuals by reducing rates of hospitalization, mortality, substance use, homelessness, and involvement with the criminal justice system.

Click here to learn more about the opportunity. Applications are due by Monday, April 10.

NIDA Reports Increased Activity in ‘Blue Lotus’ Drug

The National Institute on Drug Abuse (NIDA) reported this week that, in response to mentions of blue lotus for the first time from a Rapid Street Reporting (RSR) site visit in Austin, the substance has experienced steady activity in the past three years, with activity peaking in early and late 2022.

Also known as Nymphae caerulea, blue lotus is a water lily primarily found in East Africa and the Arabian Peninsula. The flower contains aphorphine, a dopamine agonist, and is sold primarily as tea extracts or incense.

Click here to learn more about blue lotus and the RSR team’s other recent findings in NIDA’s Feb. 10 newsletter.

In Case You Missed It: NABH Education and Research Foundation and Manatt Produce Issue Brief on Telehealth Services in PHP and IOP

The NABH Education and Research Foundation on Feb. 1 released an issue brief that shows how telehealth services effectively augment traditional partial hospitalization programs (PHP) and intensive outpatient programs (IOP).

The telehealth issue brief is the first resource from the NABH Education and Research Foundation, which worked with NABH members and Manatt to compile and evaluate data to measure the impact that telehealth services have had on access and outcomes.

NABH urges its members to read the issue brief and share it with others. The association has also created a social media toolkit with shareable graphics that highlight key research from the study. Members can access the issue brief and social media toolkit on the NABH Education and Research Foundation’s Resources page.

Manatt will host a webinar about the issue brief’s findings on Wednesday, March 1 at noon ET. Click here to learn more and register for the free webinar.

The NABH Education & Research Foundation fields independent studies and partners with other
organizations to identify and develop best practices and improve NABH members’ ability to support the country’s behavioral health needs.

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

Thank you to all members who have submitted data to NABH’s denial-of-care portal. Your data will help NABH highlight problems in the field related to health plan denials and timeliness.

Several policymaking entities are interested in these data, which could support advocacy for expanded access to care. For new participants, please e-mail Emily Wilkins, NABH’s administrative coordinator, for support.

Details Coming Soon for the NABH 2023 Annual Meeting

Please plan to join us in Washington, DC from June 12-14, 2023 for this year’s NABH Annual Meeting at the Salamander Washington, DC (formerly the Mandarin Oriental hotel). Details coming soon.

Fact of the Week

Medicare Advantage (MA) enrollment increased by 22.2 million beneficiaries, or 337%, from 2006 through 2022, while traditional Medicare enrollment declined by 1.0 million, or −2.9% during that period, according to a study published this week in the journal Health Affairs. The increase in MA enrollment and penetration “indicates that beneficiaries are reforming Medicare with their feet,” the study’s authors wrote.

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

NABH Education and Research Foundation Partners with Manatt to Produce Issue Brief on Telehealth Services in PHP and IOP

The NABH Education and Research Foundation this week released an issue brief that shows how telehealth services effectively augment traditional partial hospitalization programs (PHP) and intensive outpatient programs (IOP).

The telehealth issue brief is the first resource from the NABH Education and Research Foundation, which worked with NABH members and Manatt to compile and evaluate data to measure the impact that telehealth services have had on access and outcomes.

Results from the study show that using telehealth services improved access to care and optimized the reach of existing personnel. The initial findings from several NABH members also indicated that, relative to in-person services, telehealth delivery-of-care produced similar or better outcomes for PHP and IOP patients.

The telehealth issue brief’s key findings also include:

During the COVID-19 crisis, regulatory flexibilities enabled traditional in-person PHPs and IOP programs to implement telehealth services rapidly.

Using telehealth to deliver PHP and IOP services has improved access to care for remote patients and those facing other access obstacles.

Emerging research is showing that, relative to in-person care, the use of telehealth in PHPs and IOPs generally is improving the quality of clinical care, patient satisfaction and the overall efficiency of the healthcare system.

NABH urges its members to read the issue brief and share it with others. The association has also created a social media toolkit with shareable graphics that highlight key research from the study. Members can access the issue brief and social media toolkit on the NABH Education and Research Foundation’s Resources page.

Manatt will host a webinar about the issue brief’s findings on Wednesday, March 1 at noon ET. Click here to learn more and register for the free webinar.

The NABH Education & Research Foundation fields independent studies and partners with other
organizations to identify and develop best practices and improve NABH members’ ability to support the country’s behavioral health needs.

New 9th Circuit Court of Appeals Ruling Threatens Behavioral Healthcare Coverage

A three-judge panel in the 9^th U.S. Circuit Court of Appeals on Jan. 26 replaced its March 2022 ruling in the Wit v. United Behavioral Health (UBH) case with a new opinion that is a major disappointment to both mental health patients and providers.

NABH asserts the latest opinion will materially reduce the benefit of insurance because it does not protect medically necessary treatment based on generally accepted standards of care. NABH refuses to allow insurers to deny medically appropriate care to those who need it and will file a new amicus brief and request that the 9^th Circuit rehear the case.

The U.S. District Court for the Northern District of California’s initial ruling on this class action case in 2019 affects more than 100 million health insurance enrollees. The ruling, considered one of the most significant of the last decade, found that UBH’s reimbursement guidelines for psychiatric conditions were non-compliant with generally accepted standards of care and treatment.

In its ruling, the District Court articulated a series of clinical standards for behavioral healthcare treatment that emphasized the need for treatment to sustain improvement, rather than only address an immediate clinical crisis. The District Court also applied a holistic approach that required treatment for both primary and comorbid impairments, such as the combination of depression and a substance use disorder.

A year after this finding, the District Court ordered UBH to reprocess more than 50,000 claims it had initially denied. The 9^th Circuit Court of Appeals subsequently undid this ruling with its 2022 memorandum.

While the latest ruling in this case is a disappointment, NABH and other behavioral healthcare groups found both positive and negative elements in it. These include:

Positive Factors:

• The 9^th U.S. Circuit Court of Appeals found that UBH violated its fiduciary duty to all class members by using medical necessity criteria that were infected by UBH’s financial conflict of interest.
• The 9^th U.S. Circuit Court of Appeals upheld the U.S. District Court’s finding that UBH broke the laws of four states, which required UBH to apply specific substance use criteria to evaluate medical necessity.

Negative Factors:

• The 9^th U.S. Circuit Court of Appeals held that UBH does not have to reprocess over 60,000 claims for class members denied coverage under UBH’s flawed guidelines, contrary to longstanding precedent on reprocessing as an ERISA remedy.
• The 9^th U.S. Circuit Court of Appeals held that all ERISA class action members must first exhaust their administrative remedies, even if doing so would be futile, as the U.S. District Court found was the case here.
• The 9^th U.S. Circuit Court of Appeals held that insurers may use medical necessity criteria that are inconsistent with generally accepted standards of care.

CMS Updates Audit Protocol for Medicare Advantage Payments

The Centers for Medicare and Medicaid Services (CMS) on Jan. 30 issued a final rule related to using risk adjustment to ensure accurate payment for services provided under Medicare Advantage (MA).

Modifications to the risk adjustment audit protocol, called risk adjustment data validation (RADV), and the related overpayment refund process were initially issued in a 2018 proposed rule. Final action was delayed until now, in part, due to the COVID-19 pandemic.

The final rule reflects estimates from the HHS Office of the Inspector General of more than $15 billion in MA overpayments in fiscal year 2019, or about 7% of total payments. The final rule takes effect April 3, 2023 and has an estimated recovery amount of $4.7 billion in over 10 years.

NABH supports this final rule’s objective to increase oversight of payment accuracy under MA and improve the alignment between payments and medically necessary services for enrollees. To align MA payments with the clinical needs of enrollees, CMS risk-adjusts payments based on patients’ health status and key characteristics.

The goal of risk adjustment is to pay less for healthier enrollees and more for more medically complex enrollees. To identify any inaccuracies in MA risk-adjustment’s impact on payments, CMS conducts retrospective RADV audits of a sample of each plan’s enrollees—typically about 200 per plan— to review their medical records to quantify any gaps between medically necessary care and reimbursed services.

Extrapolation:

Beginning with payment year (PY) 2018, rather than PY 2011, as proposed, the overpayments quantified through RADV audits will be extrapolated to the full MA contract. While not articulated in the final rule, CMS’ extrapolation methodology will be disclosed to MA insurers and be focused on insurers identified as being at highest risk for improper payments. CMS stated that its use of extrapolation is intended to incentivize meaningful steps by its contractors to reduce improper MA risk-adjusted payments. Overpayments identified for PYs 2011 through 2017 will be refunded to CMS without the application of extrapolation.

FFS Adjuster:

In addition, as proposed, the final rule will not apply an adjustment factor (known as an FFS Adjuster) to RADV audit findings, which is a form of risk adjustment. This final position is based on recent case law, which found that the FFS adjuster must be applied to MA payments but not refunded overpayments, including those identified during a RADV audit.

Congressional Research Services Releases Parity Report

The Congressional Research Service (CRS)—the public policy research institute of the U.S. Congress—this week released a report that explains mental health/substance use disorder benefit coverage and parity requirements and the types of private health insurance plans subject to those requirements.

The report includes a brief review of relevant legislative history, including changes enacted in December 2022, and a discussion and examples of required federal agency activities. The CRS focused on federal private insurance requirements; it does not compare state requirements or actual plan variation in coverage. It also does not examine mental health benefits in Medicare and Medicaid.

Click here to read the report.

National Institute of Mental Health Develops Strategic Framework to Address Youth Mental Health Disparities

The National Institute of Mental Health (NIMH) has developed the National Institute of Mental Health (NIMH) Strategic Framework for Addressing Youth Mental Health Disparities for fiscal years 2022–2031, a resource intended to provide a conceptual approach to help guide NIMH activities, including research funding, stakeholder engagement, and workforce development related to research on the mental health needs of youth affected by racial and ethnic health disparities.

“Our country is in the midst of a youth mental health crisis, including alarming increases in youth suicide in recent years,” Christina P.C. Borba, Ph.D., M.P.H., wrote in the framework’s foreword message. “We also know that youth exposed to racism, discrimination, and other adverse experiences, as well as those from disadvantaged and underserved communities, are disproportionately impacted by mental illnesses, and frequently experience reduced access to high-quality, evidence-based mental health services and receive fewer follow-ups in a variety of provider settings,” Borba continued. “Addressing these challenges will require sustained attention, effort, and resources – all built on a foundation of high-quality research.”

News Report Shows How States are Responding to Synthetic Opioid Nitazene

The news outlet Axios recently examined how nitazene, a synthetic opioid thought to be 40 times more powerful than fentayl, is complicating the public health response to the opioid crisis in various states.

Nitazene comes in powder, pill, and liquid form and requires significant lab work to trace. “Often
laced into substances that users think is fentanyl or heroin, it’s potentially lethal or can cause a more severe onset of withdrawal symptoms,” the story noted.

The Centers for Disease Control and Prevention (CDC) last September published a study on nitazene-related deaths in Tennessee from 2019-2021 and reported that nitazenes are an emerging group of highly potent psychoactive substances for which tests are not often included in standard toxicology panels.

“Given their potency, raising awareness about nitazenes and implementing strategies to reduce harm through increased testing, surveillance, and linkage to treatment for substance use disorders are of vital importance,” the CDC study said. “More data are required to better understand this emerging group of psychoactive substances in the United States.”

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

Thank you to all members who have submitted data to NABH’s denial-of-care portal. Your data will help NABH highlight problems in the field related to health plan denials and timeliness.

Several policymaking entities are interested in these data, which could support advocacy for expanded access to care. For new participants, please e-mail Emily Wilkins, NABH’s administrative coordinator, for support.

Details Coming Soon for the NABH 2023 Annual Meeting

Please plan to join us in Washington, DC from June 12-14, 2023 for this year’s NABH Annual Meeting at the Salamander Washington, DC (formerly the Mandarin Oriental hotel). Details coming soon.

Fact of the Week

A new Pew Research Center study shows that 40% of parents report they are “extremely/very” worried that their children might struggle with anxiety or depression at some point.

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

NABH Submits Comment Letter on Federal and State Health Exchange Proposed Rule for 2024

Today, NABH submitted comments on the Contract Year 2024 proposed rule related to the federal and state health exchange marketplace. NABH expressed support for the generally positive rule, including its multiple proposals to assist consumers seeking to enroll in exchange-based health plans and, ultimately, to access mental health and substance use disorder treatments. Our comments also called for the Centers for Medicare & Medicaid Services (CMS) to, rather than merely requiring a minimal contracting attempt, as proposed, require health plans to meet a minimum contracting level based on a percentage of available mental health facilities and substance use disorder treatment centers. In addition, the letter urged CMS to evaluate the current level of actual coverage for mental health services being provided by plans on the federal and state marketplace. We also called on CMS to study the impact of insurer network expansion practices that result in some behavioral health sites and services being unilaterally added to, or “deemed” members of, health plan networks and paid an in-network rate that was already rejected by the provider.

The comment deadline for this proposed rule is Monday, January 30.

CMS Approves California’s Medicaid 1115 Demonstration Amendment to Support Care for Justice-Involved Individuals and Contingency Management 

The Centers for Medicare & Medicaid Services (CMS) approved a first-of-its-kind demonstration amendment in California which will provide a set of critical pre-release services and improve access to needed care for people returning home from jails and prisons. This approval marks the first time Medicaid will pay for pre-release services to incarcerated individuals.  As part of the approval, California will also increase and sustain provider payment rates and Medicaid managed care payment rates in behavioral health and select other services.

In another first for the country, the waiver also includes approval for the use of contingency management for individuals with stimulant use disorders (StUDs). The waiver outlines procedures and protocols for using financial incentives in a 24-week program to reinforce the non-use of stimulants. The protocol is followed by six or more months of additional recovery support services. Importantly, the protocols integrate measures to protect against fraud and abuse, first identified by the Motivational Incentives Policy Group, of which NABH is a member. The waiver introduced Medicaid reimbursable services provided by a Contingency Management Coordinator, a new job classification. It is believed that this pilot will serve as a template for other states that are seeking to integrate treatment for individuals with StUD.

SAMHSA Announces Funding Opportunity for Community Programs to Help Youth and Young Adults at High Risk for Psychosis

The Substance Abuse and Mental Health Services Administration (SAMHSA) announced that applications are open for a program to provide trauma-informed, evidence-based interventions to youth and young adults who are at clinical high risk for psychosis.

Award recipients are expected to use evidence-based intervention to improve symptomatic and behavioral functioning; enable youth and young adults to resume age-appropriate social, academic, and/or vocational activities; delay or prevent the onset of psychosis; and minimize the duration of untreated psychosis for those who develop psychotic symptoms.

The deadline for applications is Tuesday, March 14. Click here to learn more and to apply.

CDC Study Shows that Treating Substance Use Disorders Costs Employer-sponsored Health Insurance over $35 Billion per Year

This week, the Centers for Disease Control and Prevention (CDC) released a study assessing the medical cost of substance use disorders for US employers, employees, and health insurance plans.  The study assessed 162 million non-Medicare eligible enrollees with employer-sponsored health insurance in 2018.  The study determined that the total annual medical cost in that population was $35.3 billion and alcohol-related disorders and opioid-related disorders were the most costly. It should be noted that this amount is a fraction of the $1.1 trillion of the total personal health care expenditures paid by private insurance in the US in 2018.

NABH Mourns Behavioral Healthcare Industry Leader Joey Jacobs

NABH mourns the passing of retired behavioral healthcare executive and leader Joey J. Jacobs, 69, who died Jan. 14 in Nashville following an extended illness.

Jacobs held various roles at Nashville, Tenn.-based HCA Healthcare and co-founded Psychiatric Solutions before he sold the company 13 years ago. Jacobs was also the chair and CEO of Franklin, Tenn.-based Acadia Healthcare, all NABH system members.  A former member, Jacobs served on the NABH Board from 2005 through 2009 when NABH was the National Association of Psychiatric Health Systems.

In addition to his wife, Debbie Hammer Jacobs, Jacobs is survived by two sons, Brent and Scott; three grandchildren; and other family members. Services were held on Jan. 20.

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

Thank you to all members who have submitted data to NABH’s denial-of-care portal. Your data will help NABH highlight problems in the field related to health plan denials and timeliness.

Several policymaking entities are interested in these data, which could support advocacy for expanded access to care. For new participants, please e-mail Emily Wilkins, NABH’s administrative coordinator, for support.

Details Coming Soon for the NABH 2023 Annual Meeting

Please plan to join us in Washington, DC from June 12-14, 2023 for this year’s NABH Annual Meeting at the Salamander Washington, DC (formerly the Mandarin Oriental hotel). Details coming soon.

Fact of the Week

A new cross-sectional study including 74,474 opioid-involved deaths, buprenorphine was involved in 2.6% of opioid-involved overdose deaths during July 2019 to June 2021. Although monthly opioid-involved overdose deaths increased, the proportion of involving buprenorphine fluctuated—but did not increase.

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

SAMHSA Announces Monica Johnson as 988 & Behavioral Health Crisis Coordinating Office Director

The Substance Abuse and Mental Health Services Administration (SAMHSA) announced this week that Monica Johnson, M.A., LPC is the new director of the 988 & Behavioral Health Crisis Coordinating Office.

Johnson has worked in the behavioral health field for 26 years and most recently served as the interim commissioner for the Georgia Department of Behavioral Health & Developmental Disabilities. SAMHSA’s announcement noted that Johnson has overseen and implemented successfully several programs funded through SAMHSA, the Bureau of Justice Assistance, the Office of Juvenile Justice Delinquency Prevention, and the U.S. Education Department.

Johnson earned an undergraduate degree in psychology from Kennesaw State University in Georgia and a graduate degree in professional counseling and psychology at Argosy University in Virginia. She is the recipient of the Intensive Cognitive Behavior Therapy for Schizophrenia Certification at the Aaron T. Beck Institute for Cognitive Behavior Therapy in Philadelphia.

CMS to Host Call About Administration Simplification Proposed Rule on Jan. 25

The Centers for Medicare & Medicaid Services (CMS) National Standards Group will host a call to discuss the Administrative Simplification: Adoption of Standards for Health Care Attachments Transactions and Electronic Signatures, and Modification to Referral Certification and Authorization Transaction proposed rule next Wednesday, Jan. 25 from 2 p.m. to 3:30 p.m. ET.

The agency will use the 90-minutes session to provide an overview of the proposed rule and also offer background on the current standards, expectations of what the proposed rule is meant to do, and information about how to submit comments.

Click here to register.

CMS to Host Educational Session on Advancing Interoperability and Improving Prior Authorization Processes Proposed Rule

The CMS Office of Burden Reduction and Health Informatics will host a virtual education about the Advancing Interoperability and Improving Prior Authorization Processes proposed rule on
Thursday, Feb. 9 from noon to 1 p.m. ET.

On Dec. 6, CMS issued the prior authorization proposed rule, which aims to improve patient and provider access to health information and streamline processes. Click here to read the agency’s fact sheet.  
 
Next month’s educational session is intended to help participants learn about the rule’s provisions and hear how the proposed rule builds on current CMS interoperability policies. Participants will be permitted to ask questions.

Click here to register by Feb. 8.

ASAM to Release Training Module on Level of Care Certification Next Month

The American Society of Addiction Medicine (ASAM) and CARF International announced that a training module to introduce updated rating elements to the ASAM Level of Care Certification (LOCC) will be available on Feb. 15.

ASAM and CARF International announced the LOCC’s updated rating elements in July 2022, and residential treatment programs that are applying for the ASAM LOCC for levels 3.1, 3.5, and 3.7 will be responsible for meeting the updated elements as part of their certification survey. These facilities will also be responsible for meeting the existing rating elements listed in the ASAM LOCC manual.

Joint Commission Releases Sentinel Event Alert About Eliminating Racial & Ethnic Disparities in Pregnant and Postpartum Patients

The Joint Commission this week released a Sentinel Event Alert about eliminating barriers and racial disparities causing mortality and morbidity in pregnant and postpartum women.

Along with the announcement, the Joint Commission released a Quick Safety that addresses mental health conditions and their role in maternal death.

SAMHSA Publishes Guide on Expanding Access to Behavioral Healthcare Services for People Experiencing Homelessness

SAMHSA this week released a guide that highlights strategies for behavioral healthcare and housing providers to conduct outreach and engage with individuals experiencing homelessness.

The new resource also includes strategies for how to initiate behavioral healthcare treatment as individuals wait to receive housing and retain them in their recovery efforts after they find housing.

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

Thank you to all members who have submitted data to NABH’s denial-of-care portal. Your data will help NABH highlight problems in the field related to health plan denials and timeliness.

Several policymaking entities are interested in these data, which could support advocacy for expanded access to care. For new participants, please e-mail Emily Wilkins, NABH’s administrative coordinator, for support.

Details Coming Soon for the NABH 2023 Annual Meeting

Please plan to join us in Washington, DC from June 12-14, 2023 for this year’s NABH Annual Meeting at the Salamander Washington, DC (formerly the Mandarin Oriental hotel). Details coming soon.

Fact of the Week

A recent study found that those on medical addiction therapy had a 63% lower likelihood of an alcohol-related liver disease diagnosis.

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

HHS Awards Nearly $245 Million to Support Youth Mental Health and the Healthcare Workforce

The U.S. Health and Human Services Administration (HHS) announced this week it awarded nearly $245 million in funding from the Bipartisan Safer Communities Act to support youth mental health and help the healthcare workforce address mental health needs.
 
The funding—released through the Substance Abuse and Mental Health Services Administration (SAMHSA) and Health Resources and Services Administration (HRSA)—is for a variety of programs and grants, including Project Advancing Wellness and Resiliency in Education (Project AWARE) to help develop and support school-based mental health programs and services; Mental Health Awareness Training grants to prepare and train school personnel, emergency first responders, law enforcement, and others to recognize the signs and symptoms of mental health challenges to enable early intervention; the National Child Traumatic Stress Initiative to improve treatment for children, adolescents, and families who have experienced traumatic events, and more.
 
In its announcement, HHS noted that the Bipartisan Safer Communities Act included nearly $60 million to support the integration of mental health training into the training of primary care clinicians, with a specific focus on preparing primary care providers to treat the mental health needs of children and adolescents.

“Often the first person you turn to when you or your kids need mental health support is your trusted primary care provider—yet for too long, we haven’t given those primary care providers the mental health training they need to help, HRSA Administrator Carole Johnson said in the announcement. “With funding from the Bipartisan Safer Communities Act, the Health Resources and Services Administration is investing in making mental health a part of primary care training so that there is no wrong door when your family needs support.”

National Academies to Host Virtual Webinars About 988 Implementation on Jan. 20 and 23

The National Academies Forum on Mental Health and Substance Use Disorders will host two virtual webinars about the challenges and opportunities related to the implementation of the 988 behavioral health crisis hotline at the state and local levels.

The discussions will provide an overview of how 988 has been implemented and will also feature best practices. The two-hour webinars will be held on Friday, Jan. 20 and Monday, Jan. 23; both will begin at 12:30 p.m. ET.

Click here to register.

CMS to Host National Stakeholder Call with Administrator Brooks-LaSure on Jan. 24

The Centers for Medicare & Medicaid Services (CMS) will host a national stakeholder call featuring CMS Administrator Chiquita Brooks-LaSure and her leadership team to discuss the agency’s accomplishments in 2022 and priorities for 2023.

Click here to register.

Register Today for the 2023 Rx and Illicit Drug Summit in Atlanta

The 2023 Rx and Illicit Drug Summit will be held in Atlanta from April 10-13 and will include nearly 100 educational sessions organized in nine different tracks to highlight the most effective strategies for prevention, treatment, and recovery.

The meeting’s advanced rate ends on Jan. 27. Click here to register.

NABH’s 2023 Priorities Featured in Mental Health Weekly & Alcohol and Drug Abuse Weekly

In case you missed it, NABH President & CEO Shawn Coughlin discussed the association’s priorities for 2023 and NABH Director of Quality and Addiction Services Sarah Wattenberg reflected on accomplishments of 2022 and hopes for the New Year in Mental Health Weekly and Alcohol and Drug Abuse Weekly, respectively.

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

Thank you to all members who have submitted data to NABH’s denial-of-care portal. Your data will help NABH highlight problems in the field related to health plan denials and timeliness.

Several policymaking entities are interested in these data, which could support advocacy for expanded access to care. For new participants, please e-mail Emily Wilkins, NABH’s administrative coordinator, for support.

Save the Date for the NABH 2023 Annual Meeting!

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

Fact of the Week

In a cohort study of 5,142,577 commercially insured adults across all 50 states, the weekly rate of in-person mental health service utilization decreased by more than 50% after the Covid-19 pandemic started; however, concurrent increases in telehealth led to a slight increase in total utilization for anxiety disorders and stability in total volume of service for other disorders, according to a new study published in JAMA Health Forum.

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

NABH Welcomes Harsh K. Trivedi, M.D., M.B.A as 2023 Board Chair

NABH is pleased to welcome Sheppard Pratt President & CEO Harsh K. Trivedi, M.D., M.B.A as the association’s board chair for 2023.

Harsh has served as an NABH board member as well as a member of the association’s workplace violence prevention workgroup and Covid-19 task force. A graduate of the Mount Sinai School of Medicine, Harsh completed his general psychiatry residency at the Zucker Hillside Hospital/Albert Einstein College of Medicine. He completed his child and adolescent psychiatry training at Children’s Hospital Boston/Harvard Medical School.

Harsh has served as president and CEO at Sheppard Pratt in Baltimore since 2016. NABH is eager to work with Harsh as the association celebrates its 90^th anniversary in 2023!

SAMHSA Releases National Survey on Drug Use and Health for 2021

About one in four U.S. adults had a mental illness and more than 16% of the population—or more than 46 million people—met the criteria for substance use disorder (SUD) in 2021, according to the Substance Abuse and Mental Health Services Administration’s (SAMHSA) National Survey of Drug Use and Health (NSDUH).
 
Released annually, the latest report for the 2021 calendar year also found that younger people reported even higher levels of mental illness—one in three for those between the ages of 18 and 25. Meanwhile, nearly 94% of people with SUD didn’t receive any treatment in 2021.

“Every year since 1971, this survey has given us a window into our nation’s mental health and substance use challenges and 2021 was no different,” HHS Secretary Xavier Becerra said in an announcement about the survey. “As the findings make clear, millions of Americans young and old faced mental health and substance use challenges – sometimes both at once – during the second year of the pandemic,” he continued. “As we work to improve behavioral health across the nation, HHS is committed to ensuring that all people facing mental health or substance use challenges are connected to appropriate services and supports.”

SAMHSA noted that estimates from the 2021 NSDUH should not be compared with estimates from previous years because the Covid-19 pandemic necessitated methodological changes to the data collection process.

CMS Issues Information Bulletin on Medicaid Provisions in Consolidated Appropriations Act, 2023

The Centers for Medicare and Medicaid Services (CMS) on Thursday issued an informational bulletin that highlights provisions in the Consolidated Appropriations Act, 2023 (CAA, 2023) related to the Medicaid continuous enrollment condition.

The CAA, 2023 updates certain Medicaid and Children’s Health Insurance Program (CHIP) provisions, including significant changes to the continuous enrollment condition of the Family First Coronavirus Response Act. Under the CAA, 2023, expiration of the continuous enrollment condition will no longer be linked to the Covid-19 public health emergency (PHE); instead, the condition will end on March 31, 2023. After the condition ends, states will have up to 12 months to initiate, and 14 months to complete, a renewal for all individuals enrolled in Medicaid, CHIP, and the Basic Health Program.

Click here for more details.

HRSA Urges Nurses to Apply for Nurse Corps Loan Repayment Program

The Health Resources and Services Administration (HRSA) this week announced a reminder that the Nurse Corps Loan Repayment Program opens soon.

As part of the program, certain eligible nurses could qualify for up to 85% of unpaid debt. In return, they would be required to serve at least two years in a critical shortage facility in a high need area or accredited school of nursing in a U.S. state or territory.

Nurses must work at eligible facilities for this program, which include public or non-profit medical facilities. Click here to learn about eligibility and application requirements.

Bipartisan Policy Center to Host Behavioral Healthcare Workforce Panel Discussion

The Bipartisan Policy Center (BPC) will host a panel discussion about the organization’s federal policy recommendations to address the huge gap between need and care on Tuesday, Jan. 24.

The BPC noted that as of March 2021, about 37% of Americans lived in mental health shortage areas. Panelists will highlight findings of a new BPC report, Filling the Gaps in the Behavioral Health Workforce, which recommends ways to bolster the role of behavioral healthcare workers such as peer specialists, community health workers, and paraprofessionals, as well as community members who can help support the licensed workforce.

Click here to register for the hourlong webinar that starts at noon ET on Jan. 24.

Reminder: Apply for HRSA Grants to Reduce Neonatal Abstinence Syndrome in Rural Settings

The Health Resources and Services Administration’s (HRSA) Federal Office of Rural Health Policy will invest $20 million in about 40 grants to reduce the incidence of neonatal abstinence syndrome (NAS) in the nation’s rural communities.

According to HRSA’s announcement, grant recipients will collaborate with local, state, and regional stakeholders to provide coordinated, trauma-informed, and family centered behavioral and maternal healthcare services—including medication-assisted treatment—to rural pregnant and post-partum women and their families.

Applicant organizations may be in either an urban or rural area; however, all activities supported by the program must exclusively occur in HRSA-designated, rural areas.

The agency will accept applications through March 8, 2023.

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

Thank you to all members who have submitted data to NABH’s denial-of-care portal. Your data will help NABH highlight problems in the field related to health plan denials and timeliness.

Several policymaking entities are interested in these data, which could support advocacy for expanded access to care. For new participants, please e-mail Emily Wilkins, NABH’s administrative coordinator, for support.

Save the Date for the NABH 2023 Annual Meeting!

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

Fact of the Week

While visits to pediatric emergency rooms rose 1.5% from 2015 to 2021, visits for mental health crises increased 8% a year, according to a new study in JAMA Pediatrics. The study also found that 13% of those young patients returned in six months.

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

Two Proposed Rules Would Improve Prior Authorization and Network Adequacy

The Centers for Medicare & Medicaid Services (CMS) this week released two proposed rules related to longstanding concerns with Medicare Advantage (MA) plans and other insurers that are designed to improve quality of care and plan accountability.

These rules respond to the HHS Office of Inspector General’s report earlier this year about inappropriate prior authorization denials by MA plans as well as 4,000 comments in 2022 from stakeholders, including NABH, on related concerns.

Contract Year 2024 Proposed Rule on Medicare Advantage: Released Wednesday, this proposed rule includes significant MA refinements related to behavioral healthcare, such as a prior authorization exemption for emergency mental health services needed to evaluate and stabilize patients. It also proposes implementing a 10-percentage point payment add-on for telehealth services provided by clinical psychologists, licensed clinical social workers, and those who prescribe medication for opioid use disorder.

To assist patients seeking care, the rule proposes appointment wait-time standards for primary care and behavioral healthcare services. It would also require mid-year notices for enrollees with a behavioral health or primary care provider who dropped from their plan network.

Regarding network adequacy, CMS proposes adding clinical psychologists, licensed clinical social workers, and those who prescribe medication for opioid use disorder to the list of specialty types that CMS uses to evaluate MA networks. To improve parity in access, the proposed rule would also require most MA organizations to include behavioral healthcare services in care coordination programs.

In addition, the rule clarifies that plans should include both physical and mental conditions in their coverage of emergency medical care. Also, to address stakeholders’ concerns regarding the dramatic increase in opioid overdose deaths during the Covid-19 pandemic, the rule proposes that MA organizations designate in their provider directories those who obtained a waiver from the Substance Abuse and Mental Health Services Administration (SAMHSA) and the Drug Enforcement Administration to treat patients with medications for opioid use disorder and are listed on SAMHSA’s Buprenorphine Practitioner Locator.

Comments to CMS are due by Monday, Feb. 13, 2023.

Federal Health Exchange Notice of Benefit and Payment Parameters for 2024: On Monday, the agency issued a proposed rule related to all health insurers participating in federal and state health insurance exchanges.

Specifically, CMS would categorize mental health facilities and substance use disorder (SUD) treatment centers as essential community providers and require insurers to include at least one of these providers in each network. Previously, mental health facilities and SUD treatment centers had been designated in the “other” category.

In addition, the rule would require contract reviews to assess the actual availability of SUD and mental health services. To address concerns about reduced access to care after the Covid-19 public health emergency ends, CMS has proposed extending by 60 to 90 days those who would otherwise lose Medicaid or Children’s Health Insurance Program coverage in January 2024.

Comments on this rule will be accepted during the 45-day period after the rule is published in the Federal Register.

SAMHSA’s Proposed Rule Permits Methadone Prescribing for New Patients via Telemedicine

SAMHSA this week proposed updating federal regulations to permit using audio-visual telehealth services for any new patient treated with methadone in an Opioid Treatment Program (OTP) under specific conditions.

In a proposed rule, SAMHSA said federal regulations should be updated to allow using audio-visual telehealth services for patients treated with methadone in OTPs only if a program physician, or an authorized healthcare professional under the supervision of a program physician, determines that an adequate evaluation of the patient can be accomplished via an audio-visual telehealth platform.

This change is not extended to using audio-only telehealth platforms and applies only to ordering methadone that an OTP dispenses under existing OTP procedures.

In addition, SAMHSA’s proposed changes would update 42 CFR Part 8 by removing stigmatizing or outdated language; supporting a more patient-centered approach to treatment; and reducing barriers to receiving care.

SAMHSA’s proposed changes also would revise standards to reflect an OTP accreditation and treatment environment that has evolved since Part 8 became effective in 2001. Consequently, SAMHSA said its proposed revisions reflect evidence-based practice, language that aligns with current medical terminology, effective patient engagement approaches, and the workforce providing services in OTPs, including:

• expanding the definition of an OTP treatment practitioner to include any provider who is appropriately licensed to dispense and/or prescribe approved medications. The current Part 8 rule defines a practitioner as being: “a physician who is appropriately licensed by the State to dispense covered medications and who possesses a waiver under 21 U.S.C.823(g)(2).” During the Covid-19 public health emergency, this has been formally expanded to align with broader definitions of a practitioner (nurse practitioners, physician assistants, etc.), and OTPs reported that this change was essential in supporting workflow and access;
• adding evidence-based delivery models of care, such as split dosing, telehealth, and harm-reduction activities;
• removing such outdated terms as “detoxification”;
• updating criteria for provision of take-home doses of methadone;
• strengthening the patient-practitioner relationship through promoting shared and evidence-based decision-making;
• allowing for early access to take-home doses of methadone for all patients, to promote flexibility in creating plans of care that facilitate such every-day needs as employment, while also affording people with unstable access to reliable transportation the opportunity to also receive treatment; likewise, promoting mobile medication units to expand an OTPs geographic reach; and
• reviewing OTP accreditation standards.

According to SAMHSA, the changes– which are part of President Biden’s National Drug Control Strategy – come at a time when fewer than one out of 10 Americans can access treatment for substance use disorder.

SAMHSA will accept public comments on the proposed rule until Feb. 14, 2023.

NASHP Brief Highlights State Opioid Spending Plans

The National Academy for State Health Policy has released Understanding Opioid Settlement Spending Plans Across States: Key Components and Approaches, which highlights how states are implementing structures to disburse the more than $50 billion in opioid settlement funds awarded to them.

Opioid settlement funds began pouring into states this year, including about $26 billion from a settlement that 46 states agreed to with Johnson & Johnson (J&J), AmerisourceBergen, Cardinal Health, and McKesson in July 2021.

To understand common challenges and potential best practices for state leaders, NASHP engaged state leaders nationwide to understand both the structure and status of their current opioid settlement planning activities.

NASHP is also analyzing governing materials and entities such as state legislation, opioid settlement agreements and spending plans, advisory committees, and other groups charged with disbursing state funding, which are referenced in NASHP’s tracker.

SAMHSA Releases Resource Highlighting Drug-Related ED Visits in 2021

SAMHSA has released Drug Abuse Warning Network (DAWN): Findings from Drug-Related Emergency Department Visits, 2021, an analysis of DAWN data with a variety of information for drug-related emergency department (ED) visits last year.

The report highlights nationally representative weighted estimates, including percent and unadjusted rates per 100,000, for all drug-related ED visits; nationally representative weighted estimates for the top five drugs in drug-related ED visits; an assessment of trends and drugs involved in polysubstance ED visits in a subset of sentinel hospitals; and the identification of drugs new to DAWN’s Drug Reference Vocabulary.

Brookings Institution Releases Papers on Behavioral Health Integration and Youth Services

The Brookings Institution this week released two academic white papers related to behavioral healthcare: Making Progress on Integration of Behavioral Health Care and Other Medical Care and Meeting the Moment Children’s Mental Health: Recommendations for Federal Policy.
 
The first is a 10-page analysis of recent policy efforts in the nation’s evolving healthcare system, and the second paper seeks to clarify the potential sources of the persistent problems in mental illnesses in children. The 22-page youth services white paper also considers what tools the federal government should employ to address the crisis.

Reminder: Apply for HRSA Grants to Reduce Neonatal Abstinence Syndrome in Rural Settings

The Health Resources and Services Administration’s (HRSA) Federal Office of Rural Health Policy will invest $20 million in about 40 grants to reduce the incidence of neonatal abstinence syndrome (NAS) in the nation’s rural communities.

According to HRSA’s announcement, grant recipients will collaborate with local, state, and regional stakeholders to provide coordinated, trauma-informed, and family centered behavioral and maternal healthcare services—including medication-assisted treatment—to rural pregnant and post-partum women and their families.

Applicant organizations may be in either an urban or rural area; however, all activities supported by the program must exclusively occur in HRSA-designated, rural areas.

HRSA will offer a webinar for applicants on Wednesday, Jan. 4, 2023 from 2 p.m. to 3 p.m. ET; registration is not required. The agency will accept applications through March 8, 2023.

Reminder: NABH 2023 Board Election Ballots Due Friday, Dec. 30 

NABH has e-mailed system members NABH Board of Trustees candidate profiles and a ballot to elect new members to the 2023 Board.

If you have not done so, please vote for the open Board Chair-Elect position and one available Board seat; sign the ballot (it is not valid without a signature); and return it to NABH. You can do this by scanning your completed ballot and e-mailing it nabh@nabh.org or maria@nabh.org.

NABH must receive all ballots no later than Friday, Dec. 30, 2022. New Board members and the Board Chair-elect will take office in January 2023.

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

Thank you to all members who have submitted data to NABH’s denial-of-care portal. Your data will help NABH highlight problems in the field related to health plan denials and timeliness.

Several policymaking entities are interested in these data, which could support advocacy for expanded access to care. For new participants, please e-mail Emily Wilkins, NABH’s administrative coordinator, for support.

Save the Date for the NABH 2023 Annual Meeting!

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

Fact of the Week

Fentanyl is now the leading cause of death for Americans between the ages of 18 and 49, according to a Washington Post analysis of death data for 2021 from the Centers for Disease Control and Prevention.

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

CMS Proposes Electronic Prior Authorization for Providers and Payers

The Centers for Medicare & Medicaid Services (CMS) this week released a proposed rule that would require certain providers and payers to implement an electronic prior-authorization process, shorten the timeframe for payers to respond to prior-authorization requests, and work to make the prior-authorization process more efficient and transparent.

An announcement from CMS said the proposed requirements would apply to Medicare Advantage (MA) organizations, state Medicaid and Children’s Health Insurance Program (CHIP) agencies, Medicaid managed care plans, CHIP managed care entities, and qualified health plan issuers on the federally facilitated exchanges. The agency estimates that these proposed policies could create efficiencies that would save physician practices and hospitals more than $15 billion over a 10-year period.

The rule would automate essential prior-authorization functions related to documentation, requests, and decisions. Also, payers would be required to provide a clear reason for denials and to respond to urgent prior-authorization requests within 72 hours and standard requests within seven days.

The proposed electronic platform is the already-established “Patient Access API,” which uses the Health Level 7^® format. The rule also would enhance patients’ access to their own information on prior- authorization requests, approvals, and related information by requiring online reporting of certain performance metrics.

CMS is seeking information from stakeholders on the following topics:

• How to standardize data on patients’ social risk factors (e.g., housing instability, food insecurity) that influence patient health and health care utilization;
• How to advance electronic data exchange among behavioral health providers;
• How to improve the exchange of medical documentation between and among providers/suppliers and patients (for the purpose of care coordination);
• How to enable the connection of health information networks to advance cross-organization interoperability, such as the prior-authorization improvements in this rule, including incentives for payers; and
• Evidence-based policies that CMS could pursue to leverage health IT, data sharing, and interoperability to improve maternal health outcomes.

NABH will address these and the rule’s other key provisions in the association’s formal comments. CMS will publish the rule in the Federal Register on Dec. 13, 2022 and accept comments through March 13, 2023.

Biden Administration Launches Opioid Overdose Dashboard

The Biden Administration on Thursday unveiled a website featuring the Office of National Drug Control Policy’s (ONDCP) new Opioid Overdose Tracker to monitor non-fatal, opioid overdoses in the pre-hospital setting in an effort to prevent overdose deaths.

Non-fatal overdoses are a good predictor of fatal overdoses, Biden administration officials said during a news briefing Wednesday according to Politico. People who experience at least one non-fatal overdose are about two to three times more likely to eventually die from one, they said. Earlier this year, the Centers for Disease Control and Prevention estimated that 80,816 Americans died from opioid overdoses in 2021, increasing from an estimated 70,029 in 2020.

Using data submitted to the National Emergency Medical Services Information System (NEMSIS), the new dashboard contains one interactive page with a geo-surveillance view, and its data set includes all de-duplicated Emergency Medical Services (EMS) patient care reports for a rolling time period that meet specific inclusion criteria.

In 2022, all 50 states, three territories (the Virgin Islands, Guam, and the Northern Mariana Islands), and Washington, D.C. had submitted data to the national database, according to NEMSIS. The NEMSIS Technical Assistance Center collects data from about 95% of all EMS agencies in the United States that respond to 911 requests for emergency care and transport patients to acute care facilities.

According to a National Public Radio story, ONDCP Director Rahul Gupta, M.D. told reporters during a call that “We could see tens of thousands of additional lives saved” with the new tool, which Gupta said he hopes first responders, clinicians, and policymakers will use to connect people to care and also minimize response times and ensure that resources are available.

NABH has advocated that the dashboard be updated in 2023 to use numbers at the state and county levels, as well as the national level.

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

Of the 512,224 patients in Opioid Treatment Programs (OTPs) who reported using medications for opioid use disorders (MOUDs), 476,763 reported using methadone, 33,473 reported buprenorphine, and the remaining 1,988 reported using naltrexone, according to a new report from the National Association of State Alcohol and Drug Abuse Directors (NASADAD).

NASADAD partnered with the American Association for the Treatment of Opioid Dependence (AATOD) for the study, which was funded to determine the number of patients who receive MOUDs in OTPs, the types of federally approved medications that patients use in treatment, and the specific formulations of medication used among the patient population.

Researchers analyzed data from 1,547 Opioid Treatment Programs (OTPs) nationwide that completed the survey, reflecting an 85-percent response rate. The Substance Abuse and Mental Health Services Administration funded the study through the agency’s Opioid Response Network.

MedPAC Discusses Draft Recommendations for 2024 Physician Payment Increases

The Medicare Payment Advisory Commission (MedPAC) this week discussed draft recommendations to increase the Medicare base payment rate for physician and other health professional services by 1.25% in 2024, a rate that is half of the forecasted increase in the Medicare Economic Index for 2024.

Current law calls for no updates to 2024 payment rates relative to 2023 levels. The commission also discussed supporting a payment add-on for services for low-income Medicare beneficiaries (15% for primary care; 5% for non-primary care), which new Medicare spending would fund.

The purpose of these items is to help maintain access to physician services for Medicare beneficiaries. Both measures received substantial support from the commissioners, and they are expected to be approved as formal recommendations to Congress when MedPAC convenes in January to vote on these and other Medicare payment adequacy recommendations for 2024.

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

Since the Biden administration released its Overdose Prevention Strategy a year ago, the number of healthcare providers with waivers to prescribe buprenorphine for opioid use disorder increased by 19% and the number of naloxone prescriptions filled in pharmacies has increased by 37%, HHS announced late last week.

The announcements were made in conjunction with a news conference HHS Secretary Xavier Becerra held to mark the first anniversary of the Biden administration’s Overdose Prevention Strategy. During the news conference, Becerra highlighted some of the strategy’s recent actions, including an announcement from the Centers for Disease Control and Prevention (CDC) that state, local, and territorial awardees of the CDC Overdose Data to Action cooperative agreement can use a portion of their funds to purchase naloxone; and the U.S. Food and Drug Administration’s notice last month that certain naloxone products have the potential to be safe and effective for over-the-counter use.

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

The Health Resources and Services Administration’s (HRSA) Federal Office of Rural Health Policy will invest $20 million in about 40 grants to reduce the incidence of neonatal abstinence syndrome (NAS) in the nation’s rural communities.

According to HRSA’s announcement, grant recipients will collaborate with local, state, and regional stakeholders to provide coordinated, trauma-informed, and family centered behavioral and maternal healthcare services—including medication-assisted treatment—to rural pregnant and post-partum women and their families.

Applicant organizations may be in either an urban or rural area; however, all activities supported by the program must exclusively occur in HRSA-designated, rural areas.

HRSA will offer a webinar for applicants on Wednesday, Jan. 4, 2023 from 2 p.m. to 3 p.m. ET; registration is not required. The agency will accept applications through March 8, 2023.

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

Thank you to all members who have submitted data to NABH’s denial-of-care portal. Your data will help NABH highlight problems in the field related to health plan denials and timeliness.

Several policymaking entities are interested in these data, which could support advocacy for expanded access to care. For new participants, please e-mail Emily Wilkins, NABH’s administrative coordinator, for support.

Save the Date for the NABH 2023 Annual Meeting!

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

Fact of the Week

A new study published in The Lancet Psychiatry found that people with severe mental illness have an elevated risk for several chronic health problems even before they receive their first diagnosis of a severe mental illness.

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

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

Senate Finance Committee leaders on Thursday released what they said is their fifth and final legislative mental health parity discussion draft in their effort to place access to behavioral healthcare on par with physical healthcare in Medicare and Medicaid.
 
Previous iterations of the draft were released in May, June, September, and November this year. Policies in the final draft include: strengthening the accuracy of provider directories in Medicare Advantage plans; strengthening requirements in Medicaid for managed care organizations and states to maintain regularly updated provider directories that include, in part, information on accessing care from behavioral health professionals; directing the Government Accountability Office (GAO) to conduct a study of the differences in enrollee cost-sharing and utilization management between behavioral and non-behavioral health services in Medicare Advantage and compared with traditional Medicare; requiring Medicare to provide guidance to health care providers detailing the extent to which Medicare beneficiaries with substance use disorders can receive partial hospitalization program services; and directing GAO to report on Medicaid payment rates for behavioral health services compared to medical and surgical services across a sample of states.

“Too often the notion of mental health parity falls short of reality,” Senate Finance Committee Chairman Ron Wyden (D-Ore.) said in an announcement about the discussion draft. “These policies represent the first step towards addressing the mental health parity and ghost network challenges that I intend to build on in the coming months—especially the challenges I hear about consistently from families at home who aren’t able to find available mental health professionals covered in their insurance networks,” he added.

HHS Releases Proposed Rule to Revise 42 CFR Part 2 Regulations

The U.S. Health and Human Services Department (HHS) this week released a proposed rule
to revise regulations known as 42 CFR Part 2, or “Part 2,” which protect the confidentiality of substance use disorder (SUD) treatment records.

Specifically, Part 2 protects “records of the identity, diagnosis, prognosis, or treatment of any patient which are maintained in connection with the performance of any program or activity relating to substance abuse education prevention, training, treatment, rehabilitation, or research, which is conducted, regulated, or directly or indirectly assisted by any department or agency of the United States.”  The protections are meant to address concerns that discrimination and fear of prosecution deter people from entering treatment for SUD.

The rule proposes a host of revisions, including, but not limited to: permitting Part 2 programs to use and disclose Part 2 records based on a single prior consent signed by the patient for all future uses and disclosures for treatment, payment, and healthcare operations; permitting the redisclosure of Part 2 records as permitted by the Health Insurance Portability and Accountability Act (HIPAA) privacy rule by recipients that are Part 2 programs, HIPAA-covered entities, and business associates, with certain exceptions; and expanding prohibitions on using and disclosing Part 2 records in civil, criminal, administrative, or legislative proceedings conducted by a federal, state, or local authority against a patient, absent a court order or the consent of the patient.

HHS released a summary of the proposed rule’s provisions and will accept comments for up to 60 days after the proposed rule is published in the Federal Register.

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

The Drug Enforcement Administration (DEA) this week alerted the public of a sharp rise nationwide in the lethality of fentanyl-laced, fake prescription pills.
 
In a public safety alert, the agency said the DEA laboratory found that of the fentanyl-laced, fake prescription pills analyzed in 2022, six out of 10 contained a potentially lethal dose of fentanyl. This is an increase from DEA’s previous announcement in 2021 that four out of 10 fentanyl-laced fake prescription pills were found to contain a potentially lethal dose.

According to the alert, the pills are largely made by two Mexican drug cartels, the Sinaloa Cartel and the Jalisco (CJNG) Cartel, to look identical to real prescription medications, including OxyContin®, Percocet®, and Xanax®, and they are often deadly.

In 2021, the DEA seized more than 20.4 million fake prescription pills, and earlier this year, the DEA conducted a nationwide operational surge to target the trafficking of fentanyl-laced fake prescription pills and, seized 10.2 million fake pills in all 50 states in just more than three months.

The DEA’s One Pill Can Kill campaign alerts the American public of the dangers of fake prescription pills.

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

In her blog post to commemorate World Aids Day on Thursday, Dec. 1, National Institute on Drug Abuse (NIDA) Director Nora Volkow, M.D. promoted NIDA’s video “Sex, Meth and HIV,” to emphasize that in order to end the HIV epidemic it is important to recognize and respect both the complexity and needs of sexual and gender minorities who use drugs.

“Like other drugs, methamphetamine may help individuals cope with mental health challenges like depression, anxiety, and trauma,” Volkow wrote. “Some gay and bisexual men use methamphetamine to enhance sexual experience and sense of connectedness,” she added. “It can also temporarily boost self-confidence among individuals who may experience stigma and shame surrounding sexuality or other aspects of their lives.”

Volkow referenced a 2020 study in the Journal of Acquired Immune Deficiency Syndromes (JAIDS), which showed that a third of new HIV transmissions among sexual and gender minorities who have sex with men were in people who regularly use methamphetamine.
 
On a related note, at a conference in Boston last month, Volkow said American physicians should “absolutely” be allowed to prescribe methadone to their patients. “There’s absolutely no reason why not,” Volkow said, according to a story in STAT. “There are countries where physicians are providing methadone, and the outcomes are actually as good as those they get [at] methadone clinics.”

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

Thank you to all members who have submitted data to NABH’s denial-of-care portal. Your data will help NABH highlight problems in the field related to health plan denials and timeliness.

Several policymaking entities are interested in these data, which could support advocacy for expanded access to care. For new participants, please e-mail Emily Wilkins, NABH’s
administrative coordinator, for support.

Save the Date for the NABH 2023 Annual Meeting!

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

Fact of the Week

The likelihood that someone with serious mental illness will be the victim of a violent crime is 11.8 higher when compared with the general public.

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

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

The U.S. Health and Human Services Department’s (HHS) Health Resources and Services Administration (HRSA) on Tuesday announced a $350 million initiative for HRSA-supported health centers to increase Covid-19 vaccinations in their communities, with a specific focus on underserved populations.

The funding will help health centers provide Covid-19 vaccines through mobile, drive-up, walk-up, or community-based vaccination events, including working with community-based organizations and other efforts to increase administering Covid-19 vaccines.

According to HHS, health centers have administered more than 22 million vaccines in underserved communities nationwide, of which 70% to patients of racial and ethnic minorities.

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

Counties with a shortage of mental healthcare providers were connected to higher rates of youth suicide, researchers reported this week in JAMA Pediatrics.

The study noted that that while the findings are based on data from 2015 and 2016, the report comes at a time with the number of Americans living in areas with a shortage of mental health professionals is growing. Federal data show more than 150 million people live in such areas.

Meanwhile, researchers initially found that counties with provider shortages had a 41% higher youth suicide rate: 5.09 per 100,000 youths compared with 3.62 per 100,000 in counties without shortages. And when the researchers controlled for socioeconomic and other confounding factors—rural and high-poverty areas are known to have higher suicide rates—they still found that living in a county with a shortage of mental health workers was associated with a 16% higher youth suicide rate.

“Strategies to ameliorate mental health professional workforce shortages…. may be considered in comprehensive youth suicide prevention programs,” the authors concluded.

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

NABH is one of more than 50 organizations that sent a letter to House and Senate leaders urging the federal lawmakers to include a mental health crisis intervention benefit in the Medicare program in Congress’ end-of-year legislative package.

The organizations represent mental health and substance use treatment providers, crisis centers, family members, advocates, justice-focused organizations, and payers committed to strengthening access to mental healthcare and substance use treatment.

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

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

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

Save the Date for the NABH 2023 Annual Meeting!

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

Fact of the Week

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

Happy Thanksgiving from NABH!

The NABH staff wishes its members and their families a very happy, healthy, and safe Thanksgiving!

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

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

Several news outlets have reported that the U.S. Health and Human Services Department (HHS) intends to extend the existing Covid-19 Public Health Emergency (PHE) through April 2023.

The current PHE—which has been extended many times since 2020—is effective through Jan. 11, 2023.

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

The U.S. Food and Drug Administration (FDA) this week issued a Federal Register notice that includes the agency’s preliminary assessment that certain naloxone drug products—up to 4 milligrams (mg) nasal spray and up to 2 mg autoinjector for intramuscular (IM) or subcutaneous (SC) use—may be approvable as safe and effective for nonprescription use.

In its announcement about the notice, FDA said this move is “intended to facilitate both the development and approval of nonprescription naloxone products; however, it is not a final determination that certain naloxone drug products are safe and effective for nonprescription use, and it does not mandate an immediately effective switch to nonprescription/over-the-counter (OTC) availability for naloxone.”

The announcement also said the FDA needs additional data, such as product-specific data on the nonprescription user interface design, including packaging and labeling, before it makes its final determination.

CMS Releases Medicaid and CHIP Access Data Brief

The Centers for Medicare & Medicaid Services (CMS) this week released a data brief that includes a snapshot of selected metrics in three essential dimensions of Medicaid and Children’s Health Insurance (CHIP) access.

Culling data from various sources, CMS developed the brief to show access to Medicaid and CHIP coverage, measured by enrollment and retention; access to services, with a focus on mental health conditions and substance use disorders; and perceived access, measured by beneficiary experiences in managed care.

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

The Substance Abuse and Mental Health Services Administration’s (SAMHSA) GAINS Center on Monday, Nov. 21 will host “Black Robes and White Coats: Using Project ECHO to Increase Judiciary Knowledge about Substance Use Disorder,” a webinar that will provide an overview of the pilot Project ECHO for the Judiciary.

The purpose of Project ECHO for the Judiciary is for participating judges to learn about treatments for opioid disorder and develop a better understanding of substance use disorders to help inform their decisions in the courtroom.

The webinar will begin at 2:30 p.m. ET on Monday. Click here to register.

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

The top leaders at FDA and SAMHSA will host a stakeholder call on Monday, Nov. 28 to discuss naloxone access and harm reduction.

FDA Commissioner Robert Califf, M.D. and Marta Sokolowska, deputy center director for substance use and behavioral health in FDA’s Center for Drug Evaluation and Research, will lead the call, and SAMHSA Assistant Secretary for Mental Health and Substance Use Miriam Delphin-Rittmon, Ph.D. will participate.

“Every person who experiences an opioid overdose, whether it is with prescribed medication or an illicit drug, should have access to naloxone,” FDA said in its announcement about the call. “Entities such as harm-reduction programs help save lives by making naloxone available in underserved communities,” it continued. “The agency intends to stand by these efforts by supporting their ability to acquire FDA-approved naloxone products, and we recently issued the guidance, Exemption and Exclusion from Certain Requirements of the Drug Supply Chain Security Act (DSCSA) for the Distribution of FDA-Approved Naloxone Products During the Opioid Public Health Emergency,” it said, adding that FDA recognizes this action alone is not enough and that there is more work to do.

The hourlong Zoom call will begin at 2:30 p.m. ET. Click here to register.

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

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

For new participants, please e-mail Emily Wilkins, NABH’s administrative coordinator, for support.

Save the Date for the NABH 2023 Annual Meeting!

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

Fact of the Week

Demand for anxiety and depression treatment remains high for the third consecutive year, and 60% of practitioners report they no longer have openings for new patients, according to the American Psychological Association’s 2022 Covid19 Practitioner Impact Survey.

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

CMS Releases Final Physician Fee Schedule and OPPS Rules for 2023 

Telehealth services authorized temporarily during the Covid-19 public health emergency (PHE) will extend through at least 2023 and for at least 151 days after the PHE ends, the Centers for Medicare & Medicaid Services (CMS) announced in the agency’s final 2023 Physician Fee Schedule (PFS) this week.

CMS’ decision to extend the telehealth services benefit will allow for additional data collection to evaluate a possible permanent addition as a Medicare benefit.

CMS issued the regulation on the same day it released the final Outpatient Prospective Payment System (OPPS) rule for next year. In that regulation, CMS implemented a 4.1% payment increase for outpatient facilities in 2023. Please read below for additional details about the final regulations.

2023 Physician Fee Schedule Final Rule:
The PFS final rule directs CMS to implement an approximately 4.5-percent reduction—reflecting a decrease of $1.55— in the conversion factor, which the agency uses to calculate payments for physicians and the other clinicians paid under the PFS.

CMS also updated the payment amount for the drug component of the opioid treatment bundle using the Producer Price Index (PPI) for Pharmaceuticals for Human Use and will do so annually to account for inflation. CMS will also modify the payment rate for the non-drug bundle to base the rate on a 45-minute –rather than a 30-minute—session, which better comports with OTP practices.

Under the final rule, OTPs may also use audio-visual and audio-only telehealth for buprenorphine intake if the Substance Abuse and Mental Health Services Administration (SAMHSA) and the Drug Enforcement Administration (DEA) grant permission. Also pending authorization from SAMHSA and DEA, OTPs may furnish periodic assessments via audio-only when video is not available for the duration of 2023.

CMS also made final billing for mobile units in accordance with SAMHSA and DEA guidance. Locality adjustments will be applied and based on the location of the OTP hub.

Meanwhile, the PFS final rule implements an exception to supervision requirements to allow marriage and family therapists, licensed professional counselors, addiction counselors, certified peer recovery specialists, and others to provide behavioral healthcare services while under general supervision, rather than “direct” supervision. This means practitioners now will be able to provide services without requiring that a physician or nurse practitioner be present on site.

Responding to comments from the behavioral healthcare field, CMS also made final a new behavioral health integration service that a clinical psychologist or clinical social worker can perform when mental health services are the focal point of care integration, along with allowing a psychiatric diagnostic evaluation to initiate such integration services.

CMS also made final several provisions related to accountable care organizations to grow participation in the program, incorporate recent lessons related to episode payment approaches, and advance equity among program participants.

Outpatient Prospective Payment System Final Rule:
Although the 4.1% payment increase for outpatient services is larger than CMS had proposed, NABH does not consider this payment update adequate to address the intense cost pressures—stemming from considerable increases in labor, supplies, equipment, drugs, and other expenses—that the association had highlighted.

Regarding payments for 340B hospitals, the final OPPS rule ends the cuts that the U.S. Supreme Court found to be unlawful. Per the high court’s ruling, 340B payments in 2023 will return to pre-2018 levels: the average sale price plus 6% with an offsetting reduction to make the measure budget neutral, as required by law. The final rule falls short of reimbursing 340B payment cuts from previous years. NABH expects additional 340B rules from CMS by the summer of 2023.

Both the PFS and OPPS final rules will take effect Jan. 1, 2023.

NABH and Other Organizations Urge Federal Appropriators to Include Behavioral Health Funding in Continuing Resolution

NABH and a dozen other behavioral health organizations on Friday send a letter to House and Senate appropriators requesting that federal lawmakers include appropriate funding levels for behavioral health treatment in the upcoming Continuing Resolution (CR) to keep the federal government operating.

Specifically, NABH and the other organizations—including the American Psychiatric Association, the American Psychological Association, Mental Health America, the National Association of State Mental Health Program Directors— requested that Congress include $1.42 billion for the Community Mental Health Block Grant (MHGB), including a 10% set-aside for mental health crisis services within the MHGB; $60 million to expand the Mental Health Crisis Response Partnership Pilot Program; $747 million for the 988 behavioral health crisis hotline, including $30 million to provide specialized services for LGBTQ+ youth; $400 million for Certified Community Behavioral Health Clinics; and $10 million for the Behavioral Health Crisis 988 Coordinating Office.

“Additional federal investments are needed to strengthen the 988 system to transform how our country responds to people in crisis,” the organizations wrote in the letter. “A continuing resolution of any length threatens our ability to meet the high and growing need for behavioral health treatment and care.”

SAMHSA to Host Webinar About CCBHC Certification Criteria Next Week

SAMHSA will host a webinar open to the public next Wednesday, Nov. 9 regarding updates to the Certified Community Behavioral Health Clinic (CCBHC) certification criteria.

SAMHSA will provide a brief overview of CCBHCs, describe key elements of certification criteria and SAMHSA’s process for soliciting feedback from the field, and discuss how the public can provide feedback.

The Zoom webinar will begin at 4 p.m. ET. The meeting ID is 160 306 8999 and the passcode is 160547.

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

SAMHSA this week named Capt. Jennifer Fan, Pharm.D., J.D. as the acting director of the agency’s Center for Substance Abuse Prevention (CSAP).

A commissioned officer in the U.S. Public Health Service, Fan served in SAMHSA from 2007 through 2021 in several roles, including acting CSAP deputy director, special assistant for the CSAP director, and CSAP’s subject matter expert on opioids and prescription drug misuse. She also served as the senior editor for the Surgeon General’s Spotlight on Opioids Report and helped to create SAMHSA’s Strategic Prevention Framework for Prescription Drugs (SPF Rx) grants and the Grants to Prevent Prescription Drug/Opioid Overdose-Related Deaths (PDO).

Fan earned her doctorate in pharmacy from the University of Maryland School of Pharmacy and her law degree from the University of Baltimore School of Law.

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

SAMHSA recently announced Screen4Success, a new screening tool from the agency’s “Talk. They Hear You.” national prevention campaign that can help parents and caregivers better understand children’s health, wellness, and wellbeing, and find resources to address needs.

Parents and caregivers can access the new tool on mobile devices through the Talk. They Hear You. campaign mobile app, which is available for free on the App Store, Google Play, and Microsoft store.

Enhanced NABH Denial-of-Care Portal is Now Available

NABH recently made enhancements to its Denial-of-Care Portal that are intended to make the portal easier for members to use.

A year ago, NABH developed the Denial-of-Care Portal to collect specific data on insurers who deny care—often without regard to parity or the effects on patients. Now the association has updated this resource to make it more user-friendly for members and also more aligned with what regulators need to identify parity violations.

The updated portal includes fewer questions, which will require less time for members to complete. In addition, all questions are now optional. NABH hopes this will make it more likely for members to share the data they have. Lastly, NABH has added a checklist of “red flags” that were included in the 2022 MHPAEA Report to Congress from the U.S. Health and Human Services, Labor, and Treasury Departments in January.

Please e-mail Emily Wilkins, NABH’s administrative coordinator, if you have questions about the portal.

Save the Date for the NABH 2023 Annual Meeting!

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

Fact of the Week

Fifty-three percent of those polled said the new 988 behavioral health crisis hotline will be effective to keep people in crisis out of jail, with Black (64%) and Hispanic (54%) adults more optimistic, the American Psychiatric Association reports.

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

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

Financial, educational, and workplace challenges are three categories that pose the greatest challenges to recruiting and retaining behavioral health providers, the Government Accountability Office (GAO) concluded in a new report.

The GAO was assigned to review what is known about the behavioral health workforce, offer information regarding both barriers to and incentives for recruiting and retaining providers, and identify what actions various U.S. Health and Human Services department (HHS) agencies are taking to recruit and retain these providers. In its comprehensive review, the GAO interviewed NABH staff as a stakeholder group.

“Reimbursement rates and compensation for behavioral health services are low, according to stakeholders from multiple research organizations and behavioral health associations,” the report noted, adding that many programs designed to recruit diverse behavioral health providers only benefit individuals already studying in a behavioral health field and do not address the lack of a pipeline for underserved populations to enter the workforce.

The GAO recommended that incentives such as loan repayment and scholarships for students seeking behavioral healthcare professions could help to address some of the barriers to entering the field.

Learn more in highlights from the study and the full report.

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

HHS and the U.S. Surgeon General’s office will host a briefing on Monday, Oct. 31 to discuss the Surgeon General’s Framework for Workplace Mental Health & Well-being, which will outline the foundational role that workplaces should play in promoting the health and well-being of workers and communities.

The briefing will highlight the five essentials for workplace mental health and is intended to help organizations develop, institutionalize, and update policies, processes, and practices that best support the mental health and well-being of all workers.

Click here to register for the 30-minute briefing, which will begin at 1:30 p.m. ET.

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

A new study from the Commonwealth Fund analyzes how government regulation and inadequate treatment capacity can limit patients’ access to lifesaving care and what policymakers could do to help combat opioid addiction.

According to the report’s findings, opioids are involved in almost 75% of overdose deaths in the United States, which claim more than 100,000 lives per year. But while opioid addiction can be treated with effective medications, only 10% to 15% of U.S. residents with opioid use disorder receive them.

“During Covid-19, the federal government showed flexibility by allowing OTPs (opioid treatment programs) to provide more take-home methadone doses, allowing buprenorphine treatment initiation via telehealth, and removing buprenorphine waiver training requirements for providers treating 30 or fewer patients,” the report noted. “Data indicate that methadone take-home flexibilities have not been associated with worse outcomes or significant misuse, and telehealth services have been associated with improved medication retention and lower overdose risk,” it continued. “Some of these provisions are temporary and could sunset or change after the COVID-19 public health emergency ends.”

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

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

The hourlong call will begin next Tuesday at 3 p.m. ET. Click here to register.

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

SAMHSA will host a virtual workshop next week to help providers learn how to access the agency’s available data on Behavioral Health Services Information System (BHSIS) and online treatment locator.

Herman Alvarado, a supervisory social science analyst at SAMHSA’s Center for Behavioral Health Statistics and Quality, will provide an overview for participants. The event is intended to provide technical assistance to National Network to Eliminate in Behavioral Health (NNED) members and minority-service and under-resourced community-based organizations.

The 90-minute virtual workshop will begin at 3 p.m. next Wednesday, Nov. 2. Click here to register.

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

The National Institutes of Health’s (NIH) Helping to End Addiction Long-term, or HEAL, initiative— a trans-NIH research effort focused on improving prevention and treatment for opioid misuse and addiction and enhancing pain management—recently released examples of programs that have helped some of the youngest patients battling opioid misuse or addiction.

HEAL funds more than 1,000 research projects in every U.S. state and is a $2.5 billion effort that has grown substantially this year, adding 10 new programs and more than 200 new projects that are seeking scientific solutions to prevent overdose and connect people to treatment for pain and addiction.

Click here to learn about some innovative programs related to mobile apps.

Enhanced NABH Denial-of-Care Portal is Now Available

NABH recently made enhancements to its Denial-of-Care Portal that are intended to make the portal easier for members to use.

A year ago, NABH developed the Denial-of-Care Portal to collect specific data on insurers who deny care—often without regard to parity or the effects on patients. Now the association has updated this resource to make it more user-friendly for members and also more aligned with what regulators need to identify parity violations.

The updated portal includes fewer questions, which will require less time for members to complete. In addition, all questions are now optional. NABH hopes this will make it more likely for members to share the data they have. Lastly, NABH has added a checklist of “red flags” that were included in the 2022 MHPAEA Report to Congress from the U.S. Health and Human Services, Labor, and Treasury Departments in January.

Please e-mail Emily Wilkins, NABH’s administrative coordinator, if you have questions about the portal.

Save the Date for the NABH 2023 Annual Meeting! 

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

Fact of the Week

By 2030, HHS’ Health Resources and Services Administration (HRSA) estimates a 20% decrease in the supply of adult psychiatrists to 27,020, while the agency estimates a 22% increase in the supply of child and adolescent psychiatrists to 9,830.

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

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

More than 50 million Americans experienced a mental illness between 2019 and 2020, while more than one in 10 youth in the United States experience depression that is severely impairing their ability to function at school or work, at home, with family, or in their social life, according to a new report from Mental Health America (MHA).

The State of Mental Health in America is a nearly 40-page chartbook that provides a baseline to answer some questions about how many people in America need and have access to mental health services. The report is a companion piece to interactive data available on MHA’s website.

Using publicly available data from the 50 states and Washington, D.C., MHA used a set of 15 measures, such as adults with any mental illness, adults with thoughts of suicide, and youth with substance use disorder in the last year. MHA noted that the Covid-19 pandemic negatively affected the ability to collect data for national surveillance in 2020; consequently, the indicators in this year’s report cannot be compared with previous years.

The findings also reported that the majority of individuals with a substance use disorder in the U.S. are not receiving treatment, and that there are about 350 individuals for every one mental healthcare provider in the United States.

SAMHSA Announces $15 Million in Early 2023 for CCBHCs

The Substance Abuse and Mental Health Services Administration (SAMHSA) this week announced it will award $15 million early next year to expand access to planning grants for certified community behavioral health clinics (CCBHCs) to all 50 states.

This funding—along with the $300 million that SAMHSA awarded in September for both new and existing CCBHCs—comes from the Bipartisan Safer Communities Act that President Biden signed in June.

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

The Centers for Medicare & Medicaid Services on Oct. 17 answers to frequently asked questions about the agency’s March 2022 guidance to states regarding planning efforts to resume Medicaid and Children’s Health Insurance Program (CHIP) eligibility determinations and renewals after the Covid-19 public health emergency ends.

The FAQs address the unwinding period, renewals and changes in circumstances, non-MAGI ex parte renewals, section 1902(e)(14)(A) waivers, premiums, fraud, and more.

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

The Center for Connected Health Policy (CCHP) this week released its Fall 2022 summary of telehealth laws and Medicaid program policies, which allows users to export data for each state into a PDF document. CCHP provides bi-annual summary reports to provide a snapshot of the progress made in the past six months.

Also this week, the National Child Traumatic Stress Network released A Trauma-Informed Guide for Working with Youth in Multiple Settings, which is intended for people who work with youth involved in multiple systems (YIMS) and their families to use a traumatic stress perspective and provide trauma-informed care.

The report defines YIMS as children and adolescents who are under the care or supervision of multiple child and family-serving systems. They include “crossover youth” or “dually involved youth” who are involved in child welfare (CW) and in the juvenile justice (JJ) system. In addition to CW and JJ involvement, YIMS are also often simultaneously involved in an array of other service systems including immigration, legal, education, family services, physical and behavioral health systems and systems designed to serve those with developmental disabilities or who experience homelessness.

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

The Association for Behavioral Health and Wellness, the American Psychological Association, and the American Psychiatric Association will host a webinar about what to expect in CPT coding and billing changes for mental health in 2023 on Thursday, Oct. 27.

Stephen Gillaspy, Ph.D., senior director of health and healthcare financing at the American Psychological Association, will lead the presentation about the Centers for Medicare and Medicaid Services’ (CMS) proposed changes outlined in the agency’s 2023 physician fee schedule proposed rule.

The webinar will focus on new CPT codes and changes to existing codes, expanding the outpatient Evaluation and Management (E/M) documentation guidelines to the facility setting, and other CMS proposals, such as “incident to” billing that, if implemented, will have a significant effect on mental and behavioral clinicians beginning Jan.  1, 2023.

The hourlong webinar will begin at 12:30 p.m. ET. Click here to register.

Enhanced NABH Denial-of-Care Portal is Now Available

NABH recently made enhancements to its Denial-of-Care Portal that are intended to make the portal easier for members to use.

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

Please e-mail Emily Wilkins, NABH’s administrative coordinator, if you have questions about the portal.

Save the Date for the NABH 2023 Annual Meeting!

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

Fact of the Week

More seniors in 2022 (28%) than in 2021 (20%) said the cost of care affected their ability to seek treatment for a mental health condition, according to a survey of seniors that the Pan Foundation conducted in May 2022.

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

NABH 2023 Board Position Nominations Due Today!

The deadline to submit nominations for the 2023 NABH Board Chair-Elect and two available NABH Board seats is today, Friday, Oct. 14.

The NABH Selection Committee is seeking senior managers who represent the association’s diverse membership related to levels of care, organizational structures, and size.

Please download a nomination form to recommend individuals for the single-slate ballot in 2023. Also, please attach a curriculum vitae (CV) for every individual you recommend. This will help the Selection Committee in its deliberations. All NABH members are welcome to suggest themselves.

Please return this form and candidates’ curricula vitae by Friday, Oct. 14, 2022, to maria@nabh.org.

Becerra Extends Covid-19 PHE for Another 90 Days

HHS Secretary Xavier Becerra on Thursday renewed the Covid-19 public health emergency (PHE) for an additional 90 days.

Former HHS Secretary Alex Azar declared the Covid-19 PHE for the first time in January 2020 Since then, it has been renewed—either by Azar or Becerra— 10 times, making this week’s announcement the 11^th renewal.

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

Congress and the Biden administration should extend most of the Medicare program’s telehealth flexibilities for beneficiaries for two years after the Covid-19 pandemic ends and then evaluate the effects, the Bipartisan Policy Center (BPC) recommended in a report released this week. And that’s for a start.

The report—totaling more than 80 pages—also concluded that researchers should evaluate the benefits of hybrid (both in-person and virtual) care models for primary and specialty care, including for which conditions and specialties it is most effective; further evaluate full telehealth flexibilities in the context of value-based payment models; and assess rigorously the quality of audio-only care.

“Throughout this report, BPC recommends targeted adjustments to the current telehealth flexibilities; all recommended changes are in response to emerging evidence on benefits versus risks and to stakeholder concerns,” the researchers noted. “This approach would enable beneficiaries to maintain their access to telehealth services while minimizing risks to patients and the Medicare program, as well as provide time for policymakers to continue to review and assess the evidence.”

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

The White Office of National Drug Control Policy (ONDCP) will host a webinar on Monday, Oct. 17 to examine low-threshold buprenorphine programs, which seek to reduce barriers that often limit access or reduce retention in care.

ONDCP Director Rahul Gupta, M.D. will welcome participants to the webinar, which will feature evidence from experts in the field and include a panel discussion about policy and practice.

The webinar will be held from 1 p.m. – 3 p.m. ET. Click here to register.

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

The Association for Behavioral Health and Wellness, the American Psychological Association, and the American Psychiatric Association will host a webinar about what to expect in CPT coding and billing changes for mental health in 2023 on Thursday, Oct. 27.

Stephen Gillaspy, Ph.D., senior director of health and healthcare financing at the American Psychological Association, will lead the presentation about the Centers for Medicare and Medicaid Services’ (CMS) proposed changes outlined in the agency’s 2023 physician fee schedule proposed rule.

The webinar will focus on new CPT codes and changes to existing codes, expanding the outpatient Evaluation and Management (E/M) documentation guidelines to the facility setting, and other CMS proposals, such as “incident to” billing that, if implemented, will have a significant effect on mental and behavioral clinicians beginning Jan.  1, 2023.

The hourlong webinar will begin at 12:30 p.m. ET. Click here to register.

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

An analysis in JAMA Pediatrics this week concluded that immediate action should be taken to alter the current trajectory of unintentional pediatric ingestion of edible cannabis products.

The article noted that cannabis is the third most used psychoactive substance worldwide, with use continuously rising in the U.S. adult population. Meanwhile, cannabis products are used commonly and stored in homes in which children are present and education from healthcare professionals about safe storage is lacking, the article continued. Consequently, children are at risk of being drawn to THC (tetrahydrocannabinol, the psychoactive compound of marijuana)-infused products that resemble their favorite snacks or candy.

“Children with THC intoxication can present with neurologic impairment, including lethargy, ataxia, tachycardia, mydriasis, seizures, altered mental status, and hypotonia,” the article said. “However, given the unpredictability of the dose ingested, patient presentation can vary. Altered mental status in children results in broad differential diagnoses ranging from traumatic to infectious causes.”

Enhanced NABH Denial-of-Care Portal is Now Available

NABH recently made enhancements to its Denial-of-Care Portal that are intended to make the portal easier for members to use.

A year ago, NABH developed the Denial-of-Care Portal to collect specific data on insurers who deny care—often without regard to parity or the effects on patients. Now the association has updated this resource to make it more user-friendly for members and also more aligned with what regulators need to identify parity violations.

The updated portal includes fewer questions, which will require less time for members to complete. In addition, all questions are now optional. NABH hopes this will make it more likely for members to share the data they have. Lastly, NABH has added a checklist of “red flags” that were included in the 2022 MHPAEA Report to Congress from the U.S. Health and Human Services, Labor, and Treasury Departments in January.

Please e-mail Emily Wilkins, NABH’s administrative coordinator, if you have questions about the portal.

Save the Date for the NABH 2023 Annual Meeting!

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

Fact of the Week

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

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

NABH Seeking Candidates for 2023 Board Positions

The NABH Selection Committee is seeking nominations to fill the NABH Board Chair-Elect and two NABH Board seats that will become available in 2023.

In particular, the committee wants to identify senior managers who represent the association’s diverse membership related to levels of care, organizational structures, and size.

Please download a nomination form to recommend individuals for the single-slate ballot in 2023. Please attach a curriculum vitae (CV) for every individual you recommend. This will help the Selection Committee in its deliberations. All NABH members are welcome to suggest themselves.

Please return this form and candidates’ curricula vitae by Friday, Oct. 14, 2022, to maria@nabh.org.

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

Two in three U.S. adults say they believe they don’t have enough knowledge to tell if someone is considering suicide, while eight in 10 adults say they are open to learning how to help someone in need, according to a Harris Poll survey released this week.

Since 2015, the American Foundation for Suicide Prevention (AFSP), the National Action Alliance for Suicide Prevention (Action Alliance), and the Suicide Prevention Resource Center (SPRC) have commissioned the Harris Poll to conduct bi-annual, nationally representative survey of adults in the United States to understand the public’s beliefs and attitudes about mental health and suicide. The survey evaluates what the public knows about to support someone who is struggling and their perceptions of barriers to help those at risk for suicide.

This latest poll offers an early read on public awareness of 988, the national behavioral health crisis hotline that launched in July. Researchers found that while gains have been made in valuing mental health, there is not consistent societal support for mental healthcare.

The findings show that 76% of Americans surveyed said they perceive mental health as equal to physical health, while 51% said they feel that physical health is treated as more important of the two. Meanwhile, 67% of those surveyed said they believe they have had a mental health condition at some point in their lives, up from 60% who said so in 2018 and 57% in 2018.

“Overall, the poll indicates that progress has been made, but there is more to do,” the report noted. “We must continue to learn more about suicide and mental health particularly through increased research efforts, teach everyone how to help prevent suicide and strengthen mental health, and advocate for improved access to care and robust crisis services.”

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

The White House Office of National Drug Control Policy (ONDCP) will host a webinar on Monday, Oct. 17 to examine low-threshold buprenorphine programs, which seek to reduce barriers that often limit access or reduce retention in care.

ONDCP Director Rahul Gupta, M.D. will welcome participants to the webinar, which will feature evidence from experts in the field and include a panel discussion about policy and practice.

The webinar will be held from 1 p.m. – 3 p.m. ET. Click here to register.

HRSA Previews Behavioral Health Training Opportunities for Primary Care Residents

The Health Resources and Services Administration (HRSA) this week announced a funding opportunity totaling nearly $60 million during a five-year period to support training to expand the public health workforce.

The new program will train primary care residents in the prevention, identification, diagnosis, treatment, and referral of services for mental and behavioral health conditions. It is intended to benefit pediatric, adolescent, young adult, and other populations who are at-risk or have experienced abuse, trauma, or mental health and/or substance use disorders, including those related to the effects of gun violence.

According to HRSA, awards will support both classroom training and clinical rotations that focus on mental and behavioral health conditions. Eligible entities include accredited public or not-for-profit private hospitals; schools of allopathic medicine or osteopathic medicine; residency programs accredited by the Accreditation Council for Graduate Medical Education in family medicine, general internal medicine, general pediatrics or combined internal medicine and pediatrics (“med-peds”); and tribes and tribal organizations, if otherwise eligible.

Click here to be notified when this funding opportunity opens.

Enhanced NABH Denial-of-Care Portal is Now Available

NABH recently made enhancements to its Denial-of-Care Portal that are intended to make the portal easier for members to use.

A year ago, NABH developed the Denial-of-Care Portal to collect specific data on insurers who deny care—often without regard to parity or the effects on patients. Now the association has updated this resource to make it more user-friendly for members and also more aligned with what regulators need to identify parity violations.

The updated portal includes fewer questions, which will require less time for members to complete. In addition, all questions are now optional. NABH hopes this will make it more likely for members to share the data they have. Lastly, NABH has added a checklist of “red flags” that were included in the 2022 MHPAEA Report to Congress from the U.S. Health and Human Services, Labor, and Treasury Departments in January.

Please e-mail Emily Wilkins, NABH’s administrative coordinator, if you have questions about the portal.

Save the Date for the NABH 2023 Annual Meeting!

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

Fact of the Week

A Harris Poll survey released this week found that more than half of adults in the United States say seeing a mental health professional is a sign of strength.

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

House to Vote Friday on Senate-Approved Stopgap Spending Measure

The House of Representatives is expected to vote Friday on the short-term spending bill the Senate approved Thursday to avert a federal government shutdown and increase aid to Ukraine.

Included in the legislation is a provision to continue funding the national 988 behavioral crisis hotline through Sept. 30, 2023, for which Congress has appropriated $62,000,000.

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

Acting Deputy Assistant Secretary Tom Coderre of the Substance Abuse and Mental Health Services Administration (SAMHSA) will moderate a panel discussion at 1:15 p.m. ET today, Friday, Sept. 30, the last day of National Recovery Month.

Titled “Making Small Choices, Every Day,” the event will feature panelists who will discuss their recovery experiences while sharing success stories and providing hope that recovery is possible. The panel will address seeking treatment for mental illness or substance use disorders, overcoming challenges such as stigma, and helping the public understand the importance of helping those in recovery.

SAMHSA will livestream the event on the agency’s Facebook page.

House Passes Bill to Bolster Mental Health Parity Protections for Workers

The House earlier this week passed the Mental Health Matters Act of 2022, a bill intended to hold employer-based health plans more accountable for inappropriate denials of mental health and substance use benefits.

The legislation would give the U.S. Labor Department more authority to enforce plan requirements under the Mental Health Parity and Addiction Equity Act and the Employee Retirement Income Security Act. It also would ban forced arbitration agreements when plans deny benefits improperly, and ensure a fair standard of review from the courts.

Before the bill passed, the White House released a Statement of Administrative Policy supporting the legislation. The White House noted that the Mental Health Matters Act also would improve the well-being of young children in Head Start and K-12 schools by building on President Biden’s efforts to increase the number of school-based mental health services providers, as well as authorizing grants to partnerships between high-need, local educational agencies, and institutions of higher education.

NABH will continue to track developments related to this bill.

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

The Centers for Medicare & Medicaid Services (CMS) this week released the agency’s latest enrollment figures for Medicare, Medicaid & the Children’s Health Insurance Program (CHIP), and the health insurance marketplaces, reporting that 156.5 million Americans have coverage in these federal health insurance programs.

According to the latest figures, there are 89.4 million enrollees in Medicaid and CHIP, 64.6 million enrollees in Medicare, and 14.5 million people enrolled in state-based and federal health insurance marketplaces. The agency reported a subtotal figure of 168.5 million enrollees, which CMS then adjusted by subtracting 12 million to account for Americans who are dually eligible for both Medicare and Medicaid.

Click here for a breakdown of the individual programs.

Former ONDCP Leaders Pen Opinion Piece on Increasing Recovery Services

On this last day of National Recovery Month, two former leaders at the White House Office of National Drug Control Policy wrote an opinion piece in The Hill newspaper to call for more training in addiction science and policymaking.

In their blog, former ONDCP Director Michael Botticelli and Regina LaBelle, a former acting director at ONDCP and director of the Addiction and Public Policy Initiative at the Georgetown University Law Center’s O’Neill Institute, recognized the role that people in recovery play by building healthier communities. They also emphasized the need to remove barriers to healthcare, housing, and employment and education, including modifying the regulatory hurdles that reduce access to methadone.

Enhanced NABH Denial-of-Care Portal is Now Available

NABH recently made enhancements to its Denial-of-Care Portal that are intended to make the portal easier for members to use.

A year ago, NABH developed the Denial-of-Care Portal to collect specific data on insurers who deny care—often without regard to parity or the effects on patients. Now the association has updated this resource to make it more user-friendly for members and also more aligned with what regulators need to identify parity violations.

The updated portal includes fewer questions, which will require less time for members to complete. In addition, all questions are now optional. NABH hopes this will make it more likely for members to share the data they have. Lastly, NABH has added a checklist of “red flags” that were included in the 2022 MHPAEA Report to Congress from the U.S. Health and Human Services, Labor, and Treasury Departments in January.

Please e-mail Emily Wilkins, NABH’s administrative coordinator, if you have questions about the portal.

Save the Date for the NABH 2023 Annual Meeting!

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

Fact of the Week

Early intervention in psychosis programs contributed to, on average, 3.2 fewer hospitalizations and 2.7 more years employed during the course of patients’ lives compared with individuals with the same diagnosis who received standard care, according to a study published in Psychiatric Services.

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

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

The U.S. Health and Human Services Department (HHS) on Friday announced it will award more than $1.6 billion in investments to communities nationwide to address America’s addiction and overdose crises.

Funding will come from the Substance Abuse and Mental Health Services Administration’s (SAMHSA) State Opioid Response (SOR) program and Tribal Opioid Response (TOR) grant program and the Health Resources and Services Administration’s (HRSA) rural communities’ opioid response programs.
 
“I have heard many stories of despair from individuals battling addiction and from families who have lost loved ones to overdose,” HHS Secretary Xavier Becerra said in the grant announcement. “Through these grants, we are investing in evidence-based supports and services for individuals, families, and communities on the road to recovery.”

Click here to learn about the four individual grant opportunities.

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

The Covid-19 public health emergency (PHE) will most likely be extended for another 90 days after the PHE’s current Oct. 13, 2022 expiration date because HHS has not given states 60 days’ notice before termination.

In January 2021, HHS’s Administration for Strategic Preparedness & Response (ASPR0 sent a letter to the nation’s governors outlining the commitment to a 60-day, PHE termination notice. HHS Assistant Secretary for Public Affairs Sarah Lovenheim posted a message on Twitter this past Monday, Sept. 19, that assured states and providers there will be at least two months’ notice before the PHE is allowed to expire.

NABH will notify members about any updates related to the PHE’s end date.

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

SAMHSA announced this week that the National Center on Substance Abuse and Child Welfare will host a webinar on Thursday, Sept. 29 that highlights how contingency management can help families affected by substance use disorders.

The webinar will provide an overview of contingency management, including details about implementation with different cultural populations. It will also show how Montefiore Medical Center in New York, a Regional Partnership Grant awardee, has implemented contingency management, and provide practical strategies for implementation.

The webinar will begin next Thursday at 1:30 p.m. ET. Click here to register.

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

A medication to treat heart problems and high blood pressure may also be effective for treating alcohol use disorder, according to a new study from researchers at the National Institutes of Health (NIH) and published in Molecular Psychiatry.

The research shows evidence from experiments in mice and rats—as well as a cohort study in humans—that suggests the medication spironolactone could play a role in reducing alcohol drinking. Researchers from the NIH’s National Institute on Drug Abuse and the National Institute on Alcohol Abuse and Alcoholism, as well as from the Yale School of Medicine, produced the study.

“Combining findings across three species and different types of research studies, and then seeing similarities in those data, gives us confidence that we are onto something potentially important scientifically and clinically,” Lorenzo Leggio, M.D., Ph.D., chief of the clinical psychoneuroendocrinology and neuropsychopharmacology section, a joint laboratory of NIDA and NIAAA, and one of the senior authors, said in an announcement about the research. “These findings support further study of spironolactone as a potential treatment for alcohol use disorder, a medical condition that affects millions of people in the U.S.”

Enhanced NABH Denial-of-Care Portal is Now Available

NABH recently made enhancements to its Denial-of-Care Portal that are intended to make the portal easier for members to use.

A year ago, NABH developed the Denial-of-Care Portal to collect specific data on insurers who deny care—often without regard to parity or the effects on patients. Now the association has updated this resource to make it more user-friendly for members and also more aligned with what regulators need to identify parity violations.

The updated portal includes fewer questions, which will require less time for members to complete. In addition, all questions are now optional. NABH hopes this will make it more likely for members to share the data they have. Lastly, NABH has added a checklist of “red flags” that were included in the 2022 MHPAEA Report to Congress from the U.S. Health and Human Services, Labor, and Treasury Departments in January.

Please e-mail Emily Wilkins, NABH’s administrative coordinator, if you have questions about the portal.

Save the Date for the NABH 2023 Annual Meeting!

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

Fact of the Week

Prenatal cannabis exposure following the middle of the first trimester is associated with attention, social, and behavioral problems in children that persist into early adolescence, according to a recent study in JAMA Pediatrics based on research funded by the National Institute on Drug Abuse.

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

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

Today, Friday, Sept. 16, is the deadline for members to submit changes about their organizations for the online-only NABH 2022 Membership Directory.
Last month NABH sent its system members a message with a link to the association’s membership-update tool. To help ensure we have the most accurate information on our members, please use this tool to verify your system’s information.

NABH has added several new categories this year. The answers to these questions will help us provide a more accurate description of our diverse membership to policymakers, regulators, partner organizations, and the media. Please be sure to enter information for all your system’s facilities so that we have a better picture of our diverse membership.

If you need NABH to re-send the link, please contact Maria Merlie at maria@nabh.org. Thank you for your cooperation!

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

NABH this week sent comments and recommendations to the Centers for Medicare & Medicaid Services (CMS) regarding the agency’s proposed Medicare Hospital Outpatient Prospective Payment System (OPPS) for calendar year 2023 (CY 2023).

In its five-page letter, NABH proposed that CMS examine ways to account for increased costs to ensure that beneficiaries continue to have access to quality outpatient care and offered a range of recommendations, including: reducing the productivity cut for CY 2023; ensuring that non-340B hospitals remain unharmed; expanding telehealth services; and more.

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

The Centers for Medicare & Medicaid Services (CMS) this week announced approval of the Oregon Health Authority’s proposal to cover community-based stabilization services throughout the state.

Oregon is the first state to seek and be granted approval for the new Medicaid option that became available to states in April 2022.  The program will provide community-based stabilization services to individuals experiencing mental health and/or substance use crises by connecting them to a behavioral health specialist 24 hours a day, every day of the year.

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

Sound the Alarm for Kids will host “Helping Girls Thrive: A Conversation Examining Trends in Girls’ Mental Health” is today, Friday, Sept. 16 at 1 p.m. ET.

The virtual roundtable discussion will examine the national campaign to raise awareness about today’s mental health crisis among children and teens and how to create change. Some of the speakers include Christina Bethell, Ph.D., M.P.H., M.B.A, director of the Child and Adolescent Health Measurement Initiative at Johns Hopkins University and Kelley Haynes-Mendez, Psy.D., senior director of the human rights team at the American Psychological Association.

Click here to register.

Enhanced NABH Denial-of-Care Portal is Now Available

NABH recently made enhancements to its Denial-of-Care Portal that are intended to make the portal easier for members to use.

A year ago, NABH developed the Denial-of-Care Portal to collect specific data on insurers who deny care—often without regard to parity or the effects on patients. Now the association has updated this resource to make it more user-friendly for members and also more aligned with what regulators need to identify parity violations.

The updated portal includes fewer questions, which will require less time for members to complete. In addition, all questions are now optional. NABH hopes this will make it more likely for members to share the data they have. Lastly, NABH has added a checklist of “red flags” that were included in the 2022 MHPAEA Report to Congress from the U.S. Health and Human Services, Labor, and Treasury Departments in January.

Please e-mail Emily Wilkins, NABH’s administrative coordinator, if you have questions about the portal.

Save the Date for the NABH 2023 Annual Meeting!

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

Fact of the Week

Based on data from 14 state maternal mortality review committees, the Centers for Disease Control and Prevention (CDC) reports that mental health conditions—including suicide—are the 6th leading cause of pregnancy-related death.

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

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

Rochelle Archuleta has joined NABH as executive vice president for government relations and public policy, effective Sept. 6.

Rochelle brings to NABH 30 years of experience in the health policy, healthcare delivery system, and legislative arenas. During her 20-year tenure as a policy director for the American Hospital Association (AHA), Rochelle led AHA’s post-acute care policy team. In this role, Rochelle partnered with providers, policymakers, and leading trade associations on issues pertaining to the home health, skilled nursing facility/nursing home, inpatient rehabilitation facility, and long-term care hospital sectors.

These advocacy efforts expanded to include issues of common concern to all post-acute care providers and their hospital partners, including issues pertaining to Medicare Advantage and commercial insurers, as well as the Medicare program’s effort to create a new, unified payment system to reimburse the aforementioned, post-acute care settings.

“We are pleased to welcome Rochelle to our team,” said Shawn Coughlin, president and CEO at NABH. “Rochelle’s extensive work in healthcare policy, as well as her strong relationships with partner associations, will enhance NABH’s advocacy efforts—both with legislators and regulators.”

Rochelle is a research fellow in the Georgetown University McCourt School of Public Policy and is a former David Winston Health Policy Fellow. She earned a master of science in health administration and a master of business administration from the University of Alabama at Birmingham School of Health Professions and a bachelor of arts in political science from the University of Colorado at Boulder.

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

NABH this week sent comments and recommendations to the Centers for Medicare & Medicaid Services (CMS) regarding the agency’s proposed Medicare physician fee schedule for fiscal year 2023.

In its nine-page letter, NABH proposed revisions to the “Incident to” regulations and offered a range of recommendations related to the 2023 conversion factor, telehealth, opioid treatment services, coding and payment mechanisms, adjustments to the rate-setting methodology for behavioral health, and more.

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

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

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

Next Friday, Sept. 16 is the deadline for members to submit changes about their organizations for the online-only NABH 2022 Membership Directory.

Last month NABH sent its system members a message with a link to the association’s membership-update tool. To help ensure we have the most accurate information on our members, please use this tool to verify your system’s information.

NABH has added several new categories this year. The answers to these questions will help us provide a more accurate description of our diverse membership to policymakers, regulators, partner organizations, and the media. Please be sure to enter information for all your system’s facilities so that we have a better picture of our diverse membership.

If you need NABH to re-send the link, please contact Maria Merlie at maria@nabh.org. Thank you for your cooperation!

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

Sound the Alarm for Kids will host “Helping Girls Thrive: A Conversation Examining Trends in Girls’ Mental Health” next Friday, Sept. 16 at 1 p.m. ET.

The virtual roundtable discussion will examine the national campaign to raise awareness about today’s mental health crisis among children and teens and how to create change. Some of the speakers include Christina Bethell, Ph.D., M.P.H., M.B.A, director of the Child and Adolescent Health Measurement Initiative at Johns Hopkins University and Kelley Haynes-Mendez, Psy.D., senior director of the human rights team at the American Psychological Association.

Click here to register.

Enhanced NABH Denial-of-Care Portal is Now Available

NABH recently made enhancements to its Denial-of-Care Portal that are intended to make the portal easier for members to use.

A year ago, NABH developed the Denial-of-Care Portal to collect specific data on insurers who deny care—often without regard to parity or the effects on patients. Now the association has updated this resource to make it more user-friendly for members and also more aligned with what regulators need to identify parity violations.

The updated portal includes fewer questions, which will require less time for members to complete. In addition, all questions are now optional. NABH hopes this will make it more likely for members to share the data they have. Lastly, NABH has added a checklist of “red flags” that were included in the 2022 MHPAEA Report to Congress from the U.S. Health and Human Services, Labor, and Treasury Departments in January.

Please e-mail Emily Wilkins, NABH’s administrative coordinator, if you have questions about the portal.

Save the Date for the NABH 2023 Annual Meeting!

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

Fact of the Week

A recent study of 175,778 Medicare beneficiaries found that receipt of opioid use disorder-related telehealth services during the Covid-19 pandemic was associated with improved medications for opioid use disorder (MOUD) retention and lower odds of medically treated overdose, JAMA Psychiatry reports.

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

September is National Recovery Awareness Month

This week kicked off National Recovery Month, a national observance every September since 1989 intended to promote and support new evidence-based treatment and recovery practices, the nation’s recovery community, and the dedication of service providers and community leaders who make recovery possible.

During this past week’s Overdose Awareness Week, which concludes tomorrow, President Biden issued a National Recovery Month proclamation in which he acknowledged the more than 20 million Americans recovering from substance use disorder and highlighted his administration’s efforts to support recovery.

“This year, we secured nearly $22 billion from the Congress to support drug prevention, treatment, harm reduction, and recovery support services, with a focus on underserved communities,” the president said in his proclamation. “With the additional $4 billion investment from our American Rescue Plan, my administration is expanding recovery community organizations, recovery high schools, collegiate recovery programs, and recovery residences.”

For more information about National Recovery Month, please visit the Substance Abuse and Mental Health Administration’s (SAMHSA) website, and please remember to follow NABH @NABHbehavioral and on LinkedIn at the National Association for Behavioral Healthcare.

HHS Announces $47.6 Million in New Grant Funding for School-Based Mental Health

The U.S. Health and Human Services Department (HHS) this week announced $47.6 million in new grant funding opportunities through this Bipartisan Safer Communities Act to support mental health programs in schools.

Of that amount, $37.6 million is allocated for Project Advancing Wellness and Resiliency in Education, or AWARE, which is meant to develop a sustainable infrastructure for school-based mental health programs and services that promote the healthy social and emotional development of school-aged youth and prevent youth violence in schools.

The remaining $10 million is for the Resiliency in Communities after Stress and Trauma (ReCast) grant program, which helps assist high-risk youth and families by promoting resilience and equity in communities that have recently experienced civil unrest, community violence, and/or collective trauma through evidence-based, violence prevention, and community youth engagement programs, as well as connections to trauma-informed behavioral health services.

Nonfatal Opioid-Involved Overdoses in Emergency Departments Are Rising

The rate of nonfatal, opioid-involved overdose emergency medical services (EMS) encounters increased by an average of 4% quarterly from January 2018 – March 2022, according to new research from the Centers for Disease Control and Prevention (CDC).

The findings also reported that rates increased across most sociodemographic and county characteristics. Researchers noted that monitoring nonfatal, opioid-involved overdose trends in EMS data in near real time can help identify where overdose affects communities disproportionately and direct equitable response and prevention efforts, such as increased access to harm-reduction services and connections to care and treatment.

Click here to read the full CDC report.

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

Both not-for-profit and for-profit organizations are eligible to apply for the Health Resources and Services Administration’s (HRSA) Federal Office of Rural Health Policy’s (FORHP) 2023 Rural Health Development Program, a four-year program to support integrated healthcare networks to improve outcomes and strengthen the nation’s rural healthcare system.

The FORHP will make 44 awards of up to $300,000 each as part of the program, which focuses on four domains: improving access by addressing gaps in care, workforce shortages, better workflows and/or improving the quality of healthcare services; expanding capacity and services by creating effective systems through the development of knowledge, skills, structures, and leadership models; enhancing outcomes by improving patient and/or network development outcomes through expanding or strengthening the network’s services, activities or interventions; and establishing sustainability by positioning the network to prepare for sustainable health programs through value-based care and population health management.

FORHP will hold a webinar for applicants on Wednesday, Sept. 7, 2022 from 2 p.m. to 3:30 P.M. ET. Click here for more information about the grants and here for next month’s webinar link.

NABH Submits Medicare Advantage Program Recommendations to CMS

NABH this week responded to a request for information from the Centers for Medicare & Medicaid Services (CMS) about the Medicare Advantage (MA) program and behavioral health.

In its letter, NABH cited a recent study that found MA networks included only 23% of psychiatrists in a county on average — lower than all other medical specialties. “Not surprisingly, MA enrollees with depressive symptoms report more difficulty accessing needed treatment and rated their experience with the MA plans as worse than in traditional Medicare,” the letter said.

The association provided information and outlined recommendations related to advancing health equity, expanding access, encouraging innovation to promote patient-centered care, and engaging partners.

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

NABH has extended the deadline to Friday, Sept. 16 for members to submit changes about their organizations for the online-only NABH 2022 Membership Directory.

Last month NABH sent its system members a message with a link to the association’s membership-update tool. To help ensure we have the most accurate information on our members, please use this tool to verify your system’s information.

NABH has added several new categories this year. The answers to these questions will help us provide a more accurate description of our diverse membership to policymakers, regulators, partner organizations, and the media. Please be sure to enter information for all your system’s facilities so that we have a better picture of our diverse membership.

If you need NABH to re-send the link, please contact Maria Merlie at maria@nabh.org. Thank you for your cooperation!

Enhanced NABH Denial-of-Care Portal is Now Available 

NABH recently made enhancements to its Denial-of-Care Portal that are intended to make the portal easier for members to use.

A year ago, NABH developed the Denial-of-Care Portal to collect specific data on insurers who deny care—often without regard to parity or the effects on patients. Now the association has updated this resource to make it more user-friendly for members and also more aligned with what regulators need to identify parity violations.

The updated portal includes fewer questions, which will require less time for members to complete. In addition, all questions are now optional. NABH hopes this will make it more likely for members to share the data they have. Lastly, NABH has added a checklist of “red flags” that were included in the 2022 MHPAEA Report to Congress from the U.S. Health and Human Services, Labor, and Treasury Departments in January.

Please e-mail Emily Wilkins, NABH’s administrative coordinator, if you have questions about the portal.

Save the Date for the NABH 2023 Annual Meeting!

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

Fact of the Week

Since October, the use of hashtags related to self-harm – such as “#shtwt, short for Self-Harm Twitter – has increased roughly 500%, averaging tens of thousands of mentions per month, according to a new study from the Network Contagion Research Institute and Rutgers University.

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

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

NABH has extended the deadline to Friday, Sept. 16 for members to submit changes about their organizations for the online-only NABH 2022 Membership Directory.

Last month NABH sent its system members a message with a link to the association’s membership-update tool. To help ensure we have the most accurate information on our members, please use this tool to verify your system’s information.

NABH has added several new categories this year. The answers to these questions will help us provide a more accurate description of our diverse membership to policymakers, regulators, partner organizations, and the media. Please be sure to enter information for all your system’s facilities so that we have a better picture of our diverse membership.

If you need NABH to re-send the link, please contact Maria Merlie at maria@nabh.org. Thank you for your cooperation!

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

NABH and more than 50 other advocacy organizations this week sent a letter to U.S. Health and Human Services Department (HHS) Secretary Becerra that urged the Biden administration to integrate mental and physical health within the Administration for Strategic Preparedness and Response (ASPR).

Last month HHS announced that Becerra had elevated the then-existing Office of the Assistant Secretary for Preparedness and Response from a staff division to an operating division—taking the new name of the Administration for Strategic Preparedness and Response—in an effort to elevate ASPR to a standalone agency with the department, similar to the Centers for Disease Control and Prevention (CDC), Food and Drug Administration (FDA), and Substance Abuse and Mental Health Services Administration (SAMHSA). HHS’ announcement said the change would allow ASPR to mobilize a coordinated national response more effectively and efficiently during future disasters and emergencies.

This week, NABH was one of many organizations that called on HHS to use this opportunity to integrate mental and physical health when forming a national response to such events.

“Therefore, with the elevation of ASPR within HHS, the Biden administration must seize this important opportunity to integrate our mental and physical health response in order to truly ensure ASPR is able to fulfill its mission to prepare and respond to health crises,” the organizations wrote in their letter to Becerra. “Needed steps include having senior positions within ASPR dedicated to ensuring the integration of mental health and substance use into all of ASPR’s work, as well as broader staff training to ensure personnel have sufficient background on why mental health is so important to emergency preparedness and response.”

Click here to read the entire letter.

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

The CEO Alliance for Mental Health—of which NABH is a member organization— this week released an update Unified Vision for Transforming Mental Health and Substance Use Care for 2022.

Please read the updated vision, which includes information related to the national 988 behavioral health crisis line that launched last month.

Also, please remember to follow us @NABHbehavioral and on LinkedIn at the National Association for Behavioral Healthcare to share our posts about the vision.

HRSA Announces Funding for 2023 Rural Health Network Development Program

Both not-for-profit and for-profit organizations are eligible to apply for the Health Resources and Services Administration’s (HRSA) Federal Office of Rural Health Policy’s (FORHP) 2023 Rural Health Development Program, a four-year program to support integrated healthcare networks to improve outcomes and strengthen the nation’s rural healthcare system.

The FORHP will make 44 awards of up to $300,000 each as part of the program, which focuses on four domains: improving access by addressing gaps in care, workforce shortages, better workflows and/or improving the quality of healthcare services; expanding capacity and services by creating effective systems through the development of knowledge, skills, structures, and leadership models; enhancing outcomes by improving patient and/or network development outcomes through expanding or strengthening the network’s services, activities or interventions; and establishing sustainability by positioning the network to prepare for sustainable health programs through value-based care and population health management.

FORHP will hold a webinar for applicants on Wednesday, Sept. 7, 2022 from 2 p.m. to 3:30 P.M. ET. Click here for more information about the grants and here for next month’s webinar link.

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

The Coalition on Physician Education in Substance Use Disorders (COPE), a partner organization to the Opioid Response Network, has extended the deadline for its Innovative Learning and Teaching About Substance Use/Opioid Use Disorders Curriculum Innovation Challenge to next Wednesday, Aug. 31 at 11:59 p.m. ET.

The challenge is intended to support teams of medical school faculty and students in integrating addiction medicine/psychiatry content into core clerkship rotations. It is designed to foster engagement and collaboration between addiction medicine experts, medical school faculty (clerkship directors or the equivalent), and medical students using cutting-edge concepts and training tools. Through a series of virtual conferences, winning teams will be led in developing addiction medicine/psychiatry curriculum and planning subsequent implementation based on the needs of their school.

Click here to learn more and apply.

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

Marijuana and hallucinogen use reported by young adults 19 to 30 years old increased significantly in 2021 compared with five and 10 years ago, reaching historic highs in this age group since 1988, according to statistics released this week from the National Institute on Drug Abuse.

The findings came from the Monitoring the Future panel study, which also reported that rates of past-month nicotine vaping, which have been gradually increasing in young adults for the past four years, also continued a general upward trend in 2021, despite leveling off in 2020. Past-month marijuana vaping, which had significantly decreased in 2020, rebounded to pre-pandemic levels in 2021.

Click here to learn more.

Enhanced NABH Denial-of-Care Portal is Now Available

NABH recently made enhancements to its Denial-of-Care Portal that are intended to make the portal easier for members to use.

A year ago, NABH developed the Denial-of-Care Portal to collect specific data on insurers who deny care—often without regard to parity or the effects on patients. Now the association has updated this resource to make it more user-friendly for members and also more aligned with what regulators need to identify parity violations.

The updated portal includes fewer questions, which will require less time for members to complete. In addition, all questions are now optional. NABH hopes this will make it more likely for members to share the data they have. Lastly, NABH has added a checklist of “red flags” that were included in the 2022 MHPAEA Report to Congress from the U.S. Health and Human Services, Labor, and Treasury Departments in January.

Please e-mail Emily Wilkins, NABH’s administrative coordinator, if you have questions about the portal.

Save the Date for the NABH 2023 Annual Meeting!

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

Fact of the Week

About 6% of behavioral health providers and 29% of substance use treatment centers use electronic health record (EHR) technology, compared with more than 80% of hospitals that use EHRs, according to the Medicaid and CHIP Advisory Committee’s June report to Congress (see p. 84).

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

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

The Centers for Medicare & Medicaid Services this week released a series of fact sheets and resources to help the nation’s healthcare providers prepare for the end of the Covid-19 public health emergency (PHE), which will also end many of the flexibilities the agency offered during the global pandemic.

A blog post from three CMS leaders noted that the agency learned from providers, facilities, insurers, and other stakeholders about what worked well—and didn’t—in relation to the agency’s waivers and other temporary measures.

“Expanding telehealth is an example of a congressional change,” said the blog post from Jonathan Blum, CMS’ chief operating officer and principal deputy administrator; Carol Blackford, director of the agency’s hospital and ambulatory policy group; and Jean Moody-Williams, deputy director of the Center for Clinical Standards and Quality. “The Consolidated Appropriations Act, 2021 expanded access to telehealth services for the diagnosis, evaluation, or treatment of mental health disorders after the end of the PHE,” the authors continued. “These services have been so important to the health and well-being of Americans affected by Covid-19.”

The post also noted that U.S. Health and Human Services Department (HHS) Secretary Xavier Becerra will give the healthcare community 60 days’ notice before the PHE ends.

Providers can refer to a host of fact sheets and resources from CMS in links at the end of the blog post to help prepare as the PHE winds down.

CMS Rule Proposes Requiring Behavioral Health Quality Data Reporting

CMS on Thursday released a proposed rule that would require annual state reporting for three quality measure sets, including the behavioral health measures in the Core Set of Adult Health Care Quality Measures for Medicaid.

The Behavioral Health Core Set includes 13 measures: a depression measure under the Primary Care Access and Preventive Care domain; four measures related to individuals with substance use disorders including one related to medication assisted treatment; two related to the prescribing of opioids; and six measures related to individuals with mental disorders. These core sets are designed to measure the overall national quality of care for beneficiaries, monitor performance at the state level, improve the quality of health care, and provide a national view of quality.

CMS has proposed that reporting these measures—currently a voluntary practice—become mandatory in fiscal year 2024. Data reported in 2024 will reflect care delivered in calendar year 2023.

“The Medicaid and CHIP Core Sets of quality measures for children, adults, and health home services are key to promoting health equity,” CMS Administrator Chiquita Brooks-LaSure said in an announcement. “They will allow us not only to identify health disparities but also to implement interventions based on the very data that make those disparities clear.”

In addition to the Child and Adult Core Sets, CMS has proposed establishing reporting requirements for states that elect to implement one or both of the optional Medicaid health home benefits under sections 1945 or 1945A of the Social Security Act, which will measure healthcare quality for states that choose to establish “health homes.”

Public comments about the proposed rule are due Oct. 21, 2022. The rule will be published in the Federal Register on Monday, Aug. 22.

New JAMA Study Shows Pervasiveness of Methamphetamine Use in Rural America

Findings from a JAMA Network Open study released this week show that nearly four of five people taking drugs in rural areas across 10 states used methamphetamine in the past 30 days.

Meanwhile, non-fatal overdoses in the past six months were higher among people using both methamphetamines and opioids (22%), compared with opioids alone (14%), or methamphetamines alone (6%).

“The challenge is compounded in rural communities that often lack buprenorphine prescribers: more than one-half of U.S. counties (53.4%) do not have a buprenorphine prescriber, leaving 30 million people in those counties without access to treatment,” the researchers wrote. “Similarly, rural opioid treatment programs are rare, leading to long driving times to access methadone,” they continued, adding that educational interventions are needed to train primary care physicians, who are essential providers of opioid use disorder treatment in rural America.

“For example,” they wrote, “contingency management training interventions could be adapted to support rural primary care practitioners.”

NABH Annual Membership Updates Are Due Today

The deadline to submit changes about your organization for the online-only NABH 2022 Membership Directory is today, Friday, Aug. 19.

Last month NABH sent its system members a message with a link to the association’s membership-update tool. To help ensure we have the most accurate information on our members, please use this tool to verify your system’s information.

NABH has added several new categories this year. The answers to these questions will help us provide a more accurate description of our diverse membership to policymakers, regulators, partner organizations, and the media. Please be sure to enter information for all your system’s facilities so that we have a better picture of our diverse membership.

If you need assistance, please contact Maria Merlie at maria@nabh.org. Thank you!

Enhanced NABH Denial-of-Care Portal is Now Available

NABH recently made enhancements to its Denial-of-Care Portal that are intended to make the portal easier for members to use.

A year ago, NABH developed the Denial-of-Care Portal to collect specific data on insurers who deny care—often without regard to parity or the effects on patients. Now the association has updated this resource to make it more user-friendly for members and also more aligned with what regulators need to identify parity violations.

The updated portal includes fewer questions, which will require less time for members to complete. In addition, all questions are now optional. NABH hopes this will make it more likely for members to share the data they have. Lastly, NABH has added a checklist of “red flags” that were included in the 2022 MHPAEA Report to Congress from the U.S. Health and Human Services, Labor, and Treasury Departments in January.

Please e-mail Emily Wilkins, NABH’s administrative coordinator, if you have questions about the portal.

Save the Date for the NABH 2023 Annual Meeting!

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

Fact of the Week

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

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

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

In a final rule released Thursday, the Centers for Medicare & Medicaid Services (CMS) said total estimated payments to inpatient psychiatric facilities (IPFs) are estimated to increase by 2.5%, or $90 million, in fiscal year 2023 relative to IPF payments in 2022. This is larger than the 1.5% payment increase the agency proposed this spring.

For 2023, CMS is updating the IPF prospective payment system (PPS) rates by 3.8%, based on the final IPF market basket update of 4.1% minus a 0.3 percentage point productivity adjustment.

CMS is also updating the outlier threshold so that estimated outlier payments remain at 2% of total payments. The agency estimates this will result in a 1.2% decrease to aggregate payments, due to updating the outlier threshold. CMS noted that due to rounding, the 3.8% increase to payment rates and the 1.2% decrease to outlier payments yield a 2.5% overall increase in IPF payments.

A fact sheet from CMS highlights the final rule’s major provisions, including a permanent 5% cap policy to ease the impact of year-to-year changes in IPF payments related to decreases in the IPF wage index.

Finally, CMS did not make final any changes for the IPF Quality Reporting Program in the 2023 final rule.

Gov. Phil Murphy Announces ‘Strengthening Youth Mental Health Care’ as NGA Chair’s Initiative

Incoming National Governors Association (NGA) Chair Gov. Phil Murphy (D-N.J.) announced “Strengthening Youth Mental Health Care” is his chair’s initiative as he leads the organization from 2022-2023.

“We are all aware of the youth mental health crisis in our country,” Murphy said during the closing session of the NGA’s summer meeting in Portland, Maine. “It is a crisis that the pandemic did not create but exposed more fully,” he added. “It is one that we must tackle together, and tackle now.”

Murphy also acknowledged access-to-care problems and highlighted the four pillars of his chair’s initiative: prevention and resilience building; increasing awareness and reducing stigma; access and affordability of quality treatment and care; and caregiver and educator training and support.

Click here to read more about Murphy’s initiative.

Opioid Response Network & National Association of Counties Offer Guidance on Managing Opioid Litigation Funds   

The Opioid Response Network (ORN) and the National Association of Counties (NACo) have partnered to strengthen the association’s new Opioid Solutions Initiative and resource center, which offers guidance to U.S. counties about how to use funding from litigation between states and opioid manufacturers and distributors.

The support center provides guidance on managing opioid litigation funds, information about effective substance use prevention, treatment and recovery approaches that are approved uses of settlement funds, case studies on evidence-based practices, and  — with help from the ORN — free, on-demand education and training.

Click here to read more about NACo’s Opioid Solutions Center and click here to submit requests for free education and training.

NABH Annual Membership Update: 2022 Membership Directory

NABH is developing its online-only 2022 Membership Directory, an essential member benefit that helps the asssociation in its advocacy efforts.

Earlier this week, NABH sent its system members a separate message that includes a link to the association’s membership-update tool. To help ensure we have the most accurate information on our members, please use the link to our membership-update tool and verify your system’s information.

NABH has added several new categories this year. The answers to these questions will help us provide a more accurate description of our diverse membership to policymakers, regulators, partner organizations, and the media. Please be sure to enter information for all of your system’s facilities so that we have a better picture of our diverse membership.

The deadline to submit your changes to NABH is Friday, Aug. 19, 2022. If you need assistance, please contact Maria Merlie at maria@nabh.org. Thank you!

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

NABH recently made enhancements to its Denial-of-Care Portal that are intended to make the portal easier for members to use.

A year ago, NABH developed the Denial-of-Care Portal to collect specific data on insurers who deny care—often without regard to parity or the effects on patients. Now the association has updated this resource to make it more user-friendly for members and also more aligned with what regulators need to identify parity violations.

The updated portal includes fewer questions, which will require less time for members to complete. In addition, all questions are now optional. NABH hopes this will make it more likely for members to share the data they have. Lastly, NABH has added a checklist of “red flags” that were included in the 2022 MHPAEA Report to Congress from the U.S. Health and Human Services, Labor, and Treasury Departments in January.

“We know the best way to advocate for parity enforcement with regulators is to provide hard data from our members that show how insurers are not complying with the landmark 2008 parity law,” said NABH President and CEO Shawn Coughlin. “We hope these new changes will make it easier—and faster—for our members to use so that we can gather that critical data.”

Please e-mail Emily Wilkins, NABH’s administrative coordinator, if you have questions about the portal.

Save the Date for the NABH 2023 Annual Meeting!

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

Fact of the Week

Calls to the new, national 988 behavioral health crisis hotline increased by 45% during the week after it transitioned to a three-digit number from a longer one.

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

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

In a recent JAMA commentary, the head of the White House Office of National Drug Control Policy (ONDCP) said the lack of real-time data for both fatal and nonfatal drug overdoses in the United States undermines the ability to respond accountably and restricts the potential to understand the effects of actions and investments.

ONDCP Director Rahul Gupta, M.D., M.B.A., M.P.H., and David Holtgrave, Ph.D., also of ONDCP, argued that it’s essential to build the national data system while taking actions to prevent overdoses and save lives in the near term.

“Once established, this national system should rapidly yield higher-quality, more complete, more timely, and more actionable data to inform increasingly effective policy making to prevent and treat overdose occurrences and build health equity,” the authors wrote. “Doing so will require the partnership of many, but there is not a moment to lose.”

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

Politico reported this week that the influential Uniform Law Commission agreed to propose legislation to state legislatures that would try to create more consistency in telehealth laws and expand access to care across state lines.

The commission nearly unanimously approved the model legislation after two years of deliberations and guidance from the American Medical Association, Federal Trade Commission, state medical boards, and telehealth groups.

“It’s unclear how many states will move to create new laws around telehealth — or use the Uniform Law Commission’s model — but legislatures have embraced past proposals on issues ranging from regulation of organ donation to taxation of people who work in multiple states,” the story noted.

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

The nation’s rural health clinics (RHCs) still have an opportunity to apply for funding from the Health Resources and Services Administration’s (HRSA) program that pays providers who are waivered to prescribe buprenorphine, a medication used to treat opioid use disorder.

Launched in 2021, HRSA’s program has about $1.2 million in program funding still available, and RHCs may apply for a $3,000 payment on behalf of each provider who trained to obtain the necessary waiver. HRSA said funds will be paid on a first-come, first-served basis until funds are exhausted.

Please direct any questions to DATA2000WaiverPayments@hrsa.gov. In addition, the American Osteopathic Academy of Addiction Medicine and the Providers Clinical Support System are offering a free online course for waiver-eligibility training. Click here for more information.

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

NABH has made enhancements to its Denial-of-Care Portal that are intended to make the portal easier for members to use.

A year ago, NABH developed the Denial-of-Care Portal to collect specific data on insurers who deny care—often without regard to parity or the effects on patients. Now the association has updated this resource to make it more user-friendly for members and also more aligned with what regulators need to identify parity violations.

The updated portal includes fewer questions, which will require less time for members to complete. In addition, all questions are now optional. NABH hopes this will make it more likely for members to share the data they have. Lastly, NABH has added a checklist of “red flags” that were included in the 2022 MHPAEA Report to Congress from the U.S. Health and Human Services, Labor, and Treasury Departments in January.

“We know the best way to advocate for parity enforcement with regulators is to provide hard data from our members that show how insurers are not complying with the landmark 2008 parity law,” said NABH President and CEO Shawn Coughlin. “We hope these new changes will make it easier—and faster—for our members to use so that we can gather that critical data.”

Please e-mail Emily Wilkins, NABH’s administrative coordinator, if you have questions about the portal.

Save the Date for the NABH 2023 Annual Meeting!

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

Fact of the Week

Sixty-four percent of dual-eligible beneficiaries have a mental health diagnosis, according to a recent profile from research firm. ATI Advisory.

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

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

The Centers for Medicare & Medicaid Services (CMS) on Thursday proposed new policies to update coverage for behavioral health services in the agency’s physician fee schedule proposed rule for 2023.

In the rule, CMS proposes to address the behavioral healthcare workforce shortage by allowing licensed professional counselors (LPCs), marriage and family therapists (LMFTs), and other types of behavioral health practitioners to provide behavioral health services under general, rather than direct, supervision. CMS also proposes to pay for clinical psychologists and licensed clinical social workers to provide integrated behavioral health services as part of a patient’s primary care team.

In addition, the rule proposes to bundle certain chronic pain management and treatment services into new monthly payments to help improve patient access to team-based, comprehensive, chronic pain treatment. And the agency is proposing to cover opioid treatment and recovery services from mobile units, such as vans, to increase access to services for people who are homeless or live in rural areas.

Meena Seshamani, M.D., Ph.D., director for the Center for Medicare at CMS, and Douglas Jacobs, M.D., M.P.H., chief transformation officer at the Center for Medicare, co-authored a blog post Thursday about the behavioral health changes in the proposed rule.

Federal Health Officials Recommend ‘Preaddiction’ to Treat SUDs

Directors at the National Institutes of Health and the founder of the Treatment Research Institute this week recommended that the DSM-5 diagnostic categories “mild to moderate SUD” be a starting definition for the term preaddiction, a term they said could generate greater attention to the risks associated with early state substance use disorder (SUD) and help direct policies and resources to support preventive and early intervention measures.

Nora Volkow, M.D., director of the National Institute on Drug Abuse, George Koob, Ph.D., director of the National Institute on Alcohol and Abuse and Alcoholism, and Tom McClellan, founder of the Treatment Institute wrote a commentary in JAMA Psychiatry this week that pushed for using the term preaddiction and highlighted lessons learned from Type 2 Diabetes and the role of “prediabetes” in their argument.

As the authors explained, the American Diabetes Association in 2001 suggested the term prediabetes (defined by elevated scores on two laboratory tests: impaired glucose tolerance and impaired fasting glucose) to leverage public motivation to avoid serious diabetes.

“Intervening early is not a new concept, nor is it easy to implement,” the authors wrote. “The diabetes field likely succeeded owing to a broad, well-organized, and sustained strategy applied concurrently at the clinical, public, and policy levels,” they said, adding that if an analogous approach is to be effective in the SUD field, it will require similarly integrated efforts in three areas: measures to define and detect preaddiction; engaging, effective interventions for preaddiction; and public and clinical advocacy.

“The diabetes example illustrates why a similar strategy has not yet happened in the SUD field: poor integration into the rest of mainstream healthcare, lack of a prominent advocacy group demanding clinical and policy changes, and little reimbursement for interventions with less severe SUDs,” the authors noted. “Nonetheless, the diabetes example shows that an early intervention approach can work given a comprehensive, sustained effort. That example also suggests the potential impact from a parallel strategy to reduce addiction problems by more aggressive efforts to identify and reverse preaddiction.”

Volkow discussed the issue further in her blog on July 6.

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

The U.S. Housing and Urban Development Department (HUD) recently announced $322 million for permanent housing, supportive services, and other costs, and $43 million to fund about 4,000 new incremental housing choice vouchers.

The Initiative for Unsheltered and Rural Homelessness through HUD promotes partnerships with healthcare organizations, public housing authorities and mainstream housing providers, and people with lived experience and expertise of homelessness.

“President Biden is following through on his promise to unite our country by delivering funding for healthcare and services that support individuals who are unhoused,” Rahul Gupta, M.D., director of the White House Office of National Drug Control Policy, said in an announcement. “As a physician I have seen firsthand how important it is to address the social and economic conditions of a person’s life in order for them to realize the health and well-being every American deserves.”

Click here to learn more in the full HUD announcement.

SAMHSA Releases Advisory on Peer Supports Services in Crisis Care

The Substance Abuse and Mental Health Services Administration (SAMHSA) has released an advisory that discusses the role of peer support workers and models that are available to help individuals in crisis.

The 17-page resource includes information about the evidence base for peer support services in crisis care, what peer support workers should do, how the recovery process looks different for everyone, and more.

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

The National Academies’ Forum on Mental Health and Substance Use Disorders will host a public workshop that focuses on early intervention for psychosis, current data on the epidemiology and outcomes for people at high risk for psychosis and those who have experienced a first psychosis, and ways to improve care for these patients.

Sessions will provide an overview of the epidemiology for people with psychosis, discuss what services are available and highlight successful models of care, and examine policy solutions and strategies that the most effective for coordinated specialty services.

The workshop will be held on Monday, July 11 from 11 a.m. to 5 p.m. ET. Click here to register.

Reminder: 2022 Annual Meeting Evaluation

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

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

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

The Substance Abuse and Mental Health Services Administration (SAMHSA) will host a 90-minute webinar for business managers and compliance officers on July 7 to help ensure their organizations comply with SAMHSA’s 42 CFR Part 2 regulations.

The lesson will highlight the latest updates released in January 2018; examine multiple scenarios and frequently asked questions related to SAMHSA’s mental health, substance abuse, and alcohol abuse records; and address proper ways to secure and/or release this information.

SAMHSA urges practice managers, business associates who work with health records, compliance officers, physicians, and other medical professionals to attend the webinar on Thursday, July 7 at 1 p.m. ET.

Click here to register.

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

In its new White House Blueprint for Addressing the Maternal Health Crisis, the Biden administration has recommended 50 actions that more than a dozen federal agencies will take to improve maternal care in the United States, including some related to behavioral health.

Released in June, the 68-page blueprint outlines five goals, starting with Goal #1: Increase Access to and Coverage of Comprehensive High-Quality Maternal Health Services, Including Behavioral Health Services.

“We will continue to invest in maternal behavioral health by launching a 24/7 national support hotline for pregnant individuals and new mothers facing mental health challenges and improving provider education,” the blueprint noted in this first goal. “We will also strengthen access to perinatal addiction services by partnering with hospitals and community-based organizations to implement evidence-based practices,” it continued. “Congress must also take critical steps to bolster access to and coverage of maternal health services.”

Other behavioral health-related action items include strengthening supports and access to perinatal addiction services for individuals with substance use disorder by partnering with hospitals and community-based organizations to implement evidence-based interventions, and appointing a dedicated associate administrator for women’s services at SAMHSA to lead its efforts in promoting positive mental health during pregnancy and in the postpartum period.

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

NABH this week responded to the Agency for Healthcare Research and Quality’s (AHRQ) request for information (RFI) regarding potential Consumer Assessment of Healthcare Providers and Systems (CAHPS) for Inpatient Mental Healthcare Settings.

AHRQ’s detailed RFI seeks to identify the highest priority aspects patient experiences to include in measures and surveys, the benefits of collecting information about a patient’s experience from family members and caregivers, the challenges that exist in collecting this information, and much more.

“During inpatient stays, patients are typically experiencing an increase in psychiatric symptomatology, including, but not limited to, hallucinations, paranoia, delusions, emotional lability, and fragmented cognitive processes,” NABH’s letter said in response to a question about the challenges in administering measures and surveys in mental healthcare settings. “Patients may thus be limited in their ability to express thoughts and feelings, to comprehend written material, or sustain their attention to complete a survey,” the letter continued. “For these reasons, we suggest limiting surveys to 20-25 questions, or 8-10.”

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

The National Academies’ Forum on Mental Health and Substance Use Disorders will host a public workshop that focuses on early intervention for psychosis, current data on the epidemiology and outcomes for people at high risk for psychosis and those who have experienced a first psychosis, and ways to improve care for these patients.

Sessions will provide an overview of the epidemiology for people with psychosis, discuss what services are available and highlight successful models of care, and examine policy solutions and strategies that the most effective for coordinated specialty services.

The workshop will be held on Monday, July 11 from 11 a.m. to 5 p.m. ET. Click here to register.

Reminder: 2022 Annual Meeting Evaluation

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

Fact of the Week

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

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

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

Senate Passes Gun-Control Bill with Mental Health Provisions

The Senate on Thursday passed the most significant gun-control legislation since the mid-1990s in a bill that includes about $15 billion in mental health and school security funding. The House is expected to vote today, June 24, on the measure.

The Bipartisan Safer Communities Act expands the existing Medicaid Certified Community Behavioral Health Clinic (CCBHC) demonstration program to all states; helps states to implement, enhance, and expand school-based health programs under Medicaid through updated guidance, technical assistance, and state planning grants; requires the Centers for Medicare & Medicaid Services (CMS) to provide guidance to states on how they can increase access to behavioral health services through telehealth under Medicaid and CHIP; appropriates $150 million to help implement the upcoming 988 behavioral health crisis hotline; provides $500 million through the School-Based Mental Health Services Grant Program to increase the number of qualified mental health service providers that provide school-based mental health services to students in school districts with demonstrated need; and more.

President Biden said he intends to sign the bill into law.

“Last month, President Biden spent hours with the family members whose lives were forever changed by the recent shootings at a grocery store in Buffalo, New York and an elementary school in Uvalde, Texas,” said a Statement of Administration Policy from the Office of Management and Budget. “The family members delivered a simple message, which the president then relayed to the American people: do something. Do something to stop the carnage of gun violence that leaves behind grief and trauma in communities, both big and small, across the country.”

The statement added that the bill advances President Biden’s agenda to expand access to mental health services and address the trauma of gun violence affecting so many communities.

Click here to read the legislation.

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

In a 402-20 vote Wednesday, the House of Representatives passed H.R. 7666, the Restoring Hope for Mental Health and Well-Being Act, which would reauthorize essential Substance Abuse and Mental Health Services (SAMHSA) and Health Resources and Services Administration (HRSA) programs to address the nation’s mental health and substance use crises.

The bill would reauthorize and modify several programs, including the Community Mental Health Services Block Grant, the Substance Abuse Prevention and Treatment Block Grant, and grants related to suicide prevention and the behavioral health workforce.

In remarks on the House floor, House Majority Leader Steny Hoyer (D-Md.) applauded the House Energy and Commerce Committee and all House members whose legislation was included in the package.

“I hope this strong vote today will help move these critical policies through the Senate and see them quickly enacted into law,” Hoyer added.

On Tuesday, the Biden administration said it supported the bill in a Statement of Administrative Policy.

World Health Organization Releases First World Mental Health Report Since 2001

The World Health Organization (WHO) has released its largest review of world mental health since it released World Health Report 2001: Mental Health: New Understanding, New Hope.

The latest iteration, Transforming Mental Health for All, provides a roadmap for governments, academics, health professionals, and others to support the world in transforming mental health.

“As the world comes to live with, and learn from, the far-reaching effects of the Covid-19 pandemic, we must all reflect on one of its most striking aspects – the huge toll it has taken on people’s mental health,” the nearly 300-page report noted. “Rates of already-common conditions such as depression and anxiety went up by more than 25% in the first year of the pandemic, adding to the nearly one billion people who were already living with a mental disorder,” it continued. “At the same time, we must recognize the frailty of health systems attempting to address the needs of people with newly-presenting as well as pre-existing mental health conditions.”

The report also said that since 2001, countries worldwide have formally adopted international frameworks that guide them to act for mental health. And, it continued, WHO member states have adopted the Comprehensive Mental Health Action Plan 2013-2030, which commits them to meeting 10 global targets for improved mental health.

Categorized in eight sections, the report examines principles and drivers in public mental health, assesses world mental health today, argues for investment in mental health, considers promotion and prevention strategies for change, and explores how to restructure and scale up care.

MACPAC Examines How Medicaid Policy Can Support Adopting Behavioral Health IT

In its June report to Congress, the Medicaid and CHIP Payment and Access Commission (MACPAC) analyzed how Medicaid policy can be used to support adopting health information technology among behavioral healthcare providers.

The report highlighted that Medicaid programs play a critical role in financing behavioral health services and that those programs are focused on ways to provide behavioral health in more integrated settings.

Therefore, the Commission recommended, “…that CMS issue guidance to help states use Medicaid authorities and other federal resources to promote behavioral health IT adoption, and that the Office of the National Coordinator for Health Information Technology and the Substance Abuse and Mental Health Services Administration work together to develop voluntary standards that would encourage health IT uptake appropriate for behavioral health.”

See chapter 4 of the report, Encouraging Health Information Technology Adoption in Behavioral Health: Recommendations for Action, to learn more.

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

The Centers for Disease Control and Prevention (CDC) has launched an alcohol-screening tool for adults to check their drinking, identify barriers to drinking less frequently, and create a personalized plan to make healthier drinking choices—all anonymously.

The resource is part of the Atlanta-based agency’s new Drink Less, Be Your Best campaign that highlights the harmful effects of alcohol and provides resources to help adults drink less.

CDC noted in its announcement that the tool is not intended for medical diagnosis or treatment.

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

Award-winning filmmaker Ken Burns presents Hiding in Plain Sight: Youth Mental Illness, a two-part documentary film by Erik Ewers and Christopher Loren Ewers on Monday and Tuesday, June 27 and 28 at 9 p.m. ET on PBS.

Click here to see a preview of the film, which includes a brief introduction from Burns.

2022 Annual Meeting Presentations Available Online

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

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

The National Academies’ Forum on Mental Health and Substance Use Disorders will host a public workshop this summer that focuses on early intervention for psychosis, current data on the epidemiology and outcomes for people at high risk for psychosis and those who have experienced a first psychosis, and ways to improve care for these patients.

Sessions will provide an overview of the epidemiology for people with psychosis, discuss what services are available and highlight successful models of care, and examine policy solutions and strategies that are the most effective for coordinated specialty services.

The workshop will be held on Monday, July 11 from 11 a.m. to 5 p.m. ET. Click here to register.

Save the Date for the 2023 Annual Meeting!

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

Fact of the Week

In 2019, nearly a billion people – including 14% of the world’s adolescents – were living with a mental disorder, the World Health Organization reports.

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

NABH Annual Meeting Kicks Off on Monday!

We’re pleased to devote this week’s edition of CEO Update to details about our Annual Meeting that starts on Monday, June 13!

Our theme this year is Shaping the Future of Behavioral Healthcare, and our speakers—including HHS Secretary Xavier Becerra— will address topics that affect our industry today and in the years ahead. From parity and access to care, to the Biden’s administration’s behavioral health and drug control strategies, to the 2022 midterm elections, to workforce challenges and solutions, to the upcoming 988 behavioral health crisis hotline, this year’s program is one you won’t want to miss.

On Monday, please be sure to look for an Annual Meeting Alert, which will include a link to our mobile app that contains important details about sessions, events, committee meeting room assignments, exhibitors and sponsors, our priorities for the 117^th Congress, restaurant recommendations in the Washington area, and more.

We’ll open our meeting on Monday with two dynamic speakers: Ben Nemtin will discuss his personal battle with clinical depression and how to thrive personally and professionally, and journalist Sam Quinones will share his experiences writing his most recent book, The Least of Us: True Tales of America and Hope in the Time of Fentanyl and Meth. Sam will sign copies of his book after his presentation.

As with previous Annual Meetings, we will post presentations on our website after the meeting ends. Registration opens on Monday at noon, and our first session kicks off in the Mandarin Oriental’s Grand Ballroom at 2:30 p.m. I hope to see you there!

-Shawn Coughlin, President and CEO

HHS Secretary Becerra to Address Attendees on Tuesday, June 14

HHS Secretary Xavier Becerra, the 25^th secretary of the U.S. Health and Human Services Department and the first Latino to hold that office, will address Annual Meeting attendees on Tuesday, June 14 at 8:30 a.m. in the Grand Ballroom.

Secretary Becerra will offer brief remarks and then engage in a question-and-answer session with NABH President and CEO Shawn Coughlin.

Previously Secretary Becerra was California’s attorney general and before that served for 12 terms in the U.S. House of Representatives, where he was the first Latino to serve as a member of the powerful House Ways and Means Committee. He also served as chairman of his party’s caucus and as the ranking member of both the Ways and Means Subcommittee on Health and Ways and Means Subcommittee on Social Security.

Secretary Becerra will discuss the Biden administration’s comprehensive strategy to address America’s mental health crisis, which includes promoting the well-being of the nation’s frontline healthcare workforce, piloting new approaches to training behavioral health paraprofessionals, strengthening the country’s crisis care and suicide prevention infrastructure, integrating mental health and substance use treatment into primary care, expanding and strengthening parity, and more.

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

Following Secretary Becerra’s presentation on Tuesday, Office of National Drug Control Policy (ONDCP) Director Rahul Gupta, M.D., M.B.A., FACP will provide a presentation at 9:30 a.m. in the Grand Ballroom.

Dr. Gupta is the first medical doctor to serve as director and lead ONDCP, a component of the Executive Office of the President. ONDCP coordinates the nation’s $40 billion drug budget and federal policies, including prevention, harm reduction, treatment, recovery support, and supply reduction.

Through his work as a physician, a state and local leader, an educator, and a senior leader of a national nonprofit organization, Dr. Gupta has dedicated his career to improving public health and public safety.

He is also a buprenorphine-waivered practitioner, who has provided medication-assisted treatment for people with opioid use disorder.

The son of an Indian diplomat, Dr. Gupta was born in India and grew up in the suburbs of Washington, D.C. At age 21, he completed medical school at the University of Delhi and later completed subspecialty training in pulmonary medicine.

Dr. Gupta earned a master’s degree in public health from the University of Alabama-Birmingham and a global master’s of business administration degree from the London School of Business and Finance.

Panel to Examine Ways to Address Behavioral Healthcare Workforce Challenges

Workforce shortages have challenged NABH members for years before the pandemic worsened the problem. For this year’s Annual Meeting, NABH has developed a panel to discuss potential solutions.

Please join us in the Grand Ballroom on Tuesday, June 14 at 11 a.m. to learn from panelists Megan Baird of the Office of Apprenticeship in the U.S. Labor Department’s Employment and Training Administration; Malissa Lewis, LL.M of the Health Resources and Services Administration; and David Long of Pinnacle Treatment Centers, an NABH member organization.

NABH Director of Quality and Addiction Services Sarah Wattenberg, L.C.S.W. will moderate a discussion that will highlight apprenticeships, loan repayment programs, and more.

Political Commentator Amy Walter to Discuss 2022 Midterm Elections

Be sure to attend this year’s Annual Meeting Luncheon at noon on Tuesday, June 14 in the Oriental Ballroom to learn from political commentator Amy Walter, who will preview this fall’s midterm election season.

Walter, editor in chief of the Cook Political Report with Amy Walter and a political commentator for the PBS NewsHour, provides analysis of the issues, trends, and events that shape the political environment. She is also a regular Sunday panelist on NBC’s Meet the Press and CNN’s Inside Politics and appears frequently on Special Report with Bret Baier on Fox News Channel.

From 2017 until early 2021, Walter was the host of the weekly nationally syndicated program “Politics with Amy Walter” on The Takeaway from WNYC and PRX. She’s also the former political director of ABC News.

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

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

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

The Biden Administration concluded Mental Health Month this week by announcing new actions to advance President Biden’s mental health strategy in three previously announced objectives: strengthening system capacity, connecting more Americans to care services, and creating a continuum of support.

The White House noted that America’s mental health crisis is unprecedented, as two in five American adults report symptoms of anxiety and depression, and more than half of U.S. parents express concern about their children’s mental well-being. Meanwhile, the announcement continued, more than 40% of teenagers report they struggle with persistent feelings of sadness and hopelessness.

“These growing demands have exposed longstanding cracks in our care infrastructure while compounding many other challenges, from criminal justice to homelessness to the labor shortage,” the White House announcement said.

In a new fact sheet, the Biden Administration outlined applicable action steps to address the crisis, such as promoting the well-being of the healthcare workforce, piloting new approaches to training behavioral health paraprofessionals, bolstering the nation’s crisis care and suicide prevention infrastructure, building capacity for long-term care facilities to deliver behavioral health services, making care affordable across all types of health insurance coverage, integrating mental health services in ways that reduce stigma and access barriers, and more.

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

HHS’ Office on Women’s Health is accepting applications for projects designed to strengthen the perinatal (from conception to birth) and postnatal (up to 12 months after birth) to support structures for patients with substance use disorder (SUD) and reduce deaths during those two time periods.

Applicants who receive funding will be expected to partner with hospital and community-based organizations to implement evidence-based interventions that strengthen perinatal and postnatal support structures for patients with SUD; create a technologically innovative education and outreach products to provide support accessible to perinatal and postpartum patients with SUD at home and on the go to reduce triggers, decrease stress, and increase feelings of support; and improve health outcomes and reduce deaths among perinatal and postpartum patients associated with SUD.

Both for-profit and not-for-profit organizations are eligible to apply. Click here to learn more and apply.

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

The National Academies’ Forum on Mental Health and Substance Use Disorders will host a public workshop this summer that focuses on early intervention for psychosis, current data on the epidemiology and outcomes for people at high risk for psychosis and those who have experienced a first psychosis, and ways to improve care for these patients.

Sessions will provide an overview of the epidemiology for people with psychosis, discuss what services are available and highlight successful models of care, and examine policy solutions and strategies that are most effective for coordinated specialty services.

The workshop will be held on Monday, July 11 from 11 a.m. to 5 p.m. ET. Click here to register.

NABH Working to Enhance Denial-of-Care Portal

NABH’s Denial-of-Care Portal is temporarily unavailable as the association works to enhance features of this member-only resource.

NABH developed the portal so members could submit individual examples of claim denials or upload multiple entries via Excel. It also includes sections on appeals and physician participation and is intended to help the association in its advocacy efforts with policymakers and regulators.

NABH will inform members when the updated portal is ready to use.

Learn About Our 2022 Annual Meeting Speakers!

The NABH 2022 Annual Meeting is fewer than two weeks away. Please be sure to learn more about this year’s speakers here on our Annual Meeting homepage.

And please be sure to register for the meeting, if you have not done so yet.

We look forward to seeing you soon in Washington!

Fact of the Week

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

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

HHS Leaders Encourage States to Prioritize Efforts to Support Children’s Mental Health
 
Following Tuesday’s shooting at Robb Elementary School in Uvalde, Texas—the deadliest U.S. school shooting in 10 years in which a gunman killed 19 children and two teachers—U.S. Health and Human Services Department (HHS) agency leaders sent a joint letter to states, tribes, and jurisdictions urging them to maximize and prioritize their efforts to strengthen children’s mental health and well-being.

According to the National Survey of Children’s Health, the number of children ages 3-17 years diagnosed with anxiety grew by 29% and those with depression by 27% between 2016 and 2020. Meanwhile, there was a 21% increase in children diagnosed with behavioral or conduct problems between 2019-2020.

The letter provided a list of existing opportunities, partnerships, grants, and programs that states, tribes, and jurisdictions can access to support children’s mental health. Including HHS Secretary Xavier Becerra, leaders from the Administration for Children and Families, Administration for Community Living, Centers for Disease Control and Prevention, Centers for Medicare & Medicaid Services, Health Resources and Services Administration, and the Substance Abuse and Mental Health Services Administration (SAMHSA) signed the letter on May 25.

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

U.S. Surgeon General Vivek Murthy, M.D., M.B.A. this week released Addressing Health Worker Burnout, a 76-page advisory intended to draw the American people’s attention to an urgent public health issue and provide recommendations about how to manage it.

In a video accompanying the advisory, Murthy noted that 54% of the nation’s physicians and nurses were experiencing burnout before the pandemic began, eight out of 10 health workers have experienced workplace violence, and 66% of U.S. nurses have considered resigning.

“Healthcare systems, health insurance companies, and government must prioritize health worker well-being,” Murthy said in his recorded message. “This means increasing access to mental health services; reducing workplace burdens to prioritize time with patients; and protecting the health and safety of all health workers.”

The advisory includes separate categories describing what healthcare organizations, federal, state, local, and tribal governments, insurers and payers, healthcare technology companies, academic institutions, clinical training programs, and accreditation bodies can do to help address health worker burnout.

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

With support from a SAMHSA grant, the George Washington University Fitzhugh Mullan Institute for Health Workforce Equity and data research firm Health Landscape have developed a national database on the country’s mental health and substance use disorder workforce to provide evidence-based support for creating policy and targeting resources appropriately.

The new Behavioral Health Workforce Tracker is a comprehensive national database that identifies almost 1.2 million behavioral health providers, including more than 600,000 behavioral health specialists, including psychiatric and addiction medicine specialists, psychologists, counselors, and therapists; about 400,000 primary care physicians and advanced practice providers who provided 11 more behavioral health medications, and an additional 173,556 physician specialists who also wrote more than 11 behavioral health medications.

Click here to learn more about the database.

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

The National Academies’ Forum on Mental Health and Substance Use Disorders will host a public workshop this summer that focuses on early intervention for psychosis, current data on the epidemiology and outcomes for people at high risk for psychosis and those who have experienced a first psychosis, and ways to improve care for these patients.

Sessions will provide an overview of the epidemiology for people with psychosis, discuss what services are available and highlight successful models of care, and examine policy solutions and strategies that are most effective for coordinated specialty services.

The workshop will be held on Monday, July 11 from 11 a.m. to 5 p.m. ET. Click here to register.

NABH Working to Enhance Denial-of-Care Portal

NABH’s Denial-of-Care Portal is temporarily unavailable as the association works to enhance features of this member-only resource.

NABH developed the portal so members could submit individual examples of claim denials or upload multiple entries via Excel. It also includes sections on appeals and physician participation and is intended to help the association in its advocacy efforts with policymakers and regulators.

NABH will keep members apprised of when the updated portal is ready to use.

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

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

And please visit our Annual Meeting webpage to register for the meeting, if you have not done so yet.

We look forward to seeing you in Washington!

Fact of the Week 

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

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

NABH last week requested that the full 9^th U.S. Circuit Court of Appeals review a recent ruling from a three-judge panel that erroneously reversed a trial court’s landmark decision last year in the mental health class action, Wit v. United Behavioral Health.  

NABH filed an amicus brief to request a “rehearing en banc.” If granted, a rehearing could vacate the appellate panel’s deeply flawed ruling. The American Hospital Association, American Psychological Association, American Association for the Treatment of Opioid Dependence, California Hospital Association, Federation of American Hospitals, National Association of Addiction Treatment Providers, National Council for Mental Wellbeing, and REDC added their organization names to the amicus brief.

“Unfortunately, the likely consequence of the panel decision is that the gains achieved as a result of the district court’s rulings will be wiped out as even further restrictions are placed on the care patients receive for treatment of mental illness,” the amicus brief states. “Instead of medical necessity determinations based on GASC developed by non-profit expert bodies, the decision-making power will be left to the discretion of for-profit insurers such as UBH.”
 
Click here to read the news release that NABH distributed on Monday, May 16.

SAMHSA Introduces First ‘Behavioral Health Recovery Innovation Challenge’

The Substance Abuse and Mental Health Services Administration (SAMHSA) this week introduced its first “Behavioral Health Recovery Challenge” to identify innovations that peer-run or community-based organizations—and entities that partner with them, including hospitals and health systems—have developed to advance recovery.

SAMHSA defines recovery as “a process of change through which individuals improve their health and wellness, live self-directed lives, and strive to reach their full potential.”

SAMHSA’s announcement noted that the agency encourages participants to share details about the practices they use to advance recovery and also demonstrate how these practices have: 1) expanded on SAMHSA’s definition of recovery, or 2) helped them overcome challenges in incorporating recovery into their behavioral health services or systems.

“By using this vehicle, we hope to gain a better understanding of effective and innovative recovery practices from a very diverse field,” HHS Assistant Secretary for Mental Health and Substance Use Miriam E. Delphin-Rittmon, Ph.D., said in an announcement. Delphin-Rittmon also leads SAMHSA. “We aim to take what works for a small group and scale up to a larger population.”

Click here to learn more from SAMHSA’s Recovery Innovation Challenge webpage.

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

SAMHSA this week announced a funding opportunity that will award $2 million per year up to five years to establish a national Center of Excellence (CoE) that will develop and disseminate information, guidance, and training on the effects of children and youth’s social media use, including both its risks and benefits.

SAMHSA’s grant announcement noted that the new CoE will pay particular attention to the potential risks social media platforms pose to the mental health of children and youth, as well as the clinical and societal interventions that could be used to address those risks.

Eligible applicants include states, political divisions of states, Indian tribes or tribal organizations, health facilities, programs operated by or in accordance with a grant contract with the Indian Health Service, or other public of private, not-for-profit entities.

The deadline to apply is Monday, July 18. Click here to learn more.

SAMHSA Announces $1.5 billion for State Opioid Response Program

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

The use of contingency management for the treatment off stimulant use disorder is a permitted use of grant funds. The application process opened on Thursday, May 19 and will remain open through Monday, July 18. Click here to learn more.

NABH Working to Enhance Denial-of-Care Portal

NABH’s Denial-of-Care Portal is temporarily unavailable as the association works to enhance features of this member-only resource.

NABH developed the portal so members could submit individual examples of claim denials or upload multiple entries via Excel. It also includes sections on appeals and physician participation and is intended to help the association in its advocacy efforts with policymakers and regulators.

NABH will keep members apprised of when the updated portal is ready to use.

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

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

And please visit our Annual Meeting webpage to register for the meeting, if you have not done so yet. We look forward to seeing you in Washington!

Fact of the Week

In a recent Cigna survey of 1,000 parents, 80% said their children are struggling with mental health, and nearly one-fifth (18%) say their child’s needs are negatively affecting their job performance and productivity.

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

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

More than 107,000 Americans died of drug overdoses in 2021, according to provisional data from the Centers for Disease Control and Prevention (CDC) released this week.

The troubling statistic—the CDC predicts the total to be 107,622 lives lost— hit a new record, as the number of predicted overdose deaths in 2021 reflects a 15-percent increase in the previous record set in 2020.

“It is unacceptable that we are losing a life to overdose every five minutes around the clock,” the Office of National Drug Control Policy Director Rahul Gupta, M.D., M.P.H., M.B.A., FACP, said in a White House statement. “That is why President Biden’s new National Drug Control Strategy signals a new era of drug policy centered on individuals and communities, focusing specifically on the actions we must take right now to reduce overdoses and save lives.”

Separately this week, the United States Drug Enforcement Administration (DEA) recognized the first Fentanyl Awareness Day on Monday, May 9. The DEA reports that the synthetic opioid fentanyl is about 50 times more potent than heroin and 100 times more potent than morphine. It is also inexpensive, widely available, and highly addictive.

DEA Administrator Anne Milgram released a video announcement about the dangers of fentanyl and the need for urgent action.

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

HHS’ Health Resources and Services Administration (HRSA) this week announced it has extended the deadline for providers to request to submit a late Provider Relief Fund (PRF) Reporting Period 2 (RP2) report to Wednesday, May 18 at 11:59 p.m. ET.

According to HRSA, providers may submit a request if certain extenuating circumstances prevented them from submitting their RP2 report by the initial deadline of March31.

All requests must be completed through the PRF Reporting Portal.

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

The Center for Connected Health Policy (CCHP) this week released a summary of state telehealth policy changes for Spring 2022.

Covering state telehealth policy updates between January and April 2022, the 11-page summary examines state laws and reimbursement policies, private payors, online prescribing, and more.

The resource also includes a state summary chart and an infographic of CCHP’s essential findings.

NABH Working to Enhance Denial-of-Care Portal

NABH’s Denial-of-Care Portal is temporarily unavailable as the association works to enhance features of this member-only resource.

The portal was developed so NABH members could submit individual examples of claim denials or upload multiple entries via Excel. It also includes sections on appeals and physician participation and is intended to help the association in its advocacy efforts with policymakers and regulators.

NABH will keep members apprised of when the updated portal is ready to use.

NABH 2022 Annual Meeting Preliminary Program Now Available!

The NABH 2022 Annual Meeting online preliminary program is now available. Unless noted otherwise, meeting sessions are open to all Annual Meeting attendees.

Please remember to register for the Annual Meeting and reserve your hotel room today, if you haven’t done so yet.

We look forward to seeing you next month in Washington!

Fact of the Week

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

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

A comprehensive report from HHS’ Assistant Secretary for Planning and Evaluation (ASPE) examines the Covid-19 pandemic’s effects on the nation’s healthcare workforce and offers several recommendations, including removing barriers to practicing to the top of one’s license/certification, retaining Covid-19 flexibilities as appropriate, funding for scholarships, and more.
 
The nearly 30-page report, Impact of the COVID-19 Pandemic on the Hospital and Outpatient Clinician Workforce, found that total employment in the healthcare industry declined during the early months of the pandemic but gradually recovered during the summer of 2020. Many hospitals reported critical staffing shortages during the course of the pandemic—especially when Covid case numbers were high—and during the recent Omicron surge in January and February 2022, the seven-day average of hospitals reporting critical staffing shortages peaked at 22% during mid-January 2022, the report noted.

The report acknowledged that several provider types, including behavioral health providers, experienced staffing shortages before the pandemic began.

“Even after the pandemic, many of the effects the pandemic has had on the health care workforce will likely persist,” the report noted. “Addressing these impacts as well as the underlying challenges that pre-dated the pandemic can help build a stronger and more resilient health care system for the future.”

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

The Joint Commission said it has approved its new Infection Prevention and Control standard and its elements of performance as a response to the interim final rule from the Centers for Medicare & Medicaid Services (CMS) late last year.

According to the Joint Commission, the accrediting organization began surveying to the Omnibus Covid-19 Health Care Staff Vaccination interim final rule—which was released on Nov. 5, 2021—on Jan. 27 this year.

“While changes to Joint Commission standards requirements were under review by CMS, findings related to the COVID-19 staff vaccination regulatory requirements have been scored at Leadership (LD) Standard LD.04.01.01, EP 2, along with the applicable Medicare Conditions of Participation/Conditions for Coverage for each of the deemed programs,” the Joint Commission said in an announcement. “This scoring process will continue until June 30, 2022.

Click here to learn more.

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

NABH will welcome John Palmieri, M.D., M.H.A., senior medical advisor at the Substance Abuse and Mental Health Services Administration (SAMHSA) and acting director for the 988 behavioral health crisis hotline and Behavioral Health Crisis Coordinating Office, at the 2022 Annual Meeting in Washington on Tuesday, June 14.

Prior to his arrival at SAMHSA, Dr. Palmieri was the division chief for behavioral healthcare at the Arlington County (Virginia) Department of Human Services. Dr. Palmieri is a licensed physician in Virginia and is board certified in adult psychiatry. He graduated from Brown University Medical School and completed his adult psychiatry residency at Massachusetts General Hospital.

Please click here to learn about our 2022 Annual Meeting speakers.

National Prevention Week is May 8-14

SAMHSA’s National Prevention Week starts Sunday, May 8, and the agency will commemorate the 18^th annual National Prevention Day on Monday, May 9. Click here for an agenda of the day’s events.

The week-long commemoration is part of Mental Health Awareness Month, which kicked off on Sunday, May 1. The White House issued a proclamation honoring Mental Health Awareness Month, and Mental Health America (MHA)—which established the monthly observance in 1949—is recognizing the 2022 observance with the theme “Back to Basics.” The campaign is intended to provide what MHA has referred to as “foundational knowledge” about mental health, mental health conditions, and information about what people can do if their mental health is cause for concern.

Please remember to follow NABH on Twitter @NABHbehavioral and on LinkedIn at the National Association for Behavioral Healthcare throughout the month to learn what NABH members, federal agencies, and advocacy organizations are doing to promote Mental Health Month.

NABH Working to Enhance Denial-of-Care Portal

NABH’s Denial-of-Care Portal is temporarily unavailable as the association works to enhance features of this member-only resource.

The portal was developed so NABH members could submit individual examples of claim denials or upload multiple entries via Excel. It also includes sections on appeals and physician participation and is intended to help the association in its advocacy efforts with policymakers and regulators.

NABH will keep members apprised about the updated portal is ready to use.

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

 NABH appreciates the generous support from its exhibitors and sponsors each year at the association’s Annual Meeting.

To learn who is exhibiting and sponsoring NABH in 2022, please visit the Exhibitors & Sponsors page on our Annual Meeting homepage. The page also includes general information, tips for exhibitors, and details about shipping materials to the Mandarin Oriental Washington, DC.

And please remember to register for the Annual Meeting and reserve your hotel room today, if you haven’t done so yet. We look forward to seeing you next month in Washington!

Fact of the Week

Audio-only visits were the leading telehealth modality for primary care and behavioral health throughout the full pandemic study period of February 2019 through August 2021, according to a new research report from RAND. At the end of the study period, however, audio-only visits were eclipsed by in-person visits for primary care, but not for behavioral health, the study showed.
 

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

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

The Centers for Medicare & Medicaid Services (CMS) recently released The CMS Behavioral Health Strategy, a five-goal plan that aims to remove barriers to care and services and also adopt a data-informed approach to evaluate the agency’s behavioral health programs and policies.

Noting that the strategy “will strive to support a person’s whole emotional and mental well-being and promotes person-centered behavioral healthcare,” CMS set the following five goals: 1) strengthen equity and quality in behavioral healthcare, 2) improve access to substance use disorders treatment, prevention, and recovery services, 3) ensure effective pain treatment and management, 4) improve access and quality of mental healthcare and services, and 5) utilize data for effective actions and impact on behavioral health.

Click here to learn about the objectives in each of those goals.

SAMHSA Announces New Director of the Center for Substance Abuse Treatment

The Substance Abuse and Mental Health Services Administration (SAMHSA) this week named Yngvild Olsen, M.D., M.P.H. as the new director of the agency’s Center for Substance Abuse Treatment.

An addiction medicine specialist and general internist, Olsen began her career as the medical director for the outpatient substance use treatment services while serving as a full-time assistant professor in the department of medicine at the Johns Hopkins School of Medicine.

From 2011 to 2021, Olsen served as medical director for the Institutes for Behavior Resources/REACH Health Services, a comprehensive outpatient substance use disorder treatment program in Baltimore City.

ONDCP Director Rahul Gupta to Address Attendees at NABH Annual Meeting

NABH is pleased to announce that Director of National Drug Control Policy Rahul Gupta, M.D., M.P.H., M.B.A., FACP will address attendees at the 2022 Annual Meeting on Tuesday, June 14.

Dr. Gupta is the first medical doctor to serve as director and lead the Office of National Drug Control Policy (ONDCP), a component of the Executive Office of the President. ONDCP coordinates the nation’s $40 billion drug budget and federal policies, including prevention, harm reduction, treatment, recovery support, and supply reduction.

Through his work as a physician, a state and local leader, an educator, and a senior leader of a national nonprofit organization, Dr. Gupta has dedicated his career to improving public health and public safety.

He is also a buprenorphine-waivered practitioner, who has provided medication-assisted treatment for people with opioid use disorder.

The son of an Indian diplomat, Dr. Gupta was born in India and grew up in the suburbs of Washington, D.C. At age 21, he completed medical school at the University of Delhi and later completed subspecialty training in pulmonary medicine. Dr. Gupta earned a master’s degree in public health from the University of Alabama-Birmingham and a global master’s of business administration degree from the London School of Business and Finance.

If you have not done so yet, please visit our Annual Meeting homepage and register today. We look forward to seeing you in Washington!

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

NABH President and CEO Shawn Coughlin participated in a webinar about mental health and substance use disorder treatment parity on Tuesday, April 26 with federal health officials and healthcare organization leaders.

Coughlin joined fellow presenters HHS Secretary Xavier Becerra, Assistant Secretary for Mental Health and Substance Use Miriam Delphin-Rittmon, Ph.D., The Kennedy Forum founder and former U.S. Rep. Patrick J. Kennedy (D-R.I.), and American Medical Association President Patrice Harris, M.D. to discuss the Biden administration’s commitment to ensuring parity implementation, the recent Wit v. United Behavioral Health ruling, and ongoing problems with parity compliance. David Lloyd, senior policy advisor at The Kennedy Forum, moderated the event.

During the webinar, Delphin-Rittmon, who serves as administrator of SAMHSA, discussed three parity resources that SAMHSA has developed to help patient families, providers, and policymakers understand parity: Know Your Rights, Understanding Parity: A Guide to Resources for Families and Caretakers, and The Essential Aspects of Parity: A Training Tool for Policymakers.

NABH was the lead sponsor for this webinar and live Tweeted during the event. Click here to watch the recorded broadcast.

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

The Bipartisan Policy Center (BPC) will host a webinar on Monday, May 2 about new recommendations centered on enhancing federal spending and improving the federal response to America’s ongoing opioid crisis.

Participants include Office of National Drug Control Policy Director Rahul Gupta, M.D., M.P.H., M.B.A., FACP; Sen. Joe Manchin (D-W.Va.); American Medical Association President Patrice Harris, M.D.; former U.S. Surgeon General Jerome Adams, M.D.; and former HHS Secretary Donna Shalala.

The hour-long webinar will begin at 1 p.m. ET. Click here to register. 

Mental Health Awareness Month Starts Sunday!

Mental Health Month kicks off this Sunday, May 1 to raise awareness about mental health in America.

Mental Health America (MHA), which established the monthly observance in 1949, will commemorate Mental Health 2022 with the theme “Back to Basics” to provide what MHA has referred to as “foundational knowledge” about mental health, mental health conditions, and information about what people can do if their mental health is cause for concern.

SAMHSA’s National Prevention Week is May 8-14 and the agency will commemorate the 18^th annual National Prevention Day on Monday, May 9. Click here for an agenda of the day’s events.

And please remember to follow NABH on Twitter @NABHbehavioral and on LinkedIn at the National Association for Behavioral Healthcare throughout the month to learn what NABH members, federal agencies, and advocacy organizations are doing to promote Mental Health Month.

NABH Working to Enhance Denial-of-Care Portal

NABH’s Denial-of-Care Portal is temporarily unavailable as the association works to enhance features of this member-only resource.

The portal was developed so NABH members could submit individual examples of claim denials or upload multiple entries via Excel. It also includes sections on appeals and physician participation and is intended to help the association in its advocacy efforts with policymakers and regulators.

NABH will keep members apprised when the updated portal is ready to use.

Fact of the Week

Mental health, developmental disorders, and substance use disorders collectively accounted for 48% of all telehealth claims, according to a new report from FAIR Health, a national, not-for-profit organization that produces data products and consumer resources about transparency in healthcare costs and health insurance.
 

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

President Biden Sends National Drug Control Policy to Congress

President Biden on Thursday sent his administration’s inaugural National Drug Control Policy to Congress with the goal of using a whole-of-government approach to combat the nation’s overdose crisis.

The comprehensive strategy focuses on the main drivers of the crisis—untreated addiction and drug trafficking—as it directs federal agencies to take actions that will expand access to evidence-based prevention, harm reduction, treatment, and recovery services, while also reducing the supply of drugs.

The plan comes as the nation continues to produce grim statistics: for the first time in America’s history, the country has passed the milestone of 100,000 deaths resulting from drug overdoses in a 12-month period. Meanwhile, since 1999, drug overdoses have killed approximately 1 million Americans.

A message from President Bident to Congress at the beginning of the strategy explains the Office of National Drug Control Policy led the effort to produce the strategy in close collaboration with the 18 national drug control agencies. In addition, the Biden administration involved more than 2,000 leaders and stakeholders, including Congress, all 50 Governors, and advocates representing public safety, public health, community groups, local governments, and Tribal communities.

An important component of the strategy is its emphasis on harm reduction, an approach that works with people who use drugs to prevent overdose and infectious disease transmission; improve the physical, mental, and social wellbeing of those served; and offer flexible options for accessing substance use disorder treatment and other health care services.

“We are changing how we help people when it comes to drug use, by meeting them where they are with high-impact harm reduction services and removing barriers to effective treatment for addiction,” Rahul Gupta, M.D., M.P.H., M.B.A., director of National Drug Control Policy, said in the document, “while addressing the underlying factors that lead to substance use disorder head on.”

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

NABH President and CEO Shawn Coughlin will join HHS Secretary Xavier Becerra and other healthcare leaders in a webinar about expanding access to mental health and addiction treatment coverage on Tuesday, April 26.

The webinar will also feature Assistant Secretary for Mental Health and Substance Use Miriam Delphin-Rittmon, Ph.D., former U.S. Rep. Patrick J. Kennedy, and American Medical Association President Patrice Harris, M.D.

Click here to learn more and register for the hourlong webinar, which will start at 2 p.m. ET.

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

NABH this week responded to a request for information from the Centers for Medicare & Medicaid Services (CMS) regarding access to coverage for Medicaid and the Children’s Health Insurance Program (CHIP).

In the letter, NABH emphasized that inadequate access to acute care has led to a strong reliance on hospital emergency rooms to treat people with serious mental illness, even though these settings are not well-suited to address those particular patient needs. NABH also emphasized how the Covid-19 pandemic has heightened the already-increased need for mental health and addiction services.

NABH outlined a series of recommendations, including strengthening network adequacy for the full continuum of mental health and addiction treatment; requiring Medicaid programs and plans to implement parity compliance documentation requirements in Medicaid and CHIP; improving Medicaid reimbursement for mental health and addiction treatment providers; and more.

CMS Opens Federal Independent Dispute Resolution Process for Providers

CMS late last week opened the Federal Independent Dispute Resolution (IDR) process for healthcare providers, facilities, health plans, and issuers to resolve payment disputes for certain out-of-network charges.

According to CMS, an initiating party will need the following in order to start a dispute: information to identify the qualified IDR items or services; dates and location of items or services; type of items or services such as emergency services and post-stabilization services; codes for corresponding service and place-of-service; attestation that items or services are within the scope of the Federal IDR process; and the initiating party’s preferred certified IDR entity. A list of certified entities is available here.

After the 30-business-day open negotiation period ends, initiating parties will have four business days to initiate a dispute via the portal.

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

The U.S. Justice Department’s Bureau of Justice Assistance (BJA) is accepting applications for a range of grant programs—eligible to both for-profit and not-for-profit organizations— that seek to improve outcomes for people with mental health and substance use disorders.

BJA’s Residential Substance Abuse Treatment (RSAT) for State Prisoners Training and Technical Assistance Program offers funding to provide training and technical assistance (TTA) to grantees and practitioners to improve correctional substance use disorder treatment programming and post-release outcomes for individuals who are incarcerated. Of the four grant opportunities noted in this news item, this grant is the only one for which for-profit organizations other than small businesses are eligible.

The Connect and Protect: Law Enforcement Behavioral Health Response Program is seeking applications for funding to support law enforcement-behavioral health cross-system collaboration to improve public health and safety responses and outcomes for people with mental health and substance use disorders.

BJA is also accepting applications for its Improving Substance Use Disorder Treatment and Recovery Outcomes for Adults in Reentry for funding to establish, expand, and improve treatment and recovery support services for people with substance use disorders during their incarceration and upon reentry into the community.

And the department is accepting applications for its Justice and Mental Health Collaboration Program to support cross-system collaboration to improve public safety responses and outcomes for individuals with mental health disorders or co-occurring mental health and substance use disorders who come into contact with the justice system.

Please click on the hyperlinks above for more information and grant deadlines.

Political Analyst Amy Walter to Address Attendees at 2022 Annual Meeting Luncheon

NABH is pleased to welcome on-air political analyst Amy Walter as the association’s Annual Meeting Luncheon keynote speaker in Washington on Tuesday, June 14.

For more than 20 years, Amy Walter has built a reputation as an accurate, objective, and insightful political analyst with unparalleled access to campaign insiders and decision-makers. Known as one of the best political journalists covering Washington, she is the publisher and editor-in-chief of the non-partisan Cook Political Report with Amy Walter, where she provides analysis of the issues, trends, and events that shape the political environment.

As a contributor to the PBS NewsHour, Ms. Walter provides weekly political analysis for the popular “Politics Monday” segment. She is also a regular Sunday panelist on NBC’s Meet the Press and CNN’s Inside Politics and appears frequently on Special Report with Bret Baier on Fox News Channel.

Please plan to join us for this year’s Annual Meeting luncheon. And if you haven’t done so yet, please remember to register for the meeting and reserve your hotel room today.

We look forward to seeing you in Washington!

Fact of the Week

People with schizophrenia made up a lower proportion of telehealth encounters relative to in-person visits (1.7% versus 2.7%), while those with anxiety and fear-related disorders accounted for a higher proportion (27.5% versus 25.5%), according to a new study published in the April edition of Health Affairs. Researchers concluded the findings highlight the importance of broadening access to services through new modalities without supplanting necessary in-person care for certain groups.

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

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

In a set of draft recommendations this week, the U.S. Preventive Services Task Force (USPTF) recommended screening children 12 and older for depression and children 8 and older for anxiety.

“There is not enough evidence to recommend for or against screening for anxiety and depression in younger children and screening for suicide risk in all youth,” the USPTF announced in a bulletin on April 12.

Both the American Academy of Pediatrics (AAP) and the American Foundation for Suicide Prevention (AFSP) expressed serious concerns about the panel’s conclusion that there is insufficient evidence to weigh the benefits and harms of screening asymptomatic children and adolescents for suicide risk. The AAP is urging clinicians to screen all adolescents for suicide risk despite the panel’s finding that more research is needed.

“Youth may keep suicidal thoughts to themselves and will not bring up the topic unless directly asked,” May Lau, M.D., M.P.H., a member of the AAP Section on Adolescent Health Executive Committee and a lead author of the Blueprint for Youth Suicide Prevention from AAP/AFSP, said in an article in AAP News. “By screening all youth for suicide, we can identify those that are at risk and connect them with the services they need.”

Meanwhile, Christine Moutier, M.D., chief medical officer at the AFSP, told the Associated Press this week that the report “may actually set the field back.”

“We have grave concerns that the recommendation citing ‘insufficient evidence’ to implement routine screening for suicide risk for any age youth is 1) flawed due to the incomplete data sources included in their review, and 2) may confuse the field just as major steps are being taken,” Moutier wrote in an e-mail message to NABH. Moutier added that the Blueprint for Youth Suicide Prevention recommends screening for youth ages 12 and older and outlines evidence-based care steps to take for youth who screen positive.

A public comment period for the USPTF’s draft recommendations is open until May 9. Click here for details.

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

HHS’ Health Resources and Services Administration (HRSA) said it is making available more than $1.75 billion in Provider Relief Fund (PRF) Phase 4 General Distribution payments to more than 3,680 providers nationwide this week.

According to HRSA, on April 13 providers received an email notification if their application was among those processed in this latest round, and the agency is working to process all remaining applications as quickly as possible.

Also this week, HHS Secretary Xavier Becerra extended the PHE for an additional 90 days after the current PHE expires on April 16.

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

HRSA this week said healthcare providers will have the opportunity to submit a “Request to Report Late Due to Extenuating Circumstances for Reporting Period 2” if applicable. Last week, HRSA announced the “extenuating circumstances” option for Reporting Period 1, which lasts from April 11 through April 22.

The agency said providers will receive a notification regarding the process to submit a request for Reporting Period 2 in the coming weeks. For more information, visit the Request to Report Late Due to Extenuating Circumstances webpage, or call the Provider Support Line at (866) 569-352 from 9 a.m. to 11 p.m. CT, Monday through Friday.

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

NABH President and CEO Shawn Coughlin will join HHS Secretary Xavier Becerra and other healthcare leaders in a webinar about expanding access to mental health and addiction treatment coverage later this month.

The webinar on Tuesday, April 26 will also feature Assistant Secretary for Mental Health and Substance Use Miriam Delphin-Rittmon, Ph.D., former U.S. Rep. Patrick J. Kennedy, and American Medical Association President Patrice Harris, M.D.

Click here to learn more and register for the hour-long webinar, which will start at 2 p.m. ET.

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

The American Hospital Association (AHA) and the International Association for Healthcare Security and Safety (IAHSS) have developed a toolkit for hospitals and health systems to establish procedures to prevent violence at all levels.

Creating Safer Workplaces is an 11-page resource that provides a framework to build a safer workplace environment; outlines what leaders should consider to promote physical safety and teamwork; highlights how leaders can mitigate risk; describes the role of hospitals in violence intervention; and more.

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

A National Public Radio (NPR) story this week cited a recent Kaiser Family Foundation report that found just 11 states said they would use text messaging to alert Medicaid recipients about the end of the Covid public health emergency, while 33 states will use the U.S. Postal Service and at least 20 will rely on individual or automated phone calls.

“It’s frustrating that texting is a means to meet people where they are and that this has not been picked up more by states,” Jennifer Wagner, director of Medicaid eligibility and enrollment for research group the Center on Budget and Policy Priorities, said in the story.

NPR also noted that officials at the Centers for Medicare & Medicaid Services (CMS) have told states they should consider texting—along with other methods of communication—when trying to contact enrollees about the end of the public health emergency (PHE), but many states don’t have the technology or information about enrollees to do so.

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

NABH’s Denial-of-Care Portal is available for members to provide information about their experiences with managed care organizations that impose barriers to care through insurance-claim denials.

This NABH member-only, survey-like tool allows users to add the name of a managed care organization, type of plan, level of care, type of care (mental health or substance use disorder), duration of approved treatment, duration of unapproved treatment, criteria used to deny a claim, and more.

The portal allows members to submit individual examples of claim denials or upload multiple entries via Excel. It also includes sections on appeals and physician participation. In time, the tool could be a valuable resource for the NABH team’s advocacy efforts.

Please e-mail Emily Wilkins, NABH’s administrative coordinator, if you have questions about the portal.

Deadline for 2022 NABH Exhibitor & Sponsor Guide Ads is Next Week

The deadline to submit an ad in NABH’s 2022 Exhibitor and Sponsor Guide is Tuesday, April 19. Be sure your organization is included in this year’s edition!

Please click here for details about advertising options, requirements, payment, and more.

We hope to see you in Washington in June!

Fact of the Week 

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

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

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

HHS’ Health Resources and Services Administration (HRSA) this week said it will allow healthcare providers to submit a Request to Report Late Due to Extenuating Circumstances for the Provider Relief Fund (PRF) Reporting Period 1 if one or more certain extenuating circumstances apply to their situations.

Starting Monday, April 11 and continuing through Friday, April 22 at 11:59 p.m. ET, providers who did not submit their PRF Period 1 report by the required deadline may request to submit a late Reporting Period 1 report, via a DocuSign form, if the following extenuating circumstances exist:

• Severe illness or death: if a severe medical condition or death of a provider or key staff member responsible for reporting hindered the organization’s ability to complete the report during the reporting period

• Impacted by natural disaster: if a natural disaster occurred during or in proximity to the end of the reporting period and damaged the organization’s records or information technology

• Lack of receipt of reporting communications: if an incorrect email or mailing address on file with HRSA prevented the organization from receiving instructions prior to the reporting period deadline

• Failure to click “submit”: if the organization registered and prepared a report in the PRF Reporting Portal, but failed to take the final step to click “submit” prior to deadline

• Internal miscommunication or error: if an internal miscommunication or error regarding the individual who was authorized and expected to submit the report on behalf of the organization and/or the registered point of contact in the PRF Reporting Portal

• Incomplete Targeted Distribution payments: if the organization’s parent entity completed all General Distribution payments, but a Targeted Distribution(s) was not reported on by the subsidiary

According to HRSA, requests to report late due to extenuating circumstances must indicate and attest to a clear and concise explanation, although the agency will not require supporting documents.

If HRSA approves an organization’s request, the organization will receive a notification to proceed with completing the Reporting Period 1 report. Providers will have 10 days from the date they receive the notification to submit a report in the PRF Reporting Portal.

Click here to learn more about reporting requirements, or call the Provider Support Line at (866) 569-3522 between 9 a.m. to 11 p.m. ET for additional information.

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

The Centers for Medicare & Medicaid Services (CMS) this week released two sets of frequently asked questions (FAQ) regarding requirements enacted in the No Surprises Act.

CMS issued an FAQ on April 6 that provides additional explanation about the law’s requirements and prohibitions, as well as clarification regarding the independent dispute resolution process and associated fees. A day earlier, CMS released an FAQ with additional information about developing good-faith estimates for uninsured or self-pay patients.

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

Thorn Run Partners, a bipartisan lobbying firm that works with NABH, recently highlighted a host of flexibilities in the Medicare and Medicaid programs during the ongoing Covid-19 public health emergency (PHE).

The 14-page memo includes information about recent guidance from CMS, PHE extensions, PHE-related policies in the $1.5 trillion omnibus spending package that President Biden recently signed into law, and more.

Click here to read the memo.

NABH Supports ‘Behavioral Health Information Technology Now Act’

NABH is pleased to support the Behavioral Health Information Technology Now Act, a new bill that would offer financial incentives to behavioral healthcare providers for health information technology adoption.

Reps. Doris Matsui (D-Calif.) and Markwayne Mullin (R-Okla.) introduced the bill in an effort to coordinate care between physical and mental healthcare—and also include behavioral healthcare providers from a key resource that they have been excluded from for years.

“The National Association for Behavioral Healthcare applauds Reps. Matsui and Mullin for recognizing that for far too long, behavioral healthcare providers have not received health information technology funding that other providers have benefited from,” NABH President and CEO Shawn Coughlin said in a news release about the legislation on April 6. “Their legislation would enable behavioral healthcare providers to coordinate care across behavioral healthcare service systems, primary care facilities, and specialty medicine providers more efficiently.”

Specifically, the bill would:

• Finance behavioral health information technology (IT) adoption at $250 million

• Condition funding allocations to providers based on: 1) acquisition of health IT systems that comply with 2015 certification standards, and 2) attestation of provider compliance with Trump Administration Interoperability and Data Blocking regulations

• Direct the Office of the National Coordinator for Health Information Technology and the Substance Abuse and Mental Health Services Administration to develop voluntary behavioral health IT standards.

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

NABH’s Denial-of-Care Portal is available for members to provide information about their experiences with managed care organizations that impose barriers to care through insurance-claim denials.

This NABH member-only, survey-like tool allows users to add the name of a managed care organization, type of plan, level of care, type of care (mental health or substance use disorder), duration of approved treatment, duration of unapproved treatment, criteria used to deny a claim, and more.

The portal allows members to submit individual examples of claim denials or upload multiple entries via Excel. It also includes sections on appeals and physician participation. In time, the tool could be a valuable resource for the NABH team’s advocacy efforts.
Please e-mail Emily Wilkins, NABH’s administrative coordinator, if you have questions about the portal.

Register Today for the 2022 Annual Meeting!

NABH will host its 2022 Annual Meeting—Shaping the Future of Behavioral Healthcare—from June 13-15 at the Mandarin Oriental Washington, DC.

Please remember to register for the meeting and reserve your hotel room today!

Fact of the Week

Veterans who take medications for opioid use disorder (OUD) for at least 15 days have more than a 50% decreased risk of dying by suicide compared with those not taking OUD medications, according to a study in the April issue of the American Journal of Psychiatry.

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

CMS Proposes 2.7% Increase to Inpatient Psychiatric Facilities in 2023

The Centers for Medicare & Medicaid Services (CMS) on Thursday proposed increasing payment rates to the nation’s inpatient psychiatric facilities by 2.7% in fiscal year (FY) 2023, reflecting a 1.5% increase in payments, or about $50 million, relative to FY 2022.

According to the agency’s inpatient psychiatric facility prospective payment system (IPF PPS) proposed rule for FY 2023, the IPF PPS federal, per-diem base rate would increase to $856.80 from $832.94 and the electroconvulsive therapy payment rate would increase to $368.87 per treatment from $358.60 per treatment.

CMS said the increase is based on the proposed IPF market basket update of 3.1% less a 0.4% percentage point productivity adjustment.

For FY 2023 and subsequent years, CMS has proposed to apply a 5% cap on decreases in the IPF PPS wage index in order to mitigate instability in IPF PPS payments due to significant wage index decreases that may affect providers in any given year.

CMS did not propose any changes for the IPF Quality Reporting Program for FY 2023.

Meanwhile, the agency is seeking comments via a request for information (RFI) about what CMS should consider when advancing the use of measurement and stratification as tools to address healthcare disparities and advance healthcare equity.

Specifically, CMS would like comments related to goals and approaches for measuring disparities and using measure stratification across CMS Quality Reporting Programs; guiding principles for selecting and prioritizing measures for disparity reporting; principles for social risk factor and democratic data selection and use; identification of meaning performance differences; guiding principles for reporting disparity measures; and measures related to health equity.

CMS is considering and requesting comment about applying the following measures of health equity in the Inpatient Psychiatric Facility Quality Reporting Program: Health Equity Summary Score (HESS) and a structural measure assessing the degree of hospital leadership engagement in health equity performance data. Both of these measures are under consideration for the Medicare Inpatient Quality Reporting Program.

Please send any comments that your organization may have to Kirsten Beronio, NABH’s director of policy and regulatory affairs.

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

President Biden proposed new, mandatory investments totaling $51.7 billion over 10 years to enhance behavioral healthcare in America in the fiscal year (FY) 2023 budget proposal that he released on March 28.

Among the budget blueprint’s most notable behavioral health provisions is the president’s request of $697 million for the Substance Abuse and Mental Health Services Administration (SAMHSA) to ensure that 100% of contacts are answered for the new 988 behavioral health crisis hotline that will begin to operate in July. This is an increase of $590 million from what was enacted for fiscal year 2022.

Another significant provision is the president’s proposal for a new, $7.5 billion Mental Health System Transformation Fund through Medicaid to increase access to mental health services through workforce development and service expansion, including the development of non-traditional health delivery sites, the integration of quality mental health and substance use care into primary care settings, and the dissemination of evidence-based practices.

NABH is pleased to see President Biden’s 2023  budget proposal calls for improving compliance with behavioral health parity standards by requiring plans and issuers to use medical necessity criteria for behavioral health services that are consistent with the criteria developed by not-for-profit medical specialty associations. The proposal would also place limits on the consideration of profit in determinations of medical necessity.

The president’s budget would authorize the secretaries of the U.S. Health and Human Services, Labor, and Treasury Departments to regulate behavioral health network adequacy, and to issue regulations on a standard for parity in reimbursement rates based on the results of comparative analyses submitted by plans and issuers at a cost of $720 million over 10 years.

To learn more, please read the NABH Analysis that the association sent to members earlier this week.

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

In a bipartisan report released this week, the Senate Finance Committee concluded that “overwhelmingly, access to affordable, reliable, and high-quality behavioral health care escapes Americans when they need it most” and offered some potential solutions to address the nation’s myriad behavioral healthcare challenges.

The 36-page report is divided into eight chapters and examines behavioral health definitions, prevalence, and spending; workforce; children, adolescents, and young adults; access, integration, and coordination; mental health and substance use disorder (SUD) parity; telehealth; and next steps.

“As Chairman of the Senate Finance Committee, I am partnering with Ranking Member Mike Crapo on a major bipartisan effort to bring behavioral health care to the forefront of the U.S. health system by leveraging the programs under this Committee’s jurisdiction, including Medicare, Medicaid, and the Children’s Health Insurance Program,” Senate Finance Committee Chairman Ron Wyden (D-Ore.) said in a letter at the start of the report. Wyden added that 10 members of this committee, including five Democrats and five Republicans, are working on policy areas that Wyden deemed “vital for a path forward.”

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

The Center of Excellence for Protected Health Information (CoE-PHI) has released a video that offers guidance about when identified SUD personnel within a general medical facility must follow the federal privacy protections for SUD treatment known as 42 CFR Part 2.

The Substance Abuse and Mental Health Services Administration funds CoE-PHI to help people and organizations understand and apply federal health privacy laws and regulations at work that are specific to certain tasks and roles. CoE-PHI also works to help patients and families understand their rights when seeking treatment for SUD and mental health.

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

Mental Health America, the American Psychological Association, and the American Psychiatric Association will host a webinar next Wednesday, April 6 that examines the role digital therapeutics have in addressing America’s mental health and SUD crises.

Participants will learn from Meena Seshamani, M.D., Ph.D., director of the Center for Medicare at CMS; Bakul Patel, director of the Digital Health Center of Excellence at the U.S. Food and Drug Administration; and other experts in the field.

The hourlong webinar will begin at 2 p.m. ET. Click here to register.

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

NABH’s Denial-of-Care Portal is available for members to provide information about their experiences with managed care organizations that impose barriers to care through insurance-claim denials.

This NABH member-only, survey-like tool allows users to add the name of a managed care organization, type of plan, level of care, type of care (mental health or substance use disorder), duration of approved treatment, duration of unapproved treatment, criteria used to deny a claim, and more.

The portal allows members to submit individual examples of claim denials or upload multiple entries via Excel. It also includes sections on appeals and physician participation. In time, the tool could be a valuable resource for the NABH team’s advocacy efforts.
Please e-mail Emily Wilkins, NABH’s administrative coordinator, if you have questions about the portal.

Register Today for the 2022 Annual Meeting!

NABH will host its 2022 Annual Meeting—Shaping the Future of Behavioral Healthcare—from June 13-15 at the Mandarin Oriental Washington, DC.

Please remember to register for the meeting and reserve your hotel room today!

Fact of the Week 

Of the approximately 5.9 million adults living with severe bipolar disorder in the United States in 2020, about 51%, or 3 million adults, were untreated at any given time, the Treatment Advocacy Center reports.

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

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

In a blow to parity, a three-judge panel of the 9^th U.S. Circuit Court of Appeals this week overturned a trial court’s Wit v. United Behavioral Health (UBH) decision, asserting that UBH’s interpretation that health insurance plans do not require consistency with generally accepted standards of care (GASC) “was not unreasonable.”

On Thursday, NABH sent its members an NABH Issue Brief that highlighted the following main points of the earlier decision from the trial court and the three-judge panel’s reversal of that decision in its seven-page ruling:

• The original Witdecision determined that patients’ health and safety are protected when clinicians provide services consistent with GASC that are established by not-for-profit, professional associations, rather than insurance companies whose financial incentives often conflict with what is best for patients.

• The three-judge panel said it is “not unreasonable” for health insurers’ coverage determinations to be inconsistent with GASC; however, the trial court’s decision, including two 100-page decisions, described how UBH made medical coverage decisions based on financial interests.

• In its ruling, the appellate court’s three-judge panel did not cite one holding or one fact that the trial court concluded, despite the trial court’s exhaustive trial findings.

• The trial court’s decision explained UBH’s misrepresentation to regulators that UBH used American Society of Addiction Medicine (ASAM) criteria when, in fact, the company modified and ultimately undercut the actual ASAM criteria.

• The appellate court’s three-judge panel ruled that UBH is not obligated to cover treatment consistent with GASC if the treatment is not a covered benefit; however, the plaintiffs did not argue that UBH was obligated to cover all services consistent with GASC. Instead, the plaintiffs argued that if services—such as outpatient, intensive outpatient, and residential treatment—are covered benefits, UBH must make medical necessity determinations that are consistent with GASC.

This flawed ruling has the potential to worsen America’s mental health and addiction crises as the critical need for mental health and addiction treatment services continues to rise during the ongoing Covid-19 pandemic.

NABH will continue to fight for true mental health addiction treatment parity and expanded access to care for all who need it.

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

The U.S. Drug Enforcement Administration (DEA) on Wednesday announced a new option intended to broaden access for medication-assisted treatment (MAT) for people suffering from substance use disorder (SUD).

The new option applies to DEA-registered practitioners working in hospitals, clinics, or emergency rooms, and also for DEA-registered hospitals and clinics that allow practitioners to operate under their registration number. Under this new option, the DEA will grant requests for an exception to the one-day supply limitation in 21 CFR 1306.07(b) to allow for the dispensing of up to a three-day supply of narcotic drugs, including buprenorphine and methadone, “to a person for the purpose of relieving acute withdrawal symptoms when necessary while arrangements are being made for referral for treatment.” Adhering to The Further Continuing Appropriations Act of 2021 and Other Extensions Act, DEA will grant such exception requests while it works to amend 21 CFR 1306.07(b) that the law directs.

As part of this effort to save lives in the opioid overdose crisis, the DEA also announced that it is working to make permanent its Covid-19 public health emergency temporary regulations that allow for the initiation of buprenorphine to treat opioid use disorder via telemedicine.

Finally, the DEA said it is partnering with the U.S. Health and Human Services Department (HHS) to engage “in regular outreach with pharmacists and practitioners to express support for the use of medication-assisted treatment for those suffering from substance use disorder.”

Provider Relief Fund Reporting Period 2 Deadline is Next Week

The Health Resources and Services Administration’s (HRSA) Provider Relief Fund (PRF) reporting portal remains open for healthcare providers who need to report their use of PRF funds in Reporting Period 2 (RP2) by the deadline next Thursday, March 31.

According to HRSA, providers who received one or more payments totaling greater than $10,000 in the aggregate during a Payment Received Period must use the funds by the deadline and report for each application reporting period.

HRSA’s announcement also said that providers who received PRF payments exceeding $10,000 in the aggregate between July 1, 2020 and Dec. 2020 and who do not submit a report on use of the funds by 11:59 p.m. ET on March 31, 2022 will be required to return all funds.

HRSA said it will not grant grace periods or extensions. Click here to read HRSA’s PRF Reporting Non-Compliance fact sheet. 

BJA Announces Adult Drug Court Discretionary Grant Program Funding Opportunity

The U.S. Justice Department’s Bureau of Justice Assistance (BJA) is seeking applications to plan, implement, and enhance drug court services, including service coordination, management of drug court participants, and recovery support services.

Adult drug courts integrated evidence-based SUD treatment, mandatory drug testing, incentives, and sanctions, and transitional services in judicially supervised criminal court setting that have jurisdiction over persons with SUD treatment needs to reduce recidivism, increase access to treatment and support, and prevent overdoses.

City or township governments, county governments, federally recognized Native American tribal governments, special district governments, and state governments, and others are eligible to apply for this grant opportunity.

The deadline to apply is Friday, May 20. Click here to learn more and apply.

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

In its podcast The Dose, the Commonwealth Fund this week featured Boston Children’s Hospital psychiatrist Kevin Simon, M.D., who discussed how providers can work with families to help address the mental healthcare gap for Black and brown teenagers in America.

The Commonwealth Fund notes that in the current overwhelming demand for behavioral health services, the unmet need for Black and brown teenagers stands out. One reason is they are not getting the care they need due to a shortage of child and adolescent mental health providers—especially providers of color—in the United States. Worsening the problem are the racial stereotypes that exist in how school officials, healthcare providers, and others perceive Black and brown teens.

Simon suggests that the country diversify the mental healthcare provider workforce to correct the problem in the long term. In the short term, he adds, providers can work with families and teachers to strengthen the system and start by demonstrating “cultural humility” and a genuine curiosity about the lived experiences of Black and brown youth.

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

NABH’s Denial-of-Care Portal is available for members to provide information about their experiences with managed care organizations that impose barriers to care through insurance-claim denials.

This NABH member-only, survey-like tool allows users to add the name of a managed care organization, type of plan, level of care, type of care (mental health or substance use disorder), duration of approved treatment, duration of unapproved treatment, criteria used to deny a claim, and more.

The portal allows members to submit individual examples of claim denials or upload multiple entries via Excel. It also includes sections on appeals and physician participation. In time, the tool could be a valuable resource for the NABH team’s advocacy efforts.

Please e-mail Emily Wilkins, NABH’s administrative coordinator, if you have questions about the portal.

Register Today for the 2022 Annual Meeting!

NABH will host its 2022 Annual Meeting—Shaping the Future of Behavioral Healthcare—from June 13-15 at the Mandarin Oriental Washington, DC.

Please remember to register for the meeting and reserve your hotel room today!

Fact of the Week

Only 20% of U.S. adults received mental health treatment since the start of the Covid-19 pandemic, but 80% of those agreed they benefited from this care, the America Psychological Association reports.

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

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

The CEO Alliance for Mental Health this week announced the start of coordinated effort to help prepare state and municipal officials for the nationwide 988 behavioral crisis hotline that will launch on July 16.

NABH is a member of the CEO Alliance, a collaborative of 15 of the nation’s leading mental health professional organizations, advocacy groups, and funders that will push for leaders to adopt A Consensus Approach and Recommendations for the Creation of a Comprehensive Crisis Response System, a roadmap that outlines seven “pillars” for transforming mental health and substance use care in the United State. These are: early identification and prevention; emergency and crisis response; equity and inclusion; integration and partnership; fair and equivalent coverage; standards for care; and workforce capacity. The Alliance released the roadmap last November.

The Alliance’s outreach efforts leading to the 988 hotline launch this summer include a social media campaign intended to direct state and municipal elected officials, civic leaders, policymakers, and advocates to the roadmap.

In his State of the Union address earlier this month, President Biden announced his administration’s mental health strategy, of which the 988 hotline is a critical component.

Provider Relief Fund Reporting Period 2 Deadline is March 31

The Health Resources and Services Administration’s (HRSA) Provider Relief Fund (PRF) reporting portal remains open for healthcare providers who need to report their use of PRF funds in Reporting Period 2 (RP2) by the deadline on Thursday, March 31.

According to HRSA, providers who received one or more payments totaling greater than $10,000 in the aggregate during a Payment Received Period must use the funds by the deadline and report for each application reporting period.

HRSA’s announcement also said that providers who received PRF payments exceeding $10,000 in the aggregate between July 1, 2020 and Dec. 2020 and who do not submit a report on use of the funds by 11:59 p.m. ET on March 31, 2022 will be required to return all funds.

HRSA said it will not grant grace periods or extensions. Click here to read HRSA’s PRF Reporting Non-Compliance fact sheet.

SAMHSA Announces $25.6 Million in MAT Grant Programs

The Substance Abuse and Mental Health Services Administration (SAMHSA) this week announced two grant programs totaling $25.6 million intended to expand access to medication-assisted treatment (MAT) for opioid use disorder and prevent the misuse of prescription drugs.

One is the Strategic Prevention Framework for Prescription Drugs program, which provides funding for state agencies, territories, and tribal entities that have completed a Strategic Prevention Framework State Incentive Grant plan—or similar state plan—to target prescription drug misuse. This program is intended to raise awareness about the dangers of sharing medications, fake or counterfeit pills sold online, and over-prescribing. This grant will fund a total of $3 million over five years for up to six grantees. Applications for this grant are due by Monday, April 25.

The other is the Medication-Assisted Treatment-Prescribing Drug and Opioid Addiction grant program, which provides resources to help expand and improve access to medications for opioid use disorder. This program is intended to increase the number of individuals with opioid use disorder receiving medications for opioid use disorder and decrease illicit opioid use and prescription drug opioid misuse. This grant will fund a total of $22.6 million over five years for up to 30 grantees. According to SAMHSA, no less than $11 million will be awarded to Native American tribes, tribal organizations, or consortia. Applications for this program are due by Friday, April 29.
 
DOJ Announces ‘Second Chance Act Pay for Success Initiative’

The U.S. Justice Department’s Bureau of Justice Assistance (BJA) is seeking applications to fund state, local, and tribal governments to either enhance or implement performance-based programs that reduce recidivism and address substance use disorders (SUD) that affect people who have been incarcerated.

Specifically, the funds will be used in contracts with reentry, permanent supportive housing, or recovery housing providers in this effort. The Pay for Success Initiative is a performance-based and outcomes-based program that ties payment for services to reaching agreed-upon goals.

Click here for more information.

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

The O’Neill Institute for National and Global Health Law at Georgetown University Law Center this week released Maximizing the Impact of Opioid Litigation to Address the Overdose Crisis, a five-page issue brief that describes the themes discussed during the Opioid Litigation Summit held at Georgetown Law Center in September 2021.

The resource emphasizes that opioid litigation settlement proceeds must be used to advance a public health response to the nation’s opioid crisis. It also explains how the country can learn from its own history in this regard.

“The tobacco litigation settlements of the 1990s evince the need for a comprehensive strategy of oversight and accountability to distribute and manage opioid litigation proceeds,” the issue brief states. “Despite the intent of the settling states’ Attorneys General that funds be used primarily for tobacco-related health initiatives, the lack of specificity in the settlement agreements led to less than 10% of the $206 billion award funding tobacco-related public health strategies.”

According to the brief, these five themes emerged from last year’s opioid litigation summit: intentional collaboration leads to actionable policy; community needs should be reflected when distributing proceeds; existing opioid-related funding should be supplemented, not supplanted; oversight should be sustained; and other sources of funding should be maximized and coordinated to create a comprehensive plan to address SUDs.

Senate HELP Committee to Host Mental Health Hearing Next Week

The Senate Health, Education, Labor & Pensions (HELP) Committee will examine how to improve federal mental health and SUD programs in a hearing next week.

Senators will hear from Assistant Secretary for Mental Health and Substance Use Miriam Delphin-Rittmon, Ph.D.; Joshua Gordon, M.D., Ph.D., director of the National Institute of Mental Health; Carole Johnson, administrator at the Health Resources and Services Administration; and Nora Volkow, M.D., director of the National Institute on Drug Abuse. Delphin-Rittmon addressed attendees at the 2021 NABH Annual Meeting last October.

The hearing, “Strengthening Federal Mental Health and Substance Use Disorder Programs: Opportunities, Challenges, and Emerging Issues,” will be held Wednesday, March 23 at 10 a.m. ET.

National Drug and Alcohol Facts Week Starts Monday

National Drug and Alcohol Facts Week is from March 21-27, and The National Institute on Drug Abuse (NIDA) invites organizations to participate in the national observance meant to empower teens and young adults about making informed decisions about drugs, alcohol, and addiction.

NIDA has developed five steps to hosting a NDAFW event and created lesson plans and other materials for educators, counselors, and prevention specialists.

Please click here to learn how to register your organization’s event online.

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

NABH’s Denial-of-Care Portal is available for members to provide information about their experiences with managed care organizations that impose barriers to care through insurance-claim denials.

This NABH member-only, survey-like tool allows users to add the name of a managed care organization, type of plan, level of care, type of care (mental health or substance use disorder), duration of approved treatment, duration of unapproved treatment, criteria used to deny a claim, and more.

The portal allows members to submit individual examples of claim denials or upload multiple entries via Excel. It also includes sections on appeals and physician participation. In time, the tool could be a valuable resource for the NABH team’s advocacy efforts.

Please e-mail Emily Wilkins, NABH’s administrative coordinator, if you have questions about the portal.

Register Today for the 2022 Annual Meeting!

NABH will host its 2022 Annual Meeting—Shaping the Future of Behavioral Healthcare—from June 13-15 at the Mandarin Oriental Washington, DC.

Please remember to register for the meeting and reserve your hotel room today!

Fact of the Week

Telehealth represented less than 1% of outpatient care before the Covid-19 pandemic for both mental health and substance use and other concerns. At its pandemic peak, telehealth represented 40% of mental health and substance use outpatient visits and 11% of other visits (during the March- August 2020 period), according to research from the Kaiser Family Foundation.

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

Provider Relief Fund Reporting Period 2 Deadline is March 31

The Health Resources and Services Administration’s (HRSA) Provider Relief Fund (PRF) reporting portal remains open for healthcare providers who need to report their use of PRF funds in Reporting Period 2 (RP2) by the deadline on Thursday, March 31.

According to HRSA, providers who received one or more payments totaling greater than $10,000 in the aggregate during a Payment Received Period must use the funds by the deadline and report for each application reporting period.

HRSA’s announcement also said that providers who received PRF payments exceeding $10,000 in the aggregate between July 1, 2020 and Dec. 2020 and who do not submit a report on use of the funds by 11:59 p.m. ET on March 31, 2022 will be required to return all funds.

HRSA said it will not grant grace periods or extensions. Click here to read HRSA’s PRF Reporting Non-Compliance fact sheet.

NABH Submits Comments to CMS about Network Adequacy in Medicare Advantage

NABH this week submitted comments to the Centers for Medicare & Medicaid Services (CMS) regarding the agency’s proposed rule about technical changes to the Medicare Advantage (MA) and Medicare Prescription Drug Benefit programs for the contract year 2023.

In a letter to CMS Administrator Chiquita Brooks-LaSure, NABH described how MA plans can increase the number of behavioral healthcare providers and facilities in their networks and improve access to mental health and addiction treatment.

“Unfortunately, Medicare beneficiaries do not have adequate access to mental health and addiction treatment,” NABH’s noted. “According to a CMS Data Brief, ‘[b]eneficiaries with depression, regardless of age, were more likely to report having trouble getting healthcare, obtaining prescription medicines, and not seeing doctors than those without depression.’ In addition, Medicare ‘[b]eneficiaries with depression regardless of age, were more likely to report that they have no usual source of care due to high cost.’ These difficulties accessing behavioral healthcare undoubtedly result from MA plans disproportionately lacking in-network behavioral healthcare providers,” NABH’s letter continued. “A recent study found that MA networks included only 23% of psychiatrists in a county on average — lower than all other medical specialties. Not surprisingly, MA enrollees with depressive symptoms report more difficulty accessing needed treatment and rated their experience with the MA plans as worse than in traditional Medicare.”

NABH also provided a series of recommendations, such as establishing specific network adequacy standards for the full continuum of mental health and addiction treatment and requiring those standards be met prior to approval for participation in Medicare; requiring MA plans to demonstrate reimbursement rates for behavioral healthcare providers are comparable with rates for other similar healthcare services; and requiring MA plans to comply with parity requirements and use generally accepted standards of care for utilization management.

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

The U.S. Labor Department’s Occupational Safety and Health Administration (OSHA) has launched an initiative to protect healthcare workers who work in hospitals and skilled nursing facilities that treat or handle patients with Covid-19.

An announcement from OSHA said the goal is to expand its presence to ensure “continued mitigation to control the spread of Covid-19 and future variants of the SARS-CoV-2 virus” and to protect the health and safety of healthcare workers.

OSHA also said it will initiate focused inspections to emphasize monitoring for current and future readiness to protect workers from Covid-19 and will conduct follow-up inspections at sites that previously received citations.

“OSHA intends to expand its presence in targeted high-hazard healthcare facilities during a three-month period from March 9, 2022 to June 9, 2022,” the announcement said. “Through this focused enforcement initiative, the agency will verify and assess hospital and skilled nursing care employers’ compliance actions taken, including their readiness to address any ongoing or future Covid-19 surges.” 

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

The Congressional Addiction, Treatment, and Recovery Caucus will host a webinar titled “The Changing Landscape & New Challenges of the Opioid Epidemic” next Thursday, March 17 at 3 p.m. ET.

Presenters include award-winning actor Michael Keaton; Beau Kilmer, Ph.D., director of RAND’s Drug Policy Research Center; and Arnold Alier Martinez, Ed.D., NRP, director of the division of pre-hospital medicine research and overdose prevention at the South Carolina Department of Health and Environment Control.

Click here to register.

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

The Joint Commission will host a complimentary webinar about behavioral health and human services accreditation on Tuesday, March 22 from 10 am. – 12:30 p.m. ET.

In a live executive training, the Joint Commission will address the process, cost, requirements, and resources for assistance and will also leave time for questions. The Joint Commission’s announcement also said attendees will leave with a free, 90-day trial of the Joint Commission’s requirements and a copy of the webinar’s slides.

Click here to register.

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

National Drug and Alcohol Facts Week is approaching, and The National Institute on Drug Abuse (NIDA) invites organizations to participate in the national observance meant to empower teens and young adults about making informed decisions about drugs, alcohol, and addiction.

NIDA has developed five steps to hosting a NDAFW event and created lesson plans and other materials for educators, counselors, and prevention specialists.

Please click here to learn how to register your organization’s event online.

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

NABH’s Denial-of-Care Portal is available for members to provide information about their experiences with managed care organizations that impose barriers to care through insurance-claim denials.

NABH’s Managed Care Committee worked for more than a year to develop the Denial-of-Care Portal as a way to collect specific data on insurers who deny care—often without regard for parity or the effects on patients.

This NABH member-only, survey-like tool allows users to add the name of a managed care organization, type of plan, level of care, type of care (mental health or substance use disorder), duration of approved treatment, duration of unapproved treatment, criteria used to deny a claim, and more.

The portal allows members to submit individual examples of claim denials or upload multiple entries via Excel. It also includes sections on appeals and physician participation. In time, the tool could be a valuable resource for the NABH team’s advocacy efforts.

Please e-mail Emily Wilkins, NABH’s administrative coordinator, if you have questions about the portal.

Advertise in the 2022 NABH Exhibitor and Sponsor Guide!

NABH will distribute the 2022 NABH Exhibitor and Sponsor Guide to all registrants at the Annual Meeting from June 13–15, 2022 at the Mandarin Oriental Washington, D.C. Be sure your organization is included in it!

All ads are due by April 19, 2022. Please click here for details about advertising options, requirements, payment, and more. NABH will also post the 2022 NABH Exhibitor and Sponsor Guide on the association’s website after the Annual Meeting.

If you haven’t done so yet, please register for the Annual Meeting and reserve your hotel room today!

Fact of the Week

Between April 2021 and October 2021, the highest rates of telehealth visits were among those with Medicaid (29.3%) and Medicare (27.4%), Black individuals (26.8%), and those earning less than $25,000 (26.7%), according to data from HHS’ Assistant Secretary for Planning and Evaluation.

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

HHS Secretary Becerra Launches National Tour to Strengthen Mental Health

U.S. Health and Human Services (HHS) Secretary Xavier Becerra on Thursday kicked off the National Tour to Strengthen Mental Health as a way to hear directly from Americans about their behavioral health challenges and engage with local officials to strengthen the mental health and crisis care systems in the United States.

The move came two days after President Biden announced his administration’s strategy to address America’s mental health crisis during the president’s first State of the Union address. Part of a broader “unity agenda,” the strategy aims to strengthen system capacity, connect more Americans to care, and create healthy environments where the country’s health and social services infrastructure addresses mental health holistically and equitably.

“The pandemic has not only taken a physical toll on all of us, but also brought on greater behavioral health challenges for everyone,” Becerra said in an announcement. “From small towns to big cities, I’ll be traveling nationwide with members of my leadership team to meet with people who have been hit particularly hard and partnering with local leaders to find ways to save lives in our communities.”

In the coming months, Becerra will make announcements about new initiatives and resources from HHS, such as increasing the number of behavioral health professionals and community and behavioral health supporter workers in underserved and under-resourced communities, expanding pediatric mental healthcare access through telehealth services, and transitioning to the national 988 behavioral health crisis hotline that will begin operating in July.

New CDC Data Show U.S. Suicides Peaked in 2018

The Centers for Disease Control and Prevention (CDC) this week reported that after rising from 2000 to 2018, the age-adjusted suicide rate in the United States declined after peaking in 2018.

Suicide dropped to the 10^th leading cause of death from the 12^th leading cause in 2020, “due to the emergence of Covid–19 deaths and increases in deaths from chronic liver disease and cirrhosis,” the CDC reported in Suicide Mortality in the United States, 2000-2020.

The new findings also showed that suicide rates were three to four times higher for males compared with females from 2000 through 2020. And for females, firearm-related suicide recently replaced poisoning as the leading means of suicide.

CMS Publishes Report to Congress on Medicaid Managed Care Regulations

The Centers for Medicare & Medicaid Services (CMS) recently released a report to Congress that focuses on coverage of services received in Institutions for Mental Diseases (IMD) by managed care plans through states in lieu of services (ILOS) authority.

Required by the 21^st Century Cures Act, the report found that the majority of states that cover inpatient behavioral health treatments through risk-based managed care use the IMD ILOS authority, and that states primary rationale for using this authority is to increase access to behavioral health services.

Joint Commission Issues Statement on Dr. Lorna Breen Health Care Provider Protection Act

The Joint Commission recently released a statement after Congress passed the Dr. Lorna Breen Health Care Provider Protection Act.

Passed in February, the legislation seeks to reduce and prevent suicide, burnout, and mental and behavioral health conditions among healthcare professionals. Lorna Breen was a physician who served as emergency room director at New York Presbyterian Hospital and died by suicide in April 2020 while on a break visiting family in Virginia.

“The Covid-19 pandemic has increased to a devastating degree with the amount of burnout and stress among physicians, nurses and other health care providers,” Ana Pujols McKee, M.D. said in the statement. Pujols McKee serves as The Joint Commission’s interim president and CEO, executive vice president, chief medical officer, and chief diversity, equity, and inclusion officer. “While we share in the deep sadness of Dr. Breen’s death from across the health care community, it is not without hope for positive change,” Pujols McKee continued. “It is critical that we increase awareness and provide resources to support our nation’s health care providers as they continue to work tirelessly into the third year of the pandemic.”

The Joint Commission’s announcement said research has shown that clinicians fear seeking mental health treatment because of questions related to their mental health history.

Click here to read a statement from The Joint Commission about removing barriers to mental health for clinicians and other providers; here to read a “Quick Safety” on promoting psychosocial well-being of healthcare staff during a crisis; and here to read the organization’s sentinel alert regarding the well-being of healthcare staff.

The Dr. Lorna Breen Health Care Provider Protection Act is awaiting President Biden’s signature.

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

The National Institute on Drug Abuse (NIDA) invites organizations to participate in National Drug and Alcohol Facts Week (NDAFW), a national health observance meant to empower teens and young adults about making informed decisions about drugs, alcohol, and addiction.

NIDA has developed five steps to hosting a NDAFW event and created lesson plans and other materials for educators, counselors, and prevention specialists.

Please click here to learn how to register your organization’s event online.

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

NABH’s Denial-of-Care Portal is available for members to provide information about their experiences with managed care organizations that impose barriers to care through insurance-claim denials.

NABH’s Managed Care Committee worked for more than a year to develop the Denial-of-Care Portal as a way to collect specific data on insurers who deny care—often without regard for parity or the effects on patients.

This NABH member-only, survey-like tool allows users to add the name of a managed care organization, type of plan, level of care, type of care (mental health or substance use disorder), duration of approved treatment, duration of unapproved treatment, criteria used to deny a claim, and more.

The portal allows members to submit individual examples of claim denials or upload multiple entries via Excel. It also includes sections on appeals and physician participation. In time, the tool could be a valuable resource for the NABH team’s advocacy efforts.

Please e-mail Emily Wilkins, NABH’s administrative coordinator, if you have questions about the portal.

Register Today for NABH’s 2022 Annual Meeting!

Please visit our Annual Meeting homepage to view the 2022 Annual Meeting At-A-Glance for preliminary meeting details, register for the meeting, and reserve a hotel room.

We hope to see you in Washington from June 13-15!

Fact of the Week

For the first time, Black Americans are dying from drug overdoses at a higher rate than white Americans, according to a new study in JAMA. The report suggests that the high potency of the illicit drug supply may be disproportionately harming racial and ethnic minoritized communities.

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

HHS Pays More Than $560 Million to Providers in PRF Phase 4 Distribution This Week

HHS on Thursday announced that the department’s Health Resources and Services Administration (HRSA) is making more than $560 million in Provider Relief Fund (PRF) Phase 4 Distribution payments to more than 4,100 healthcare providers nationwide this week.

With this latest announcement, nearly $11.5 billion in PRF Phase 4 payments have now been distributed to more than 78,000 providers in all 50 states, Washington, D.C., and five territories, according to HHS. This is in addition to HRSA’s distribution of American Rescue Plan Rural Payments totaling about $7.5 billion in funding to more than 44,000 providers since November 2021.

Click here to view a state-by-state breakdown of all Phase 4 distributions to date and here for a state-by-state breakdown of all American Rescue Plan Rural Payments to date. For more information about the PRF, click here.

Federal Judge in Texas Blocks Part of HHS’ Surprise Billing Rule

A federal judge in Texas on Wednesday struck down part of the Biden administration’s interpretation of a part of the federal law banning surprise medical bills.

Siding with the Texas Medical Association, Judge Jeremy Kernodle of the Eastern District of Texas struck down a narrow part of the surprising billing rule that outlines how to resolve payment disputes between payers and providers regarding out-of-network claims.

The ruling maintains the protections for patients against receiving bills for thousands of dollars in situations such as going to a hospital emergency room and later learning one of the physicians was not covered by the patient’s insurance.

Click here to read news coverage about the ruling.

Neuroscientist and Former NIMH Director Tom Insel’s Book ‘Healing’ Now Available

Healing: Our Path From Mental Illness To Mental Health, the new book by former National Institute of Mental Health (NIMH) Director Tom Insel, M.D., was released this week.

Insel, a neuroscientist and psychiatrist who led the NIMH from 2002 to 2015, spoke with The New York Times about this new book, which highlights failures in our nation’s behavioral healthcare system, including ineffective delivery of care, gaps in community services, and a reliance on police and jails for crises services.

Insel—who addressed attendees at NABH’s Annual Meeting last year—said in the interview that he hopes his new book will sound an alarm for the country.

“I want to ring the bell to tell people that we can do so much better today,” Insel said in the interview, “and there is no excuse for allowing people with these brain disorders to languish on our streets like this and die at age 55, eating out of trash bins.”

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

The National Institute on Drug Abuse (NIDA) invites organizations to participate in National Drug and Alcohol Facts Week (NDAFW), a national health observance meant to empower teens and young adults about making informed decisions about drugs, alcohol, and addiction.

NIDA has developed five steps to hosting a NDAFW event and created lesson plans and other materials for educators, counselors, and prevention specialists.

Please click here to learn how to register your organization’s event online.

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

NABH’s Denial-of-Care Portal is available for members to provide information about their experiences with managed care organizations that impose barriers to care through insurance-claim denials.

NABH’s Managed Care Committee worked for more than a year to develop the Denial-of-Care Portal as a way to collect specific data on insurers who deny care—often without regard for parity or the effects on patients.

This NABH member-only, survey-like tool allows users to add the name of a managed care organization, type of plan, level of care, type of care (mental health or substance use disorder), duration of approved treatment, duration of unapproved treatment, criteria used to deny a claim, and more.

The portal allows members to submit individual examples of claim denials or upload multiple entries via Excel. It also includes sections on appeals and physician participation. In time, the tool could be a valuable resource for the NABH team’s advocacy efforts.

Please e-mail Emily Wilkins, NABH’s administrative coordinator, if you have questions about the portal.

Register Today for NABH’s 2022 Annual Meeting!

Please visit our Annual Meeting homepage to view the 2022 Annual Meeting At-A-Glance for preliminary meeting details, register for the meeting, and reserve a hotel room.

We hope to see you in Washington from June 13-15!

Fact of the Week

Between 1990 and 2019, the global number of disability-adjusted life-years (DALYS) due to mental disorders increased to 125.3 million from 80.8 million, according to a recent study in the journal The Lancet.

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

Biden Administration Announces RFI on Access to Care for Medicaid and CHIP Enrollees

The Biden administration this week announced a request for information (RFI) in its effort to develop a comprehensive access strategy to ensure equitable access to healthcare for Medicaid and Children’s Health Insurance Program (CHIP) beneficiaries.

According to the announcement, this strategy will require the Centers for Medicare & Medicaid Services (CMS) to use regulations, guidance, and other tools to apply a multi-faceted approach to reducing health disparities. The agency is seeking feedback on topics such as enrolling in and maintaining coverage, accessing healthcare services and supports, and ensuring adequate provider payment rates.

“With this RFI, we are taking a first step towards a broader perspective of what ‘access’ to Medicaid means,” Daniel Tsai, director of the Center for Medicaid and CHIP Services, said in an announcement. “Ensuring access to Medicaid includes addressing a range of barriers current and potential Medicaid beneficiaries may experience, from enrolling in Medicaid to maintaining coverage, to accessing care across both fee-for-service and managed care delivery systems,” Tsai continued. “Access must also cross physical healthcare, behavioral health, and home and community-based services.”

Click here to learn more about the process and how to provide information to CMS. The 60-day comment period opened Feb. 17.

White House Issues Proclamation for National Eating Disorders Awareness Week: Feb. 21-25

President Biden on Friday issued a proclamation that announced National Eating Disorders Awareness Week next week to build awareness around this serious behavioral health issue that has increased in recent years.

According to the announcement, nearly 1 in 10 Americans are expected to develop an eating disorder in their lifetime. Eating disorders include binge-eating, bulimia nervosa, and anorexia nervosa and can have serious or fatal consequences if left untreated.

Please remember to follow NABH on Twitter @NABHbehavioral and on Linkedin for social media posts during National Eating Disorders Awareness Week.

ASAM Releases ASAM Criteria® Interview Guide

This week the American Society of Addiction Medicine (ASAM) and the University of California, Los Angeles Integrated Substance Abuse Programs (UCLA ISAP) released a paper-based resource to support more consistent and effective implementation of The ASAM Criteria, a national framework for patient-centered, evidence-based addiction care.

The ASAM Criteria Assessment Interview Guide is the first publicly available, standardized version of The ASAM Criteria assessment. An announcement about the new resource said both ASAM and UCLA hope to increase both the quality and consistency of patient assessments and treatment recommendations.

Center for Rural Opioid Prevention, Treatment & Recovery to Host Contingency Management Webinar on March 2

The Center for Rural Opioid Prevention, Treatment & Recovery will host Introduction to Contingency Management—a webinar that highlights the intervention in which tangible incentives are provided in exchange for evidence of drug or alcohol abstinence—on Wednesday, March 2 at 4 p.m. ET.

Led by Michael McDonnell, Ph.D. and Sara Parent, ND, both of Washington State University, the webinar will be available on Zoom and will educate participants on how to describe contingency management; summarize evidence supporting contingency management as an intervention for stimulant use disorders; review guidelines for implementing contingency management; and formulate strategies for overcoming barriers to contingency management implementation.

Click here to register.

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

The National Institute on Drug Abuse (NIDA) invites organizations to participate in National Drug and Alcohol Facts Week (NDAFW), a national health observance meant to empower teens and young adults about making informed decisions about drugs, alcohol, and addiction.

NIDA has developed five steps to hosting an NDAFW event and created lesson plans and other materials for educators, counselors, and prevention specialists.

Please click here to learn how to register your organization’s event online.

Action Alliance to Host Webinar About 988 Hotline Messaging Framework on March 22

The National Action Alliance for Suicide Prevention (Action Alliance) will release a 988 Messaging Framework next month to help people transition to the national 988 behavioral health crisis hotline that takes effect in July.

The hourlong webinar is free and will highlight how to use the resource in public messaging efforts. The Action Alliance will host the event on Tuesday, March 22 at 2 p.m. ET.

Click here to register.

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

NABH’s Denial-of-Care Portal is available for members to provide information about their experiences with managed care organizations that impose barriers to care through insurance-claim denials.

NABH’s Managed Care Committee worked for more than a year to develop the Denial-of-Care Portal as a way to collect specific data on insurers who deny care—often without regard for parity or the effects on patients.

This NABH member-only, survey-like tool allows users to add the name of a managed care organization, type of plan, level of care, type of care (mental health or substance use disorder), duration of approved treatment, duration of unapproved treatment, criteria used to deny a claim, and more.

The portal allows members to submit individual examples of claim denials or upload multiple entries via Excel. It also includes sections on appeals and physician participation. In time, the tool could be a valuable resource for the NABH team’s advocacy efforts.

Please e-mail Emily Wilkins, NABH’s administrative coordinator, if you have questions about the portal.

NABH 2022 Annual Meeting At-A-Glance Available Online

Registration is open for NABH’s 2022 Annual Meeting—Shaping the Future of Behavioral Healthcare—and this week NABH posted the meeting’s At-A-Glance online.

Please visit our Annual Meeting homepage to view the At-A-Glance for preliminary meeting details, register for the meeting, and reserve a hotel room.

We hope you join us from June 13-15 in Washington!

Fact of the Week

A new estimate from Forbes, the cost of America’s opioid crisis is now more than $1.3 trillion and rising.
 
For questions or comments about this CEO Update, please contact Jessica Zigmond.

2022 NABH Annual Meeting Registration is Open!

NABH is pleased to announce that registration opened this week for the 2022 NABH Annual Meeting: Shaping the Future of Behavioral Healthcare.

Please join us from Monday, June 13 – Wednesday, June 15 at the Mandarin Oriental Washington, DC, and visit our Annual Meeting webpage to register for the meeting and reserve your hotel room.

We look forward to seeing you in Washington!

U.S. Surgeon General Vivek Murthy, MD Testifies to Senate Panel About Youth Mental Health

U.S. Surgeon General Vivek Murthy, MD offered four recommendations to address the nation’s growing youth mental health crisis when he testified before the influential Senate Finance Committee this week.

Speaking not only as the nation’s doctor, but also as someone who experienced bullying as a child, and as a parent, Murthy said there are number of longstanding, preventable factors that are driving feelings of loneliness and hopelessness among American youth.

“The recent ubiquity of technology platforms, especially social media platforms, has had harmful effects on many children,” Murthy said. “Though undoubtedly they serve as a benefit to the lives of many in important ways, these platforms have also exacerbated feelings of loneliness, futility, and low self-esteem for some youth,” he continued.

Murthy offered four recommendations to address the myriad youth mental health challenges in the United States: first, ensure that every child has access to high-quality, affordable, and culturally competent mental health care; next, focus on prevention, by investing in school and community-based programs that gave been shown to improve the mental health and emotional well-being of children at low cost and high benefit; third, better understand the impact that technology and social media have on mental health; and, finally, overcome stigma. For that last recommendation, Murthy said this area concerns both individual and community engagement, and it requires understanding the role we each have to play in overcoming stigma.

CDC, FDA Release Draft Guidance for Opioid Prescribing

The Centers for Disease Control and Prevention (CDC) on Thursday released its anticipated draft guidance on opioid prescribing for acute pain, subacute pain, and chronic pain in adults.

The guidance includes recommendations on clinician-patient communication, improved safety and effectiveness, and reduction in risks of developing an opioid use disorder (OUD), overdose, and death. It also recommends periodic review of the state prescription drug monitoring program data, consideration for toxicology testing, caution when co-prescribing benzodiazepines, and arrangement of medication treatment for patients with OUD.

This clinical practice guideline provides recommendations and does not require mandatory compliance. Public comments on the recommendations are due April 11.

Also this week, the U.S. Food and Drug Administration (FDA) released guidance to develop non-addictive alternatives to opioids for acute pain, in response to the statutory requirements of section 3001(b) of the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities (SUPPORT) Act. The FDA said it expects to address chronic pain in future guidance.

Comments on the FDA guidance are also due April 11.

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

The National Institute on Drug Abuse (NIDA) invites organizations to participate in National Drug and Alcohol Facts Week (NDAFW), a national health observance meant to empower teens and young adults about making informed decisions about drugs, alcohol, and addiction.

NIDA has developed five steps to hosting a NDAFW event and created lesson plans and other materials for educators, counselors, and prevention specialists.

Please click here to learn how to register your organization’s event online.

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

NABH’s Denial-of-Care Portal is available for members to provide information about their experiences with managed care organizations that impose barriers to care through insurance-claim denials.
NABH’s Managed Care Committee worked for more than a year to develop the Denial-of-Care Portal as a way to collect specific data on insurers who deny care—often without regard for parity or the effects on patients.

This NABH member-only, survey-like tool allows users to add the name of a managed care organization, type of plan, level of care, type of care (mental health or substance use disorder), duration of approved treatment, duration of unapproved treatment, criteria used to deny a claim, and more.

The portal allows members to submit individual examples of claim denials or upload multiple entries via Excel. It also includes sections on appeals and physician participation. In time, the tool could be a valuable resource for the NABH team’s advocacy efforts.

Please e-mail Emily Wilkins, NABH’s administrative coordinator, if you have questions about the portal.

Fact of the Week

Beyond nursing home care, members of racial and ethnic minority groups are more likely to reside in areas that suffer from physician shortages, including shortages of primary care doctors, surgeons, and mental health providers, which is also a product of structural racism. Learn more in the February 2022 edition of Health Affairs, a theme issue devoted to system racism and its effects on health.

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

Federal Lawmakers Examine U.S. Mental Health Crisis in Committee Hearings

The influential Senate Health, Education, Labor & Pensions (HELP) and House Ways and Means Committees learned about the nation’s persistent mental health and substance use crises in separate hearings on Capitol Hill this week.

On Tuesday, senators heard from five expert witnesses, including Mitch Prinstein, Ph.D., chief science officer at the American Psychological Association; Michelle Durham, M.D., M.P.H., vice chair of education in the psychiatry department and clinical associate professor of psychiatry and pediatrics at Boston Medical Center, Boston University School of Medicine; and Sara Goldsby, M.S.W., M.P.H., director of South Carolina’s Department of Alcohol and Other Drug Abuse Services.

Senate HELP Committee Chairwoman Patty Murray (D-Wash.) acknowledged that the Covid-19 pandemic has worsened the country’s existing mental health and substance use crises and emphasized more than once that the behavioral healthcare workforce is stretched too thin. Murray also said it’s time to increase access to behavioral healthcare services.

“If we’re going to respond to the behavioral health issues the pandemic has made worse … that will take legislative action,” Murray said.

In a hearing the following day, members of the House Ways and Means Committee heard from experts representing UConn Health, the Legal Action Center, and the North Carolina Division on Mental Health, Developmental Disabilities, and Substance Abuse Services.

The Senate Finance Committee will host a hearing on protecting youth mental health on Tuesday, Feb. 8 at 10 a.m. ET. Click here to watch the hearing next week.

CMS Releases Reminder About ‘Extraordinary Circumstance’ Exception to Quality Data Reporting

The Centers for Medicare & Medicaid Services (CMS) has released a notice to remind healthcare providers that CMS offers a process for hospitals or facilities to request exceptions to the reporting of quality data, including data for electronic clinical quality measures, for one or more quarters when providers experience an extraordinary circumstance beyond their control.

Click here to read the announcement, which also includes information about performance-related extraordinary circumstance exception requests and promoting interoperability hardship requests.

Satcher Health Leadership Institute Adds ‘Behavioral Health’ Category and Indicators to Health Equity Tracker

The Satcher Health Leadership Institute (SHLI) has expanded its Health Equity Tracker (HET) outcomes to include a “behavioral health” category and six corresponding indicators.

Named for David Satcher, M.D., the nation’s 16^th U.S. surgeon general, the SHLI works to transform health equity through policy, leadership development, and research as it focuses on three priority areas: the political determinants of health, health system transformation, and mental and behavioral health.

The six indicators for the new behavioral health category include: frequent mental distress, depression, suicide, illicit opioid use, non-medical drug use, and alcohol use (excessive drinking).

Click here to learn more.

National Academy of Medicine Releases Discussion Proceedings for Stigma of Addiction Summit

The National Academy of Medicine has released the discussion proceedings of the Stigma of Addiction Summit that the Academy held last summer.

The summit’s six sessions cover topics including how stigma presents itself and interventions to prevent it. The new publication also outlines priorities to guide future actions.

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

The National Institute on Drug Abuse (NIDA) invites organizations to participate in National Drug and Alcohol Facts Week (NDAFW), a national health observance meant to empower teens and young adults about making informed decisions about drugs, alcohol, and addiction.

NIDA has developed five steps to hosting an NDAFW event and created lesson plans and other materials for educators, counselors, and prevention specialists. Click here to learn how to register your organization’s event online.

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

NABH’s Denial-of-Care Portal is available for members to provide information about their experiences with managed care organizations that impose barriers to care through insurance-claim denials.
NABH’s Managed Care Committee worked for more than a year to develop the Denial-of-Care Portal as a way to collect specific data on insurers who deny care—often without regard for parity or the effects on patients.

This NABH member-only, survey-like tool allows users to add the name of a managed care organization, type of plan, level of care, type of care (mental health or substance use disorder), duration of approved treatment, duration of unapproved treatment, criteria used to deny a claim, and more.

The portal allows members to submit individual examples of claim denials or upload multiple entries via Excel. It also includes sections on appeals and physician participation. In time, the tool could be a valuable resource for the NABH team’s advocacy efforts.

Please e-mail Emily Wilkins, NABH’s administrative coordinator, if you have questions about the portal.

Fact of the Week

U.S. universities are developing creative ways to provide mental health resources on their campuses. For example, the University of California-Davis embeds counselors in student groups such as the Cross-Cultural Center and the LGBTQIA Resource Center, while Stanford University’s Bridge Peer Counseling Center offers anonymous counseling 24/7 to students who are more comfortable speaking with a trained fellow student.

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

HHS, Treasury, and Labor Departments Release Parity Report to Congress

The Departments of Labor (DOL), Health and Human Services (HHS), and Treasury issued a report and fact sheet on Tuesday, Jan. 25 documenting widespread lack of compliance with federal parity rules among commercial health plans. The report specifically highlights lack of compliance with a new requirement enacted in late December 2020 that plans must document how their non-quantitative treatment limitations (NQTLs) comply with the Mental Health Parity and Addiction Equity Act (MHPAEA).

During a webinar on Wednesday, Jan. 26, DOL representatives stressed that none of the responses to requests for documentation the agency sent to 156 plans and issuers were sufficient to demonstrate compliance with MHPAEA. Furthermore, despite insufficient documentation, DOL has already issued initial determination letters finding 48 NQTLs imposed on mental health or substance use disorder (MH/SUD) benefits violate parity. HHS reported that all the responses to requests for documentation of compliance with parity from issuers in states where the agency has direct enforcement authority and non-federal government plans similarly were insufficient. HHS has issued initial determination letters finding 16 NQTLs were out of compliance with parity. DOL officials also mentioned that the agencies plan to amend the federal regulations implementing MHPAEA.

The Departments included a set of legislative recommendations for Congress in the report including authorizing the Departments to impose civil monetary penalties for parity violations and directly pursue parity violations by entities that provide administrative services to group health plans. In addition, the report recommends that Congress consider ways to permanently expand access to telehealth. The report also recommends that Congress amend MHPAEA to ensure that MH/SUD benefits are “defined in an objective and uniform manner pursuant to external benchmarks that are based in nationally recognized standards”.

These developments regarding possible regulatory and legislative changes point to the importance of NABH member submissions to the denial-of-care portal. Please see additional information about the portal below.

CMS Issues Updated Guidance on Covid-19 Vaccination Requirements for Healthcare Workers

The Centers for Medicare and Medicaid Services (CMS) issued updated guidance and resources regarding Covid-19 vaccination requirements for personnel in Medicare-participating facilities including psychiatric hospitals and psychiatric residential treatment facilities. This updated information responds to the Supreme Court’s decision earlier this month to overturn the lower court decisions blocking implementation of CMS’ Covid-19 vaccination requirements in almost half of the states. These requirements now apply in all 50 states with various deadlines.

In the 25 states not affected by the litigation, CMS had previously clarified that healthcare facility personnel had to have at least one dose of a Covid-19 vaccine (or be exempt due to religious conviction or medical condition) by Jan. 27, 2022, and a second dose (of any two dose regimen) by Feb. 28, 2022.

New deadlines for healthcare facility personnel in states previously under a stay on enforcement are Feb. 14, 2022, for a first dose and March 15, 2022, for a second dose. Texas was affected by separate litigation and the new deadlines for Medicare-regulated healthcare facilities in that state are Feb. 22, 2022, for the first dose and March 21, 2022, for the second.

Below are links to updated CMS guidance on the Covid-19 vaccination requirements:

• Guidance memo (cms.gov) – This memo provides guidance for assessing and maintaining compliance with this new regulatory requirement for certain Medicare and Medicaid providers and suppliers.
• CMS Omnibus COVID-19 Health Care Staff Vaccination Requirements FAQ (PDF cms.gov) (PDF) – These FAQs have been updated to explain the recent ruling and how it impacts employee vaccination requirements.
• IFC-6 Vaccination Requirements Infographic (cms.gov) (PDF) – This infographic visually shows the types of providers and suppliers the vaccine requirement applies to, how the requirement can be met, and associated requirement enforcement actions.
• Vaccine Requirement Implementation Timeline (cms.gov) (PDF) – This infographic illustrates the phases of the vaccination rule implementation, state-by-state, and their associated deadlines. Note that the phased deadlines vary by state.
• Vaccine Requirement Decision Tree (cms.gov) (PDF) – This handy decision tree visually explains the steps in determining to which providers and suppliers the vaccine requirement applies.

OSHA Withdraws Vaccine-or-Test Requirement

The U.S. Supreme Court, on Jan. 13, 2022, blocked implementation of the Occupational Safety and Health Administration’s (OSHA’s) vaccination and testing requirements for employers with 100 or more employees. Accordingly, the agency withdrew its emergency temporary standard (ETS) on this topic. However, the agency clarified that “[a]though OSHA is withdrawing the ETS as an enforceable emergency temporary standard, the agency is not withdrawing the ETS to the extent that it serves as a proposed rule.” In a statement on the withdrawal, the agency clarified it is “prioritizing its resources to focus on finalizing a permanent Covid-19 Healthcare Standard.”

HHS Distributes More Than $2 Billion in PRF Phase 4 Funding

HHS’ Health Resources and Services Administration (HRSA) this week is making more than $2 billion in Provider Relief Fund (PRF) Phase 4 general distribution payments to more than 7,600 healthcare providers nationwide.

These payments follow nearly $9 billion that HRSA released to providers last month. According to HRSA, a total of more than $11 billion in PRF Phase 4 payments have been distributed to more than 74,000 providers in all 50 states, Washington, D.C., and five territories.

HRSA clarified that these payments reflect “full processing of approximately 82 percent of Phase 4 applications. The remaining applications require additional review as part of the risk mitigation and cost containment safeguards previously outlined in the Phase 4 methodology”.

NABH and Other Behavioral Health Groups Send Letter to CMS about ‘No Surprises Act’ Rules

NABH and 10 other behavioral health organizations this week sent a letter to the Centers for Medicare & Medicaid Services (CMS) expressing concern that the agency’s No Surprises Act regulations will have a disproportionately negative effect on behavioral healthcare providers and add to their administrative burdens.

The No Surprises Act’s, signed into law in late 2020, requirements became effective this year. NABH and other groups have requested that CMS issue a stay on enforcement of the interim final rules (IFR) that affect routine mental and behavioral health services. If the agency insists on retaining the existing regulations, NABH and the other groups requested an exemption for behavioral healthcare providers.

“The duty to furnish a “Good Faith Estimate” (“GFE”) of costs outlined in Part 2 of the regulations imposes an undue administrative burden on our members,” the letter said. “Our providers have a long-standing practice of being transparent about fees with their patients because it is required by their professional ethics. Requiring clinicians to fill out the GFE form and update it every time there is a minor change in the treatment plan that may or may not have an impact on costs takes away from valuable treatment time – which is in extremely high demand as more and more people are struggling with the mental health impact of the COVID pandemic,” it continued. “Demand is already so high that many patients are finding it difficult to find a provider with enough availability to meet their needs.”

ONC Seeks Request for Information on EHR Standards for Prior Authorization and More

HHS’ Office of the National Coordinator (ONC) on Jan. 24, 2022, requested information about electronic health record standards for prior authorization, implementation specifications, and certification criteria for the ONC certification program to inform future rulemaking.
 
The request for information builds on a set of recommendations made in November 2020 from the HHS Intersection of Clinical and Administrative Data Task Force (ICAD) of the Health Information Technology Advisory Committee (HITAC). The task force is addressing methods for improving data interoperability across the health ecosystem.
 
“We support efforts that can serve to advance electronic prior authorization for patients, providers, and payers,” Mary Greene, M.D., director of CMS’ Office of Burden Reduction and Health Informatics, said in an announcement. “We look forward to reviewing the input received on this RFI and to exploring opportunities for alignment between future ONC policymaking and ongoing CMS initiatives on this critical topic.”

Click here to learn more about how to submit comments, which must be submitted by March 25.

CMS Releases Third Publication of T-MSIS-based Medicaid SUD Data Book

The percentage of Medicaid beneficiaries treated for a substance use disorder (SUD) who received any medication-assisted treatment increased by 7.8 percentage points to 31.6% in 2019 from 23.8% in 2018, according to CMS’ third publication of the Transformed Medicaid Statistical Information System (T-MSIS)-based Medicaid Substance Use Disorder (SUD) Data Book.

Required by the Substance Use–Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act (SUPPORT) that Congress passed in 2018, the resource is meant to help policymakers, researchers, and others better understand where to focus drug-prevention and treatment efforts.

The data book contains 2019 data on Medicaid beneficiaries treated for SUD, the services they received by both type and setting, delivery system, and progression of care.

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

The National Institute on Drug Abuse (NIDA) invites organizations to participate in National Drug and Alcohol Facts Week (NDAFW), a national health observance meant to empower teens and young adults about making informed decisions about drugs, alcohol, and addiction.

NIDA has developed five steps to hosting a NDAFW event and created lessons plans and other materials for educators, counselors, and prevention specialists. Click here to learn how to register your organization’s event online

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

NABH’s Denial-of-Care Portal is available for members to provide information about their experiences with managed care organizations that impose barriers to care through insurance-claim denials.

NABH’s Managed Care Committee worked for more than a year to develop the Denial-of-Care Portal as a way to collect specific data on insurers who deny care—often without regard for parity or the effects on patients.

This NABH member-only, survey-like tool allows users to add the name of a managed care organization, type of plan, level of care, type of care (mental health or substance use disorder), duration of approved treatment, duration of unapproved treatment, criteria used to deny a claim, and more.

The portal allows members to submit individual examples of claim denials or upload multiple entries via Excel. It also includes sections on appeals and physician participation. In time, the tool could be a valuable resource for the NABH team’s advocacy efforts.

Please e-mail Emily Wilkins, NABH’s administrative coordinator, if you have questions about the portal.

Fact of the Week

A new study found that 62% of Americans surveyed prefer in-person mental health services.

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

HHS Announces $103 Million to Reduce Burnout and Promote Wellness in Healthcare Workforce

The U.S. Health and Human Services Department (HHS) this week announced it will award $103 million in American Rescue Plan funding for evidence-informed programs, practices, and training to retain healthcare workers, reduce burnout, and promote health and wellness among the nation’s healthcare workforce.

HHS’ Health Resources and Services Administration (HRSA) will disburse the funding to 45 grantees and focus especially on healthcare providers in underserved and rural communities, according to HHS.

“I have traveled to many health centers across the country and know that the Covid-19 pandemic has intensified issues that have long been a source of stress for frontline healthcare workers — from increased patient volumes to long working hours,” HHS Secretary Xavier Becerra said in an announcement. “This funding reflects the Biden-Harris administration’s commitment to ensuring we have enough critical frontline workers by supporting healthcare providers now and beyond as they face burnout and mental health challenges. We will continue to promote the well-being of those who have made so many sacrifices to keep others well.”

HRSA is awarding the funds through the following three programs: Promoting Resilience and Mental Health Among Health Professional Workforce, Health and Public Safety Workforce Resiliency Training Program, and Health and Public Safety Workforce Resiliency Technical Assistance Center. Click here to see the list of award recipients.

Also this week, the National Academy of Medicine released a Resource Compendium for Health Care Worker Well-Being, a collection that highlight tools and strategies to address healthcare worker burnout.

HHS Announces $13 Million to Improve Behavioral Healthcare Access in Rural America

HHS this week also announced it will award $13 million through HRSA to increase access to behavioral healthcare services in rural America, including through evidence-based, trauma-informed treatment for substance use disorder.

These funds, similar to the funds to address healthcare worker burnout and wellness, are available through last year’s American Rescue Plan.

“Our response to the Covid-19 pandemic must include meeting the behavioral health needs of individuals experiencing substance use disorder,” HRSA Administrator Carole Johnson said in an announcement. “In rural areas, accessing the care and services to address these needs can be a particular challenge,” she added. “The funding we are announcing today is directly targeted to the community needs of rural areas and will help expand access to behavioral health services to meet these needs.”

HRSA’s Federal Office of Rural Health Policy will make the awards available through the Rural Communities Opioid Response Program-Behavioral Health Care Support.

Interested applicants must apply by Tuesday, April 19 at 11:59 p.m. ET. Click here for more information.

CMS Seeks Comments on Time and Distance Standards for Network Adequacy in Marketplace Insurance Plans

The Centers for Medicare & Medicaid Services (CMS) is requesting comments on proposals that the agency made regarding specific standards for outpatient, clinical behavioral health providers, psychiatrists, and inpatient or residential behavioral health facilities among other provider types in qualified health plans offered in the federally qualified health insurance exchanges.

Earlier this month, CMS released its Qualified Health Plan Notice of Benefit and Payment Parameters proposed rule for 2023. In it, CMS proposed specific time and distance standards for measuring network adequacy in qualified health plans offered in federally facilitated exchanges. Federally facilitated exchanges are offered in Alabama, Alaska, Arizona, Delaware, Florida, Georgia, Hawaii, Illinois, Indiana, Kansas, Louisiana, Michigan, Mississippi, Missouri, Montana, Nebraska, New Hampshire, North Carolina, North Dakota, Ohio, Oklahoma, South Carolina, South Dakota, Tennessee, Texas, Utah, West Virginia, Wisconsin, and Wyoming.

The agency proposed time and distance standards for behavioral healthcare providers in a draft letter to issuers that clarifies specific provisions in the proposed rule. See pages 11 and 12 in the letter for proposed time and distance standards.

Please send any comments regarding these proposals to Kirsten Beronio, NABH’s director of policy and regulatory affairs, Director of Policy and Regulatory Affairs, before next Thursday, Jan. 27.

The Joint Commission Publishes Covid-19 Vaccination Requirement FAQs

The Joint Commission (TJC) has released a series of Covid-19 vaccination requirement resources and frequently asked questions (FAQs) for providers.

Beginning Jan. 27, TJC will start surveying to CMS’ Covid-19 vaccination healthcare staff vaccination interim final rule in all of the Commission’s applicable program surveys. As TJC noted in its announcement about the FAQs, “the CMS Covid-19 vaccination requirements apply to organizations that elect to use Joint Commission accreditation for deemed status purposes.”   

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

The National Institute on Drug Abuse (NIDA) invites organizations to participate in National Drug and Alcohol Facts Week (NDAFW), a national health observance meant to empower teens and young adults about making informed decisions about drugs, alcohol, and addiction.

NIDA has developed five steps to hosting a NDAFW event and created lessons plans and other materials for educators, counselors, and prevention specialists. Click here to learn how to register your organization’s event online

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

NABH’s Denial-of-Care Portal is available for members to provide information about their experiences with managed care organizations that impose barriers to care through insurance-claim denials.

NABH’s Managed Care Committee worked for more than a year to develop the Denial-of-Care Portal as a way to collect specific data on insurers who deny care—often without regard for parity or the effects on patients.

This NABH member-only, survey-like tool allows users to add the name of a managed care organization, type of plan, level of care, type of care (mental health or substance use disorder), duration of approved treatment, duration of unapproved treatment, criteria used to deny a claim, and more.

The portal allows members to submit individual examples of claim denials or upload multiple entries via Excel. It also includes sections on appeals and physician participation. In time, the tool could be a valuable resource for the NABH team’s advocacy efforts.

Please e-mail Emily Wilkins, NABH’s administrative coordinator, if you have questions about the portal.

Fact of the Week

During 2015-2019, an estimated 10.6 million adults in the United States, or about 4.3% of the adult population, reported having had suicidal thoughts during the preceding year.

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

U.S. Supreme Court Allows Covid-19 Vaccine Mandate for Healthcare Workers

In a 5-4 vote Thursday, the U.S. Supreme Court ruled it will allow the Centers for Medicare & Medicaid Services’ (CMS) regulation to proceed that mandates the Covid-19 vaccine for about 10.3 million workers at approximately 76,000 healthcare facilities that accept money from the Medicare and Medicaid programs.

Chief Justice John Roberts and Justice Brett Kavanaugh joined the Court’s liberal justices in the majority decision. In its other ruling, the Court voted 6-3 to block the Occupational Safety and Health Administration’s (OSHA) vaccine-or-test mandate for large businesses.

CMS Administrator Chiquita Brooks-LaSure said in a statement that the agency is “extremely pleased” with the Court’s decision for healthcare workers and added that giving patients assurance of safe care is a critical responsibility for CMS.

“CMS is already implementing its healthcare worker vaccination rule in 25 states and territories that were not covered by preliminary injunctions,” Brooks-LaSure continued in her Jan. 13 statement. “Today’s decision will enable us to fully implement this rule, and we look forward to working with healthcare providers and their workers to protect patients,” she continued. “We will continue our extensive outreach and assistance efforts encouraging individuals working in healthcare to get vaccinated.”

As a result of Thursday’s decision, healthcare providers subject to the Omnibus Health Care Staff Vaccination rule in the 24 states (Alabama, Alaska, Arizona, Arkansas, Georgia, Idaho, Indiana, Iowa, Kansas, Kentucky, Louisiana, Mississippi, Missouri, Montana, Nebraska, New Hampshire, North Dakota, Ohio, Oklahoma, South Carolina, South Dakota, Utah, West Virginia, and Wyoming) covered by this decision will now need to establish plans and procedures to ensure their staff are vaccinated.

CMS also said the decision does not affect compliance timelines for providers in the District of Columbia, the territories, and the 25 states where the preliminary injunction was previously lifted. CMS released guidance about this on Dec. 28, 2021.

Becerra Extends Covid Public Health Emergency for 90 Days

HHS Secretary Xavier Becerra has extended the Covid-19 public health emergency (PHE) for an additional 90 days, effective Jan. 16.

Former HHS Secretary Alex Azar made the original determination on Jan. 31, 2020. Azar renewed the Covid-19 PHE four times, and this recent determination is the fourth time Becerra has renewed it.

SAMHSA and Partner Groups Launch National Survey of Mobile Crisis Teams

The Substance Abuse and Mental Health Services Administration (SAMHSA) has partnered with other groups to launch a survey that will gather information about mobile crisis teams (MCTs) across the United States.

SAMHSA, along with organizations including the National Association of State Mental Health Program Directors and Vibrant Emotional Health (formerly the Mental Health Association of New York City) has released the survey to better understand the organization, operation, and financing of MCTs.

The organizations encourage all mobile crisis, co-responder, and other field-based mental health crisis response teams to complete the 10-minute survey by Tuesday, Feb. 28 and to share the survey widely.

CMS Requests Information on Behavioral Health Networks Within Medicare Advantage Plans

CMS on Wednesday published a proposed rule that includes a request for information about how to improve behavioral health networks within Medicare Advantage (MA) health plans.

NABH will develop a response to the regulation and welcomes comments from NABH members.
Although all comments are welcome, CMS asked specifically for  comments related to the following topics:

• Challenges for behavioral healthcare providers to establish contracts with MA health plans;

• Providers’ inability or unwillingness to contract with MA plans, including issues related to provider reimbursement; and

• Opportunities to expand services for the treatment of opioid addiction and substance use disorders.

Please send comments to Kirsten Beronio, NABH’s director of policy and regulatory affairs. Public comments are due March 7.

GAO Offers Recommendations to Improve State Opioid Response Grant Program Assessment

In its recent review of SAMHSA’s State Opioid Response (SOR) grant program, the Government Accountability Office (GAO) concluded that SAMHSA did not fully leverage available information to adequately assess the program, and that the agency did not identify the program’s potential limitations.

The GAO noted that SAMHSA assesses the SOR grant program through two annual performance reports, and it recommended that SAMHSA make those reports more useful by first identifying potential limitations and how those limitations may affect the conclusions that can and cannot be drawn; and second by further analyzing existing program information to provide a more comprehensive, in-depth assessment of the program to identify opportunities for improvement.

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

The National Institute on Drug Abuse (NIDA) invites organizations to participate in National Drug and Alcohol Facts Week (NDAFW), a national health observance meant to empower teens and young adults about making informed decisions about drugs, alcohol, and addiction.

NIDA has developed five steps to hosting a NDAFW event and created lessons plans and other materials for educators, counselors, and prevention specialists. Click here to learn how to register your organization’s event online.

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

NABH’s Denial-of-Care Portal is available for members to provide information about their experiences with managed care organizations that impose barriers to care through insurance-claim denials.

NABH’s Managed Care Committee worked for more than a year to develop the Denial-of-Care Portal as a way to collect specific data on insurers who deny care—often without regard for parity or the effects on patients.

This NABH member-only, survey-like tool allows users to add the name of a managed care organization, type of plan, level of care, type of care (mental health or substance use disorder), duration of approved treatment, duration of unapproved treatment, criteria used to deny a claim, and more.

The portal allows members to submit individual examples of claim denials or upload multiple entries via Excel. It also includes sections on appeals and physician participation. In time, the tool could be a valuable resource for the NABH team’s advocacy efforts.

Please e-mail Emily Wilkins, NABH’s administrative coordinator, if you have questions about the portal.

Fact of the Week

A new analysis in the JAMA Network Open found there were 10,292 fatal overdoses among people over the age of 55 in 2019, compared with 518 overdoses in the same age group in 1999. The study examined disparities by sex, race, and ethnicity in death rates due to opioid overdose during this time period.

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

CMS Issues Guidance on Covid-19 Vaccination Requirements for Most Medicare- and Medicaid-Certified Providers

The Centers for Medicare & Medicaid Services (CMS) on Dec. 29 issued guidance regarding the Interim Final Rule (IFR) regarding Covid-19 vaccination requirements for healthcare staff that the agency published in early November.

In the Dec, 29 memo, CMS specified that this guidance does not apply to the following states that are still subject to preliminary injunctions that federal courts issued to block implementation of the IFR in those states: Alabama, Alaska, Arizona, Arkansas, Georgia, Idaho, Indiana, Iowa, Kansas, Kentucky, Louisiana, Mississippi, Missouri, Montana, Nebraska, New Hampshire, North Dakota, Ohio, Oklahoma, South Carolina, South Dakota, Texas, Utah, West Virginia, and Wyoming.

To learn more, please read the NABH Issue Brief that NABH sent to members this week.

OSHA Withdraws Non-Recordkeeping Portions of Covid-19 Healthcare ETS

The U.S. Labor Department’s Occupational Safety and Health Administration (OSHA) last week said it is withdrawing the non-recordkeeping portion of the Covid-19 healthcare emergency temporary standard (ETS) that it adopted last June.

Separate from a Covid-19 vaccine mandate, the healthcare ETS required that employers provide personal protective equipment, physical barriers, and ventilation, and also require screening of each individual who enters the facility. The temporary standard also provided paid leave to workers who must quarantine due to infections or exposure.

“OSHA announces today that it intends to continue to work expeditiously to issue a final standard that will protect healthcare workers from COVID-19 hazards and will do so as it also considers its broader infectious disease rulemaking,” OSHA’s announcement said on Dec. 27. “However, given that OSHA anticipates a final rule cannot be completed in a timeframe approaching the one contemplated by the OSH Act, OSHA also announces today that it is withdrawing the non-recordkeeping portions of the healthcare ETS.

HHS’ Provider Relief Fund Reporting Portal for Reporting Period #2 Open Through March 31

HHS’ Health Resources and Services Administration (HRSA) announced the Provider Relief Fund (PRF) Reporting Portal for Reporting Period 2 (RP2) opened on Jan. 1 and will remain open through March 31, 2022.

According to HRSA’s announcement, healthcare providers who received one or more general and/or targeted PRF payments exceeding $10,000, in the aggregate, from July 1, 2020 to Dec. 31, 2020 must report on their use of funds during RP2.

In addition, HRSA created a stakeholder toolkit with content to share information about RP2 within organizations and networks. The agency has also developed the following resources for providers: What’s New in Reporting Period 2 Fact Sheet, Lost Revenues Guide, and a webpage for reporting on nursing home and infection control payments.

To learn more, register for either of HRSA’s upcoming webinars: one for new reporting entities on Jan. 12 at 3 p.m. ET and one for returning reporting entities on Jan. 13 at 3 p.m. ET.

SAMHSA Invests $282 Million to Implement 988 Behavioral Health Crisis Hotline

The Substance Abuse and Mental Health Services Administration (SAMHSA) announced it has invested $282 million in American Rescue Plan funding to help transition the current National Suicide Prevention Lifeline to the 988 three-digit dialing code from its current 10-digit number.

Congress designated the new 988 dialing code in 2020 to operate through the existing National Suicide Prevention Lifeline. The new code will be available national for calls, texts, and chats, beginning in July 2022.

According to SAMHSA, it has allotted $177 million to strengthen and expand the existing Lifeline network operations and infrastructure, including chat and text response, backup center capacity, and special services, such as a sub-network for Spanish language-speakers. The agency has invested $105 million to develop staffing across states’ local crisis call centers. SAMHSA is recruiting for a director for the crisis coordination office.

California’s Medicaid Program Receives CMS Approval to Implement Contingency Management

California Medi-Cal, the state’s Medicaid program, has received approval from the Centers for Medicaid & Medicare Services (CMS) to implement contingency management (CM) through a Section 1115 waiver.

Several insurance companies are financing CM, an evidence-based intervention for stimulant use disorders, and some states have engaged in pilot programs for the practice. CMS’ approval of the California CM pilot represents the first time the treatment intervention has been approved formally as a benefit in a Medicaid program.

While there is substantial research supporting the efficacy of CM, implementation has lagged for decades due to an Office of Inspector General opinion that raised concerns about fraud and abuse.

OSHA Publishes Workplace Violence Prevention Standard Fact Sheet

OSHA has announced it will convene a Small Business Advocacy Review (SBAR) panel of small entity representatives early this year to help OSHA in its work to develop a potential Prevention of Workplace Violence in Healthcare and Social Assistance standard.

In the meantime, OSHA has published a fact sheet that describes who might be covered by a new workplace violence prevention standard, why OSHA is considering the standard, what the standard might include, what a small entity representative would do, and how small businesses and local government entities can participate.

NIMH to Host Webinar on School-based Suicide Prevention on Jan. 14

The National Institute of Mental Health (NIMH) will host a webinar next week about new practices in school-based suicide prevention for school administrators, researchers, practitioners, policymakers, and other stakeholders.

The presentation will focus on identifying and supporting high-risk youth, as well as opportunities to evaluate these efforts.

NIMH will host the webinar next Friday, Jan. 14 from 2 p.m. to 3:30 p.m. ET. Click here to register.

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

NABH’s Denial-of-Care Portal is available for members to provide information about their experiences with managed care organizations that impose barriers to care through insurance-claim denials.

NABH’s Managed Care Committee worked for more than a year to develop the Denial-of-Care Portal as a way to collect specific data on insurers who deny care—often without regard for parity or the effects on patients.

This NABH member-only, survey-like tool allows users to add the name of a managed care organization, type of plan, level of care, type of care (mental health or substance use disorder), duration of approved treatment, duration of unapproved treatment, criteria used to deny a claim, and more.

The portal allows members to submit individual examples of claim denials or upload multiple entries via Excel. It also includes sections on appeals and physician participation. In time, the tool could be a valuable resource for the NABH team’s advocacy efforts.

Please e-mail Emily Wilkins, NABH’s administrative coordinator, if you have questions about the portal.

Fact of the Week

A meta-analysis of 21 studies that analyzed interventions in prisons to address the needs of people with co-occurring serious mental illness and substance use disorders generally showed decreases in substance use and lower odds of committing a substance use-related offense after reentry into the community for those who were in a treatment program compared with those who were not, according to research published in Psychiatric Services.

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

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

President Biden on Thursday signed legislation that permits a federal debt ceiling increase and also forestalls expected Medicare payment cuts to providers.

Passed by Congress this week, the bill to raise the federal government’s borrowing limit by about $2.5 trillion—and cover its obligations into 2023—also delays through March 2022 the 2% Medicare sequestration cuts that were to take effect in January.

After the first quarter of 2022, a phased-in, 1% cut will take effect for the second quarter, followed by the full 2% cut for the third and fourth quarters of the year.

Under the legislation, the sequestration will be increased to 2.25% for the first two quarters of 2030, increasing to 3% in quarters three and four of 2030. The bill would also extend the Medicare conversion factor through calendar year 2022 at a rate of 3%, marking a reduction in provider reimbursement by 0.75 percent from the 3.75 conversion factor in 2021.

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

Senate Majority Leader Charles Schumer (D-N.Y.) on Friday signaled that the Biden administration’s Build Back Better Act will be delayed as discussions continue about the $1.7 trillion climate and social spending plan.

Reports have noted that Democrats are continuing to push for action on the legislation before Christmas, but that ongoing conversations between the White House and Sens. Joe Manchin (D-W.Va.) and Kyrsten Sinema (D-Ariz.)—both of whom have expressed concern about passing another trillion-dollar spending bill—will push the legislation into 2022.

“The president requested more time to continue his negotiations, and so we will keep working with him, hand in hand, to bring this bill over the finish line and deliver on these much-needed provisions,” Schumer said on the Senate floor.” Schumer did not say when the Senate will consider the measure.

HHS Releases 2022 Regulatory Priorities

The U.S. Health and Human Services Department (HHS) has included behavioral health in the department’s recently released Statement of Regulatory Priorities for 2022.

Beginning on page 5 of the 15-page document, HHS noted it will propose two rules intended to extend telehealth flexibilities for substance use disorder treatments granted during the Covid-19 public health emergency.

One rule will propose revisions to the Substance Abuse and Mental Health Services Administration’s (SAMHSA) regulations that would make permanent regulatory flexibilities for opioid treatment programs to provide extended take-home doses of methadone to patients when it is safe to do so.

In the other telehealth rule, HHS will propose revisions to SAMHSA regulations to permanently allow opioid treatment programs to provide buprenorphine via telehealth services.

The document also describes HHS’ plans to work with the U.S. Labor Department on a rule related to the Mental Health Parity and Addiction Treatment Equity Act and the Consolidated Appropriations Act, 2021 related to compliance. Finally, the HHS plan said it will work on revisions related to Part 2 requirements to align rules about the confidentiality of SUD treatment records with rules that the Health Insurance Portability and Accountability Act of 1996 and the Coronavirus Aid, Relief, and Economic Security Act of 2020 require.

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

The Centers for Medicare & Medicaid Services (CMS) has added two measures to the 2022 updates to the core set of children’s healthcare quality measures.

In Follow-Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence: Ages 13-17, the measure assesses the percentage of emergency department (ED) visits for beneficiaries aged13 and older with a principal diagnosis of alcohol or other drug (AOD) abuse or dependence who had a follow-up visit for AOD abuse or dependence.

The other measure, Follow-Up After Emergency Department Visit for Mental Illness: Ages 6-17, assesses the percentage of ED visits for beneficiaries aged 6 and older with a principal diagnosis of mental illness or intentional self-harm and who had a follow-up visit for mental illness.

CDC Data Show Drug Overdose Deaths Involving Fentanyl Increasing

A new report from the Centers for Disease Control and Prevention (CDC) shows that in 2019 and 2020, deaths involving illegal fentanyl increased 94% in the West, 65% in the South, and 33% in the Midwest.

“Pressed into counterfeit pills made to look like oxycodone or other painkillers, illegally made fentanyl has been showing up east of the Mississippi where heroin is sold and in two-thirds of drug overdose deaths charted by CDC through April,” the report noted.

Meanwhile, HHS’ Office of the Inspector General (OIG) this week released a data brief that reported many Medicare beneficiaries are not receiving medication to treat their opioid use disorder.

“About 1 million Medicare beneficiaries were diagnosed with opioid use disorder in 2020. Yet less than 16 percent of these beneficiaries received medication to treat their opioid use disorder, raising concerns that beneficiaries face challenges accessing treatment,” the OIG’s data brief noted. “Furthermore, less than half of the beneficiaries who received medication to treat their opioid use disorder also received behavioral therapy. These services may be provided in-person or via telehealth; however, the full extent to which beneficiaries use telehealth for behavioral therapy is unknown as Medicare does not require opioid treatment programs to report this information.”

SAMHSA Releases New Prescribing Tools for Buprenorphine in Primary Care Settings

SAMHSA has published a new resource to provide primary care providers with information on how to implement opioid use disorder treatment using buprenorphine.

The publication highlights common barriers and identifies strategies to address them and also includes specific tactics to support buprenorphine implementation.

SAMHSA to Host Webinar on Harm Reduction Grant Program on Monday

SAMHSA is accepting applications for its first harm-reduction program and will host a webinar Monday, Dec. 20 to review the program’s requirements.

The agency said it expects to award about $30 million in grants with funding from the American Rescue Plan for programs intended to increase access to a range of community harm-reduction services and to support harm-reduction providers as they work to prevent overdose deaths.
The webinar will be held on Monday at 2 p.m. ET. Click here to register.

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

NABH’s Denial-of-Care Portal is available for members to provide information about their experiences with managed care organizations that impose barriers to care through insurance-claim denials.

NABH’s Managed Care Committee worked for more than a year to develop the Denial-of-Care Portal as a way to collect specific data on insurers who deny care—often without regard for parity or the effects on patients.

This NABH member-only, survey-like tool allows users to add the name of a managed care organization, type of plan, level of care, type of care (mental health or substance use disorder), duration of approved treatment, duration of unapproved treatment, criteria used to deny a claim, and more.

The portal allows members to submit individual examples of claim denials or upload multiple entries via Excel. It also includes sections on appeals and physician participation. In time, the tool could be a valuable resource for the NABH team’s advocacy efforts.

Please e-mail Emily Wilkins, NABH’s administrative coordinator, if you have questions about the portal.

Fact of the Week

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

Happy Holidays from NABH!

NABH will not publish CEO Update for the next two weeks and will resume on Friday, Jan. 7, 2022. The entire NABH team wishes you, your families, and your teams a very happy, healthy, and safe holiday season!
 
For questions or comments about this CEO Update, please contact Jessica Zigmond.

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

U.S. Surgeon General Vivek Murthy, M.D. this week issued the U.S. Surgeon General’s Advisory on Protecting Youth Mental Health, which outlines recommendations to address America’s youth mental health crisis.

“Even before the pandemic, an alarming number of young people struggled with feelings of helplessness, depression, and thoughts of suicide — and rates have increased over the past decade,” Murthy said in a news release. “The Covid-19 pandemic further altered their experiences at home, school, and in the community, and the effect on their mental health has been devastating,” he continued, adding that the future of the country’s well-being depends on how we support and invest in the next generation.

The 53-page advisory recommends that individuals, families, community organizations, technology companies, governments, and others recognize that mental health is an essential part of overall health; empower youth and their families to recognize, manage, and learn from difficult emotions; ensure that every child has access to high-quality, affordable, and culturally competent mental healthcare; support the mental health of children and youth in educational, community, and childcare settings and expand and support the early childhood and education workforce; address the economic and social barriers that contribute to poor mental health for young people, families, and caregivers; and increase timely data collection and research to identify and respond to youth mental health needs more rapidly.

“This includes more research on the relationship between technology and youth mental health, and technology companies should be more transparent with data and algorithmic processes to enable this research,” the Surgeon General’s announcement said.

SAMHSA Announces $30 Million in Harm-Reduction Grant Funding

The Substance Abuse and Mental Health Services Administration (SAMHSA) this week said it will issue about $30 million in American Rescue Plan funding for the agency’s first harm-reduction grant program to help prevent overdose deaths and reduce the health risks associated with drug use.

SAMHSA will accept applications from state, local, tribal, and territorial governments; tribal organizations; not-for-profit, community-based organizations; and behavioral health organizations to increase access to a range of community services and supports.

“The reality is, evidence-based harm reduction services are out of reach for far too many people,” Rahul Gupta, M.D., director of the Office of National Drug Control Policy, said in SAMHSA’s announcement. “Building on the Biden-Harris Administration’s efforts to expand evidence-based prevention, treatment and recovery support services, this historic funding will help make harm reduction services more accessible, so we can meet people where they are and save lives,” Gupta added.

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

The number of Medicare fee-for-service (FFS) beneficiary telehealth visits for behavioral health increased to 10.1 million in 2020 from 317,800 in 2019, reflecting a 32-fold increase, according to a new report from the U.S. Health and Human Services’ (HHS) Assistant Secretary for Planning and Evaluation’s (ASPE).
 
Medicare Beneficiaries’ Use of Telehealth in 2020: Trends by Beneficiary Characteristics and Location
showed that Medicare telehealth flexibilities “mitigated declines in in-person visits during the pandemic in 2020, but there is also evidence of disparities by race/ethnicity and for rural populations.”

Researchers examined claims data from the 34.9 million Medicare FFS beneficiaries who had part A or B coverage and found that the number of Medicare FFS beneficiary telehealth visits rose 63-fold to nearly 52.7 million in 2020 from about 840,000 in 2019. Despite the increase in telehealth visits during the pandemic, total utilization of all Medicare FFS Part B clinician visits declined about 11% in 2020 compared with 2019 levels, the report showed.

“Visits to behavioral health specialists showed the largest increase in telehealth in 2020,” the report noted. “Telehealth comprised a third of total visits to behavioral health specialists. While data limitations preclude clear identification of audio-only telehealth services, up to 70% of these telehealth visits during 2020 were potentially reimbursable for audio-only services,” it added.

CMS Updates State Medicaid & CHIP Telehealth Toolkit

The Centers for Medicare & Medicaid Services (CMS) this week released updates to the agency’s State Medicaid and Children’s Health Insurance Program (CHIP) Telehealth Toolkit: Policy Considerations for States Expanding Use of Telehealth, Covid-19 Version.
 
CMS said it updated the resource to clarify that states may deliver covered services via audio-only telehealth both during the Covid-19 public health emergency and beyond. The toolkit provides quick facts, state considerations, pediatric considerations, a state checklist, and an appendix that includes frequently asked questions.

“This guide is intended to help states identify which aspects of their statutory and regulatory infrastructure may impede the rapid deployment of telehealth capabilities in their Medicaid program,” the toolkit noted. “As such, this guide will describe each of these policy areas and the challenges they present below. The toolkit concludes with a list of questions state policymakers can use to ensure they have explored and/or addressed potential obstacles.”

NABH Submits Comments on Surprise Billing to Federal Agencies

NABH this week sent a letter to five federal agencies that expressed concerns about the second set of regulations issued to implement the No Surprises Act.

NABH’s main concern in the interim final rule titled “Requirements Related to Surprise Billing; Part II” is the interpretation of the independent dispute resolution (IDF) provisions to highly favor health plans and issuers.

“The interim final rule requires IDR entities to presume that the plan or issuer’s median in-network payment rate is the appropriate out-of-network reimbursement rate,” NABH said in its letter to HHS Secretary Xavier Becerra and top officials at the U.S. Labor Department, U.S. Treasury Department, Internal Revenue Service, and Office of Personnel Management. “This interpretation is contrary to the clear intent of Congress that required IDR arbiters to consider a long list of factors specified in the law including the median in-network rate.

NABH added that it is also concerned about provisions in the interim final rule regarding good-faith estimates for uninsured and self-pay patients about the potential cost of care.

“It is unclear how these requirements align with the price transparency requirements established earlier this year,” NABH wrote. “We urge you to issue additional guidance on how these two sets of rules overlap and differ.

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

CMS hosted an open door forum this week to explain provider requirements in the No Surprise Act that will take effect Jan. 1.

Beginning next month, consumers will have new billing protections when receiving emergency care, non-emergency care from out-of-network providers at in-network facilities, and air ambulance services from out-of-network providers. The requirements apply mostly to items and services provided to people enrolled in group health plans, group or individual health insurance coverage, Federal Employees Health Benefits plans, and the uninsured.

These requirements don’t apply to people with coverage through programs such as Medicare, Medicaid, Indian Health Services, Veterans Affairs Health Care, or TRICARE that have other protections against high medical bills.

Click here to view the presentation and here to access the provider requirements and resources page.

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

NABH’s Denial-of-Care Portal is available for members to provide information about their experiences with managed care organizations that impose barriers to care through insurance-claim denials.

NABH’s Managed Care Committee worked for more than a year to develop the Denial-of-Care Portal as a way to collect specific data on insurers who deny care—often without regard for parity or the effects on patients.

This NABH member-only, survey-like tool allows users to add the name of a managed care organization, type of plan, level of care, type of care (mental health or substance use disorder), duration of approved treatment, duration of unapproved treatment, criteria used to deny a claim, and more.

The portal allows members to submit individual examples of claim denials or upload multiple entries via Excel. It also includes sections on appeals and physician participation. In time, the tool could be a valuable resource for the NABH team’s advocacy efforts.

Please e-mail Emily Wilkins, NABH’s administrative coordinator, if you have questions about the portal.

Fact of the Week

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

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

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

More than 100,000 Americans died of overdoses for the 12-month period that ended in April 2021, marking the first time the number of U.S. overdose deaths has surpassed 100,000 in a year, according to provisional data from the National Center for Health Statistics (NCHS).

This record number represents a nearly 30% increase from the 78,000 deaths in the prior year. Meanwhile, the NCHS data show that overdose deaths in the United States have more than doubled since 2015.

“This translates to an American perishing from a drug overdose death every five minutes,” Rahul Gupta, M.D., M.P.H., M.B.A., director of the Office of National Drug Control Policy (ONDCP) told National Public Radio in an interview on Wednesday. “This is unacceptable, and it requires an unprecedented response.”

Also this week, Gupta’s office released a state model law to help make access to the prescription naloxone consistent nationwide. The law offers a template of recommended legislative provisions that states can enact so they can offer access to the life-saving treatment.

The model law maps out ways to expand access to naloxone; addresses the need to provide uniformity in the ability of citizens to access antagonists such as naloxone; protects individuals administering opioid antagonists such as naloxone from unjust persecution; requires health insurance coverage of opioid antagonists, and more.

“No one should die from an overdose, and naloxone is one of the most effective tools we have to save lives,” Gupta said in ONDCP’s announcement. “But sadly, today, people with substance use disorders are overdosing and dying across the country because naloxone access depends a great deal on where you live.”

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

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

SAMHSA’s announcement said it is extending the flexibilities for a year “effective upon the eventual expiration of the Covid-19 Public Health Emergency.

Click here to read SAMHSA’s announcement.

Provider Relief Fund Reporting Period 1 Ends Nov. 30

The Health Resources and Services Administration (HRSA) this week reminded providers that the 60-day grace period for the Provider Relief Fund (PRF) Reporting Period 1 ends Tuesday, Nov. 30.

Non-compliant providers still have time to complete their reporting requirements, HRSA noted, by submitting their report to the PRF reporting portal by Nov. 30. Providers who fail to meet the deadline will be required to return their PRF payments by Dec. 30, 2021.

HRSA also provided a Returning Funds Fact Sheet and additional information is available on the PRF Reporting Resources webpage.

OSHA Suspends Enforcement of Vaccine Mandate for Businesses

The U.S. Labor Department’s Occupational Safety and Health Administration (OSHA) announced it has suspended enforcement of its vaccine mandate for businesses, pending litigation.

Earlier this month OSHA released an Emergency Temporary Standard that requires employers with 100 or more employees to develop, implement, and enforce a mandatory Covid-19 vaccination policy to minimize the risk of the deadly virus.

“While OSHA remains confident in its authority to protect workers in emergencies, OSHA has suspended activities related to the implementation and enforcement of the ETS pending future developments in the litigation,” the agency announced on its website.

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

NABH and 14 other behavioral health organizations and advocacy groups this week released A Consensus Approach and Recommendations for the Creation of a Comprehensive Crisis Response System to help guide the mental health and substance crisis response mandated in the National Suicide Hotline Designation Act of 2020.

The 17-page roadmap outlines the scope of implementing the 988 Crisis Hotline that will begin operating in July 2022. It also highlights the following seven pillars for transforming mental health and substance use care: early identification and prevention, emergency and crisis response, equity and inclusion, integration and partnership, fair and equivalent coverage, standards for care, and workforce capacity.

“988 is not just a new number to call,” the guide states. “It is an opportunity to rethink how we approach mental health, substance use disorders, and suicide prevention in our communities.”

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

NABH’s Denial-of-Care Portal is available for members to provide information about their experiences with managed care organizations that impose barriers to care through insurance-claim denials.

NABH’s Managed Care Committee worked for more than a year to develop the Denial-of-Care Portal as a way to collect specific data on insurers who deny care—often without regard for parity or the effects on patients.

This NABH member-only, survey-like tool allows users to add the name of a managed care organization, type of plan, level of care, type of care (mental health or substance use disorder), duration of approved treatment, duration of unapproved treatment, criteria used to deny a claim, and more.

The portal allows members to submit individual examples of claim denials or upload multiple entries via Excel. It also includes sections on appeals and physician participation. In time, the tool could be a valuable resource for the NABH team’s advocacy efforts.

Please e-mail Emily Wilkins, NABH’s administrative coordinator, if you have questions about the portal.

Fact of the Week

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

CMS Freezes CY 2022 Methadone Reimbursement Rates in Interim Final Rule

In an interim final rule (IFR), the Centers for Medicare & Medicaid Services (CMS) said it will freeze methadone reimbursement rates for calendar year (CY) 2022.

CMS is establishing a limited exception to the current CMS methodology for determining rates for the drug episode of care for methadone (HCPCS G2067-weekly bundle) and the add-on take-home for methadone (HCPCS G2708) by freezing rates at the CY2021 rate.

The most recent average sale price (ASP) quarterly rates for oral methadone decreased by just more than 50% over last year’s rate, resulting in a reimbursement rate of 17.64 versus the CY 2021 rate of 37.38 (100% of ASP). CMS said the reduction is due to the inclusion of methadone tablets, where previously only the oral concentrate form was reflected in ASP sales. In addition, because ASP is not required for oral methadone, only a small number of manufacturers report ASP data. Moreover, CMS is not clear about OTP utilization rates for the oral and tablet forms of methadone; however, the agency has heard anecdotally that OTPs use oral methadone exclusively.

CMS said that collectively, these three factors raised concerns about implementing such a “sudden and significant decrease in the rate for methadone” [that] could affect the ability of OTPs to continue to offer services to Medicare beneficiaries, thereby impeding access to treatment for OUD, at a time when overdose deaths are at an all-time high.” The freeze of reimbursement rates at the CY 2021 rates will allow time for further research and discussion with stakeholders to develop a new payment methodology in time for the CY 2023 payment rate determination.

CMS requested information from stakeholders on the following are of interest:

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

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

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

NABH recently sent letters to members of the influential Senate Finance and Senate Health, Education, Labor, & Pensions (HELP) Committees that provided detailed information and recommendations about how to improve access to mental health and addiction treatment.

The first letter to Senate Finance Committee Chairman Ron Wyden (D-Ore.) and Ranking Member Mike Crapo (R-Idaho) was a response to a request for information from the senators this summer. In it, NABH emphasized ensuring parity; expanding telehealth; strengthening workforce; increasing integration, coordination, and access; improving access for children and youth; and increasing Medicare Advantage accountability for mental health and addiction treatment.

NABH also sent a letter to Senators Christopher Murphy (D-Conn.) and Bill Cassidy, M.D. (R-La.) of the Senate HELP Committee regarding their request for feedback on the programs authorized in the Mental Health Reform Act of 2016.

“The pandemic has highlighted and amplified the need for improved access to mental health and addiction treatment,” NABH President and CEO Shawn Coughlin explained in both letters. “Studies have consistently found significantly higher levels of anxiety and depression and suicidal ideation. In addition, alcohol consumption has increased significantly,” he added. “Drug overdose deaths increased almost 30% in 2020 to more than 90,000 deaths, the highest number ever recorded over a 12-month period. Although suicide rates seemed to have leveled off and decreased last year, there have been troubling increases in suicides and suicidal ideation among certain subgroups including Black Americans and adolescent girls.”

Both letters also noted that experts expect mental health and substance use disorders to remain elevated long after the Covid-19 pandemic ends.

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

NABH led development of a stakeholder group letter to the U.S. Labor Department’s Occupational Safety and Health Administration (OSHA) about ensuring the safety of personnel in healthcare settings, including those focused on behavioral health.

The letter from NABH, the American Nurses Association, the American Psychiatric Association, the National Alliance on Mental Illness, the National Association of State Mental Health Program Directors, and the National Council for Mental Wellbeing followed an early August meeting with representatives from all of the organizations and OSHA that focused on settings where people access mental health or substance use disorder treatment.

NABH and the other organizations highlighted a variety of issues, including incorporating trauma-informed care to inform both environmental interventions and settings; conducting debriefing sessions when incidents do occur, including the patient’s perspective to inform additional prevention measures; and providing clinician and staff development/training on de-escalation techniques.

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

The Commonwealth Fund and the Council of State Governments have released Mental Health Resource Guide for State Policymakers, a new resource based on state priorities, best practices, and perspectives from leaders in the field of mental health.

Overseen by an advisory group of state legislators, health officials, and experts, the guide focuses on four policy areas: social isolation and loneliness, maternal mental health, social determinants of mental health, and mental health insurance parity.

“The resource guide addresses the issue of workforce shortages, and also highlights ways to stretch existing resources, including, for instance, providing peer support and consultation between primary care and behavioral health providers,” The Commonwealth Fund noted in its announcement about the guide. “Some strategies include expanding telehealth psychiatric services and incorporating mental health screening and interventions into various settings like schools, senior centers, workplaces, primary care offices, and in law enforcement.”

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

The American Society of Addiction Medicine (ASAM) and the Well Being Trust this week released Speaking the Same Language: A Toolkit for Strengthening Patient-Centered Addiction Care in the United States, a toolkit written by Manatt Health Strategies to emphasize the need for adopting a common framework to addiction care in the United States.

The toolkit is meant to educate stakeholders about the strategies and tools available to support more effective implementation of The ASAM Criteria and also provide legislative, regulatory, and contractual language that interested states can use.

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

The Substance Abuse and Mental Health Services Administration (SAMHSA) will host Advancing Behavioral Health Equity: National CLAS Standards in Action on Tuesday, Nov. 16 at 2:30 p.m. ET.

The webinar will examine real-world examples of behavioral health service providers who use the National Standards for Culturally and Linguistically Appropriate Services (CLAS) and the Behavioral Health Implementation Guide.
 
Presenters include Assistant Secretary for Mental Health and Substance Use Miriam Delphin-Rittmon, Ph.D. and Rear Admiral Felicia Collins, M.D., M.P.H., director of the U.S. Health and Human Services Department’s Office of Minority Health. Click here to register.

NABH 2021 Annual Meeting Photos and Recorded Sessions Now Available!

Photos and recorded sessions from last month’s Annual Meeting are now available on the association’s Annual Meeting webpage.

NABH looks forward to welcoming members to the 2022 Annual Meeting in Washington from June 13-15, 2022!

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

NABH’s Denial-of-Care Portal is available for members to provide information about their experiences with managed care organizations that impose barriers to care through insurance-claim denials.

NABH’s Managed Care Committee worked for more than a year to develop the Denial-of-Care Portal as a way to collect specific data on insurers who deny care—often without regard for parity or the effects on patients.

This NABH member-only, survey-like tool allows users to add the name of a managed care organization, type of plan, level of care, type of care (mental health or substance use disorder), duration of approved treatment, duration of unapproved treatment, criteria used to deny a claim, and more.

The portal allows members to submit individual examples of claim denials or upload multiple entries via Excel. It also includes sections on appeals and physician participation. In time, the tool could be a valuable resource for the NABH team’s advocacy efforts.

Please e-mail Emily Wilkins, NABH’s administrative coordinator, if you have questions about the portal.

Fact of the Week

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

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

The Centers for Medicare & Medicaid Services (CMS) on Thursday issued an emergency regulation requiring Covid-19 vaccination for eligible staff at certain healthcare facilities that participate in the Medicare and Medicaid programs.

Facilities covered under this regulation must establish a policy that ensures all eligible staff have received the first dose of a two-dose Covid-19 vaccine or a one-dose Covid-19 vaccine by Dec. 5, 2021 before they provide any care or treatment, CMS said in its announcement.

All eligible staff must have received the necessary shots to be vaccinated—either two doses of the Pfizer or Moderna vaccines or one dose of the Johnson & Johnson vaccine—by Jan. 4, 2022. The regulation provides exemptions based on recognized medical conditions, religious beliefs, observances, or practices.

“Ensuring patient safety and protection from Covid-19 has been the focus of our efforts in combatting the pandemic and the constantly evolving challenges we’re seeing,” CMS Administrator Chiquita Brooks-LaSure said in the announcement. “Today’s action addresses the risk of unvaccinated healthcare staff to patient safety and provides the stability and uniformity across the nation’s healthcare system to strengthen the health of people and the providers who care for them.”

The regulations became effective today, Friday, Nov. 5, and CMS will accept comments on this interim final rule until Jan. 4, 2022. Click here for details about submitting comments.

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

The Occupational Safety and Health Administration (OSHA) on Thursday released an emergency temporary standard (ETS) that requires employers with 100 or more employees to develop, implement, and enforce a mandatory Covid-19 vaccination policy to minimize the risk of the deadly coronavirus.

In the highly anticipated rule, OSHA noted an exception for employers who instead adopt a policy that requires employees to choose either to get vaccinated or to undergo Covid-19 testing at least once per week in the workplace and wear a face covering at work.

The testing requirement for unvaccinated workers is scheduled to begin on Jan. 4, 2022, and employers must comply with all other requirements in the ETS—such as providing paid time off for employees to get vaccinated and “reasonable time and paid sick leave” to recover from the vaccination’s potential side effects—by Dec. 6, 2021. Employees who fall under the ETS rule must have their final vaccination dose by Jan. 4, 2022.

“We must take action to implement this emergency temporary standard to contain the virus and protect people in the workplace against the grave danger of Covid-19,” U.S. Labor Secretary Marty Walsh said in a news release. “Many businesses understand the benefits of having their workers vaccinated against Covid-19, and we expect many will be pleased to see this OSHA rule go into effect.”

According to the rule, states and U.S. territories that have their own OSHA-approved occupational and health plans must “either amend their standards to be identical or ‘at least as effective’ as the new standard or show that an existing state plan standard covering this area is ‘at least as effective’ as the new federal standard.”

Of the 28 states and territories with OSHA-approved state plans, 22 cover both public and private sector employees and six states and territories (Connecticut, Illinois, Maine, New Jersey, New York, and the Virgin Islands) cover only state and local governments.
OSHA released a fact sheet about the ETS and will accept written comments about any aspect of the rule by Dec. 6, 2021. Click here to submit comments and attachments.

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

CMS this week released both the final Medicare Physician Fee Schedule (PFS) and final hospital outpatient prospective payment system (OPPS) regulations for 2022. Highlights for both regulations are included below.

PFS Highlights:
The final PFS for next year includes a cut to practitioner rates due to a statutory budget neutrality requirement. In addition, a 3.75% payment increase provided in the Consolidated Appropriations Act for 2021 is expected to expire. Click here for additional details about the agency’s payment provisions.

For telehealth services, the Medicare program will continue covering mental health and substance use disorder services via telehealth after the public health emergency ends.

The frequency of in-person visits that will be required for those receiving care via telehealth has been modified to lessen the frequency. Instead of every six months, CMS changed its proposal to require in-person visits once every 12 months for those receiving behavioral health treatment via telehealth. CMS also will allow for exceptions to this 12-month interval if both the provider and patient agree the risks and burdens outweigh the benefits and this is documented.

The requirement that beneficiaries receiving mental health treatment via telehealth must have been seen in-person during the prior six months before the first telehealth service will be maintained because this previous in-person visit requirement was established in the statute.

Meanwhile, Medicare will continue to cover audio-only telehealth for mental health. CMS also clarified that MH services include treatment of substance use disorders for purposes of Medicare coverage of audio-only telehealth. Providers must have the capacity to offer telehealth via audio and visual technology. CMS is requiring use of a service-level modifier for services provided via audio-only telehealth.

Medicare will continue to cover a long list of services covered via telehealth on a temporary basis during the pandemic until the end of CY 2023. Click here to see the telehealth services that will be covered for 2022.

For the nation’s Opioid Treatment Programs (OTPs), the Medicare program will continue to cover individual and group therapy and substance use counseling provided by OTPs via audio-only, telehealth technology after the public health emergency ends. This coverage of audio-only is limited to situations when video is not available to the beneficiary or they do not consent to the use of video.

In addition, CMS made final the proposal that new service-level modifier be appended to claims submitted for the counseling and therapy add-on code when services are furnished via audio-only. The agency is not finalizing the prior proposal to require additional documentation in the medical record to support the use of audio-only services.

CMS also finalized its proposals to provide annual updates and locality adjustments for the add-on payments for the non-drug components for opioid antagonist medication (i.e., naloxone) that were new for CY 2021, to provide a new code for a higher dose of the naloxone nasal spray, pricing methodologies for this higher dose naloxone product; reaffirmed recoupment of duplicative payments for naloxone (where separately paid under Medicare Part B or D) from the OTP; and finalized a new code (G1028) for a higher dose 8mg naloxone nasal spray.

The agency also published an interim final rule, the “Opioid Treatment Programs: CY2022 Methadone Payment Exception” in which CMS proposes to extend 2021 OTP reimbursement rates for methadone under the OTP benefit through 2023.

OPPS Rule Highlights:
In this rule, CMS made final its earlier proposal to set a minimum civil monetary penalty of $300 per day that would apply to smaller hospitals with bed counts of 30 or fewer beds and apply a penalty of $10 per bed, per day for hospitals with a bed count greater than 30 beds, not to exceed a maximum daily dollar amount of $5,5500. The maximum would be imposed if hospitals do not provide documentation of bed counts.

CMS also finalized its proposal to maintain the existing methodology for per diem partial hospitalization rates using calendar year (CY) 2019 claims and cost report data to develop the CY 2022 rates. CMS will also use the CY 2021 finalized per diem costs as cost floors for CY 2022.

CMS did not specify that Medicare will continue coverage of services by partial hospitalization programs (PHPs) via telehealth. The agency noted comments, including some from NABH, that expressed strong support for continued coverage and said it will consider these comments in future rulemaking.

The agency did not address whether Medicare would continue to cover PHP facility fees for telehealth services, which could require a legislative change.

NABH Supports Sound the Alarm for Kids! Campaign

NABH is proud to be one of more than 75 organizations to support Sound the Alarm for Kids!, a campaign from the Children’s Hospital Association, American Academy of Pediatrics, and the American Academy of Child and Adolescent Psychiatrists to urge Congress to enact legislation and increase funding to address children’s mental health.

The campaign notes there has been a 25% increase in overall mental health-related emergency department visits for kids between the ages of 5 and 11 between 2019 and 2020, while emergency department visits for youth between the ages of 12 and 17 have seen a 31% increase in that same period.

“The latest data from SAMHSA show that almost 3 million adolescents had serious thoughts of suicide last year, with more than 1 million who said they made suicide plans,” NABH President and CEO Shawn Coughlin said in the campaign’s news release on Nov. 2. “These statistics are even more troubling as we face significant shortages across behavioral healthcare professions and treatment settings,” he added. “We are eager to work with policymakers, workforce agencies, and partner organizations to identify where the gaps in access to care are—and how we can fill those gaps.”

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

NABH remembers with grateful appreciation psychiatrist Aaron Beck, M.D., who died Nov. 1 in Philadelphia, for his pragmatic approach to psychotherapy that changed the treatment of depression, anxiety, and other mental disorders in the United States.

“He took a hundred years of dogma, found that it didn’t hold up, and invented something brief, lasting and effective to put in its place,” Steven Hollon, a psychologist at Vanderbilt University, told The New York Times. “He basically saved psychotherapy from itself.”

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

NABH’s Denial-of-Care Portal is available for members to provide information about their experiences with managed care organizations that impose barriers to care through insurance-claim denials.

NABH’s Managed Care Committee worked for more than a year to develop the Denial-of-Care Portal as a way to collect specific data on insurers who deny care—often without regard for parity or the effects on patients.

This NABH member-only, survey-like tool allows users to add the name of a managed care organization, type of plan, level of care, type of care (mental health or substance use disorder), duration of approved treatment, duration of unapproved treatment, criteria used to deny a claim, and more.

The portal allows members to submit individual examples of claim denials or upload multiple entries via Excel. It also includes sections on appeals and physician participation. In time, the tool could be a valuable resource for the NABH team’s advocacy efforts.

Please e-mail Emily Wilkins, NABH’s administrative coordinator, if you have questions about the portal.

Fact of the Week

Grant funding from the National Institute of Mental Health (NIMH) for research into bipolar disorder is lower than funding for other serious mental illness research and focuses heavily on basic science research instead of clinical research, according to an article published in Journal of Affective Disorders.

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

Provider Relief Fund Phase 4 Application Deadline is Next Week

The U.S. Health and Human Services Department (HHS) will accept applications for Phase 4 of the Provider Relief Fund (PRF) and American Rescue Plan (ARP) rural payments through next Tuesday, Oct. 26 by 11:59 p.m. ET.

PRF Phase 4 is open to a broad range of healthcare providers affected by the Covid-19 pandemic, and ARP Rural is open to Medicare, Medicaid, or the Children’s Health Insurance Program (CHIP) providers who serve rural patients. Click here for more information and here to apply.

And if you missed it, HHS hosted a briefing session to provide information about these funding opportunities. Click here to watch the video.

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

A new report from the Centers for Disease Control and Prevention’s (CDC) National Center for Health Statistics estimates that 20.3% of adults received any mental health treatment in 2020, including 16.5% who had taken prescription medication for their mental health and 10.1% who received counseling or therapy from a mental health professional.

The data also showed that women were more likely than men to have received any mental health treatment, and that non-Hispanic white adults (24.4%) were more likely than non-Hispanic black (15.3%), Hispanic (12.6%), and non-Hispanic Asian (7.7%) adults to have received any mental health treatment.

Meanwhile, as the level of urbanization decreased, the percentage of adults who had taken medication for their mental health increased, and the percentage who had received counseling or therapy decreased, the report showed.

Bipartisan Policy Center Webinar Discusses Mental Health Workforce Shortage

The Bipartisan Policy Center this week hosted a panel of healthcare and policy experts to discuss solutions to the nation’s mental health workforce shortage, including workforce expansion, community training, and behavioral healthcare and primary care service integration.

Panelists included Benjamin Miller, Psy.D., president of the Well Being Trust; former U.S. Surgeon General Regina Benjamin, M.D., who is also founder and CEO of BayouClinic, Inc.; and Shekhar Saxena, M.D., professor of the Practice of Global Mental Health, Harvard T.H. Chan School of Public Health.

Click here to watch the recorded webinar.

Urban Institute Study Examines Commercial Insurance Markups Over Medicare Prices

Psychiatry was among a group of medical specialties that had the lowest commercial markups relative to Medicare prices, according to a new study from the Urban Institute.

The report shows that family medicine, obstetrics and gynecology, dermatology, ophthalmology, and psychiatry averaged about 110% of Medicare rates or less, while the following nine specialties received commercial payments between 120% and 150% of Medicare rates, on average: gastroenterology, cardiology, general surgery, and orthopedics.

Researchers analyzed March 2019 to February 2020 data from FAIR Health’s private health insurance claims database covering more than 150 million people nationwide. The sample included 17 physician specialties and about 20 services per specialty that represent about 40% of total professional spending.

FAIR Health is an independent, national, not-for-profit organization that provides information to consumers.

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

NABH this week sent Annual Meeting attendees a survey to evaluate the 2021 Annual Meeting. If you attended the meeting and have not submitted an evaluation, please take a moment to complete the survey.

As a reminder, our Speakers & Presentations page includes presentations that NABH has permission to post publicly, and the 2021 Exhibitor & Sponsor Guide is available on both the NABH Resources and Exhibitors & Sponsors pages on our website. Annual Meeting photos and videos will be posted to our Annual Meeting page later this month.

We look forward to seeing everyone in Washington from June 13-15, 2022 for next year’s Annual Meeting!

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

NABH’s Denial-of-Care Portal is available for members to provide information about their experiences with managed care organizations that impose barriers to care through insurance-claim denials.

NABH’s Managed Care Committee worked for more than a year to develop the Denial-of-Care Portal as a way to collect specific data on insurers who deny care—often without regard for parity or the effects on patients.

This NABH member-only, survey-like tool allows users to add the name of a managed care organization, type of plan, level of care, type of care (mental health or substance use disorder), duration of approved treatment, duration of unapproved treatment, criteria used to deny a claim, and more.

The portal allows members to submit individual examples of claim denials or upload multiple entries via Excel. It also includes sections on appeals and physician participation. In time, the tool could be a valuable resource for the NABH team’s advocacy efforts.

Please e-mail Emily Wilkins, NABH’s administrative coordinator, if you have questions about the portal.

Fact of the Week

A new study published in Health Affairs found that people with mental health disorders had 50% higher rates of severe maternal morbidity compared with people without mental health disorders, and $458 higher costs per delivery hospitalization.

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

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

The U.S. Health and Human Services Department (HHS) will accept applications for Phase 4 of the Provider Relief Fund (PRF) through Tuesday, Oct. 26.

HHS’ Health Resources and Services Administration (HRSA) administers provider relief programs and is using a single application portal to make $17 billion in PRF phase 4 general distribution payments and $8.5 billion in American Rescue Plan Act (ARP) rural payments available to the nation’s providers.

To offer guidance for providers, HRSA has produced a series of webinars for Phase 4 and ARP rural applications on how to navigate the application portal and provide the required financial documentation. These sessions include:

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

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

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

NASHP Examines How States are Spending American Rescue Plan Act Funds

The National Academy for State Health Policy (NASHP) has developed a state-by-state analysis to show how states are using funds from the $1.9 trillion American Rescue Plan Act (ARP) that became law on March 11, 2021.

The ARP provides considerable funding for continued pandemic response, including $195.3 billion in Coronavirus State Fiscal Recovery Funds for the 50 states and Washington, D.C. Those funds must be obligated by Dec. 31, 2024 and expended by Dec. 31, 2026.

Click here to view NASHP’s map and accompanying state profiles to see the status of the State Fiscal Recovery Fund.

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

Palo Alto University has announced it will begin offering a 50-hour training program for incorporating digital therapy tools into mental health practices.

According to the university, the new program—Foundations of Digital Mental Health— will offer “foundational knowledge, training, and best practices necessary” for delivering mental health services online.

Course topics include Technology and Mental Health for Children and Adolescents: Screen Time, Digital Interventions, and Teletherapy; Suicide, Risk Assessment & Treatment Planning Via Tele-Mental Health; and Evidence-Based Internet Interventions to Reduce Health Disparities.

Click here to learn more and to register.

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

Thank you to all who attended NABH’s 2021 Annual Meeting in Washington last week!

NABH was pleased to welcome in person top officials from SAMHSA and the U.S. Labor Department, former National Institute of Mental Health Director Tom Insel, M.D., New York Times bestselling author and four-time Emmy winner Larry Sabato, Ph.D. of the University of Virginia, award-winning singer and mental health advocate Judy Collins, and others.

Please visit our Speakers & Presentations page to view the presentations that included slides and that NABH has permission to post publicly.

Also, NABH mailed copies of the 2021 Exhibitor & Sponsor Guide to members this week, and the guide’s online version is available on both the NABH Resources and Exhibitors & Sponsors pages on our website.

Annual Meeting photos and videos will be posted to our Annual Meeting page later this month.

We look forward to seeing everyone in Washington from June 13-15, 2022 for next year’s Annual Meeting!

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

Please help the NABH Selection Committee identify potential candidates for Board Chair-Elect and two Board seats that will become available in 2022

The Selection Committee is particularly interested in identifying senior managers who represent the broad diversity within the NABH membership, including various levels of care, organizational structures, and size.

Please download a nomination form to share your recommendations of individuals you would like to see included in the single-slate ballot for 2022. Please attach a curriculum vitae (CV) for each individual you recommend. This will help the Selection Committee in its deliberations. You are welcome to suggest yourself.

Please return this form and candidates’ CVs to maria@nabh.org by the end of today, Oct. 15.

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

NABH’s Denial-of-Care Portal is available for members to provide information about their experiences with managed care organizations that impose barriers to care through insurance-claim denials.

NABH’s Managed Care Committee worked for more than a year to develop the Denial-of-Care Portal as a way to collect specific data on insurers who deny care—often without regard for parity or the effects on patients.

This NABH member-only, survey-like tool allows users to add the name of a managed care organization, type of plan, level of care, type of care (mental health or substance use disorder), duration of approved treatment, duration of unapproved treatment, criteria used to deny a claim, and more.

The portal allows members to submit individual examples of claim denials or upload multiple entries via Excel. It also includes sections on appeals and physician participation. In time, the tool could be a valuable resource for the NABH team’s advocacy efforts.

Please e-mail Emily Wilkins, NABH’s administrative coordinator, if you have questions about the portal.

Fact of the Week

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

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

The U.S. Health and Human Services Department (HHS) is accepting applications for phase 4 of the Provider Relief Fund (PRF) through Tuesday, Oct. 26.

HHS’ Health Resources and Services Administration (HRSA) administers provider relief programs and is using a single application portal to make $17 billion in PRF phase 4 general distribution payments and $8.5 billion in American Rescue Plan rural payments available to the nation’s providers.

Click here to learn more about the programs and how to apply.

President Biden Honors Everyone in Recovery in Video Message

President Biden helped to conclude National Recovery Month this week with a brief video celebrating all Americans in recovery.

The president acknowledged that about 23 million Americans are in recovery and millions more are affected by addiction. He also sent a clear message to people who are not in recovery, and to people with loved ones who are not in recovery.

“You are not alone. This is personal to millions of families,” President Biden said. “This is personal to my family. My son has written about it. And I know—I know there is hope,” he added. “Treatment works. Recovery is possible. And my administration is here to support every person and their family on their journey to recovery.”

SAMHSA to Establish New Office of Recovery

The Substance Abuse and Mental Health Services Administration (SAMHSA) is launching an Office of Recovery within the Office of the Assistant Secretary for Mental Health and Substance Use to advance the agency’s commitment to recovery for all Americans.

“We have identified recovery as a crosscutting principle throughout SAMHSA’s policies and programs,” Assistant Secretary for Mental Health and Substance Use Miriam Delphin-Rittmon, Ph.D. said in an announcement. “In standing up this new office, SAMHSA is committed to growing and expanding recovery support services nationwide.”

SAMHSA’s announcement said the new office will have a dedicated team with an understanding of recovery to promote policies, programs, and services to those in or seeking recovery.

NABH 2021 Annual Meeting is Next Week

NABH is pleased to welcome attendees to the NABH 2021 Annual Meeting in Washington Oct.6-8!

Please join us at the Mandarin Oriental hotel and hear from our speakers, including Acting Assistant Secretary Ali Khawar from the U.S. Labor Department’s Employee Benefits Security Administration, SAMHSA Administrator Miriam Delphin-Rittmon, Ph.D., former National Institute of Mental Health Director Tom Insel, M.D., folk singer and mental health advocate Judy Collins, and more.

Learn more about our speakers on our Annual Meeting webpage, and please be sure to register if you have not done so yet. We look forward to seeing you next week!

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

Please help the NABH Selection Committee identify potential candidates for Board Chair-Elect and two Board seats that will become available in 2022

The Selection Committee is particularly interested in identifying senior managers who represent the broad diversity within the NABH membership, including various levels of care, organizational structures, and size.

Please download a nomination form to share your recommendations of individuals you would like to see included in the single-slate ballot for 2022. Please attach a curriculum vitae (CV) for each individual you recommend. This will help the Selection Committee in its deliberations. You are welcome to suggest yourself.

Please return this form and candidates’ CVs to maria@nabh.org by Friday, Oct. 15, 2021.

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

NABH’s Denial-of-Care Portal is available for members to provide information about their experiences with managed care organizations that impose barriers to care through insurance-claim denials.

NABH’s Managed Care Committee worked for more than a year to develop the Denial-of-Care Portal as a way to collect specific data on insurers who deny care—often without regard for parity or the effects on patients.

This NABH member-only, survey-like tool allows users to add the name of a managed care organization, type of plan, level of care, type of care (mental health or substance use disorder), duration of approved treatment, duration of unapproved treatment, criteria used to deny a claim, and more.

The portal allows members to submit individual examples of claim denials or upload multiple entries via Excel. It also includes sections on appeals and physician participation. In time, the tool could be a valuable resource for the NABH team’s advocacy efforts.

Please e-mail Emily Wilkins, NABH’s administrative coordinator, if you have questions about the portal.

Fact of the Week

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

CEO Update Will Publish Next on Friday, Oct. 15

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