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CEO Updates

CEO Update 165

House & Senate Advance Key Behavioral Healthcare Legislation to Consider in the New Year

The House and Senate advanced several behavioral healthcare-related bills this week that NABH either supports and opposes and Congress is expected to consider early in the New Year.
 
The Senate Health, Education, Labor and Pensions (HELP) Committee marked up several pieces of legislation, including reauthorization of the SUPPORT Act and S. 644, the Modernizing Opioid Treatment Access Act (MOTAA). The Committee approved its version of the SUPPORT Act reauthorization bill 19-1. This bill would reauthorize programs to improve the prevention, treatment, and recovery of substance use disorders (SUD), including supporting training for first responders and programs that support youth and mental health. The legislation also directs the U.S. Health and Human Services Department (HHS) and the Drug Enforcement Agency (DEA) to establish a special registration program permitting physicians to prescribe controlled substances through telemedicine, among other provisions.

The Modernizing Opioid Treatment Access Act, S. 644 was reported favorably as amended by a roll call vote of 16-5 with Ranking Member Sen. Bill Cassidy, M.D. (R-La.) supporting the legislation. Sens. Susan Collins (R-Maine), Rob Marshall (R-Kan.), Tommy Tuberville (R-Ala.), Markwayne Mullin (R-Okla.), and Ted Budd (R-NC) voted against the bill. NABH opposed the bill, which would expand access to methadone by permitting take-home prescribing of the drug through pharmacies.
 
On Wednesday the House passed both the Lower Costs, More Transparency Act (H.R. 5378), and the H.R.4531, the Support for Patients and Communities Reauthorization (SUPPORT) Act of 2023.  H.R. 5378 contains provisions to promote more transparency within various sectors of the healthcare industry; delay certain disproportionate share payment cuts; and extend funding for community health centers, the National Health Service Corp, and teaching health centers that operate graduate medical education (GME) programs. The bill also increases reporting requirements for insurers, hospitals and pharmacy benefit managers, and changes Medicare payment policy so that drugs administered in a hospital outpatient department are reimbursed at the same rate as they are in a physician’s office, a policy known as site-neutral payments.
 
Meanwhile, House Energy and Commerce Subcommittee on Health Chair Brett Guthrie (R-Ky.) and Rep. Anne Kuster (D-N.H.) led H.R.4531, the Support for Patients and Communities Reauthorization (SUPPORT) Act of 2023, which the House passed in a 386-37 vote. The bill includes several important NABH priorities, including permanently lifting Medicaid’s IMD Exclusion, which restricts access to care for rehab and institutional care services; ensuring Medicaid beneficiaries have access to Medication Assisted Treatment; reauthorizing resources for residential SUD treatment for pregnant and postpartum women; and monitoring prescribing of antipsychotic medications. The House Energy and Commerce Committee passed H.R. 4531 in a 49-0 vote this past July.

These healthcare bills, in addition to the Senate Finance Committee’s previously passed Better Mental Health Care, Lower-Cost Drugs and Extenders Act, which included language from S. 3098, the Securing Advances and a Variety of Evidence-Based (SAVE) Institutions for Mental Diseases (IMD) Options Act which would make the state plan amendment option permanent, will be rolled into one healthcare package for Congress to consider in the New Year.

Other healthcare issues include addressing scheduled cuts to the Medicare Physician Fee Schedule (MPFS), reform and transparency for pharmacy benefit managers (PBM) and Medicare Advantage (MA) plans, and other bipartisan policies to address drug shortages, antimicrobial resistance, and workforce needs.

Congress has two early deadlines in 2024 to move the healthcare package across the finish line — Jan. 19 and Feb. 2, the latter of which includes the deadline for Labor-HHS-Education funding bill. NABH and allied partners will be working to stop MOTAA and include our policy priorities in this final package.

HHS Takes Step to Regulate AI in Health Data, Technology, and Interoperability Final Rule

HHS this week unveiled the department’s data-related priorities for the next two years in a rule that includes information about data sharing across the government and the private sector and using artificial intelligence (AI) to boost medical innovation and improve health outcomes.

HHS’ Office of the National Coordinator (ONC) for Health Information Technology finalized its Health Data, Technology, and Interoperability rule, which establishes the first transparency requirements for AI and other predictive algorithms that are part of certified health information technology. ONC reports that it certifies health IT that supports care delivered by more than 96% of hospitals and 78% of office-based physicians nationwide.

The final rule also implements the 21st Century Cures Act’s requirement to adopt a Condition of Certification (the “Insights Condition”) for developers of certified health IT to report certain metrics as part of their participation in the Certification Program. These metrics will give more insight into how certified health IT is used in support of care delivery.

Click here to learn when ONC will host information sessions about the rule in January and February.

CMS Releases Guidance on Dually Eligible Beneficiaries Receiving Medicare Part B Marriage and Family Therapist, Mental Health Counselor, and Intensive Outpatient Services

The Centers for Medicare & Medicaid Services (CMS) on Thursday released Guidance to State Medicaid Agencies on Dually Eligible Beneficiaries Receiving Medicare Part B Marriage and Family Therapist Services, Mental Health Counselor Services, and Intensive Outpatient Services, an informational bulletin with changes that take effect on Jan. 1, 2024.
 
Beginning in the New Year, Medicare will become the primary payer for dually eligible beneficiaries receiving these services from Medicare-enrolled practitioners or providers.

According to CMS, typically state Medicaid agencies may not pay claims if it is likely that a third party (such as Medicare) is liable for the claim, as Medicaid is generally the payer of last resort. For dually eligible beneficiaries, Medicare is generally liable for claims for Medicare-covered services, including MFT services, MHC services, and IOP services furnished on or after Jan. 1, 2024, and therefore state Medicaid agencies are required to cost-avoid claims for such services, or seek reimbursement from the practitioner or provider.

Currently, MFTs and MHCs provide services that can be covered as an optional state plan benefit such as services of other licensed practitioners under the Medicaid state plan. IOP services are generally covered through the optional rehabilitative services benefit under the Medicaid state plan.

AMCHP and ASTHO Release Guidance on Public Health Approaches to Perinatal Substance Use

The Association of Maternal & Child Health Programs (AMCHP) and the Association of State and Territorial Health Officials (ASTHO) have released a special issue of the Maternal and Child Health Journal focused on public health approaches to perinatal substance use.

This December 2023 special issue features 21 open-access articles with the latest research, programs, and policy initiatives related to perinatal substance use that highlight approaches to preventing and mitigating the harmful effects of perinatal substance use and improving maternal and child health.

AMCHP and ASTHO will host a virtual forum about the special issue on Tuesday, Dec. 19 at 12:30 p.m. ET. Click here to learn more and register.

NABH 2024 Board Election Ballots Due Friday, Dec. 29!

NABH has e-mailed system members NABH Board of Trustees candidate profiles and a ballot to elect new members to the 2024 Board.

If you have not done so, please vote for the open Board Chair-Elect position and four available Board seats; 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. 29, 2023. New Board members and the Board Chair-elect will take office in January 2024.

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

NABH thanks all members who have submitted data to the association’s Denial-of-Care Portal. You have provided critical information that expands the portal and helps NABH strengthen its advocacy efforts related to erroneous prior-authorization denials.

With guidance from our members, NABH has improved the portal by adding two elements:

  1. Time-based data on the number of days between a request for coverage and a plan’s denial, which improves our ability to assess and compare health plan responsiveness.
  1. The gap between days of provided care versus days of covered care to quantify and compare uncompensated days per health plan.

We strongly encourage all NABH members to submit their denial-of-care data in the portal. If you need help starting, or if you have other questions, please e-mail NABH Associate Manager for Congressional Affairs Emily Wilkins.

Save the Date for the NABH 2024 Annual Meeting!

Please mark your calendars and plan to join us at the Salamander Washington, DC from May 13-15, 2024 for next year’s NABH Annual Meeting!

Fact of the Week

Overdoses in the United States involving methadone were 48% higher in 2020 than in 2019, according to a study of overdose deaths during the COVID-19 pandemic published in Forensic Science International.
 
For questions or comments about this CEO Update, please contact Jessica Zigmond.

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CEO Update 164

Senate HELP Committee to Mark Up SUPPORT Act Reauthorization Bill Next Week

The Senate Health, Education, Labor, and Pensions (HELP) Committee is slated to mark up the Substance-Use Disorder Prevention that Promotes Opioid Recovery and Treatment Act’s (SUPPORT Act) reauthorization bill along with other legislation – including the Modernizing Opioid Treatment Access Act (MOTAA) – on Tuesday, Dec. 12.

The SUPPORT Act expired on Sept. 30, and Congress has long been expected to reauthorize the opioid treatment and prevention programs that the 2018 law created.

NABH sent a Government Relations Network alert asking members to contact Senate HELP Committee members and urge them to apply an all-hands-on-deck approach to America’s mental health and addiction crises by reauthorizing the SUPPORT Act’s expired provisions.

The association also asked NABH members to encourage HELP Committee members to oppose the MOTAA bill, which would threaten patient safety if methadone prescriptions were allowed outside opioid treatment programs. While the MOTAA bill was not incorporated into the underlying SUPPORT Act, lawmakers will consider it as stand-alone legislation and the committee may pass it. If this happens, NABH will work with partners to oppose the bill if it moves to the full Senate for a vote and also urge House lawmakers not to consider it.

Also next week, the House is expected to pass its version of the SUPPORT Act, which includes several NABH priorities. The House Energy and Commerce Committee passed this bill with bipartisan support and did not consider the MOTAA bill in this legislation.

Meanwhile, House and Senate conferees are negotiating a broader healthcare package for Congress to consider in early 2024. NABH will provide the latest information about these and other congressional actions next week and future editions of CEO Update.

ONDCP to Host Webinar on Medicaid 1115 Re-Entry Demonstration Opportunity on Dec. 12

The White House Office of National Drug Control Policy (ONDCP) will host a webinar on Tuesday, Dec. 12 to highlight the state of Washington’s work on the Medicaid Re-Entry Demonstration Opportunity that the Centers for Medicare and Medicaid Services (CMS) announced in April 2023.

The opportunity allows states to cover a package of pre-release services, including medications for opioid use disorder and connection to substance use disorder care, for up to 90 days before an incarcerated individual’s release date. To date, 16 states have applied for the waiver and two states have been approved.

Click here to register for the 90-minute webinar, which will begin at 2:30 p.m. ET on Tuesday.

National Academies to Host Webinar About Social Media and Adolescent Health on Dec. 13

The National Academies of Sciences, Engineering, and Medicine will host a webinar next week highlighting the conclusions and recommendations from the Academies’ ad hoc committee that drafted a report about social media’s effect on adolescents’ mental and physical health.

Click here to learn more and register for the hourlong webinar, which will start at noon ET on Wednesday, Dec. 13.

CMS Provides Guidance to States on Mandatory Medicaid and CHIP Core Set Reporting Requirements

CMS sent a letter to state health officials that offered guidance about implementing the reporting requirements outlined in the Mandatory Medicaid and Children’s Health Insurance Program (CHIP) Core Set Reporting final rule that the agency released in August.

The letter includes guidance about mandatory reporting regulations and adherence to reporting guidance; Core Set measures for which reporting is mandatory in 2024; the populations who must be included in reporting and the population exemption process; categories of stratified data that must be reported in or before 2025; measures subject to stratification in 2025; attribution rules; and the Child and Adult Core Set State Plan Amendment.

Reminder: Please Contribute Data to NABH’s Enhanced Denial-of-Care Portal

NABH thanks all members who have submitted data to the association’s Denial-of-Care Portal. You have provided critical information that expands the portal and helps NABH strengthen its advocacy efforts related to erroneous prior-authorization denials.
With guidance from our members, NABH has improved the portal by adding two elements:

  1. Time-based data on the number of days between a request for coverage and a plan’s denial, which improves our ability to assess and compare health plan responsiveness.
  1. The gap between days of provided care versus days of covered care to quantify and compare uncompensated days per health plan.

We strongly encourage all NABH members to submit their denial-of-care data in the portal. If you need help starting, or if you have other questions, please e-mail NABH Associate Manager for Congressional Affairs Emily Wilkins.

Save the Date for the NABH 2024 Annual Meeting!

Please mark your calendars and plan to join us at the Salamander Washington, DC from May 13-15, 2024 for next year’s NABH Annual Meeting!

Fact of the Week

The first government-sanctioned overdose prevention centers (OPCs) opened in New York City in November 2021, drawing concerns that they might increase crime and disorder. A new study in JAMA that examined two OPCs and 17 syringe service programs found no significant increases in crimes recorded by the police or calls for emergency service.
 
For questions or comments about this CEO Update, please contact Jessica Zigmond.

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CEO Update 163

Please Urge Your Senators to Reauthorize the SUPPORT Act and Oppose MOTAA

As Congress returned this week for its year-end push, NABH continues to advocate for federal lawmakers to reauthorize the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act (SUPPORT) and oppose the Modernizing Opioid Treatment Access Act (MOTAA).

The Senate Health, Education, Labor and Pensions (HELP) Committee has not announced a markup for these bills; however, lawmakers may act on them during the first or second week of December.

As NABH outlined in a letter to Sen. Bill Cassidy, M.D. (R-La.) on Nov. 22, the association supports efforts to reauthorize the expired provisions of the SUPPORT Act. NABH wrote in the letter that the nation’s mental health crisis requires an all-hands-on-deck approach, and that it makes no sense to limit grantees based on a facility’s tax status when many individuals who need mental health and substance use disorder services are not able to access those services.

Meanwhile, in a letter to the Senate HELP Committee this week, NABH expressed our firm opposition to the MOTAA bill, which would threaten patient safety if methadone prescription would be allowed outside Opioid Treatment Programs (OTPs). Our concern reflects the complexity of this patient population, which requires comprehensive and ongoing clinical oversight that would be difficult for busy pharmacies to provide.

To assure patient safety, NABH supports additional research and data collection prior to altering current methadone prescribing protections provided by OTPs.

Please help NABH’s advocacy efforts by contacting Senate HELP Committee members in your region and urge their support to reauthorize the SUPPORT Act and oppose MOTAA.

Thank you for your support!

Please contact NABH Director for Congressional Affairs Andy Dodson if you have questions.

HHS OIG Reports Low Misuse of Medicare Part D Buprenorphine

A new report from HHS’ Office of the Inspector General (OIG) found most Medicare Part D beneficiaries prescribed buprenorphine for opioid use disorder received recommended amounts in 2022, meaning there was likely little misuse of the drug.

The findings are similar to a 2021 report’s results, which led the OIG to conclude in the new review that there continues to be little risk of buprenorphine misuse among Part D enrollees.

Click here to read the full report.

Bipartisan Policy Center to Host Medicare Reform Webinar on Dec. 11

The Bipartisan Policy Center (BPC) will explore potential solutions to improve the beneficiary experience and ensure a fiscally responsible Medicare program, which nearly 20% of Americans rely on for healthcare coverage and is estimated to become insolvent by 2031.

During the discussion, BPC will release federal policy recommendations meant to enhance Medicare benefits, increase competition, establish better program management, and improve financing.

The hourlong event starts at 11:30 a.m. ET. Click here to register.

NIDA to Host ‘Monitoring the Future’ Survey Data Release Webinar on Dec. 13

The National Institute on Drug Abuse (NIDA) at the National Institutes of Health (NIH) will host a webinar to discuss results from its annual Monitoring the Future (MTF) survey on Wednesday, Dec. 13.

The MTF survey has measured drug and alcohol use and related attitudes among adolescent students nationwide since 1975. In it, a nationally representative sample of survey participants report their drug use behaviors across three time periods: lifetime, past year, and past month. NIDA funds the survey, which is conducted by the University of Michigan.

This year, the hourlong briefing will feature Marsha Lopez, Ph.D., M.H.S., who serves as chief of the epidemiology research branch in NIDA’s Division of Epidemiology, Services and Prevention Research.

The webinar will begin at 10 a.m. ET. Click here to register.

National Academies to Host Workshop that Examines Adult ADHD Diagnosis & Treatment

The National Academies’ Forum on Drug Discovery, Development and Translation and Forum on Neuroscience and Nervous System Disorders will host a workshop to explore the diagnosis and treatment of adults with Adult Attention-Deficit/Hyperactivity (ADHD) Disorder and the challenges and opportunities for drug development on Dec. 12 and 13.

The workshop is intended to offer professionals who typically diagnose ADHD—such as physicians, psychologists, social workers, nurse practitioners, and other licensed counselors or therapists—as well as drug developers, researchers, and regulators, to discuss and support the public health goal of treating adults with ADHD safely and effectively.

Supported partly through a grant from the Food and Drug Administration’s Center for Drug Evaluation and Research, the workshop will be presented on Tuesday, Dec. 12 from 8:30 a.m. – 5 p.m. ET and on Wednesday, Dec. 13 from 8:30 a.m. – 2 p.m. ET.

Click here to register.

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

NABH thanks all members who have submitted data to the association’s Denial-of-Care Portal. You have provided critical information that expands the portal and helps NABH strengthen its advocacy efforts related to erroneous prior-authorization denials.

With guidance from our members, NABH has improved the portal by adding two elements:

  1. Time-based data on the number of days between a request for coverage and a plan’s denial, which improves our ability to assess and compare health plan responsiveness.
  1. The gap between days of provided care versus days of covered care to quantify and compare uncompensated days per health plan.

We strongly encourage all NABH members to submit their denial-of-care data in the portal.

If you need help starting, or if you have other questions, please e-mail NABH Associate Manager for Congressional Affairs Emily Wilkins.

Save the Date for the NABH 2024 Annual Meeting!

Please mark your calendars and plan to join us at the Salamander Washington, DC from May 13-15, 2024 for next year’s NABH Annual Meeting!

Fact of the Week

Drug overdose deaths rose noticeably between January to June 2018 and July to December 2021 among 10- to 44-year-old girls and women who were pregnant or pregnant within the previous 12 months, according to a new study by NIDA researchers at the NIH.

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

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CEO Update 162

SAMHSA Releases 2022 National Survey on Drug Use and Health

Among U.S. adults aged 18 or older in 2022, 23.1%, or 59.3 million people, had any mental illness in the past year while 48.7 million people aged 12 or older, or 17.3%, had a substance use disorder (SUD) in the past year, according to the Substance Abuse and Mental Health Services Administration’s (SAMHSA) 2022 National Survey on Drug Use and Health (NSDUH).

The annual report provides nationally representative data on the use of tobacco, alcohol, and drugs; SUDs; mental health issues; and receipt of substance use and mental health treatment among the civilian, noninstitutionalized population aged 12 or older in the United States.

In addition, the 2022 Methodological Summary and Definitions report summarizes the information users need to properly interpret NSDUH estimates related to substance use and mental health. This report accompanies the annual detailed tables and provides information on overall methodology, key definitions for measures and terms used in 2022 NSDUH reports and tables, along with some analysis of these measures and of the survey as a whole.

NIH Study Examines How to Reduce Suicide Risk Among Young People in Hospital EDs

The National Institutes of Health (NIH) has released Emergency Department Safety Assessment and Follow-Up Evaluation 2 (ED-SAFE 2), a study that shows it’s possible to significantly reduce suicidal behaviors among young people at risk for suicide in emergency departments.
ED-SAFE is a randomized clinical trial designed to improve suicide risk screening and detection in emergency department settings.

The trial differs from similar studies because routine clinical staff—rather than researchers—deliver the suicide risk intervention, according to the NIH. This approach increases the likelihood that the suicide prevention strategies can be reliably implemented and sustained in the real world.

ED-SAFE is also the largest practical clinical trial of suicide-related best practices in emergency departments.

National Academies Examines How to Support and Sustain the Current and Future Workforce to Care for People with Serious Illness

The National Academies Roundtable on Quality Care for People with Serious Illness has released a resource from its April 2023 public workshop that explored strategies and approaches to address major workforce challenges for those who care for people with serious illness.

The workshop built on a 2019 Roundtable workshop, Building the Workforce We Need to Care for People with Serious Illness.

Click here to access the free resource.

SAMHSA to Host Webinar on Certified Peer Specialist Career Outcomes Study

SAMHSA’s Office of Recovery will host a webinar later this month to discuss the results from the Certified Peer Specialist (CPS) Career Outcomes Study.

Laysha Ostrow, Ph.D. will present some of the findings from the three-year study, including information about wages and financial wellbeing, workplace burnout, and CPS in rural areas.

The webinar will start Monday, Nov. 27 at 1 p.m. ET. Click here to register.

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

NABH thanks all members who have submitted data to the association’s Denial-of-Care Portal. You have provided critical information that expands the portal and helps NABH strengthen its advocacy efforts related to erroneous prior-authorization denials.

With guidance from our members, NABH has improved the portal by adding two elements:

  1. Time-based data on the number of days between a request for coverage and a plan’s denial, which improves our ability to assess and compare health plan responsiveness.
  1. The gap between days of provided care versus days of covered care to quantify and compare uncompensated days per health plan.

We strongly encourage all NABH members to submit their denial-of-care data in the portal. If you need help starting, or if you have other questions, please e-mail NABH Associate Manager for Congressional Affairs Emily Wilkins.

Fact of the Week

More Americans used illicit drugs in 2022 than in 2021, with illicit marijuana being the most common. Nearly 62 million people used illicit marijuana last year, up from 52.5 million in 2021, according to the 2022 National Survey on Drug Use and Health.

Save the Date for the NABH 2024 Annual Meeting!

Please mark your calendars and plan to join us at the Salamander Washington, DC from May 13-15, 2024 for next year’s NABH Annual Meeting!

Happy Thanksgiving!

The NABH staff wishes its members and their families a very happy, healthy, and safe Thanksgiving! NABH will not publish CEO Update next week and will resume on Friday, Dec. 1, 2023.
 
For questions or comments about this CEO Update, please contact Jessica Zigmond.

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CEO Update 161

Senate Finance Committee Advances ‘Better Mental Health Care, Lower-Cost Drugs and Extenders Act’

The Senate Finance Committee on Wednesday advanced the bipartisan Better Mental Health Care, Lower-Cost Drugs and Extenders Act in a unanimous vote.

The healthcare package partially mitigates Medicare payment cuts for physicians, extends certain expiring Medicare and Medicaid provisions, targets pharmacy benefit manager practices, and extends several substance use disorder (SUD) measures that expired on Oct. 1 as lawmakers missed the deadline to reauthorize the SUPPORT Act.

Included in the legislation is language from S. 3098, the Securing Advances and a Variety of Evidence-Based (SAVE) Institutions for Mental Diseases (IMD) Options Act that Sens. John Thune (R-S.D.), Maggie Hassan (D-N.H.), and Marsha Blackburn (R-Tenn.) introduced to make the state plan amendment option permanent, a provision also included in the House Energy & Commerce Committee-passed SUPPORT Act Reauthorization bill. Some states, including South Dakota and Tennessee, opted into a state plan amendment option authorized under the SUPPORT Act that allows states to avoid the IMD Exclusion. Without renewal, states avoiding the payment exclusion will be forced to terminate payments to IMD facilities or cover such costs through state funds.

Other provisions in the legislation include prohibiting states from terminating Medicaid coverage for incarcerated individuals and expanding access to mental health and SUD services for Medicaid-eligible individuals 30 days prior to their release from incarceration. The legislation also requires the Centers for Medicare & Medicaid Services (CMS) to collect and publish data from Medicare Advantage plans on the number of prior authorization requests, denials, and appeals for mental health and SUD services at the plan level, including the timelines of prior authorization decisions and justifications for denials.

Senate Finance Committee leaders said the goal is to include the Better Mental Health Care, Lower-Cost Drugs and Extenders Act legislation into a broader healthcare package, a second Continuing Resolution (CR), or end-of-year omnibus funding package.

CMS Extends MA Coverage to Additional Behavioral Healthcare Practitioners

In a proposed rule released this week, CMS proposed several changes to increase access to behavioral healthcare services for Medicare Advantage (MA) enrollees.

As required by law, CMS proposed to expand network adequacy standards for MA plans by adding a new category of specialists, “outpatient behavioral health” providers, as a required element of each network. Practitioners in this new category would include marriage and family therapists, mental health counselors, opioid treatment program providers, community mental health centers, addiction-medicine physicians, and other providers already providing traditional Medicare-covered addiction medicine and behavioral health counseling or therapy services.

Also, CMS would extend the existing 10% compensation boost to this new category of practitioners for any MA network that has at least one provider group providing telehealth services.

Comments on this rule are due to CMS by Jan. 25, 2024.

White House, ONDCP, Domestic Policy Council, and 12 Federal Agencies Release Recovery-Ready Workplace Toolkit

The White House, the Office of National Drug Control Policy, the Domestic Policy Council, and a dozen federal departments and independent agencies released their Recovery-Ready Workplace Toolkit: Guidance and Resources for Private and Public Sector Employers this week.

The 140-page resource supports the fourth pillar of President Biden’s Unity Agenda for the Nation: beating the opioid and overdose epidemic. Specifically, the toolkit is designed to help businesses and other employers prevent and respond more effectively to substance misuse among employees, build their workforces through hiring of people in recovery, and develop a recovery-supportive workplace culture.

It is also intended to serve as a resource to states, local governments, labor organizations, business groups, and non-profits considering launching multi-employer recovery-ready workforce initiatives at the local or state levels.

HHS Releases ‘Action for Adolescents: A Call to Action for Adolescent Health and Well-Being’

HHS recently released Action for Adolescents: A Call to Action for Adolescent Health and Well-Being, a new effort to promote collaboration and prompt action to improve the health and well-being of U.S. adolescents nationwide.

Take Action for Adolescents is a research-based resource that outlines a vision, key principles, and eight goals, including: 1) Eliminate disparities to advance health equity, 2) Increase youth agency and youth engagement, 3) Ensure access to safe and supportive environments, 4) Increase coordination and collaboration within and across systems, 5) Expand access to health care and human services, 6) Strengthen training and support for caring adults, 7) Improve health information and health literacy, and 8) Support, translate, and disseminate research. The resource also includes a Take Action toolkit.

In other HHS news related to the nation’s youth, HHS Secretary Xavier Becerra was recently named Chair of the U.S. Interagency Council on Homelessness and announced $6.1 million in new measures on affordable housing and support for runaway youth. Some of that funding will be used to enhance a variety of supportive services, including mental health services, on-site child care, financial literacy and coaching, GED preparation classes, transportation assistance, and early childhood and youth programs.

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

NABH thanks all members who have submitted data to the association’s Denial-of-Care Portal. You have provided critical information that expands the portal and helps NABH strengthen its advocacy efforts related to erroneous prior-authorization denials.

With guidance from our members, NABH has improved the portal by adding two elements:

  1. Time-based data on the number of days between a request for coverage and a plan’s denial, which improves our ability to assess and compare health plan responsiveness.
  1. The gap between days of provided care versus days of covered care to quantify and compare uncompensated days per health plan.

We strongly encourage all NABH members to submit their denial-of-care data in the portal. If you need help starting, or if you have other questions, please e-mail NABH Associate Manager for Congressional Affairs Emily Wilkins.

Fact of the Week

For young people between the ages of 15 to 24, time spent in person with friends has reduced by nearly 70% during the last two decades to 40 minutes per day in 2020 from roughly 150 minutes per day in 2003 to 40 minutes per day in 2020, according to The U.S. Surgeon General’s Advisory on the Healing Effects of Social Connection and Community.

Save the Date for the NABH 2024 Annual Meeting!

Please mark your calendars and plan to join us at the Salamander Washington, DC from May 13-15, 2024 for next year’s NABH Annual Meeting!

Many Thanks to All Veterans!

This Veterans Day Weekend, NABH thanks its members and their families who have served or are serving in the U.S. military. We appreciate your sacrifice and service.
 
For questions or comments about this CEO Update, please contact Jessica Zigmond.

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CEO Update 160

White House Asks Congress for $1.55 Billion to Address Nation’s Fentanyl Crisis

The Biden administration this week requested $1.55 billion from Congress for HHS’ Substance Abuse and Mental Health Services Administration (SAMHSA) State Opioid Response grants to provide treatment, harm reduction, and recovery support services in all states and territories to combat the nation’s ongoing fentanyl crisis.
 
Thanks to historic funding and bipartisan efforts, the rate of overdose deaths is slowing after a period of exponential increase, access to treatment is expanding, and historic amounts of fentanyl are being seized at our borders,” the White House said in a fact sheet about the Biden administration’s domestic spending requests to Congress. “But our work to beat the overdose epidemic is far from over and additional resources are needed to continue the Administration’s aggressive action to save lives.”

CDC: Healthcare Workers Report a Decrease in Odds of Burnout if They Trust Management

Healthcare workers continued to face a mental health crisis in 2022, although positive working conditions were associated with less burnout and better mental health, the Centers for Disease Control and Prevention (CDC) concluded in a Vital Signs report released this week.

From 2018 to 2022, healthcare workers reported an increase of 1.2 days of poor mental health during the previous 30 days (to 4.5 days from 3.3 days), while the percentage who reported feeling burnout very often increased to 19% from 11.6%, the findings showed. However, the report found healthcare workers experienced a decrease in odds of burnout if they trusted management, had supervisor help, had enough time to complete work, and felt their workplace supported productivity.

The report highlighted the CDC’s National Institute for Occupational Safety and Health (NIOSH), which has implemented efforts to promote the mental health and well-being of healthcare workers, including a national social marketing campaign, Impact Wellbeing, which emphasizes primary prevention strategies such as worker participation in decision-making, supportive supervision, and increasing psychological safety for help-seeking.

“NIOSH has also developed burnout training for supervisors of public health workers and through its efforts has emphasized improving the work environment, rather than asking workers to be more resilient or fix problems themselves,” the report said.

SAMHSA Summary Report Shows Climate Change is a Social Determinant of Mental Health

A recent SAMHSA report concluded climate change is a social determinant of mental health; behavioral health systems should become “climate-informed;” and intergenerational trauma will be one of the layered effects of climate-related environmental change.

The report summarized the findings from SAMHSA’s August 2022 request for information that sought feedback about potential agency actions regarding mental health and substance use wellbeing in the context of climate change and health equity.

Respondents suggested SAMHSA should develop an agency-wide climate action plan to serve as a roadmap for change and integration of climate-informed behavioral health in SAMHSA research, programs, contracts, technical assistance, and reports.

They also said SAMHSA should support increased resources and allowable costs that shift behavioral health systems toward public behavioral health strategies for mental health promotion, substance use prevention, community-level response, and community-based mental health resilience.

“Respondents emphasized that a protective factor for healthcare workers is adequate training and preparation,” the report said. “Therefore, building out a climate-informed behavioral health system that provides resources to an increasingly diverse behavioral health workforce is protective to both the behavioral health workforce and the communities they serve,” it continued. “Timely and tailored interventions need to be designed in such a way that they can be altered over time to meet current and evolving needs.”

CMS Seeking Feedback to Improve Provider Resources

The Centers for Medicare and Medicaid Services (CMS) is conducting a study to help the agency improve user experience with Medicare program and billing resources.

Responses are confidential, and the survey should take about 10 minutes to complete. Click here to take the survey, which is due Thursday, Nov. 9.

SAMHSA Releases 988 Lifeline Videos

SAMHSA has produced two new videos that promote the 988 Lifeline. Called “Impact of the 988 Lifeline” and “You Matter PSA,” the videos are included in SAMHSA’s 988 Partner Toolkit.

In its announcement, SAMHSA noted that its 988 fact sheet, available in both English and Spanish, has been helpful in communicating about the 988 Lifeline’s services and successes.

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

NABH thanks all members who have submitted data to the association’s Denial-of-Care Portal. You have provided critical information that expands the portal and helps NABH strengthen its advocacy efforts related to erroneous prior-authorization denials.

With guidance from our members, NABH has improved the portal by adding two elements:

  1. Time-based data on the number of days between a request for coverage and a plan’s denial, which improves our ability to assess and compare health plan responsiveness.
  1. The gap between days of provided care versus days of covered care to quantify and compare uncompensated days per health plan.

We strongly encourage all NABH members to submit their denial-of-care data in the portal. If you need help starting, or if you have other questions, please e-mail NABH Associate Manager for Congressional Affairs Emily Wilkins.

Reminder: The O’Neill Institute to Host Webinar on Recovery Housing Next Month

The O’Neill Institute’s Addiction and Public Policy Initiative will host a webinar next month about the current state of recovery housing and the opportunities for improving recovery housing in the United States.

As the O’Neil Institute explains, social determinants, such as housing, and expanded access to medications for substance use disorder are part of effective, long-term solutions. National standards for recovery housing, along with protecting the rights of individuals under the law, are central to facilitating a needed societal shift and maximizing opportunities for people with substance use disorder.

Recognizing the critical role that housing plays in improving outcomes for people with substance use disorder (SUD), SAMHSA recently issued Best Practices for Recovery Housing, and the U.S. Justice Department protects the rights of individuals with SUD afforded under the Fair Housing Act and the Americans with Disabilities Act.

Fact of the Week:

More than 1 million hospital emergency department visits are attributed annually to children and adolescents with a mental health disorder diagnosis, according to a new CDC study.

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

Read more

CEO Update 159

Reminder: NABH Board Nominations Due Today, Friday, Oct. 20! 

NABH is seeking help from members as the NABH Selection Committee prepares to consider possible nominees to serve on the NABH Board of Trustees. Specifically, NABH requests that members help the association identify:

Board Chair-Elect and
     ► Four Board seats that will become available in 2024

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 for 2024. Please attach a curriculum vitae (CV) for each person you recommend. This will help the Selection Committee in its deliberations. You are welcome to suggest yourself.

Please return this form (and candidates’ CVs) by today, Oct. 20, 2023, to maria@nabh.org.

Sens. Thune, Hassan, and Blackburn Introduce SAVE IMD Options Act

Sens. John Thun (R-S.D.), Maggie Hassan (D-N.H.), and Marsha Blackburn (R-Tenn.) on Thursday introduced the Securing Advances and a Variety of Evidence-Based (SAVE) Institutions for Mental Disease (IMD) Options Act.

The bipartisan legislation would establish a permanent state plan option in Medicaid that allows states to provide patients between the ages of 21 and 64 with substance use disorder (SUD) treatment in an IMD. Current law does not allow federal Medicaid funds to be used for those patients at IMDs, which include hospitals, nursing facilities, or other institutions with more than 16 beds that provide care for mental health diseases, including SUD.

NABH strongly supports the bill and is working with the lawmakers’ congressional staff to provide support.

“Establishing a permanent state option in Medicaid for substance use disorder treatment provided in IMD will provide states with certainty and ensure individuals have access to this lifesaving treatment,” NABH President and CEO Shawn Coughlin said in a news release about the bill.

NABH Submits Parity Comments to HHS, DOL, and Treasury

NABH this week submitted comments to the U.S. Health and Human Services, Labor, and Treasury Departments on this year’s proposed parity rule and thanks all members who provided feedback.

In its letter, NABH recognized the three departments for their collective determination to enforce the Mental Health Parity and Addiction Equity Act (MHPAEA) that passed 15 years ago this month and has yet to be implemented fully and fairly nationwide.

NABH’s letter also said the association especially supports the proposed rule’s requirement that each plan’s comparative analysis on parity compliance include substantive data on non-quantitative treatment limitations (NQTL), including network composition. These requirements will do much to enforce both the letter and spirit of the MHPAEA, NABH noted.

The letter continued by categorizing NABH’s comments into the following sections: 1) parity in behavioral healthcare benefits, 2) NQTL comparative analysis requirements, 3) improving and expanding meaningful parity standards, and 4) network adequacy.

“We appreciate that the rule addresses ambiguous definitions that contribute to the disparity between mental and physical healthcare,” the letter said in a section about clarifying meaningful coverage and scope of covered services. “Such ambiguity tends to yield overly flexible interpretations that generally favor health plans over patients. In particular, the proposed, more specific definitions for ‘meaningful coverage’ and ‘scope of covered services’ will bring valuable clarity and consistency to coverage determinations,” it continued. “Of notable benefit, we strongly support the proposed requirement for plans that provide behavioral healthcare benefits in any classification of care, to do so in all classifications of care. Similarly, we urge the departments to add to the final rule a definition of ‘meaningful’ as it applies to scope of covered MH and SUD benefits in each classification.”

Fewer Medicare Advantage Plans Earned a 5-Star Rating for 2024

In its 2024 Star Ratings released last week, the Centers for Medicare & Medicaid Services (CMS) gave 31 Medicare Advantage (MA) contracts a five-star rating, a notable drop from the 57 contracts that earned the top rating in 2023. An MA contract must earn at least a four-star rating to receive a quality bonus payment from CMS.

MA open enrollment for 2024 kicked off on Oct. 15 using new MA requirements that CMS finalized in April and will take effect on Jan. 1, 2024. The 40 quality metrics that apply to MA plans with a drug benefit in 2024 will include new restrictions on deceptive marketing, multiple prior authorization improvements, and affordable drug pricing, with the latter required by law.

CMS is in the process of remaking the star-rating system to remove incentives that inadvertently permitted lower quality and unnecessary spending. This effort includes applying more stringent criteria for star-rating quality metrics, which are expected to result in fewer insurers securing high ratings and greater financial benefits for insurers focused on treating disadvantaged populations.

CMS’ effort also includes changes from the 2024 MA final rule, which strives to improve coverage, ensure timely access to care, and advance parity between MA and traditional fee-for-service coverage.

The National Academies Seeks Experts to Participate in Workshop to Explore Data-Collection Efforts for People Who Use Drugs

The National Academies is seeking suggestions for experts to participate in a White House Office of National Drug Control Policy-sponsored workshop to explore data-collection efforts, evidence gaps, and research needs on harm-reduction services for people who use drugs (PWUD).

Specifically, the workshop will examine harm-reduction services that aim to prevent overdose and infectious disease transmission; enhance the health, safety, and wellbeing of PWUD; and offer low-threshold options for accessing SUD treatment. According to the National Academies, services include syringe services programs; providing fentanyl and xylazine test strips; distributing naloxone and other reversal medications; and facilitating connections to social services for PWUD in need of medical services, stable housing, food-assistance, or employment.

Nominations are due next Wednesday, Oct. 25 to help the National Academies establish a 10-person, volunteer planning committee for the project. Click here to learn more and submit a nomination.

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

NABH thanks all members who have submitted data to the association’s Denial-of-Care Portal. You have provided critical information that expands the portal and helps NABH strengthen its advocacy efforts related to erroneous prior-authorization denials.

With guidance from our members, NABH has improved the portal by adding two elements:

  1. Time-based data on the number of days between a request for coverage and a plan’s denial, which improves our ability to assess and compare health plan responsiveness.
  1. The gap between days of provided care versus days of covered care to quantify and compare uncompensated days per health plan.

We strongly encourage all NABH members to submit their denial-of-care data in the portal. If you need help starting, or if you have other questions, please e-mail NABH Associate Manager for Congressional Affairs Emily Wilkins.

Reminder: The O’Neill Institute to Host Webinar on Recovery Housing Next Month

The O’Neill Institute’s Addiction and Public Policy Initiative will host a webinar next month about the current state of recovery housing and the opportunities for improving recovery housing in the United States.

As the O’Neil Institute explains, social determinants, such as housing, and expanded access to medications for substance use disorder are part of effective, long-term solutions. National standards for recovery housing, along with protecting the rights of individuals under the law, are central to facilitating a needed societal shift and maximizing opportunities for people with substance use disorder.

Recognizing the critical role that housing plays in improving outcomes for people with substance use disorder (SUD), SAMHSA recently issued Best Practices for Recovery Housing, and the U.S. Justice Department protects the rights of individuals with SUD afforded under the Fair Housing Act and the Americans with Disabilities Act.

Fact of the Week:

New data from the Centers for Disease Control and Prevention show 1 out of 5 persons who died from drug overdoses in 2020 worked in construction or restaurants.

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

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CEO Update 158

FDA Creates Advisory Committee to Examine Digital Health Technologies

The U.S. Food and Drug Administration (FDA) this week announced it has created a Digital Health Advisory Committee to help the agency explore the scientific and technical issues related to digital health technologies (DHTs), such as artificial intelligence/machine learning (AI/ML), augmented reality, virtual reality, digital therapeutics, wearables, remote patient monitoring and software.

The new committee will advise the FDA on issues related to DHTs and provide expertise to help the agency better understand benefits, risks, and clinical outcomes associated with use of DHTs.

“As one of our strategic priorities, our goal is to advance health equity in part through expanding access by bringing prevention, wellness, and healthcare to all people where they live – at home, at work, in big cities and rural communities,” Jeff Shuren, M.D., J.D., director of the FDA’s Center for Devices and Radiological Health, said in an announcement. “Digital health technologies are critical for achieving this transformation in care delivery,” he continued. “As digital health technologies advance, the FDA must capitalize on knowledge from inside and outside of the agency to help ensure we appropriately apply our regulatory authority in a way that protects patient health while continuing to support innovation.”

FDA’s announcement said the committee should be fully operational in 2024.

SAMHSA Releases Mental Health Client-Level Data 2021 Annual Report

The Substance Abuse and Mental Health Services Administration (SAMHSA) this week released Mental Health Client-Level Data (MH-CLD) 2021: Data on Clients Receiving Mental Health Treatment Services Through State Mental Health Agencies, the annual report that details the total number of clients receiving mental health treatment services in 2021 by demographics, national outcomes measures, and the top five mental health diagnoses for children (ages 0-17) and adults (ages 18 and older) by geographic distribution.

SAMHSA uses the MH-CLD data to better understand publicly funded mental health treatment service systems. The data are also used to inform decisions about how SAMHSA’s uses its mental health block grant funds, and are used to help the agency learn about the technical assistance and support needs of mental health providers and the communities they serve.

CMS Administrator Brooks-LaSure to Host Stakeholder Update Next Week

CMS Administrator Chiquita Brooks-LaSure and her leadership team will provide a stakeholder and partner update about the agency’s recent accomplishments and efforts to advance the CMS Strategic Plan on Tuesday, Oct. 17.

Click here to RSVP for the hourlong call, which starts at 1 p.m. ET.

Manatt Health to Host Webinar Next Week on Emerging Fraudulent Healthcare Schemes

Manatt Health will host a webinar next week to help providers and health plans navigate the emerging landscape of fraudulent healthcare schemes and provide practical answers to the legal questions that resulted from recent litigation and enforcement actions.

The free webinar will feature panelists — all of whom have successfully defended litigants who have been forced to deal with inducement-based lawsuits in both federal and state courts – who will share an overview of the current litigation and policy landscape and offer insights into how providers and plans can protect themselves and their organizations.

The webinar also will discuss the findings from internal investigations that have uncovered fraudulent activities and improper conduct impacting patients’ health and safety and providers’ and plans’ financial viability.

Click here to register for the hourlong webinar on Tuesday, Oct. 17, which starts at 1 p.m. ET.

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

NABH thanks all members who have submitted data to the association’s Denial-of-Care Portal. You have provided critical information that expands the portal and helps NABH strengthen its advocacy efforts related to erroneous prior-authorization denials.

With guidance from our members, NABH has improved the portal by adding two elements:

  1. Time-based data on the number of days between a request for coverage and a plan’s denial, which improves our ability to assess and compare health plan responsiveness.
  1. The gap between days of provided care versus days of covered care to quantify and compare uncompensated days per health plan.

We strongly encourage all NABH members to submit their denial-of-care data in the portal. If you need help starting, or if you have other questions, please e-mail NABH Associate Manager for Congressional Affairs Emily Wilkins.

Reminder: NABH Board Nominations Due Next Friday, Oct. 20! 

NABH is seeking help from members as the NABH Selection Committee prepares to consider possible nominees to serve on the NABH Board of Trustees. Specifically, NABH requests that members help the association identify:

Board Chair-Elect and
     ► Four Board seats that will become available in 2024

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 for 2024. Please attach a curriculum vitae (CV) for each person you recommend. This will help the Selection Committee in its deliberations. You are welcome to suggest yourself.

Please return this form (and candidates’ CVs) by Friday, Oct. 20, 2023, to maria@nabh.org.

The O’Neill Institute to Host Webinar on Recovery Housing Next Month

The O’Neill Institute’s Addiction and Public Policy Initiative will host a webinar next month about the current state of recovery housing and the opportunities for improving recovery housing in the United States.

As the O’Neil Institute explains, social determinants, such as housing, and expanded access to medications for substance use disorder are part of effective, long-term solutions. National standards for recovery housing, along with protecting the rights of individuals under the law, are central to facilitating a needed societal shift and maximizing opportunities for people with substance use disorder.

Recognizing the critical role that housing plays in improving outcomes for people with substance use disorder (SUD), SAMHSA recently issued Best Practices for Recovery Housing, and the U.S. Justice Department protects the rights of individuals with SUD afforded under the Fair Housing Act and the Americans with Disabilities Act.

Fact of the Week:

Nearly 40% of primary care providers (PCPs) are screening patients for behavioral health conditions, according to a new report from The Advisory Board, which included survey responses from 300 PCPs.

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

Read more

CEO Update 157

DEA Extends Pandemic Telemedicine Rules Through December 2024

The Drug Enforcement Administration (DEA) on Friday said it will extend its eased, COVID-19 pandemic rules for prescribing controlled substances via telemedicine through Dec. 31, 2024.

This is DEA’s second extension of these rules; the agency first extended its pandemic-era, telehealth regulations in May 2023, which are set to expire on Nov. 11, 2023.

DEA said in its notice that DEA and HHS continue to consider revisions to the agency’s March 2023 proposed rule and that DEA’s telemedicine listening sessions last month helped inform this latest extension. NABH reported on those listening sessions in CEO Update on Sept. 15.

FDA Issues Draft Guidance on Developing Treatment Drugs for Stimulant Use Disorders

The U.S. Food and Drug Administration (FDA) this week issued draft guidance for developing drugs to treat stimulant use disorders.

Stimulant Use Disorders: Developing Drugs for Treatment addresses the FDA’s current recommendations regarding the overall development program and clinical trial designs for developing drugs to treat moderate-to-severe cocaine use disorder, methamphetamine use disorder, or prescription drug stimulant use disorder.

The FDA will accept public comments about the guidance through Monday, Dec. 4. Click here for comment submission instructions.

CMS Seeks Feedback on Assessing Parity Compliance in Medicaid Managed Care, ABPs, & CHIP

The Centers for Medicare & Medicaid Services (CMS) is seeking public comments about a set of questions regarding processes to assess compliance with mental health parity ad addiction equity requirements for Medicaid managed care arrangements, Medicaid Alternative Benefit Plans (ABPs), and the Children’s Health Insurance Program. (CHIP).

The questions for comment address a variety of topics, including model formats (e.g., templates) and key questions to consider that could make documenting compliance with parity requirements more efficient and effective; processes that states and managed care plans use to determine whether existing coverage policies are comparable for mental health and substance use disorders compared with medical and surgical benefits; how data should be collected; and more.

CMS will accept public comments here through Monday, Dec. 4. NABH will submit comments.

CBO Estimates Federal Subsidies for Health Insurance to be $1.8 Trillion in 2023

In a new report, the Congressional Budget Office (CBO) estimates federal subsidies for health insurance in 2023 to be $1.8 trillion, or 7% of the nation’s Gross Domestic Product.

Meanwhile, the CBO and the Joint Committee on Taxation (JCT) together project those net subsidies to grow substantially–reaching $3.3. trillion, or 8.3% of GDP, by 2033.

The CBO said this is the first time the projections reflect the entire population instead of only the civilian, noninstitutionalized population younger than 65.

CMS Administrator Brooks-LaSure to Host Stakeholder Update on Oct. 17

CMS Administrator Chiquita Brooks-LaSure and her leadership team will provide a stakeholder and partner update about the agency’s recent accomplishments and efforts to advance the CMS Strategic Plan on Tuesday, Oct. 17.

Click here to RSVP for the hourlong call, which starts at 1 p.m. ET.

NIMH Marks 75th Anniversary with Podcast Series

The National Institute of Mental Health is honoring its 75th anniversary with a podcast series that explores the stories behind influencers and innovators in mental health research and the lives of people with mental illness.

The latest podcasts feature “Depression: The Case for Ketamine,” and “Understanding and Preventing Youth Suicide.” Click here to listen.

Please Nominate Members for the NABH Board of Trustees!

NABH is seeking help from members as the NABH Selection Committee prepares to consider possible nominees to serve on the NABH Board of Trustees. Specifically, NABH requests that members help the association identify:

Board Chair-Elect and
     ► Four Board seats that will become available in 2024

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 for 2024. Please attach a curriculum vitae (CV) for each person you recommend. This will help the Selection Committee in its deliberations. You are welcome to suggest yourself.

Please return this form (and candidates’ CVs) by Friday, Oct. 20, 2023, to maria@nabh.org.

Fact of the Week:

People who work shift work are 22% more likely to develop depression than those who work a regular daytime schedule, according to a recent study published in JAMA Network Open.

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

Read more

CEO Update 156

HHS Releases Contingency Plan as Federal Government Shutdown Looms

HHS this week released a government shutdown contingency plan if federal lawmakers don’t pass legislation by Saturday, Sept. 30 to extend government funding and maintain federal operations. If they don’t, critical federal services will end at 12:01 a.m. on Sunday.

The ongoing government funding talks have put on hold consideration of all other bills that are set to expire after Sept. 30, including the SUPPORT Act reauthorization. NABH expects reauthorization to move through both chambers of Congress after lawmakers resolve the federal funding issue.

Meanwhile, here are HHS’ plans for the agencies that affect NABH members: the Agency for Healthcare Research and Quality, Centers for Medicare & Medicaid Services, Health Resources and Services Administration, National Institutes of Health, and Substance Abuse and Mental Health Services Administration.

SAMHSA Announces $131.7 Million in Grants for Youth and Families  

The Substance Abuse and Mental Health Services Administration (SAMHSA) this week said it awarded $131.7 million in grant programs to connect youth and families with behavioral healthcare services.

The awards will fund a variety of programs and services, including cooperative agreements for school-based, trauma-informed support services for mental healthcare, expanding substance use treatment capacity in adult and family drug courts, preventing youth overdose, and more.

Click here to read more about the awards.

Joint Commission Revises Terms to Reflect Current Terminology in Addiction Medicine

The Joint Commission said it has revised two terms for Behavioral Health Care and Human Services to reflect current terminology in the addiction medicine field.

“Medication-assisted treatment” has been updated to “medications for substance use disorders,” and, if the requirement needs to be more specific, the term used is “medications for opioid use disorder” or “medications for alcohol use disorder.”

Meanwhile, the Joint Commission removed “detoxification,” which is now referred to as “withdrawal,” “withdrawal management,” or “medically supervised withdrawal management.”

“These revisions are editorial in nature and do not change any requirements,” the Joint Commission said in its announcement, adding that any questions should be directed to the organization’s Department of Standards and Survey Methods.

The changes take effect on Jan. 1, 2024.

October is Youth Substance Use and Misuse Prevention Month

As National Recovery Month draws to a close, the nation now turns to Youth Substance Use Prevention Month and Substance Misuse Prevention Month for October.

SAMHSA has created a Prevention Month toolkit with shareable social media graphics to help people promote the message of prevention for kids and family and developed other resources and events to help communities participate.

In conjunction with Prevention Month, SAMHSA this week announced it awarded $42.6 million in grants to 17 states and 60 communities—located across 33 states—as a foundational investment for substance use prevention. Click here to learn more.

Please Nominate Members for the NABH Board of Trustees!

NABH is seeking help from members as the NABH Selection Committee prepares to consider possible nominees to serve on the NABH Board of Trustees. Specifically, NABH requests that members help the association identify:

Board Chair-Elect and
     ► Four Board seats that will become available in 2024

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 for 2024. Please attach a curriculum vitae (CV) for each person you recommend. This will help the Selection Committee in its deliberations. You are welcome to suggest yourself.

Please return this form (and candidates’ CVs) by Friday, Oct. 20, 2023, to maria@nabh.org.

Fact of the Week:

Between 2014 and 2019, the national Hispanic population increased by 4.5%, or 5.2 million people. During the same period, the proportion of facilities that offered treatment in Spanish declined by 17.8%, or a loss of 1,163 Spanish-speaking mental health facilities, according to a study published in Psychiatric Services. Overall, 44 states saw a decline in the availability of services in Spanish, despite growth in Hispanic populations across all states.
 
For questions or comments about this CEO Update, please contact Jessica Zigmond.

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CEO Update 155

White House Recovery Summit Seeks to Create a ‘Recovery-Ready Nation’

As part of Recovery Month, the White House this week held a Recovery Summit to celebrate people with substance use disorders (SUD) who are in treatment and to discuss ways that Americans can build a recovery-ready nation.
 
The Office of National Drug Control Policy Director Rahul Gupta, M.D., M.P.H. hosted the event, and one highlight included a panel of high school students who shared their personal recovery journeys. Assistant Secretary for Mental Health and Substance Use Disorders Miriam Delphin-Rittmon, Ph.D., who leads the Substance Abuse and Mental Health Services Administration (SAMHSA), moderated the panel, and Sen. Jeanne Shaheen (D-N.H.) and Rep. Paul Tonko (D-N.Y.) offered remarks.

Sarah Wattenberg, director of quality and addiction services at NABH, represented the association at the summit. Click here to learn more.

SAMHSA Releases New Data on Recovery from SUD and Mental Health Problems Among Adults

About 70 million U.S. adults aged 18 and older perceived they ever had a substance use and/or mental health problem, according to a new report SAMHSA released this week.

Using data from the 2021 National Survey on Drug Use and Health, the report also showed that for substance use specifically, 29 million adults perceived they ever had a substance use problem, and 20.9 million people (or 72.2%) considered themselves to be in recovery or to have recovered from their drug or alcohol use problem.
 
For mental health, of the 58.7 million adults who perceived they ever had a mental health problem, 38.8 million (or 66.5%) considered themselves to be in recovery or to have recovered from their mental health problem.

Click here to read the report, Recovery from Substance Use and Mental Health Problems Among Adults in the United States.

2023 NABH Membership Directory Updates Are Due Wednesday, Sept. 27!

NABH has extended the deadline for system members to submit changes about their organizations for the 2023 NABH Directory to Wednesday, Sept. 27.

NABH’s online-only 2023 Membership Directory is an essential member benefit that helps the association advance its advocacy efforts. Last month NABH sent system members 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 verify your system’s information.

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 to help provide NABH with an accurate picture of our membership.

If you need assistance, please contact Maria Merlie maria@nabh.org or 202-393-6700, ext. 104.

Reminder: Deadline for Health Data Privacy Feedback to Senate HELP Committee is Next Week

Senate Health, Education, Labor, and Pensions (HELP) Committee Ranking Member Sen. Bill Cassidy, M.D. (R-La.) announced earlier this month he’s seeking information from stakeholders about ways to improve the privacy protections of health data in a way that safeguards sensitive information while balancing the need to support medical research.

According to a Senate HELP Committee announcement, Cassidy, an NABH Champion, hopes to use the stakeholder feedback to identify solutions to modernize HIPAA and ensure that all health data are safeguarded properly.
 
The deadline to submit feedback is Thursday, Sept. 28. Click here to read Cassidy’s full request and here to submit comments.    

Reminder: CMS to Host Webinar on Person-Centered Approaches to Improving Behavioral Health Condition Management

CMS’ Medicare-Medicaid Coordination Office recently announced an upcoming webinar that will examine how traditional silos of care impede comprehensive approaches to care coordination and explore potential solutions to improve behavioral health condition management in persons with intellectual and developmental disabilities.

Presenters include Andrea Witwer, Ph.D., associate clinical professor in psychiatry and behavioral health at Ohio State; family caregiver Patricia Nobbie, Ph.D.; and Olivia Ayers, LMCH, LPC, clinical director at Elevate Certified Community Behavioral Health Clinic in Iowa.

The 90-minute webinar will be held on Wednesday, Sept. 27 starting at 2:30 p.m. ET. Click here to learn more and to register.

Fact of the Week:

Researchers at the not-for-profit research institute RTI International have found that approximately 3.7 million, or 1.8%, of U.S. adults ages 18 to 65, have a lifetime history of schizophrenia spectrum disorders— a figure two-to-three times higher than previous studies. The findings came from the Mental Health and Substance Use Disorder Prevalence Study, which SAMHSA funds.
 
For questions or comments about this CEO Update, please contact Jessica Zigmond.

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CEO Update 154

NABH Comments on 2024 OPPS and Physician Payment Proposed Rules

This week NABH submitted a comment letter to the Center for Medicare & Medicaid Services (CMS) about the agency’s proposed rules pertaining to both the outpatient prospective payment system (OPPS) and physician fee schedule (PFS) for 2024.

Outpatient PPS Proposed Rule. Among the rule’s multiple behavioral healthcare provisions, a key item was CMS’ proposed design and implementation of the congressionally mandated intensive outpatient program (IOP) as a new Medicare benefit in hospital outpatient departments, community mental health centers, federally qualified health centers, rural health clinics, and opioid treatment programs. NABH generally supports CMS’ proposed approach of basing many of the new IOP design features on the existing partial hospitalization program (PHP) framework because PHPs treat a similar mix of patients, although with a higher level of intensity.

That said, NABH raised concerns regarding some of the proposed design features, including the need to align the new IOP patient eligibility criteria with the clinical characteristics of current IOP populations. Specifically, NABH urged CMS to remove these criteria: “adequate support system at home” and “risk of danger to self or others” as they would exclude a significant portion of the patient population for whom this benefit is intended.
 
NABH expressed additional concerns related to the implementation of IOP benefit by opioid treatment programs including that the physician-driven IOP certification and treatment planning requirements do not align with the scopes of practice of non-physician professionals nor with the ASAM requirements for IOP and other level of care assessments; that additional specialty care settings should be considered for IOP services; and that CMS develop a contingency management bundle for individuals with stimulant use disorder.

Physician Fee Schedule Proposed Rule. NABH’s comments about the PFS rule respond to CMS’ proposed 2.0% increase for psychiatric service payments, relative to CY 2023 rates, which starkly contrasts to the proposed decrease for overall PFS payments of negative 3.3%. Our comments recommend increases for both overall and psychiatric services due to significant workforce and other pressures facing all healthcare providers. We also support the agency’s provision to set payments to 150% of facility-based payments for “psychotherapy for crisis” services that are furnished in a setting other than a physician’s office or mobile unit or home.

In addition, we support CMS’ proposal to allow three new behavioral healthcare practitioners to bill under Medicare Part B: marriage and family therapists, mental health counselors (MHCs), and addiction counselors that meet Medicare criteria for MHCs. NABH also called for a 10 percentage-point increase in payments for these providers and the addition of psychiatric mental health nurse practitioners to this group.

We also recommended that telehealth services offered by community health integration, social determinants of health, and principal illness navigation specialists be covered; that remote monitoring codes be developed for opioid treatment programs and office-based opioid treatment providers; and that progressively decreasing buprenorphine reimbursement rates be re-evaluated and increased.

Providers Share the Negative Impact of Returning to DEA’s Pre-Pandemic Telemedicine Rules

The Drug Enforcement Administration held a two-day listening session this week in response to almost 40,000 comments it received earlier in the year about its proposal to reimpose in-person visits for the prescribing of controlled substances, including buprenorphine.
 
DEA Administrator Anne Milgram announced that the agency would provide an additional comment period for telemedicine. This would likely require an extension of the telemedicine flexibilities offered during the COVID-19 pandemic.

Testimony over the course of two days addressed how changes to pandemic-era telemedicine rules would impede care for individuals needing medication for attention-deficit/hyperactivity disorder and opioid use disorder, individuals in end-of-life care needing opioids for pain relief, individuals receiving gender-affirming care, and many others.

The listening session requested recommendations on a “special registration” process that Congress requested many years ago.

National Academies Seeking Experts to Participate in Study to Develop National Prevention Infrastructure for Behavioral Health Disorders Blueprint

The National Academies of Sciences, Engineering, and Medicine is seeking suggestions for experts to participate in a study to develop a Blueprint for a National Prevention Infrastructure for Behavioral Health Disorders.
 
The study also will identify funding needs and strategies to support the infrastructure; identify gaps in policy research and health services research that may serve as barriers to implementing the program; and recommend state and federal policies to support the financing and infrastructure, including workforce development and data interoperability for promoting behavioral health. Click here to learn more about the scope of work for the ad hoc committee that will develop the blueprint and click here to submit recommendations of volunteer experts.

The deadline to submit recommendations is Wednesday, Sept. 20.

SAMHSA Releases Resources to Help Communities Address Opioid Overdose Crisis

The Substance Abuse and Mental Health Services Administration (SAMHSA) this week released two resources to help community practitioners end America’s opioid crisis.

SAMHSA commissioned RTI International to develop—together with a SAMHSA technical expert panel— Engaging Community Coalitions to Decrease Opioid Overdose Deaths and Opioid-Overdose Reduction Continuum of Care Approach.

The guides are based on insights and tools from the ongoing National Institutes of Health (NIH) HEALing Communities Study. NIH and SAMHSA launched that study in 2019 to test the effect of an integrated set of evidence-based practices across healthcare, behavioral health, justice, and other community-based settings.

Reminder: Sept. 28 Deadline for Health Data Privacy Feedback to Senate HELP Committee

Senate Health, Education, Labor, and Pensions (HELP) Committee Ranking Member Sen. Bill Cassidy, M.D. (R-La.) last week announced he’s seeking information from stakeholders about ways to improve the privacy protections of health data in a way that safeguards sensitive information while balancing the need to support medical research.

According to a Senate HELP Committee announcement, Cassidy, an NABH Champion, hopes to use the stakeholder feedback to identify solutions to modernize HIPAA and ensure that all health data are safeguarded properly.

The deadline to submit feedback is Thursday, Sept. 28. Click here to read Cassidy’s full request and here to submit comments.   

Reminder: CMS to Host Webinar on Person-Centered Approaches to Improving Behavioral Health Condition Management

CMS’ Medicare-Medicaid Coordination Office recently announced an upcoming webinar that will examine how traditional silos of care impede comprehensive approaches to care coordination and explore potential solutions to improve behavioral health condition management in persons with intellectual and developmental disabilities.

Presenters include Andrea Witwer, Ph.D., associate clinical professor in psychiatry and behavioral health at Ohio State; family caregiver Patricia Nobbie, Ph.D.; and Olivia Ayers, LMCH, LPC, clinical director at Elevate Certified Community Behavioral Health Clinic in Iowa.

The 90-minute webinar will be held on Wednesday, Sept. 27 starting at 2:30 p.m. ET. Click here to learn more and to register.

Deadline Extended! 2023 NABH Membership Directory Updates Are Due Sept. 27

NABH has extended the deadline for system members to submit changes about their organizations for the 2023 NABH Directory to Wednesday, Sept.27.

NABH’s online-only 2023 Membership Directory is an essential member benefit that helps the association advance its advocacy efforts. Last month NABH sent system members 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 verify your system’s information.

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 to help provide NABH with an accurate picture of our membership.

If you need assistance, please contact Maria Merlie maria@nabh.org or 202-393-6700, ext. 104.

Reminder: Please Submit Your Managed Care Denials Data to Support NABH Advocacy

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:

Recent research found that, overall, people with mental health conditions seemed to have an elevated risk of heat-related death. This was even more severe for people with schizophrenia: a 200% increase compared with typical summers.

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

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CEO Update 153

CMS Announces AHEAD Model to Improve Overall Health of State Population

The Centers for Medicare & Medicaid Services on Thursday unveiled its States Advancing All-Payer Health Equity Approaches and Development (AHEAD) model to better address chronic disease, behavioral health, and other medical conditions among state populations.

CMS said the new approach is intended to help participating states be better equipped to promote health equity, increase access to primary care services, set healthcare expenditures on a more sustainable trajectory, and lower healthcare costs for patients.
 
AHEAD also includes specific payment models for participating hospitals and primary care practices as a tool to achieve the model’s goals. Through AHEAD, CMS said it aims to strengthen primary care, improve care coordination for people with Medicare and Medicaid, and increase screening and referrals to community resources such as housing and transportation to address social drivers of health.

CMS will issue awards to up to eight states, and each selected state will have an opportunity to receive up to $12 million from CMS to support state implementation. The agency said states interested in participating in the model may apply during two different application periods and elect to participate in one of three cohorts with staggered start dates and performance years.
CMS will release the Notice of Funding Opportunity, which includes the specific application requirements, in the late fall.

CMS Releases Request for Applications for New ‘Making Care Primary’ Model

CMS also announced it is now accepting applications for its recently introduced voluntary Making Care Primary, or MCP, model.

Launching on July 1, 2024, the 10.5-year model will be tested in eight states – Colorado, North Carolina, New Jersey, New Mexico, New York, Minnesota, Massachusetts, and Washington – and is meant to give primary care clinicians the tools they need to form partnerships with healthcare specialists and leverage community-based connections to address patients’ needs.

“This model will attempt to strengthen coordination between patients’ primary care clinicians, specialists, social service providers, and behavioral health clinicians, ultimately leading to chronic disease prevention, fewer emergency room visits, and better health outcomes,” CMS said in its announcement about accepting applications.

CMS also said its new MCP care approach communicates the agency’s vision for three domains: care management, care integration, and community engagement. For the second domain of care integration, CMS said participants will strengthen their connections with specialty care clinicians while using “evidence based behavioral health screening and evaluation to improve patient care and coordination.”

CMS will accept applications through Thursday, Nov. 30, 2023 by 11:59 p.m. ET. Click here for more details and eligibility requirements.

Cassidy Seeks Information to Improve Americans’ Health Data Privacy

Senate Health, Education, Labor, and Pensions (HELP) Committee Ranking Member Sen. Bill Cassidy, M.D. (R-La.) on Thursday announced he’s seeking information from stakeholders about ways to improve the privacy protections of health data in a way that safeguards sensitive information while balancing the need to support medical research.

According to a Senate HELP Committee announcement, Cassidy, an NABH Champion, hopes to use the stakeholder feedback to identify solutions to modernize HIPAA and ensure that all health data are safeguarded properly.

The deadline to submit feedback is Thursday, Sept. 28. Click here to read Cassidy’s full request and here to submit comments.       

CMS Announces Webinar on Person-Centered Approaches to Improving Behavioral Health Condition Management

CMS’ Medicare-Medicaid Coordination Office this week announced an upcoming webinar that will examine how traditional silos of care impede comprehensive approaches to care coordination and explore potential solutions to improve behavioral health condition management in persons with intellectual and developmental disabilities.

Presenters include Andrea Witwer, Ph.D., associate clinical professor in psychiatry and behavioral health at Ohio State; family caregiver Patricia Nobbie, Ph.D.; and Olivia Ayers, LMCH, LPC, clinical director at Elevate Certified Community Behavioral Health Clinic in Iowa.

The 90-minute webinar will be held on Wednesday, Sept. 27 starting at 2:30 p.m. ET. Click here to learn more and to register.

2023 NABH Membership Directory Update Deadline is Next Week!

The deadline for NABH system members to submit changes about their organizations for the 2023 NABH Directory is Wednesday, Sept. 13.

NABH’s online-only 2023 Membership Directory is an essential member benefit that helps the association advance its advocacy efforts. Last month NABH sent system members 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 verify your system’s information.

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 to help provide NABH with an accurate picture of our membership.

If you need assistance, please contact Maria Merlie maria@nabh.org or 202-393-6700, ext. 104.

Reminder: Please Submit Your Managed Care Denials Data to Support NABH Advocacy

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:

Of people appointed to HHS between 2004 and 2020, about one-third (32%) left for positions in industry, according to a comprehensive Health Affairs study of the “revolving door” in healthcare regulation. Axios, Becker’s Hospital Review, and Fierce Healthcare were among the news outlets that reported on the findings, which raise questions about the potential conflict-of-interest risks between industry and the federal department that regulates it.

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

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CEO Update 152

Biden Highlights Parity in National Recovery Month Proclamation

Today kicks off National Recovery Month, a nationwide observance every September since 1989 to promote and support new evidence-based treatment and recovery practices, the nation’s recovery community, and the dedication of service providers and communities who make recovery in all its forms possible.

In his proclamation on the annual observance, President Biden noted that drug overdoses last year took more than 100,000 American lives and that addressing the country’s substance use disorder (SUD) crisis is a core pillar of his Unity Agenda.

“That work starts by fulfilling the promise of true parity for mental health and substance use disorder treatment for all Americans,” Biden said in the proclamation. “Mental health and substance use disorder care is healthcare.  It is essential to people’s well-being — to their ability to lead full and productive lives, to find joy and meaning, to take care of themselves and their loved ones, and to give back to their communities and our nation,” he continued. “It is about dignity. Health insurers should cover it the same way they would cover treatment for a broken bone or any other kind of health condition.  And since I took office, that is what we have been fighting to do.”

Click here to access the Substance Abuse and Mental Health Services Administration (SAMHSA) National Recovery Month toolkit.

And please remember to follow NABH @NABHBehavioral and on LinkedIn at the National Association for Behavioral Healthcare to read and share our social media posts about National Recovery Month.

Appellate Court Vacates Earlier Ruling in Wit v. UBH Case

A three-judge panel in the 9th U.S. Circuit Court of Appeals last week vacated its prior holdings in the ongoing Wit v. United Behavioral Health (UBH) case for the second time and issued this opinion.

NABH consultant Meiram Bendat, JD, Ph.D, founder and president of Psych Appeal, summarized the decision: “Essentially, the appellate court affirmed the trial court’s findings that UBH’s medical necessity guidelines were inconsistent with generally accepted standards of care (GASC), but also held that the trial court erred in holding that UBH’s plans required it to cover all services consistent with GASC,” Bendat wrote, adding, “The appellate court affirmed the trial court’s class certification order to allow the classes to pursue their breach of fiduciary duty claim. The trial court findings that UBH violated the laws of jurisdictions requiring the use of state-mandated criteria also remain undisturbed,” he continued. “The appellate court also walked away from its previous holdings that remand is not an available remedy under ERISA and that all absent class members must exhaust their administrative remedies prior to pursuing their claims in court.”
 
Bendat added that—absent another petition for review—the case will be sent back to the trial court, which will likely again clarify that it based UBH’s liability on UBH’s deviation from GASC in its medical necessity guidelines, which were intended to implement the GASC requirement in the plans. The trial court is also expected to answer several other questions the 9th Circuit posed.

“In short, plaintiffs are now in a far better position than they were last year,” Bendat wrote. “Hopefully, folks can appreciate how important it is to have laws like SB 855, which require medical necessity to be made consistent with GASC and which don’t vest plan administrators with discretion to adopt self-serving clinical guidelines with which to deny claims.”

HRSA Announces More than $80 Million in Funding for Rural Communities to Combat Opioid Crisis

HHS’ Health Resources and Services Administration (HRSA) announced Thursday more than $80 million in awards to rural communities in 39 states to support key strategies that respond to the overdose risk from fentanyl and other opioids.

HRSA funding will support interventions such as distributing the lifesaving overdose reversal drug naloxone to prevent overdose; creating and expanding treatment sites in rural areas to provide medications to treat opioid use disorder; expanding access to behavioral health care for young people in rural communities; and, caring for infants in rural areas who are at-risk for opioid exposure or experiencing symptoms related to opioid exposure.

Click here to learn more and here to see the list of awardees.

SAMHSA Awards $57.6 Million to Connect Americans with Substance Use Recovery and Treatment Supports

As part of Overdose Awareness Week and the start of National Recovery Month, SAMHSA this week announced $57.6 million in seven grant programs to connect Americans who misuse substances to recovery and treatment supports.

According to SAMHSA, the grant awards facilitate ongoing efforts throughout the nation in treatment, recovery support and harm reduction – three of the pillars of the HHS’ Overdose Prevention Strategy.

Click here to read about the grant programs.

SAMHSA Releases Guide for Reentry from Criminal Justice Settings for People with Mental Health Conditions and SUD

SAMHSA has released Best Practices for Successful Reentry From Criminal Justice Settings for People Living With Mental Health Conditions and/or Substance Use Disorders, which examines the types of interventions that support successful reentry for adults with mental health conditions and/or substance use disorders who are leaving jail/prison.

The 85-page guide includes an issue brief on the topic, current evidence on three interventions, guidance for identifying and implementing evidence-based practices to support reentry, and more.

Manatt to Examine Latest Wit v. UBH Ruling in Mental Health Parity Webinar 

Manatt litigation and benefits experts will discuss a host of parity issues in an upcoming webinar, including the latest federal report to Congress, action items for health plans and service providers, and the latest decision in the Wit v. UBH case.
 
Presenters will include Manatt partners Joe Laska and Harvey Rochman, as well as
Jean Kim, special counsel, executive compensation and employee benefits. The hourlong webinar will take place Tuesday, Sept. 19 at 1 p.m. ET.
 
Click here to register.

Please Update Your Member Information for the 2023 NABH Membership Directory! 

NABH is developing its online-only 2023 Membership Directory, an essential member benefit that helps the association in its advocacy efforts.

NABH has sent members 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 verify your system’s information.

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 membership.

The deadline to submit your changes to NABH is Wednesday, Sept. 13. If you need assistance, please contact Maria Merlie maria@nabh.org or 202-393-6700, ext. 104.

As always, thank you for your time and for all you do to advance NABH’s Mission and Vision!

Reminder: Please Submit Your Managed Care Denials Data to Enhance NABH Advocacy

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:

This summer Texas lawmakers enacted Tucker’s Law. which mandates that middle schools and high schools educate students about fentanyl abuse prevention and drug-poisoning awareness.

NABH wishes its members, their teams, and families a happy and safe Labor Day weekend!

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

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CEO Update 151

Please Update Your Member Information for the 2023 NABH Membership Directory!

NABH is developing its online-only 2023 Membership Directory, an essential member benefit that helps the association in its advocacy efforts.

Earlier this week NABH sent members 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 verify your system’s information.

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 membership.

The deadline to submit your changes to NABH is Wednesday, Sept. 13. If you need assistance, please contact Maria Merlie maria@nabh.org or 202-393-6700, ext. 104.

As always, thank you for your time and for all you do to advance NABH’s Mission and Vision!

NABH Board Members Comment On SAMHSA’s 2023-2026 Strategic Plan

NABH Board Chair Harsh Trivedi, M.D., M.B.A. this week commented on behalf of the association about the Substance Abuse and Mental Health Services Administration’s (SAMHSA) 2023-2026 Strategic Plan.
 
Released last week, the plan presents a new person-centered mission and vision and identifies the following five priority areas to better meet the behavioral health needs of individuals, communities, and service providers: Preventing Substance Use and Overdose, Enhancing Access to Suicide Prevention and Mental Health Services, Promoting Resilience and Emotional Health for Children, Youth and Families, Integrating Behavioral and Physical Health Care, and Strengthening the Behavioral Health Workforce.

In a Behavioral Health Business article published Aug. 23, NABH Board Chair Trivedi supported the plan and emphasized access, behavioral-physical healthcare integration, and preventing substance use and overdose.

“Substance use is a chronic disease. We do not penalize people when their blood sugar goes out of whack or when their blood pressure goes a little too high,” said Trivedi, president and CEO of Sheppard Pratt. “We really do have to think about substance use in a different manner, which is that it’s going to be something that people battle over time. We can’t let a slip up mean that you, essentially, are out of treatment, which is exactly what you wouldn’t do for any other medical condition.”

NABH board member David White, Ph.D., CEO of BayMark Health Services in Lewisville, Texas, was also interviewed for the article and noted that the behavioral healthcare industry needs to see a comprehensive implementation plan.

“This agenda is huge, complex, and high-level,” White said. “The strategy, in most cases, is spot on, but it’s a very heavy lift for the execution phase and requires lots of great people with great abilities to impact each and every area in the way outlined.”

National Quality Forum to Join Joint Commission as An Affiliate

The Joint Commission and National Quality Forum (NQF) announced on Aug. 16 that NQF will join The Joint Commission enterprise, maintaining its independence in convening and developing consensus-based measures, implementation guidance, and practices that benefit all stakeholders.

The organizations said in an announcement that the affiliation allows The Joint Commission and NQF to build upon their shared expertise in measuring quality and rationalizing the measurement landscape so the focus shifts from competing measures to advancing key outcomes.

In addition, the affiliation is intended to strengthen The Joint Commission’s national and international accreditation and certification processes to be more evidence-based, data-driven, and outcomes-oriented.

Cigna Removes Prior Authorization Requirement for 25% of Medical Services

Cigna Healthcare on Thursday announced it would remove nearly 25% of medical services from prior authorization (or precertification) requirements.

With the removal of these more than 600 additional codes, Cigna Healthcare has now removed prior authorization on more than 1,100 medical services since 2020, with the goal of simplifying the healthcare experience for both customers and clinicians, Cigna said in an announcement.

More information about Cigna Healthcare’s approach to prior authorizations is available here.

Health Affairs: Five Urgent Steps to Address Violence Against Nurses in the Workplace

An Op-Ed published in the journal Health Affairs this week outlined five specific steps to address violence against nurses in the workplace, starting with enacting federal legislation to address workplace violence in healthcare, social service, and other sectors.

Seven authors collaborated on the opinion piece, including several nursing school professors and one psychiatric mental health nurse practitioner at the University of New Mexico College of Nursing.

“We write today, as psychiatric mental health nurses and workplace violence and nursing workforce researchers, to express our alarm: Our nurse colleagues aren’t safe at the bedside,” the authors wrote. “The American Psychiatric Nurses Association reports that fewer than two-thirds of nurses report feeling either safe or very safe at work. As nurses reported in last year in the National Plan for Health Workforce Well Being, violent injury of nursing staff by patients results in nurses’ short- and long-term disability, psychological stress, post-traumatic stress disorder, burnout, reduced quality of care, errors, and accidents.”

In addition to federal legislation, other steps to address the issue include: emphasizing quality indicators that elevate efforts to protect staff from harm; strengthening data systems to better monitor worker exposure to aggressive events; improving reporting of workplace violence; and holding educational institutions accountable for teaching about quality and safety standards that protect nurses and staff from injury.

DEA and FDA Issue Joint Letter to the Public on Actions to Address Shortages in Prescription Stimulants

Earlier this month the Drug Enforcement Administration (DEA) and U.S. Food and Drug Administration (FDA) issued a joint letter updating the public about the ongoing prescription stimulant shortages affecting patients nationwide and actions to resolve these shortages.
The DEA and FDA said both agencies are committed to working together on this issue and providing up-to-date information to the public.

“The FDA and DEA do not manufacture drugs and cannot require a pharmaceutical company to make a drug, make more of a drug, or change the distribution of a drug,” FDA Commissioner Robert Califf, M.D. and DEA Administrator Anne Milgram wrote in the letter to the public. “That said, we are working closely with numerous manufacturers, agencies, and others in the supply chain to understand, prevent, and reduce the impact of these shortages.
Click here to read the full letter.

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:

Half of parents say their child’s emotional and physical health has improved over the past year, according to a new Harris poll. Meanwhile, half also say their schools provide neither academic nor mental health counseling.

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

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CEO Update 150

Federal Lawmakers Introduce Bipartisan Behavioral Health IT Legislation

Reps. Doris Matsui (D-Calif.) and Bill Johnson (R-Ohio) and Sens. Markwayne Mullin (R-Okla.) and Catherine Cortez Masto (D-Nev.) recently introduced the Behavioral Health Information Technology (BHIT) Coordination Act to improve coordination of mental and physical healthcare by supporting behavioral healthcare providers’ efforts to adopt health IT systems.
                                 
NABH is proud to support the BHIT Coordination Act, which:

  • Provides $20 million a year in grant funding over five fiscal years (FY25-29) to finance behavioral health IT adoption through the Office of the National Coordinator for Health Information Technology (ONC).
  • Requires a report to Congress on the number and type of behavioral healthcare providers that receive the grant, their ability to electronically exchange patient health information with other provider types, and clinical and non-clinical outcomes for patients.
  • Directs ONC and the Substance Abuse and Mental Health Services Administration (SAMHSA) to develop voluntary behavioral health IT standards.
  • Directs the Centers for Medicare & Medicaid Services (CMS), SAMHSA, and ONC to develop joint guidance on how states can use Medicaid authorities and funding sources to promote the adoption and interoperability of certified Electronic Health Record (EHR) technology for behavioral health providers.

“Robust, interoperable EHRs are a core clinical and operational tool to expand coordinated, high-quality care – and now we must ensure that all of our behavioral health providers have access to these vital IT systems,” Rep. Matsui said in an announcement about the bill. “Despite widespread recognition of the value of health IT, behavioral health providers do not have the resources to utilize these tools,” she added. “The Behavioral Health IT Coordination Act will bridge this gap and ensure we invest the necessary resources for widespread adoption throughout the behavioral health community.”

Rep. Matsui originally co-authored H.R. 3331, a bill to promote testing of incentive payments for behavioral healthcare providers to adopt and use certified electronic health record technology. In 2018, Congress included this legislation as Section 6001 of the SUPPORT Act. The BHIT Coordination Act seeks dedicated funding to fulfill the objectives of her previous efforts.

DEA Revises Existing Regulations to Expand Access to OUD Treatment Medication

The U.S. Drug Enforcement Administration (DEA) this week issued a final rule pursuant to the Easy Medication Access and Treatment of Opioid Addiction Act (the Act) that revises existing regulations to expand access to medications for Opioid Use Disorder (OUD).

The Act directed DEA to revise its regulation to allow practitioners to dispense not more than a three-day supply of narcotic drugs to one person for one person’s use at one time to initiate maintenance treatment, detoxification treatment, or both.

SAMHSA Report Highlights Cost and Financing Strategies for Coordinated Specialty Care for First- Episode Psychosis

SAMHSA has released Coordinated Specialty Care for First Episode Psychosis: Costs and Financing Strategies, which offers states financing strategies to provide critical services for first-episode psychosis.

SAMHSA estimates 100,000 people in the United States experience first-episode psychosis. Coordinated Specialty Care, or CSC, is a multi-component, evidence-based, early intervention service for individuals experiencing a first episode of psychosis who can improve their quality of life and social and clinical outcomes.

The new report provides an overview of the costs and outcomes of providing services for first episode psychosis and strategies for financing the services in different states.

FDA Recommends Minimum of Six Months for Pivotal OUD Device Trials

The U.S. Food and Drug Administration (FDA) has released guidance cautioning device makers developing products to treat OUD to proceed carefully as they design clinical studies, recommending pivotal trials last at least six months.

“Appropriate study duration is necessary because OUD is a condition with a high rate of relapse, and brief intervals of modification of drug use are unlikely to confer significant clinical benefit,” the guidance noted.

FDA Commissioner Robert Califf, M.D. said in a statement that the guidance should prompt industry to collect more comprehensive, timely, and diverse data to support device submissions that may help improve the lives of those with OUD.

“These and similar efforts will continue to advance within the agency, with the input from industry, stakeholders, and, most importantly, those managing opioid use disorder,” Califf added.

Public comments about the guidance are due by Thursday, Oct. 26.

Biotech Company Cessation to Initiate U.S. Clinical Trial for Drug to Prevent Fentanyl Overdose

Clinical-stage biotechnology company Cessation has announced the FDA has authorized the Chapel Hill, N.C.-based company to initiate a clinical trial this month for CSX-1004, a monoclonal antibody designed specifically to prevent fentanyl overdose.

The clearance follows the FDA’s review and approval of Cessation’s Investigational New Drug (IND) application and serves as a launching point for Cessation’s first in-human clinical trials, according to the company’s announcement. Cessation’s IND summarized years of the company’s safety and manufacturing data and included a detailed description of the planned clinical study in humans.
 
Cessation’s announcement said CSX-1004 works by sequestering fentanyl molecules as they enter the bloodstream, effectively neutralizing them in the blood before they reach the brain and preventing them from exerting their harmful effects.

Reminder: 2023 NABH Annual Meeting Photos Now Available

NABH is pleased to share photos from the 2023 Annual Meeting: Security the Promise of Parity.
If you choose to download and use a photo, please credit photographer Chris Ferenzi. Thank you.

Click here to learn more about the training.

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.

CEO Update During the Congressional August Recess

NABH will publish CEO Update only on Friday, Aug. 11 and Friday, Aug. 25 during the congressional August recess.

Fact of the Week:

A recent study published in Neuropharmacology suggests that central Ghrelin receptors (GHSR) mediate binge-like alcohol intake. These data reveal novel pharmacological compounds with translational potential in the treatment of alcohol use disorder (AUD) and provide further evidence of the GHSR as a potential treatment target for AUD, the study noted. The National Institute on Drug Abuse and the National Institute on Alcohol Abuse and Alcoholism published the study.

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

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CEO Update 149

CMS Releases FY 2024 IPF PPS Final Rule

The Centers for Medicare & Medicaid Services (CMS) on Thursday released its Fiscal Year (FY) 2024 Inpatient Psychiatric Facility Prospective Payment System (IPF PPS) final rule.
 
NABH’s Position

While the final rule includes many NABH priorities, we remain concerned that it does not go far enough to account for the cost pressures IPFs face. The NABH team will meet with CMS to discuss the field’s health information technology and other obstacles that will greatly hinder compliance with the quality measures (QMs) to be added to the inpatient psychiatric facility quality reporting program (IPFQRP).
 
Final Payment Update

The rule finalizes a net increase in Medicare FY 2024 payments to IPFs of 2.3%, or $70 million, relative to FY 2023. While the agency’s final FY 2023 payment update is larger than the proposed rule’s 1.9% increase, NABH will continue to push policymakers to recognize fully the high costs that our members face. The FY 2024 update includes increases in the federal per-diem base rate to $895.63 from $865.63, and in the outlier threshold to $33,470 from $24,630, which will reduce the number of cases that qualify for an outlier payment.

Updated IPF Marketbasket:

The rule also finalizes CMS’ proposal to rebase and revise the IPF marketbasket using more recent cost report data from 2021 in place of 2016 data.

Streamlined Process for Opening New IPF Units:

The rule will allow new IPF units to open and begin billing Medicare at any time during its cost reporting year, following a 30-day advance notice.

Final Updates to IPFQRP              

The final rule implements four new QMs and a data validation pilot, among other changes. The new QMs include these three QMs related to health equity and social drivers of health:

  • A Facility Commitment to Health Equity measure, which providers will begin reporting in FY 2026 and will affect payments;
  • A Screening for Social Drivers of Health (SDOH) measure, for which voluntary reporting will begin in FY 2025 and later will affect payments; and
  • A Screen Positive Rate for SDOH measure beginning with voluntary reporting of CY 2024 data with impact on payment to begin in FY 2027.

The new data validation pilot program will begin data collection in FY 2025. While NABH supported the general concept of this pilot, we urged CMS to postpone it because the field is currently focused on its first year of submitting patient-level quality data. Because the agency is moving forward, we will continue to emphasize that the pilot is too much, too fast.

More information on these IPFQRP updates can be found in the NABH comment letter on this rule, as well as the final rule text using the link above.

HHS, DOL and Treasury Release Proposed Rules to Strengthen MHPAEA

The U.S. Health and Human Services (HHS), Labor (DOL), and Treasury Departments on Tuesday released proposed rules to bolster the Mental Health Parity and Addiction Equity Act (MHPAEA) of 2008 and remove obstacles to behavioral healthcare access.
 
The rules propose several amendments to the 2013 MHPAEA final regulations, as well as provisions that would establish the content requirements of the Non-Qualitative Treatment Limitations, or NQTL, comparative analyses required under amendments to MHPAEA included in the Consolidated Appropriations Act, 2021 (CAA, 2021).

“In evaluating their compliance with these proposed rules, plans and issuers would be required to consider whether an NQTL is inhibiting access to treatment for mental health conditions and substance use disorders by examining whether the NQTL that applies to mental health or substance use disorder benefits is more restrictive than the predominant NQTL that applies to substantially all medical/surgical benefits within a classification of benefits set forth under the regulations,” the guidance noted.

Meanwhile, the guidance said a plan or issuer would also be required to consider whether the processes, strategies, evidentiary standards, or other factors that it uses to design or apply an NQTL to mental health or substance use disorder benefits in a classification are comparable to, and applied no more stringently than, those used in designing and applying the NQTL to medical/surgical benefits in the same classification.
 
The three departments also released a Technical Release on NQTLs that outlines principles and seeks public comment to inform future technical guidance about the application of proposed data collection and evaluation requirements to NQTLs related to network composition that the rule proposes.

Along with the proposed rules, the departments released the 2023 MHPAEA Comparative Analysis Report to Congress that the CAA, 2021 requires. The report includes information about the agencies’ enforcement efforts and identifies plans and issuers that received final determinations of non-compliance with MHPAEA.

The White House released a fact sheet about the rule and DOL’s Employee Benefits Security Administration posted all the related documents here.

NABH is a member of the CEO Alliance on Mental Health, which released a statement about the guidance this week.

“The Biden Administration, along with bipartisan leadership in Congress, has made great progress in increasing access to comprehensive mental health and substance use care, including expanding the Certified Community Behavioral Health Clinic (CCBHC) model, improving crisis services and suicide prevention, and addressing youth mental health,” the Alliance statement said. “However, more work is needed to ensure everyone can access high quality care as early as possible, so we thank President Biden for this focus on improving parity.”
CMS will accept comments until 60 days after the rules are published in the Federal Register. NABH will seek feedback from members and submit comments about the proposed rules and Technical Release.

CMS Releases Ligature Risk Guidance

CMS has released guidance to state survey directors about ligature risk and assessment in hospitals.

The agency’s guidance centers around three main elements CMS said hospitals should consider when ensuring patient safety related to ligature risk: patient assessment, staffing/monitoring, and environmental risk.

“Based on their clinical evaluation, some patients may require both a more restrictive environment and an increased level of monitoring than other patients,” the guidance noted. “Therefore, it is not expected that hospitals have the same ligature risk configuration throughout their facility, but rather focus on the specific needs and risks of individual patients, based on their clinical or psychiatric assessment,” it continued. “Similarly, corrective actions implemented in response to deficiencies or adverse events should focus on appropriately addressing the findings or failures, rather than universal remedies.”

The changes are effective 30 days from when CMS released the memorandum on July 17. Please send any questions to QSOG_Hospital@cms.hhs.gov.

Reminder: DEA Registration Training Requirement for Buprenorphine Prescribing

Early this year SAMSHA announced that clinicians no longer need a federal waiver to prescribe buprenorphine to treat opioid use disorder; however, clinicians must still register with the U.S. Drug Enforcement Agency (DEA) to prescribe controlled medications.

In late June, the DEA announced that both new and renewing applicants must complete a new, one-time, eight-hour training course. Exceptions for the training requirement are practitioners who are board-certified in addiction medicine or addiction psychiatry, and those who graduated from a medical, dental, physician assistant, or advanced practice nursing school in the United States within five years of June 27, 2023.

Click here to learn more about the training.

2023 NABH Annual Meeting Photos Now Available

NABH is pleased to share photos from last month’s 2023 Annual Meeting: Security the Promise of Parity.

If you choose to download and use a photo, please credit photographer Chris Ferenzi. Thank you.

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.

CEO Update During the Congressional August Recess

NABH will publish CEO Update only on Friday, Aug. 11 and Friday, Aug. 28 during the congressional August recess.

Fact of the Week:

A new study published in Psychiatric Services reports disruptions in opioid use disorder outpatient and medications for opioid use disorder were marginal during the pandemic, possibly because of increased telehealth services.

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

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CEO Update 148

House Energy and Commerce Committee Passes SUPPORT Act Reauthorization Bill

The House Energy and Commerce Committee this week voted unanimously to pass the SUPPORT for Patients and Communities Reauthorization Act (SUPPORT), which would renew programs from the 2018 law that would otherwise expire at the end of September.
 
Today’s SUPPORT Act reauthorization includes a number of key bipartisan wins, including agreements on lifting the IMD exclusion, helping people in our criminal justice system, and caring for foster youth in need,” House Energy and Commerce Committee Chair Cathy McMorris Rodgers said in a statement after the committee passed the bill on Wednesday.

Rep. Michael Burgess, M.D. (R-Texas) sponsored a bill included in the reauthorization act to remove the decades-old Institutions for Mental Diseases (IMD) exclusion.

“It is no longer the 1960s and there is no longer the same stigma against the treatment of mental health,” Burgess told the news outlet Politico. Burgess also pushed for boosting the healthcare workforce and supporting providers “to ensure that mental health and substance use patients have access to personalized care, personalized medicine.”

The legislation also includes a provision that would allow federal funding to pay for test strips that can detect drugs such as fentanyl and the animal tranquilizer xylazine that drug dealers often mix with it.

House lawmakers could vote on the measure before they leave Washington for Congress’ August recess. NABH will keep members apprised of developments.

Becerra to Host 988 Stakeholder Webinar Today at 1 p.m. ET

U.S. Health and Human Services Department (HHS) Secretary Xavier Becerra and Substance Abuse and Mental Health Services Administration (SAMHSA) Assistant Secretary Miriam Delphin-Rittmon will host a 988 Lifeline anniversary stakeholder webinar today, Friday, July 21 at 1 p.m. ET.

Other Biden administration officials will join the event, which commemorates one year since the 988 Suicide and Crisis Lifeline launched.

The webinar will last 30 minutes. Click here to register.

NABH Supports Bowman Family Foundation Report on Equitable Access

NABH supports the Bowman Family Foundation’s new report, Equitable Access to Mental Health and Substance Use Care: An Urgent Need, which examines strategies for bridging the gap in access to mental health and substance use care.

The 33-page report found that 57% of patients sought mental health or substance use care but did not receive any care in at least one case, compared with 32% of patients seeking physical healthcare. For children and teens under 18 (defined here as “adolescents”), the “care not received” figure was 69% for mental health or substance use compared with 17% for physical health (see Figure 2 on p. 11 of the report).

Meanwhile, 80% of patients in employer-sponsored health plans who received outpatient care from at least one out-of-network mental health or substance use provider said they went to out-of-network providers “all of the time,” compared with 6% of patients who said the same for physical healthcare.

NABH strongly supports the report’s recommendation for the Departments of Labor, Health and Human Services, and the Treasury to issue additional guidance on detailed templates for MHPAEA compliance data reporting to employer group plans, third party administrators, and insurance issuers that indicates what data they should be prepared to submit upon request.

SAMHSA Seeking Comments on Harm Reduction Framework Draft

SAMHSA is seeking public comment on a draft of the agency’s Harm Reduction Framework, which is intended to inform SAMHSA’s harm-reduction activities as well as all related policies, programs, and practices.

Comments are due by Monday, Aug. 14 at 5 p.m. ET.

SAMHSA Releases Advisory on Digital Therapeutics in Behavioral Health

SAMHSA this week released Digital Therapeutics for Management and Treatment in Behavioral Health, which describes the research, regulatory, and reimbursement implications for digital therapeutics, including those by various federal agencies.

The advisory also maps out selection and implementation considerations for payers and providers and addresses issues related to equitable access to behavioral healthcare.

Kaiser Family Foundation Examines Federal Policy for SUD Treatment

A new Kaiser Family Foundation analysis found that 24% more buprenorphine was dispensed in 2022 than in 2019, the year before the COVID-19 global pandemic.

Health policy researchers examined five essential federal policies governing SUD treatment, the changes they have undergone during the pandemic, and the implications for access and treatment to opioid use disorder.

Click here to read the brief analysis.

Reminder: DEA Registration Training Requirement for Buprenorphine Prescribing

Early this year SAMSHA announced that clinicians no longer need a federal waiver to prescribe buprenorphine to treat opioid use disorder; however, clinicians must still register with the U.S. Drug Enforcement Agency (DEA) to prescribe controlled medications.

In late June, the DEA announced that both new and renewing applicants must complete a new, one-time, eight-hour training course. Exceptions for the training requirement are practitioners who are board-certified in addiction medicine or addiction psychiatry, and those who graduated from a medical, dental, physician assistant, or advanced practice nursing school in the United States within five years of June 27, 2023.

Click here to learn more about the training.

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

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:

A new report from the HHS Office of the Inspector General found three factors that raise concerns that some people enrolled in Medicaid managed care may not be receiving all medically necessary healthcare services intended to be covered: (1) the high number and rates of denied prior authorization requests by some managed care organizations, (2) the limited oversight of prior authorization denials in most states, and 3) the limited access to external medical reviews.

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

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CEO Update 147

CMS Proposes to Expand Behavioral Healthcare Access in 2024 OPPS Rule

The Centers for Medicare & Medicaid Services (CMS) on Friday proposed expanding access to behavioral healthcare services through coverage of intensive outpatient services.
 
Currently, Medicare covers and pays for various behavioral healthcare services, including inpatient psychiatric hospitalizations, partial hospitalizations services, and outpatient therapeutic services; however, there is a gap in coverage when Medicare beneficiaries require levels of services more frequent than individual outpatient therapy visits, but less intensive than a partial hospitalization program.

The agency’s 2024 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System Proposed Rule includes proposals to implement provisions of the Consolidated Appropriations Act, 2023 (CAA, 2023) that created a new benefit category for Intensive Outpatient Program (IOP) services. CMS proposed to establish payment and program requirements for the benefit across various settings, including hospital outpatient departments, Community Mental Health Centers (CMHCs), Federally Qualified Health Centers (FQHCs), and Rural Health Clinics (RHCs) effective Jan. 1, 2024.

CMS also proposed to establish payment for IOP services provided by Opioid Treatment Programs (OTPs) effective Jan. 1, 2024, and is clarifying that these intensive behavioral healthcare services are available for individuals with mental health conditions and for individuals with substance use disorders.

“This proposed rule reflects CMS’ commitment to ensure Medicare is comprehensive in its ability to address patient needs, filling gaps in the health care system including behavioral health,” Meena Seshamani, M.D., deputy administrator and director for CMS’ Center for Medicare, said in a news release. “Through these proposals, we will ensure people get timely access to quality care in their communities, leading to improved outcomes and better health.”

CMS provided the following details about the scope of benefits for IOP and its proposals for each setting:

Scope of Benefits for IOP:

CMS proposed a scope of benefits for IOP services that the CAA, 2023 mandates. The agency noted an IOP is a distinct and organized outpatient program of psychiatric services provided for individuals who have an acute mental illness or substance use disorder, consisting of a specified group of behavioral healthcare services paid on a per-diem basis under the OPPS or other applicable payment system when furnished in hospital outpatient departments, CMHCs, FQHCs and RHCs. CMS proposed to base the per-diem costs of items and services included in IOP that have been, and are, paid for by Medicare either as part of the PHP benefit or under the OPPS more generally.

Physician Certification and Plan of Treatment Requirements for IOP:

The CAA, 2023 requires that a physician determine that each patient needs a minimum of nine hours of IOP services per week, and this determination must occur no less frequently than every other month. CMS proposes to codify this requirement in regulation for IOP provided in all settings and is soliciting comments on the recertification period.

IOP Payment Rates and Policy in Hospital Outpatient Departments and CMHCs:

CMS proposed to establish two IOP ambulatory payment classifications for each provider type: one for days with three services per day and one for days with four or more services per day.

For CY 2024, CMS proposed to calculate hospital-based and CMHC IOP payment rates for three services per day and four or more services per day based on cost per day using a broader set of OPPS data that includes PHP days and non-PHP days.

CMS noted that while no Medicare IOP benefit currently exists, the agency believes using the broader OPPS data set would allow us to capture data from hospital claims that are not identified as IOP, but that include the service codes and intensity required for an IOP day.

Opioid Treatment Program (OTP) Settings:

CMS proposed to extend IOP coverage to include OTPs. The agency also proposed to establish a weekly payment adjustment via an add-on code for IOP services furnished by OTPs for the treatment of opioid use disorder (OUD) and to revise the definition of OUD treatment services to include IOP services.

The payment adjustment would also be updated based on the Medicare Economic Index and receive the Geographic Adjustment Factor if finalized. CMS proposed that Medicare would pay for IOP services that OTPs provide as long as each service is medically reasonable and necessary, and not duplicative of any service paid for under any bundled payments billed for an episode of care in a given week.

For an OTP to receive the additional payment adjustment for IOP services, a physician must certify that the beneficiary requires a higher level of care intensity compared to existing OTP services, and the certification, plan of care, and all other applicable requirements are met. CMS said it believes that payment for IOP services that OTPs provide would improve continuity of care between different treatment settings and levels of care, expand access to treatment for Medicare beneficiaries with an OUD and further promote health equity for racial/ethnic populations and older beneficiaries.

RHCs and FQHCs:

For CY 2024, CMS proposed to make conforming regulatory text changes to applicable RHC and FQHC regulations related to the scope of IOP benefits and services, certification and plan of care requirements, and special payment rules for IOP services as the CAA, 2023 mandates.

The scope of IOP benefits and certification and plan of care requirements will be the same for RHCs and FQHCs as described above for hospitals. CMS proposed to pay for three IOP services/day, and according to the statute, payment is based on the hospital rate. This means RHCs would be paid the three-services per day payment amount for hospital outpatient departments.

For FQHCs, payment would be the lesser of a FQHC’s actual charges or the three-services per day payment amount for hospital outpatient departments. For grandfathered tribal FQHCs, payment would be the Medicare outpatient per visit rate as the Indian Health Service has established when furnishing IOP services, and payment is based on the lesser of a grandfathered tribal FQHC’s actual charges or the Medicare outpatient per-visit rate.

Regarding OPPS payment rates, CMS proposed updating OPPS payment rates for hospitals by 2.8%. This update is based on the projected hospital market basket percentage increase of 3.0%, reduced by a 0.2 percentage point for the productivity adjustment.

CMS Includes Behavioral Healthcare Provisions in Proposed 2024 Physician Fee Schedule

CMS on Thursday included a provision to extend OTP periodic assessment flexibilities via audio-only telehealth through the end of 2024 in the agency’s proposed 2024 Physician Fee Schedule rule.

CMS noted it will continue to consider the value of extending this flexibility permanently. For mental healthcare, the agency’s proposed rule included implementing the CAA, 2023’s requirements that marriage and family therapists (MFTs) and mental health counselors (MHCs) can bill through the Medicare program.

The agency also proposed HCPCS codes for crisis psychotherapy services, and proposed permitting Behavior Assessments and Intervention to be performed and billed by clinical social workers, MFTs and MHCs. Increases for timed PFS behavioral health services will be implemented over four years, according to CMS.

988 Suicide & Crisis Line Adds New Services as One-Year Anniversary Approaches

This week the Biden administration announced it has added Spanish text and chat services as well as specialized services for LGBTQI+ youth and young adults to the nation’s 988 Suicide & Crisis Lifeline following a successful pilot test.

This Sunday marks the one-year anniversary of 988’s launch, and the Biden administration reports the Lifeline has answered nearly 5 million contacts in the past year—2 million more than were received in the previous 12 months—following a $1 billion investment from the administration.

Meanwhile, in June the National Alliance on Mental Illness (NAMI) released its 988 Suicide & Crisis Lifeline Tracker that found familiarity with 988 remains low despite increasing overall awareness since it launched last July. NAMI found that 63% of Americans report at least hearing something about 988, up 19% percentage points since September 2022 and up 41 percentage points since May 2022. Still, only 17% of Americans say they are very or somewhat familiar with it, while only 4% say they are very familiar with it.

The study also found Americans 49 and under are more likely than older Americans to report having heard of 988, and LGBTQ+ Americans are twice as likely to say they are familiar with it than non-LGBTQ+ Americans.

White House Releases National Response Plan to Address Emerging Threat of Fentanyl Combined with Xylazine

The White House Office of National Drug Control Policy this week released a national response plan to combat the dangerous and deadly combination of xylazine mixed with fentanyl.

Earlier this year, the Biden administration used its executive designation authority for the first time when it declared xylazine mixed with fentanyl as an emerging threat in the United States.

“Since we announced the emerging drug threat earlier this year, we’ve been working tirelessly to create the best plan of attack to address this dangerous and deadly substance head-on,” Rahul Gupta, M.D., director of the White House Office of National Drug Control Policy (ONDCP), said in an announcement. “Now, with this National Response Plan, we are launching coordinated efforts across all of government to ensure we are using every lever we have to protect public health and public safety and save lives.”

The plan outlines action steps and key responsibilities for departments and agencies across the federal government and directs them to develop and submit an Implementation Report to the White House in 60 days.

As required by statute in the SUPPORT Act and the Criteria for Designating Evolving and Emerging Drug Threats (Dir. No. 2022-002), the national response plan’s goal is to terminate fentanyl combined with xylazine as an emerging threat. This will require a 15% reduction (compared with 2022 as the baseline year) of xylazine positive drug poisoning deaths in at least three of four U.S. census regions by 2025.

NABH Members Highlight Behavioral Health EMR Gap in Health Affairs Commentary

A recent Health Affairs commentary explores the 2009 HITECH Act’s failure to include behavioral healthcare providers in its $19 billion of meaningful use incentives and the resulting lag in electronic medical record (EMR) adoption in the behavioral healthcare segment.

“There was no clear rationale for this exclusion beyond implicit prioritization of physical health over mental health in the competition for funding dollars. And this disparity continues to this day,” wrote the article’s authors William Shrank, M.D., Christopher Hunter, M.B.A., and Andrew Lynch, Ph.D., adding that EMR use has exceeded 95% since 2014 but only 6% of outpatient behavioral healthcare facilities and 29% of substance use disorder treatment centers use EMRs. Shrank is a venture partner at Andreeseen Horowitz; Hunter is CEO at NABH member Acadia Healthcare, and Lynch serves as Acadia’s chief strategy officer.

The article reviews earlier legislative attempts to bridge the EMR gap, including the bill Rep. Doris Matsui (D-Calif.) introduced last year.

Reminder: Provider Relief Fund Reporting Portal Now Open for Period 5

The Health Resources and Services Administration has announced that the Provider Relief Fund (PRF) Reporting Portal is now open for Reporting Period 5.
 
Recipients who received one or more General Distribution, Targeted Distribution, or ARP Rural Distribution payments exceeding $10,000, in the aggregate, from Jan. 1, 2022 to June 30, 2022 are required to report on the use of their payments during Reporting Period 5.

This latest reporting period will close at 11:59 p.m. ET on Sept. 30, 2023. Click here to learn more.

In Case You Missed It: NABH Education & Research Foundation Workforce Resources

If you missed the 2023 Annual Meeting, be sure to access the workforce resources that the NABH Education and Research Foundation featured at the meeting and are available on the Foundation’s Resources page.

First, watch speaker John Pallasch’s presentation and listen to the question-and-answer period from NABH members. Pallasch, founder and CEO of workforce consultancy One Workforce Solutions, served previously as the Senate-confirmed assistant secretary for employment and training at the U.S. Labor Department. Pallasch’s presentation challenged attendees to think beyond recruitment and retention and instead focus on re-designing the U.S. workforce system. He offered practical ideas for how NABH members can get involved in this process.

Also be sure to use the workforce resource guide that the Foundation co-branded with One Workforce Solutions. The guide includes links to state workforce agencies, workforce development boards, and 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 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 estimates that 109,940 people died of an overdose between February 2022 and February 2023, compared with 110,063 people in the same period the previous year. ONDCP cited the seizure of illicit drugs at the nation’s borders and access to naloxone as reasons for the continued flattening in the overdose rate.

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

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CEO Update 146

Provider Relief Fund Reporting Portal Now Open for Period 5

The Health Resources and Services Administration has announced that the Provider Relief Fund (PRF) Reporting Portal is now open for Reporting Period 5.
 
Recipients who received one or more General Distribution, Targeted Distribution, or ARP Rural Distribution payments exceeding $10,000, in the aggregate, from Jan. 1, 2022 to June 30, 2022 are required to report on the use of their payments during Reporting Period 5.

This latest reporting period will close at 11:59 p.m. ET on Sept. 30, 2023. Click here to learn more.

NIH Research Shows Lack of Buprenorphine for Adolescents in RTFs

Only one in four residential treatment facilities that treat adolescents in the United States for opioid use disorder offer buprenorphine, the sole U.S. Food and Drug Administration-approved medication for 16- to 18-year-olds, the National Institutes of Health (NIH) reports.

An NIH-funded research team identified 354 facilities nationwide that offered treatment for substance use in a residential treatment setting for people aged 17 and younger. Researchers called each facility to inquire about the treatments offered, and, in each case, a researcher posed as the relative of a 16-year-old with a recent, non-fatal fentanyl overdose. They found that 160 of these facilities, or 45%, provided residential treatment to patients younger than 18 years old.

Of the facilities that treated adolescents, only 39, or less than 25%, offered buprenorphine to 16- to 18-year-old patients. In contrast, almost two-thirds of adult residential facilities offer buprenorphine. The likelihood of offering buprenorphine varied by region, from 40% in the Northeast to 18% in the West, the NIH reports.

Meanwhile, the situations in which facilities offered buprenorphine also varied. Only 20 facilities—or one in eight—offered buprenorphine for ongoing treatment, and 12 offered it to patients younger than 16.

“These residential treatment centers see some of the most vulnerable adolescents in our communities,” lead researcher Caroline King, M.P.H., and an M.D./Ph.D. student in the Oregon Health & Science University School of Medicine, said in an NIH announcement about the findings. “But they don’t offer the standard of care for these kids. With rising fentanyl-related overdoses among adolescents, we really need these centers to provide the best care.”

In Case You Missed It: NABH Education & Research Foundation Workforce Resources

If you missed the 2023 Annual Meeting, be sure to access the workforce resources that the NABH Education and Research Foundation featured at the meeting and are available on the Foundation’s Resources page.

First, watch speaker John Pallasch’s presentation and listen to the question-and-answer period from NABH members. Pallasch, founder and CEO of workforce consultancy One Workforce Solutions, served previously as the Senate-confirmed assistant secretary for employment and training at the U.S. Labor Department. Pallasch’s presentation challenged attendees to think beyond recruitment and retention and instead focus on re-designing the U.S. workforce system. He offered practical ideas for how NABH members can get involved in this process.

Also be sure to use the workforce resource guide that the Foundation co-branded with One Workforce Solutions. The guide includes links to state workforce agencies, workforce development boards, and 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 timeliness. If you are a new participant, please e-mail NABH Administrative Coordinator Emily Wilkins for support.

Fact of the Week:

New antitransgender legislation passed in several U.S. states is raising concern among psychologists about the effect on the mental health of trans individuals—in particular children and teens—as well as members of the LGBTQ+ community, the American Psychological Association reports.

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

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CEO Update 145

MedPAC Report to Congress Analyzes Behavioral Health Services and Patients

In its annual report to Congress last week, the Medicare Payment Advisory Commission (MedPAC) examined behavioral health services covered under Medicare’s inpatient and outpatient prospective payments systems and physician fee schedule.

The 76-page report’s behavioral health chapter addresses Medicare beneficiaries’ service utilization patterns, Medicare spending trends to providers and clinicians, and payment adequacy and margins. Regarding access, the report notes a drop in inpatient psychiatric facility (IPF) patient volume from 2019 through 2021 (the most recent data evaluated) due to the COVID-19 pandemic. Meanwhile, during the same period, the occupancy rates grew in government IPFs—an indicator of service shortages for patients with severe mental illness.

Concerning the 2021 acuity level of IPF patients relative to beneficiaries in other settings, IPF patients were 3.5 times more likely to be disabled and 2.4 times more likely to have low-income status (eligible for Part D low-income subsidy or dually-qualified for Medicare and Medicaid), metrics used as proxy indicators of acuity, according to the report.

For telehealth, among other findings, MedPAC cited the widely recognized increased use in telehealth services for behavioral health patients, which grew to 28% in 2021 from 1% of Part B behavioral health services in 2019.

MedPAC recommends gathering more information to assess the alignment between payments and the cost of care for ancillary and other behavioral health services, as well as additional data about patient-level outcomes. These additional data would be used to better understand variation in Medicare margins across IPF facility types, including differences due to scale and the mix of patients in different IPFs. The report also provides data on service utilization for patients affected by the Medicare’s 190-day-limit policy.

DOJ Releases Guidelines for Managing Substance Withdrawal in Jails

The U.S. Justice Department’s (DOJ) Bureau of Justice Assistance and the National Institute of Corrections this week released Guidelines for Managing Substance Withdrawal in Jails: A Tool for Local Government Officials, Jail Administrators, Correctional Officers, and Health Care Professionals.
 
In an announcement, DOJ said the document supports the department’s commitment to increasing access to evidence-based treatment for individuals with SUDs and those at risk for overdose, including individuals who are incarcerated or reentering their communities.
 
“These guidelines are a critical and much-needed resource to support local government officials, jail administrators, correctional officers and healthcare professionals faced with the difficult task of managing substance withdrawal in jail settings,” Associate Attorney General Vanita Gupta said in a statement. “Providing this new, evidence-based tool and treatment guidance, developed by a committee of clinical and correctional experts, will better safeguard the health and well-being of individuals at risk for or experiencing substance withdrawal in jails.”

DEA Now Requires One-Time Training for Buprenorphine Prescribing

Starting this week, the Drug Enforcement Agency (DEA) requires clinicians who register to prescribe controlled medications to complete a new, one-time, eight-hour training.

In January, the Substance Abuse and Mental Health Services Administration (SAMHSA) announced clinicians no longer need a federal waiver to prescribe buprenorphine to treat opioid use disorder. Instead, the DEA now requires all clinicians prescribing any controlled substance to complete a one-time training.

Exceptions for the training requirement include practitioners who are board-certified in addiction medicine or addiction psychiatry, and those who graduated from a medical, dental, physician assistant, or advanced practice nursing school in the United States within five years of June 23, 2023.

In addition, Rural Health Clinics (RHCs) will have the opportunity to apply for a $3,000 payment on behalf of each provider who received buprenorphine waiver training between Jan. 1, 2019 and Jan. 25, 2023 (when Congress eliminated the waiver requirement). According to the Health Resources and Services Administration, about $900,000 in program funding remains available for RHCs and will be paid on a first-come, first-served basis.

The International Certification and Reciprocity Adopts SAMHSA’s National Model Standards for Peers

The International Certification and Reciprocity Consortium (IC&RC) has announced it has adopted SAMHSA’s National Model Standards for Peer Support Certification in the form of a new credential.

In an announcement, the IC&RC said this national entry-level peer credential is intended to be the first rung of a career ladder that will lead to stronger substance use disorder (SUD) workforce development that is needed greatly nationwide. The IC&RC is the first—and currently only—nationally recognized, peer-certification organization to adopt the standards.

FDA Publishes First Draft Guidance on Psychedelic Drug Trials

The U.S. Food and Drug Administration (FDA) has published its first draft guidance on clinical trials for psychedelic drugs as research on using psychedelic drugs to treat conditions such as depression and post-traumatic stress disorder increases.

In an announcement, FDA noted that developing psychedelic drugs poses several challenges, including minimizing the risk of the drugs being misused and addressing the role that psychotherapy plays in psychedelic drug administration.

“By publishing this draft guidance, the FDA hopes to outline the challenges inherent in designing psychedelic drug development programs and provide information on how to address these challenges,” Tiffany Farchione, director of the division of psychiatry in FDA’s drug center, said in a news release. “The goal is to help researchers design studies that will yield interpretable results that will be capable of supporting future drug applications.”

GAO Examines Behavioral Healthcare Services in Critical Access Hospitals

A new Government Accountability Office (GAO) study of 10 critical access hospitals (CAHs) found that these providers offered behavioral healthcare services in a variety of ways in various settings, including emergency departments, inpatient services, and outpatient services.

Unlike other hospitals, under Medicare fee-for-service, CAHs are paid based on the cost of providing services in most, but not all, care settings. GAO researchers received mixed views on how Medicare fee-for-service payment policies affect CAHs’ ability to provide behavioral healthcare services in various settings that are not paid solely based on cost.

GAO said officials from multiple CAHs and stakeholders said factors outside Medicare were “substantial challenges” to their ability to provide behavioral healthcare services and patients’ access to these services.

“Hiring and recruitment of behavioral health professionals, such as psychiatrists and licensed clinical social workers, was cited as one of their biggest challenges due to nationwide workforce shortages,” the study said. “In addition, they said shortages of inpatient psychiatric beds made it difficult to find inpatient treatment for their patients,” the study continued, adding that patients were sometimes stuck in an emergency department for several days waiting to be transferred to an open psychiatric bed elsewhere in their community or state.

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 two most common mental disorders among adults aged 18 to 65 were major depressive disorder (15.5%, or about 31.4 million adults) and generalized anxiety disorder (10%, or about 20.2 million adults), according to the SAMHSA-funded Mental and Substance Use Disorders Prevalence Study from RTI International.

The NABH team wishes all its members, their teams, and their families a safe and happy Independence Weekend!

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

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2023 NABH Annual Meeting Presentations Now Available

Earlier this week NABH posted all 2023 Annual Meeting presentations for which the association has received permission to share publicly.

Please remember to save the date for next year’s Annual Meeting: May 13-15, 2024 at the Salamander Washington, DC. We look forward to seeing you then!

We Want Your Opinion: Please Submit Your 2023 Annual Meeting Evaluation!

NABH welcomes your feedback on the 2023 Annual Meeting held in Washington, D.C. last week.

If you attended this year’s Annual Meeting, please take a moment to complete NABH’s 10-question evaluation form if you have not done so already.

Your comments help to inform future NABH Annual Meetings. Thank you for your time!

SAMHSA Releases Resource on Findings from Drug-Related ED Visits in 2022

Alcohol was reported in the highest percentage of drug-related emergency department (ED) visits (45.0%) in 2022, followed by opioids (12.7%) and cannabis (11.9%), according to data from the Drug Abuse Warning Network (DAWN): Findings from Drug-Related Emergency Department Visits, 2022 that the Substance Abuse and Mental Health Services Administration (SAMHSA) released this week.

DAWN is a nationwide public health surveillance system that captures data on ED visits related to recent substance use directly from the electronic health records of participating hospitals. In 2022, DAWN identified 143,596 (unweighted) drug-related ED visits from 53 participating hospitals.

These data were analyzed to generate 1) nationally representative weighted estimates for all drug-related ED visits, 2) the top drugs involved in drug-related ED visits, 3) for different opioid types involved in ED visits, 4) to describe polysubstance in ED visits, and 5) to identify newly mentioned drugs in 2022.

The analysis for 2022 also showed heroin (5.6%) and prescription or other opioid (5.0%) were reported more often than fentanyl (2.7%) in drug-related ED visits.

CDC: Nearly One in Five U.S. Adults Report Having Ever Been Diagnosed with Depression

Data from the Centers for Disease Control and Prevention (CDC) show nearly one in five U.S. adults reported having ever been diagnosed with depression, although the rate – averaging at 18.4% in 2020 –varies significantly by state and county.

State-level, age-standardized estimates ranged from 12.7% in Hawaii to 27.5% in West Virginia. Meanwhile, model-based, age-standardized, county-level prevalence estimates ranged from 10.7% to 31.9%, and there was considerable state-level and county-level variability.

The CDC notes decisionmakers can use these estimates to guide resource allocation to areas where the need is greatest, possibly by implementing recommendations from The Guide to Community Preventive Services Task Force and SAMHSA.

NIH Study Deepens Understanding of Possible Mechanism Through Which Xylazine Affects Overdose Risk

A new study in rats suggests that xylazine, the active ingredient in a non-opioid veterinary tranquilizer not approved for human use, can worsen the life-threatening effects of opioids.

Published in Psychopharmacology, the study’s findings imply that when used in combination with opioid drugs such as fentanyl and heroin, xylazine may damage the ability of the brain to get enough oxygen, one of the most dangerous effects of opioid drugs that can lead to death.

Research has shown xylazine is often added to illicit opioids, including fentanyl, and that xylazine has been increasingly detected in the illicit opioid supply.

“Drug mixtures containing both xylazine and opioids such as fentanyl demonstrate how rapidly the drug supply can change, and how dangerous products can proliferate despite rampant overdose deaths,” Nora Volkow, M.D, director of the National Institute on Drug Abuse – which led the study – said in a statement about the study. “Understanding the mechanisms behind how xylazine contributes to drug overdoses is essential to enable us to develop interventions that can reverse overdoses and save lives,” she continued. “In the meantime, naloxone, an opioid overdose reversal medication, should always be administered in the event of an overdose because xylazine is most often combined with opioids such as fentanyl.”

Fact of the Week:

Men had a two-to-three times greater rate of overdose mortality from opioids – such as fentanyl and heroin – and psychostimulants –such as methamphetamine and cocaine – than women, according to a new study published in Neuropsychopharmacology.

For questions about CEO Update, please contact Jessica Zigmond.

 

 

 

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CEO Update 143

2023 NABH Annual Meeting Starts Monday!

We’re pleased to devote this week’s edition of CEO Update to details about the 2023 Annual Meeting that starts on Monday, June 12 in Washington, D.C.

This year’s Annual Meeting celebrates two important milestones for NABH: the association’s 90th anniversary and the 15th anniversary of the Mental Health Parity and Addiction Equity Act (MHPAEA). We’re eager to remind our members of the many ways the behavioral healthcare community has helped change the U.S. healthcare system, and, in turn, helped improve and save lives in the last nine decades.

Mostly, though, we’re looking ahead. This year’s Annual Meeting theme – Securing the Promise of Parity – is a call to action for the work that remains to ensure MHPAEA is implemented fully and fairly.

NABH is pleased to welcome HHS Secretary Xavier Becerra, J.D. on Monday, and you also won’t want to miss our parity panel with NABH President and CEO Shawn Coughlin, U.S. Labor Department Assistant Secretary for Employee Benefits Security Lisa Gomez, and former U.S. Rep. Patrick Kennedy (D-R.I.), founder of The Kennedy Forum, on Tuesday. We’ll conclude our meeting on Wednesday with Sen. Chris Murphy (D-Conn.), who will address attendees at this year’s policy breakfast. Details about these and other sessions and events follow below.

To prepare for the meeting, view our preliminary program, learn more about this year’s speakers, and see our list of exhibitors and sponsors.

Be Sure to Access the 2023 NABH Annual Meeting Mobile App

Again this year, attendees will have access to all Annual Meeting programming and materials through NABH’s online mobile app.

On Monday, June 12, NABH will send all attendees an Annual Meeting alert with a link to the app that will display important details about sessions, events, exhibitors and sponsors, our 2023 advocacy priorities, restaurant recommendations in the Washington area, and more.

Attendees can also access the link through a QR code near the Registration Desk at the meeting.

HHS Secretary Becerra to Kick Off Annual Meeting

HHS Secretary Xavier Becerra, the 25th secretary of the U.S. Health and Human Services Department and the first Latino to hold that office, will open this year’s Annual Meeting on Monday, June 12 at 2:15 p.m. in the Salamander hotel’s Grand Ballroom.

Secretary Becerra will offer brief remarks and then engage in a question-and-answer session with 2023 NABH Board Chair Harsh Trivedi, M.D., M.B.A., president and CEO of Sheppard Pratt.
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.

Please join us in welcoming him and be sure to stay for additional remarks from NABH Board Chair Trivedi, who will introduce a brief video commemorating our 90 years as an advocacy association.

Monday’s General Sessions to Examine Workforce Challenges and Potential Solutions

Following Monday’s opening session, NABH will present back-to-back sessions that will examine current behavioral healthcare workforce challenges and how to address them.

At 3 p.m., NABH will welcome John Pallasch, former Senate-confirmed assistant secretary for employment and training at the U.S. Labor Department (DOL) and the founder and CEO of One Workforce Solutions, 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.

Following Pallasch’s presentation, the NABH Education and Research Foundation will lead a panel discussion about workforce challenges and potential solutions at 4 p.m. ET.

New Season/Colonial Management Group CEO Jim Shaheen, the foundation’s vice president, will moderate the hourlong panel that will feature Hackensack Meridian Health Carrier Clinic President Donald Parker, the foundation’s president; Vanderbilt Psychiatric Hospital and Clinics President Mary Pawlikowski, the foundation’s secretary; and Susan Wright, director of BayCare Behavioral Health’s Behavioral Health Operations and this year’s Annual Meeting program chair.

Panelists will discuss best practices on a variety of topics and answer questions from Shaheen and audience members. Earlier presenter John Pallasch will also participate in the panel’s question-and answer period.

Please join us for both sessions in the Salamander’s Grand Ballroom.

Tuesday’s Parity Panel to Feature 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 at 9:30 a.m., the Annual Meeting’s second day.

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 MHPAEA. 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 take place in the Grand Ballroom and will discuss the landmark 2008 parity law and the work that remains to secure the law’s promise.

Center for Medicaid & CHIP Services CMO Aditi Mallick, M.D. to Address Attendees on Tuesday

Aditi Mallick, M.D., chief medical officer at the Center for Medicaid and CHIP (Children’s Health Insurance Program) Services (CMCS), will discuss her department’s mental health and substance use disorder initiatives at the 2023 Annual Meeting on Tuesday, June 13 at 11 a.m.

Dr. Mallick leads the Center’s clinical strategy and cross-center work on health equity, social determinants of health, and innovation in whole-person care among other areas. Before joining CMCS, Dr. Mallick led the COVID-19 Response Command Center for the North Carolina Department of Health and Human  Services (NCDHHS), where she oversaw strategic and operational efforts around vaccination, testing, case investigation, and contact tracing statewide. A core focus of her COVID-19 work was ensuring equitable access and improving outcomes for historically marginalized populations.

Before her work at NCDHHS, Dr. Mallick worked closely with a range of healthcare stakeholders across the public and private sectors – including state Medicaid agencies, provider organizations, managed care organizations, and other payors – focusing on strategy, innovation, and data-driven change implementation.

Dr. Mallick continues to care for patients and brings that experience to her work at CMS. She earned her bachelor’s degree with honors from Harvard College, her medical degree from Stanford University School of Medicine, and completed internal medicine residency at Massachusetts General Hospital and Harvard Medical School.

NABH President and CEO Shawn Coughlin to Address Attendees at Annual Meeting Luncheon

Please join us for this year’s Annual Meeting Luncheon on Tuesday, June 13 at noon to hear from NABH President and CEO Shawn Coughlin.

Coughlin will provide updates on NABH’s work and initiatives and will help prepare any attendees who will head to Capitol Hill for congressional visits following the luncheon.

This year’s Annual Meeting Luncheon will take place in the hotel’s Gallery Room.

Hill Day Returns!  

For the first time since 2019, NABH is eager to welcome its members and guests back to Hill Day on Tuesday, June 13 from 1:30 to 5 p.m. ET.

This year NABH is working with the firm Advocacy Associates to help schedule congressional meetings and briefings on Capitol Hill for interested Annual Meeting attendees during Hill Day.
NABH will help prepare interested attendees by providing materials through a mobile app. For those attending Hill Day this year: please look for additional correspondence on Friday, June 9.

Also, Hill Day participants—and all Annual Meeting attendees—can review the association’s 2023 Advocacy Priorities and Contingency Management fact sheet before or during the Annual Meeting.

U.S. Sen. Chris Murphy to Address Attendees at Annual Meeting Policy Breakfast

U.S. Sen. Chris Murphy (D-Conn.) will address attendees at the 2023 Annual Meeting policy breakfast on Wednesday, June 14 at 9:30 a.m. ET.

Sen. Murphy serves on the Senate Foreign Relations Committee, the Health, Education, Labor and Pensions (HELP) Committee, and the Appropriations Committee. Before he was elected to the Senate, Sen. Murphy represented Connecticut’s fifth congressional district for three terms in the U.S. House of Representatives. Murphy is known in Congress as a leading voice for stronger anti-gun violence measures, a smarter foreign policy, and reform of our nation’s mental health system.

Before he was elected to Congress, Murphy served for eight years in the Connecticut state legislature. Murphy graduated with honors from Williams College in Massachusetts and received his law degree from the University of Connecticut School of Law. Please help us welcome Sen. Murphy on Wednesday.

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

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CEO Update 142

U.S. Sen. Chris Murphy to Address Attendees at Annual Meeting Policy Breakfast

NABH is pleased to announce U.S. Sen. Chris Murphy (D-Conn.) will address attendees at the 2023 Annual Meeting policy breakfast on Wednesday, June 14 at 9:30 a.m. ET.

Sen. Murphy serves on the Senate Foreign Relations Committee, the Health, Education, Labor and Pensions (HELP) Committee, and the Appropriations Committee. Before he was elected to the Senate, Sen. Murphy represented Connecticut’s fifth congressional district for three terms in the U.S. House of Representatives. Murphy is known in Congress as a leading voice for stronger anti-gun violence measures, a smarter foreign policy, and reform of our nation’s mental health system.

Before he was elected to Congress, Murphy served for eight years in the Connecticut state legislature. Murphy graduated with honors from Williams College in Massachusetts and received his law degree from the University of Connecticut School of Law.

Please help us welcome Sen. Murphy on June 14. And if you haven’t done so yet, please be sure to register for the Annual Meeting.

NABH Education and Research Foundation to Present Workforce Panel at Annual Meeting

The NABH Education and Research Foundation is pleased to lead a panel discussion about workforce challenges and potential solutions during the Annual Meeting on Monday, June 12 at 4 p.m. ET.

New Season/Colonial Management Group CEO Jim Shaheen, the foundation’s vice president, will moderate the hourlong panel that will feature Hackensack Meridian Health Carrier Clinic President Donald Parker, the foundation’s president; Vanderbilt Psychiatric Hospital and Clinics President Mary Pawlikowski, the foundation’s secretary; and Susan Wright, director of BayCare Behavioral Health’s Behavioral Health Operations and this year’s Annual Meeting program chair.

Panelists will discuss best practices on a variety of topics and answer questions from Shaheen and audience members. The panel will follow a 3 p.m. workforce presentation from John Pallasch, founder and CEO of One Workforce Solutions and former assistant secretary for employment and training at the U.S. Labor Department. Pallasch will participate later in the panel’s question-and answer period.

Please join us for both sessions in the Salamander’s Grand Ballroom on the Annual Meeting’s first day. We look forward to seeing you there!

Reminder: Hill Day is Back!  

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 congressional meetings and briefings on Capitol Hill 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. There is still time 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 Emily Wilkins at NABH.

SAMHSA Awards Grants to Bolster Mobile Response Teams for 988 Lifeline

The Substance Abuse and Mental Health Services Administration (SAMHSA) has awarded 13 grants to communities to create new or enhance existing mobile crisis response teams to support the national 988 Suicide and Crisis Lifeline.

In an announcement, HHS noted the Biden administration has invested about $3.8 billion through the American Rescue Plan and more than $800 million through the Bipartisan Safer Communities Act through SAMHSA programs as part of President Biden’s effort to improve access to mental healthcare, prevent overdoses, and save lives.

“The expansion of mobile crisis response across the country is a big part of our efforts to achieve comprehensive, responsive crisis care services,” HHS Assistant Secretary for Mental Health and Substance Use and SAMHSA leader Miriam Delphin-Rittmon, Ph.D., said in an announcement. “Responding effectively to behavioral health crises in our communities will involve strong partnerships among first responders, community-based support services, and 988 Lifeline call centers.”

Click here to view the list of grant awardees.

Reminder: HRSA’s Substance Use Disorder Treatment and Recovery Loan Repayment Program Now Open

The Health Resources and Services Administration’s (HRSA) Substance Use Disorder Treatment and Recovery Loan Repayment Program (STAR LRP) application is open now through mid-July.

Anyone who is a behavioral health clinician or support worker, clinical support staff, or trained in substance use disorders may apply to the STAR LRP and receive up to $250,000 in loan repayment. In exchange, loan recipients must work full time for six years in a STAR LRP-approved facility.

The application process ends on Thursday, July 13 at 7:30 p.m. ET. 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 timeliness. If you are a new participant, please e-mail NABH Administrative Coordinator Emily Wilkins for support.

Fact of the Week

More than half of Americans who suffer from schizophrenia or another mental illness didn’t get the care they needed in 2021, the National Alliance on Mental Illness reports. A recent analysis in Kaiser Health News shows that coverage often depends on where you live—and how coverage of early psychosis treatment can be lifesaving.

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

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CEO Update 142

NABH 2023 Annual Meeting is Approaching: Be Sure You’re Registered!

NABH’s 2023 Annual Meeting—Securing the Promise of Parity—is a little more than two weeks away!

Please review our online preliminary program, learn about this year’s speakers, view the list of exhibitors and sponsors, register for the meeting, and reserve your hotel room, if you haven’t done so yet.

We look forward to seeing you in Washington!

U.S. Surgeon General Releases Advisory on Social Media and Youth Mental Health

U.S. Surgeon General Vivek Murthy, M.D. this week released Social Media and Youth Mental Health, a new advisory that shows while social media may offer some benefits, there are “ample indicators” that social media can pose a risk of harm to the mental health and well-being of children and adolescents.

The advisory notes that social-media use by young people is nearly universal, with up to 95% of young people ages 13-17 reporting using a social media platform and more than a third saying they use social media “almost constantly.”

“The most common question parents ask me is, ‘Is social media safe for my kids?’” Murthy said in a news release about the advisory. “The answer is that we don’t have enough evidence to say it’s safe, and in fact, there is growing evidence that social media use is associated with harm to young people’s mental health,” he continued. “Children are exposed to harmful content on social media, ranging from violent and sexual content, to bullying and harassment. And for too many children, social media use is compromising their sleep and valuable in-person time with family and friends,” he added. “We are in the middle of a national youth mental health crisis, and I am concerned that social media is an important driver of that crisis – one that we must urgently address.”

Murthy’s office reported that adolescents spending more than three hours per day on social media face double the risk of experiencing poor mental health outcomes, such as symptoms of depression and anxiety; yet one 2021 survey of teenagers found that, on average, they spend 3.5 hours a day on social media.

NIMH Finds Youth Suicide Rates Increased During the COVID-19 Pandemic

The National Institute of Mental Health this week released research that shows 5,568 youth died by suicide during the first 10 months of the COVID-19 pandemic, which was higher than the expected number of deaths had the pandemic not occurred.

Higher-than-expected suicide rates were found a few months into the pandemic, starting in July 2020. According to the research, the increase in suicide deaths varied significantly by sex, age, race and ethnicity, and suicide method.

For this period, researchers also found higher-than-expected suicide deaths among males, preteens aged 5–12 years, young adults aged 18–24 years, non-Hispanic American Indian or Alaskan Native youth, and non-Hispanic Black youth as compared with before the pandemic. Suicide deaths involving firearms were also higher than expected, the study showed.

CMS Reports to Congress on SUD Planning Grant Implementation

The Centers for Medicare & Medicaid Services (CMS) has released the Initial Report to Congress that the SUPPORT Act requires.

The 2018 law directs CMS to release three reports to Congress, and the one released this week provides details on states awarded planning grants under the SUPPORT Act, the criteria used to select these states, and initial activities proposed or carried out under the planning grants.

Findings in the report are from the first 13 months of the planning period of the demonstration: Sept. 30, 2019-Oct. 31, 2020.

Now Open: HRSA’s Substance Use Disorder Treatment and Recovery Loan Repayment Program

The Health Resources and Services Administration (HRSA) announced this week that the agency’s Substance Use Disorder Treatment and Recovery Loan Repayment Program (STAR LRP) application is open now through mid-July.

Anyone who is a behavioral health clinician or support worker, clinical support staff, or trained in substance use disorders may apply to the STAR LRP and receive up to $250,000 in loan repayment. In exchange, loan recipients must work full time for six years in a STAR LRP-approved facility.

The application process ends on Thursday, July 13 at 7:30 p.m. ET. Click here to learn more.

Also this week, HRSA announced a grant program for professionals focused on behavioral health workforce education and training for children, adolescents, and transitional-aged youth. The grant’s purpose is to address the behavioral health needs of children, adolescents, and transitional-aged youth by increasing the supply and distribution of behavioral health providers in rural and underserved communities. Click here to view the grant opportunity.

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

A new study published in Health Affairs found that although almost all insurance plans covered immediate-release buprenorphine in 2021 (with a general trend of decreasing prior authorization requirements and quantity limits since 2017), only two payers had relatively low coverage of extended-release buprenorphine, with only 46% of commercial plans and only 19% of Medicare Advantage plans covering this formulation. The study authors recommended that policymakers and researchers “concerned with buprenorphine insurance barriers should shift their attention to extended-release buprenorphine.”

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

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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.

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CEO Update 140

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.

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CEO Update 139

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.

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CEO Update 138

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.

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CEO Update 137

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, 10th, and 12th 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.

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CEO Update 135

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

Read more

CEO Update 134

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) 15th 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.

Read more

CEO Update 133

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 9th 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) 15th 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.

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CEO Update 132

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) 15th 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.

Read more

CEO Update 131

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) 15th 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.

Read more

CEO Update 130

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) 15th 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.

Read more

CEO Update 129

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) 15th 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.

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CEO Update 128

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.

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CEO Update 127

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.

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CEO Update 226

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 9th 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 9th 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 9th 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 9th 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 9th 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 9th 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 9th 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 9th 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.

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CEO Update 225

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.

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CEO Update 224

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.

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CEO Update 223

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.

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CEO Update 222

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 90th 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.

Read more

CEO Update 221

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.

Read more

CEO 220

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.

Read more

CEO Update 219

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

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

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

HHS Releases Proposed Rule to Revise 42 CFR Part 2 Regulations

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Save the Date for the NABH 2023 Annual Meeting!

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

Fact of the Week

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

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

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CEO Update 218

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.

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CEO Update 217

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

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

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

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

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

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

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

CMS Releases Medicaid and CHIP Access Data Brief

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Save the Date for the NABH 2023 Annual Meeting!

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

Fact of the Week

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

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

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CEO Update 216

CMS Releases Final Physician Fee Schedule and OPPS Rules for 2023 

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

SAMHSA to Host Webinar About CCBHC Certification Criteria Next Week

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

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

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

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

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

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

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

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

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

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

Enhanced NABH Denial-of-Care Portal is Now Available

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

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

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

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

Save the Date for the NABH 2023 Annual Meeting!

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

Fact of the Week

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

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

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CEO Update 215

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Enhanced NABH Denial-of-Care Portal is Now Available

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

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

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

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

Save the Date for the NABH 2023 Annual Meeting! 

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

Fact of the Week

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

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

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CEO Update 214

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.

Read more

CEO Update 213

NABH 2023 Board Position Nominations Due Today!

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

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

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

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

Becerra Extends Covid-19 PHE for Another 90 Days

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

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

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

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

The report—totaling more than 80 pages—also concluded that researchers should evaluate the benefits of hybrid (both in-person and virtual) care models for primary and specialty care, including for which conditions and specialties it is most effective; further evaluate full telehealth flexibilities in the context of value-based payment models; and assess rigorously the quality of audio-only care.

“Throughout this report, BPC recommends targeted adjustments to the current telehealth flexibilities; all recommended changes are in response to emerging evidence on benefits versus risks and to stakeholder concerns,” the researchers noted. “This approach would enable beneficiaries to maintain their access to telehealth services while minimizing risks to patients and the Medicare program, as well as provide time for policymakers to continue to review and assess the evidence.”

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

The White Office of National Drug Control Policy (ONDCP) will host a webinar on Monday, Oct. 17 to examine low-threshold buprenorphine programs, which seek to reduce barriers that often limit access or reduce retention in care.

ONDCP Director Rahul Gupta, M.D. will welcome participants to the webinar, which will feature evidence from experts in the field and include a panel discussion about policy and practice.

The webinar will be held from 1 p.m. – 3 p.m. ET. Click here to register.

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

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

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

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

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

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

An analysis in JAMA Pediatrics this week concluded that immediate action should be taken to alter the current trajectory of unintentional pediatric ingestion of edible cannabis products.

The article noted that cannabis is the third most used psychoactive substance worldwide, with use continuously rising in the U.S. adult population. Meanwhile, cannabis products are used commonly and stored in homes in which children are present and education from healthcare professionals about safe storage is lacking, the article continued. Consequently, children are at risk of being drawn to THC (tetrahydrocannabinol, the psychoactive compound of marijuana)-infused products that resemble their favorite snacks or candy.

“Children with THC intoxication can present with neurologic impairment, including lethargy, ataxia, tachycardia, mydriasis, seizures, altered mental status, and hypotonia,” the article said. “However, given the unpredictability of the dose ingested, patient presentation can vary. Altered mental status in children results in broad differential diagnoses ranging from traumatic to infectious causes.”

Enhanced NABH Denial-of-Care Portal is Now Available

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

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

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

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

Save the Date for the NABH 2023 Annual Meeting!

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

Fact of the Week

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

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

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CEO Update 212

NABH Seeking Candidates for 2023 Board Positions

The NABH Selection Committee is seeking nominations to fill the NABH Board Chair-Elect and two NABH Board seats that will become available in 2023.

In particular, the committee wants to identify senior managers who represent the association’s diverse membership related to levels of care, organizational structures, and size.

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

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

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

Two in three U.S. adults say they believe they don’t have enough knowledge to tell if someone is considering suicide, while eight in 10 adults say they are open to learning how to help someone in need, according to a Harris Poll survey released this week.

Since 2015, the American Foundation for Suicide Prevention (AFSP), the National Action Alliance for Suicide Prevention (Action Alliance), and the Suicide Prevention Resource Center (SPRC) have commissioned the Harris Poll to conduct bi-annual, nationally representative survey of adults in the United States to understand the public’s beliefs and attitudes about mental health and suicide. The survey evaluates what the public knows about to support someone who is struggling and their perceptions of barriers to help those at risk for suicide.

This latest poll offers an early read on public awareness of 988, the national behavioral health crisis hotline that launched in July. Researchers found that while gains have been made in valuing mental health, there is not consistent societal support for mental healthcare.

The findings show that 76% of Americans surveyed said they perceive mental health as equal to physical health, while 51% said they feel that physical health is treated as more important of the two. Meanwhile, 67% of those surveyed said they believe they have had a mental health condition at some point in their lives, up from 60% who said so in 2018 and 57% in 2018.

“Overall, the poll indicates that progress has been made, but there is more to do,” the report noted. “We must continue to learn more about suicide and mental health particularly through increased research efforts, teach everyone how to help prevent suicide and strengthen mental health, and advocate for improved access to care and robust crisis services.”

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

The White House Office of National Drug Control Policy (ONDCP) will host a webinar on Monday, Oct. 17 to examine low-threshold buprenorphine programs, which seek to reduce barriers that often limit access or reduce retention in care.

ONDCP Director Rahul Gupta, M.D. will welcome participants to the webinar, which will feature evidence from experts in the field and include a panel discussion about policy and practice.

The webinar will be held from 1 p.m. – 3 p.m. ET. Click here to register.

HRSA Previews Behavioral Health Training Opportunities for Primary Care Residents

The Health Resources and Services Administration (HRSA) this week announced a funding opportunity totaling nearly $60 million during a five-year period to support training to expand the public health workforce.

The new program will train primary care residents in the prevention, identification, diagnosis, treatment, and referral of services for mental and behavioral health conditions. It is intended to benefit pediatric, adolescent, young adult, and other populations who are at-risk or have experienced abuse, trauma, or mental health and/or substance use disorders, including those related to the effects of gun violence.

According to HRSA, awards will support both classroom training and clinical rotations that focus on mental and behavioral health conditions. Eligible entities include accredited public or not-for-profit private hospitals; schools of allopathic medicine or osteopathic medicine; residency programs accredited by the Accreditation Council for Graduate Medical Education in family medicine, general internal medicine, general pediatrics or combined internal medicine and pediatrics (“med-peds”); and tribes and tribal organizations, if otherwise eligible.

Click here to be notified when this funding opportunity opens.

Enhanced NABH Denial-of-Care Portal is Now Available

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

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

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

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

Save the Date for the NABH 2023 Annual Meeting!

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

Fact of the Week

A Harris Poll survey released this week found that more than half of adults in the United States say seeing a mental health professional is a sign of strength.

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

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CEO Update 211

House to Vote Friday on Senate-Approved Stopgap Spending Measure

The House of Representatives is expected to vote Friday on the short-term spending bill the Senate approved Thursday to avert a federal government shutdown and increase aid to Ukraine.

Included in the legislation is a provision to continue funding the national 988 behavioral crisis hotline through Sept. 30, 2023, for which Congress has appropriated $62,000,000.

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

Acting Deputy Assistant Secretary Tom Coderre of the Substance Abuse and Mental Health Services Administration (SAMHSA) will moderate a panel discussion at 1:15 p.m. ET today, Friday, Sept. 30, the last day of National Recovery Month.

Titled “Making Small Choices, Every Day,” the event will feature panelists who will discuss their recovery experiences while sharing success stories and providing hope that recovery is possible. The panel will address seeking treatment for mental illness or substance use disorders, overcoming challenges such as stigma, and helping the public understand the importance of helping those in recovery.

SAMHSA will livestream the event on the agency’s Facebook page.

House Passes Bill to Bolster Mental Health Parity Protections for Workers

The House earlier this week passed the Mental Health Matters Act of 2022, a bill intended to hold employer-based health plans more accountable for inappropriate denials of mental health and substance use benefits.

The legislation would give the U.S. Labor Department more authority to enforce plan requirements under the Mental Health Parity and Addiction Equity Act and the Employee Retirement Income Security Act. It also would ban forced arbitration agreements when plans deny benefits improperly, and ensure a fair standard of review from the courts.

Before the bill passed, the White House released a Statement of Administrative Policy supporting the legislation. The White House noted that the Mental Health Matters Act also would improve the well-being of young children in Head Start and K-12 schools by building on President Biden’s efforts to increase the number of school-based mental health services providers, as well as authorizing grants to partnerships between high-need, local educational agencies, and institutions of higher education.

NABH will continue to track developments related to this bill.

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

The Centers for Medicare & Medicaid Services (CMS) this week released the agency’s latest enrollment figures for Medicare, Medicaid & the Children’s Health Insurance Program (CHIP), and the health insurance marketplaces, reporting that 156.5 million Americans have coverage in these federal health insurance programs.

According to the latest figures, there are 89.4 million enrollees in Medicaid and CHIP, 64.6 million enrollees in Medicare, and 14.5 million people enrolled in state-based and federal health insurance marketplaces. The agency reported a subtotal figure of 168.5 million enrollees, which CMS then adjusted by subtracting 12 million to account for Americans who are dually eligible for both Medicare and Medicaid.

Click here for a breakdown of the individual programs.

Former ONDCP Leaders Pen Opinion Piece on Increasing Recovery Services

On this last day of National Recovery Month, two former leaders at the White House Office of National Drug Control Policy wrote an opinion piece in The Hill newspaper to call for more training in addiction science and policymaking.

In their blog, former ONDCP Director Michael Botticelli and Regina LaBelle, a former acting director at ONDCP and director of the Addiction and Public Policy Initiative at the Georgetown University Law Center’s O’Neill Institute, recognized the role that people in recovery play by building healthier communities. They also emphasized the need to remove barriers to healthcare, housing, and employment and education, including modifying the regulatory hurdles that reduce access to methadone.

Enhanced NABH Denial-of-Care Portal is Now Available

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

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

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

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

Save the Date for the NABH 2023 Annual Meeting!

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

Fact of the Week

Early intervention in psychosis programs contributed to, on average, 3.2 fewer hospitalizations and 2.7 more years employed during the course of patients’ lives compared with individuals with the same diagnosis who received standard care, according to a study published in Psychiatric Services.

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

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CEO Update 210

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.

Read more

CEO Update 209

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

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CEO Update 208

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

Rochelle Archuleta has joined NABH as executive vice president for government relations and public policy, effective Sept. 6.

Rochelle brings to NABH 30 years of experience in the health policy, healthcare delivery system, and legislative arenas. During her 20-year tenure as a policy director for the American Hospital Association (AHA), Rochelle led AHA’s post-acute care policy team. In this role, Rochelle partnered with providers, policymakers, and leading trade associations on issues pertaining to the home health, skilled nursing facility/nursing home, inpatient rehabilitation facility, and long-term care hospital sectors.

These advocacy efforts expanded to include issues of common concern to all post-acute care providers and their hospital partners, including issues pertaining to Medicare Advantage and commercial insurers, as well as the Medicare program’s effort to create a new, unified payment system to reimburse the aforementioned, post-acute care settings.

“We are pleased to welcome Rochelle to our team,” said Shawn Coughlin, president and CEO at NABH. “Rochelle’s extensive work in healthcare policy, as well as her strong relationships with partner associations, will enhance NABH’s advocacy efforts—both with legislators and regulators.”

Rochelle is a research fellow in the Georgetown University McCourt School of Public Policy and is a former David Winston Health Policy Fellow. She earned a master of science in health administration and a master of business administration from the University of Alabama at Birmingham School of Health Professions and a bachelor of arts in political science from the University of Colorado at Boulder.

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

NABH this week sent comments and recommendations to the Centers for Medicare & Medicaid Services (CMS) regarding the agency’s proposed Medicare physician fee schedule for fiscal year 2023.

In its nine-page letter, NABH proposed revisions to the “Incident to” regulations and offered a range of recommendations related to the 2023 conversion factor, telehealth, opioid treatment services, coding and payment mechanisms, adjustments to the rate-setting methodology for behavioral health, and more.

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

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

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

Next Friday, Sept. 16 is the deadline for members to submit changes about their organizations for the online-only NABH 2022 Membership Directory.

Last month NABH sent its system members a message with a link to the association’s membership-update tool. To help ensure we have the most accurate information on our members, please use this tool to verify your system’s information.

NABH has added several new categories this year. The answers to these questions will help us provide a more accurate description of our diverse membership to policymakers, regulators, partner organizations, and the media. Please be sure to enter information for all your system’s facilities so that we have a better picture of our diverse membership.

If you need NABH to re-send the link, please contact Maria Merlie at maria@nabh.org. Thank you for your cooperation!

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

Sound the Alarm for Kids will host “Helping Girls Thrive: A Conversation Examining Trends in Girls’ Mental Health” next Friday, Sept. 16 at 1 p.m. ET.

The virtual roundtable discussion will examine the national campaign to raise awareness about today’s mental health crisis among children and teens and how to create change. Some of the speakers include Christina Bethell, Ph.D., M.P.H., M.B.A, director of the Child and Adolescent Health Measurement Initiative at Johns Hopkins University and Kelley Haynes-Mendez, Psy.D., senior director of the human rights team at the American Psychological Association.

Click here to register.

Enhanced NABH Denial-of-Care Portal is Now Available

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

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

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

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

Save the Date for the NABH 2023 Annual Meeting!

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

Fact of the Week

A recent study of 175,778 Medicare beneficiaries found that receipt of opioid use disorder-related telehealth services during the Covid-19 pandemic was associated with improved medications for opioid use disorder (MOUD) retention and lower odds of medically treated overdose, JAMA Psychiatry reports.

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

Read more

CEO Update 207

September is National Recovery Awareness Month

This week kicked off National Recovery Month, a national observance every September since 1989 intended to promote and support new evidence-based treatment and recovery practices, the nation’s recovery community, and the dedication of service providers and community leaders who make recovery possible.

During this past week’s Overdose Awareness Week, which concludes tomorrow, President Biden issued a National Recovery Month proclamation in which he acknowledged the more than 20 million Americans recovering from substance use disorder and highlighted his administration’s efforts to support recovery.

“This year, we secured nearly $22 billion from the Congress to support drug prevention, treatment, harm reduction, and recovery support services, with a focus on underserved communities,” the president said in his proclamation. “With the additional $4 billion investment from our American Rescue Plan, my administration is expanding recovery community organizations, recovery high schools, collegiate recovery programs, and recovery residences.”

For more information about National Recovery Month, please visit the Substance Abuse and Mental Health Administration’s (SAMHSA) website, and please remember to follow NABH @NABHbehavioral and on LinkedIn at the National Association for Behavioral Healthcare.

HHS Announces $47.6 Million in New Grant Funding for School-Based Mental Health

The U.S. Health and Human Services Department (HHS) this week announced $47.6 million in new grant funding opportunities through this Bipartisan Safer Communities Act to support mental health programs in schools.

Of that amount, $37.6 million is allocated for Project Advancing Wellness and Resiliency in Education, or AWARE, which is meant to develop a sustainable infrastructure for school-based mental health programs and services that promote the healthy social and emotional development of school-aged youth and prevent youth violence in schools.

The remaining $10 million is for the Resiliency in Communities after Stress and Trauma (ReCast) grant program, which helps assist high-risk youth and families by promoting resilience and equity in communities that have recently experienced civil unrest, community violence, and/or collective trauma through evidence-based, violence prevention, and community youth engagement programs, as well as connections to trauma-informed behavioral health services.

Nonfatal Opioid-Involved Overdoses in Emergency Departments Are Rising

The rate of nonfatal, opioid-involved overdose emergency medical services (EMS) encounters increased by an average of 4% quarterly from January 2018 – March 2022, according to new research from the Centers for Disease Control and Prevention (CDC).

The findings also reported that rates increased across most sociodemographic and county characteristics. Researchers noted that monitoring nonfatal, opioid-involved overdose trends in EMS data in near real time can help identify where overdose affects communities disproportionately and direct equitable response and prevention efforts, such as increased access to harm-reduction services and connections to care and treatment.

Click here to read the full CDC report.

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

Both not-for-profit and for-profit organizations are eligible to apply for the Health Resources and Services Administration’s (HRSA) Federal Office of Rural Health Policy’s (FORHP) 2023 Rural Health Development Program, a four-year program to support integrated healthcare networks to improve outcomes and strengthen the nation’s rural healthcare system.

The FORHP will make 44 awards of up to $300,000 each as part of the program, which focuses on four domains: improving access by addressing gaps in care, workforce shortages, better workflows and/or improving the quality of healthcare services; expanding capacity and services by creating effective systems through the development of knowledge, skills, structures, and leadership models; enhancing outcomes by improving patient and/or network development outcomes through expanding or strengthening the network’s services, activities or interventions; and establishing sustainability by positioning the network to prepare for sustainable health programs through value-based care and population health management.

FORHP will hold a webinar for applicants on Wednesday, Sept. 7, 2022 from 2 p.m. to 3:30 P.M. ET. Click here for more information about the grants and here for next month’s webinar link.

NABH Submits Medicare Advantage Program Recommendations to CMS

NABH this week responded to a request for information from the Centers for Medicare & Medicaid Services (CMS) about the Medicare Advantage (MA) program and behavioral health.

In its letter, NABH cited a recent study that found MA networks included only 23% of psychiatrists in a county on average — lower than all other medical specialties. “Not surprisingly, MA enrollees with depressive symptoms report more difficulty accessing needed treatment and rated their experience with the MA plans as worse than in traditional Medicare,” the letter said.

The association provided information and outlined recommendations related to advancing health equity, expanding access, encouraging innovation to promote patient-centered care, and engaging partners.

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

NABH has extended the deadline to Friday, Sept. 16 for members to submit changes about their organizations for the online-only NABH 2022 Membership Directory.

Last month NABH sent its system members a message with a link to the association’s membership-update tool. To help ensure we have the most accurate information on our members, please use this tool to verify your system’s information.

NABH has added several new categories this year. The answers to these questions will help us provide a more accurate description of our diverse membership to policymakers, regulators, partner organizations, and the media. Please be sure to enter information for all your system’s facilities so that we have a better picture of our diverse membership.

If you need NABH to re-send the link, please contact Maria Merlie at maria@nabh.org. Thank you for your cooperation!

Enhanced NABH Denial-of-Care Portal is Now Available 

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

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

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

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

Save the Date for the NABH 2023 Annual Meeting!

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

Fact of the Week

Since October, the use of hashtags related to self-harm – such as “#shtwt, short for Self-Harm Twitter – has increased roughly 500%, averaging tens of thousands of mentions per month, according to a new study from the Network Contagion Research Institute and Rutgers University.

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

Read more

CEO Update 206

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

Read more

CEO Update 205

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

The Centers for Medicare & Medicaid Services this week released a series of fact sheets and resources to help the nation’s healthcare providers prepare for the end of the Covid-19 public health emergency (PHE), which will also end many of the flexibilities the agency offered during the global pandemic.

A blog post from three CMS leaders noted that the agency learned from providers, facilities, insurers, and other stakeholders about what worked well—and didn’t—in relation to the agency’s waivers and other temporary measures.

“Expanding telehealth is an example of a congressional change,” said the blog post from Jonathan Blum, CMS’ chief operating officer and principal deputy administrator; Carol Blackford, director of the agency’s hospital and ambulatory policy group; and Jean Moody-Williams, deputy director of the Center for Clinical Standards and Quality. “The Consolidated Appropriations Act, 2021 expanded access to telehealth services for the diagnosis, evaluation, or treatment of mental health disorders after the end of the PHE,” the authors continued. “These services have been so important to the health and well-being of Americans affected by Covid-19.”

The post also noted that U.S. Health and Human Services Department (HHS) Secretary Xavier Becerra will give the healthcare community 60 days’ notice before the PHE ends.

Providers can refer to a host of fact sheets and resources from CMS in links at the end of the blog post to help prepare as the PHE winds down.

CMS Rule Proposes Requiring Behavioral Health Quality Data Reporting

CMS on Thursday released a proposed rule that would require annual state reporting for three quality measure sets, including the behavioral health measures in the Core Set of Adult Health Care Quality Measures for Medicaid.

The Behavioral Health Core Set includes 13 measures: a depression measure under the Primary Care Access and Preventive Care domain; four measures related to individuals with substance use disorders including one related to medication assisted treatment; two related to the prescribing of opioids; and six measures related to individuals with mental disorders. These core sets are designed to measure the overall national quality of care for beneficiaries, monitor performance at the state level, improve the quality of health care, and provide a national view of quality.

CMS has proposed that reporting these measures—currently a voluntary practice—become mandatory in fiscal year 2024. Data reported in 2024 will reflect care delivered in calendar year 2023.

“The Medicaid and CHIP Core Sets of quality measures for children, adults, and health home services are key to promoting health equity,” CMS Administrator Chiquita Brooks-LaSure said in an announcement. “They will allow us not only to identify health disparities but also to implement interventions based on the very data that make those disparities clear.”

In addition to the Child and Adult Core Sets, CMS has proposed establishing reporting requirements for states that elect to implement one or both of the optional Medicaid health home benefits under sections 1945 or 1945A of the Social Security Act, which will measure healthcare quality for states that choose to establish “health homes.”

Public comments about the proposed rule are due Oct. 21, 2022. The rule will be published in the Federal Register on Monday, Aug. 22.

New JAMA Study Shows Pervasiveness of Methamphetamine Use in Rural America

Findings from a JAMA Network Open study released this week show that nearly four of five people taking drugs in rural areas across 10 states used methamphetamine in the past 30 days.

Meanwhile, non-fatal overdoses in the past six months were higher among people using both methamphetamines and opioids (22%), compared with opioids alone (14%), or methamphetamines alone (6%).

“The challenge is compounded in rural communities that often lack buprenorphine prescribers: more than one-half of U.S. counties (53.4%) do not have a buprenorphine prescriber, leaving 30 million people in those counties without access to treatment,” the researchers wrote. “Similarly, rural opioid treatment programs are rare, leading to long driving times to access methadone,” they continued, adding that educational interventions are needed to train primary care physicians, who are essential providers of opioid use disorder treatment in rural America.

“For example,” they wrote, “contingency management training interventions could be adapted to support rural primary care practitioners.”

NABH Annual Membership Updates Are Due Today

The deadline to submit changes about your organization for the online-only NABH 2022 Membership Directory is today, Friday, Aug. 19.

Last month NABH sent its system members a message with a link to the association’s membership-update tool. To help ensure we have the most accurate information on our members, please use this tool to verify your system’s information.

NABH has added several new categories this year. The answers to these questions will help us provide a more accurate description of our diverse membership to policymakers, regulators, partner organizations, and the media. Please be sure to enter information for all your system’s facilities so that we have a better picture of our diverse membership.

If you need assistance, please contact Maria Merlie at maria@nabh.org. Thank you!

Enhanced NABH Denial-of-Care Portal is Now Available

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

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

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

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

Save the Date for the NABH 2023 Annual Meeting!

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

Fact of the Week

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

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

Read more

CEO Update 203

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

In a final rule released Thursday, the Centers for Medicare & Medicaid Services (CMS) said total estimated payments to inpatient psychiatric facilities (IPFs) are estimated to increase by 2.5%, or $90 million, in fiscal year 2023 relative to IPF payments in 2022. This is larger than the 1.5% payment increase the agency proposed this spring.

For 2023, CMS is updating the IPF prospective payment system (PPS) rates by 3.8%, based on the final IPF market basket update of 4.1% minus a 0.3 percentage point productivity adjustment.

CMS is also updating the outlier threshold so that estimated outlier payments remain at 2% of total payments. The agency estimates this will result in a 1.2% decrease to aggregate payments, due to updating the outlier threshold. CMS noted that due to rounding, the 3.8% increase to payment rates and the 1.2% decrease to outlier payments yield a 2.5% overall increase in IPF payments.

A fact sheet from CMS highlights the final rule’s major provisions, including a permanent 5% cap policy to ease the impact of year-to-year changes in IPF payments related to decreases in the IPF wage index.

Finally, CMS did not make final any changes for the IPF Quality Reporting Program in the 2023 final rule.

Gov. Phil Murphy Announces ‘Strengthening Youth Mental Health Care’ as NGA Chair’s Initiative

Incoming National Governors Association (NGA) Chair Gov. Phil Murphy (D-N.J.) announced “Strengthening Youth Mental Health Care” is his chair’s initiative as he leads the organization from 2022-2023.

“We are all aware of the youth mental health crisis in our country,” Murphy said during the closing session of the NGA’s summer meeting in Portland, Maine. “It is a crisis that the pandemic did not create but exposed more fully,” he added. “It is one that we must tackle together, and tackle now.”

Murphy also acknowledged access-to-care problems and highlighted the four pillars of his chair’s initiative: prevention and resilience building; increasing awareness and reducing stigma; access and affordability of quality treatment and care; and caregiver and educator training and support.

Click here to read more about Murphy’s initiative.

Opioid Response Network & National Association of Counties Offer Guidance on Managing Opioid Litigation Funds   

The Opioid Response Network (ORN) and the National Association of Counties (NACo) have partnered to strengthen the association’s new Opioid Solutions Initiative and resource center, which offers guidance to U.S. counties about how to use funding from litigation between states and opioid manufacturers and distributors.

The support center provides guidance on managing opioid litigation funds, information about effective substance use prevention, treatment and recovery approaches that are approved uses of settlement funds, case studies on evidence-based practices, and  — with help from the ORN — free, on-demand education and training.

Click here to read more about NACo’s Opioid Solutions Center and click here to submit requests for free education and training.

NABH Annual Membership Update: 2022 Membership Directory

NABH is developing its online-only 2022 Membership Directory, an essential member benefit that helps the asssociation in its advocacy efforts.

Earlier this week, NABH sent its system members a separate message that includes a link to the association’s membership-update tool. To help ensure we have the most accurate information on our members, please use the link to our membership-update tool and verify your system’s information.

NABH has added several new categories this year. The answers to these questions will help us provide a more accurate description of our diverse membership to policymakers, regulators, partner organizations, and the media. Please be sure to enter information for all of your system’s facilities so that we have a better picture of our diverse membership.

The deadline to submit your changes to NABH is Friday, Aug. 19, 2022. If you need assistance, please contact Maria Merlie at maria@nabh.org. Thank you!

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

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

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

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

“We know the best way to advocate for parity enforcement with regulators is to provide hard data from our members that show how insurers are not complying with the landmark 2008 parity law,” said NABH President and CEO Shawn Coughlin. “We hope these new changes will make it easier—and faster—for our members to use so that we can gather that critical data.”

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

Save the Date for the NABH 2023 Annual Meeting!

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

Fact of the Week

Calls to the new, national 988 behavioral health crisis hotline increased by 45% during the week after it transitioned to a three-digit number from a longer one.

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

Read more

CEO Update 202

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

In a recent JAMA commentary, the head of the White House Office of National Drug Control Policy (ONDCP) said the lack of real-time data for both fatal and nonfatal drug overdoses in the United States undermines the ability to respond accountably and restricts the potential to understand the effects of actions and investments.

ONDCP Director Rahul Gupta, M.D., M.B.A., M.P.H., and David Holtgrave, Ph.D., also of ONDCP, argued that it’s essential to build the national data system while taking actions to prevent overdoses and save lives in the near term.

“Once established, this national system should rapidly yield higher-quality, more complete, more timely, and more actionable data to inform increasingly effective policy making to prevent and treat overdose occurrences and build health equity,” the authors wrote. “Doing so will require the partnership of many, but there is not a moment to lose.”

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

Politico reported this week that the influential Uniform Law Commission agreed to propose legislation to state legislatures that would try to create more consistency in telehealth laws and expand access to care across state lines.

The commission nearly unanimously approved the model legislation after two years of deliberations and guidance from the American Medical Association, Federal Trade Commission, state medical boards, and telehealth groups.

“It’s unclear how many states will move to create new laws around telehealth — or use the Uniform Law Commission’s model — but legislatures have embraced past proposals on issues ranging from regulation of organ donation to taxation of people who work in multiple states,” the story noted.

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

The nation’s rural health clinics (RHCs) still have an opportunity to apply for funding from the Health Resources and Services Administration’s (HRSA) program that pays providers who are waivered to prescribe buprenorphine, a medication used to treat opioid use disorder.

Launched in 2021, HRSA’s program has about $1.2 million in program funding still available, and RHCs may apply for a $3,000 payment on behalf of each provider who trained to obtain the necessary waiver. HRSA said funds will be paid on a first-come, first-served basis until funds are exhausted.

Please direct any questions to DATA2000WaiverPayments@hrsa.gov. In addition, the American Osteopathic Academy of Addiction Medicine and the Providers Clinical Support System are offering a free online course for waiver-eligibility training. Click here for more information.

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

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

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

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

“We know the best way to advocate for parity enforcement with regulators is to provide hard data from our members that show how insurers are not complying with the landmark 2008 parity law,” said NABH President and CEO Shawn Coughlin. “We hope these new changes will make it easier—and faster—for our members to use so that we can gather that critical data.”

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

Save the Date for the NABH 2023 Annual Meeting!

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

Fact of the Week

Sixty-four percent of dual-eligible beneficiaries have a mental health diagnosis, according to a recent profile from research firm. ATI Advisory.

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

Read more

CEO Update 200

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

The Centers for Medicare & Medicaid Services (CMS) on Thursday proposed new policies to update coverage for behavioral health services in the agency’s physician fee schedule proposed rule for 2023.

In the rule, CMS proposes to address the behavioral healthcare workforce shortage by allowing licensed professional counselors (LPCs), marriage and family therapists (LMFTs), and other types of behavioral health practitioners to provide behavioral health services under general, rather than direct, supervision. CMS also proposes to pay for clinical psychologists and licensed clinical social workers to provide integrated behavioral health services as part of a patient’s primary care team.

In addition, the rule proposes to bundle certain chronic pain management and treatment services into new monthly payments to help improve patient access to team-based, comprehensive, chronic pain treatment. And the agency is proposing to cover opioid treatment and recovery services from mobile units, such as vans, to increase access to services for people who are homeless or live in rural areas.

Meena Seshamani, M.D., Ph.D., director for the Center for Medicare at CMS, and Douglas Jacobs, M.D., M.P.H., chief transformation officer at the Center for Medicare, co-authored a blog post Thursday about the behavioral health changes in the proposed rule.

Federal Health Officials Recommend ‘Preaddiction’ to Treat SUDs

Directors at the National Institutes of Health and the founder of the Treatment Research Institute this week recommended that the DSM-5 diagnostic categories “mild to moderate SUD” be a starting definition for the term preaddiction, a term they said could generate greater attention to the risks associated with early state substance use disorder (SUD) and help direct policies and resources to support preventive and early intervention measures.

Nora Volkow, M.D., director of the National Institute on Drug Abuse, George Koob, Ph.D., director of the National Institute on Alcohol and Abuse and Alcoholism, and Tom McClellan, founder of the Treatment Institute wrote a commentary in JAMA Psychiatry this week that pushed for using the term preaddiction and highlighted lessons learned from Type 2 Diabetes and the role of “prediabetes” in their argument.

As the authors explained, the American Diabetes Association in 2001 suggested the term prediabetes (defined by elevated scores on two laboratory tests: impaired glucose tolerance and impaired fasting glucose) to leverage public motivation to avoid serious diabetes.

“Intervening early is not a new concept, nor is it easy to implement,” the authors wrote. “The diabetes field likely succeeded owing to a broad, well-organized, and sustained strategy applied concurrently at the clinical, public, and policy levels,” they said, adding that if an analogous approach is to be effective in the SUD field, it will require similarly integrated efforts in three areas: measures to define and detect preaddiction; engaging, effective interventions for preaddiction; and public and clinical advocacy.

“The diabetes example illustrates why a similar strategy has not yet happened in the SUD field: poor integration into the rest of mainstream healthcare, lack of a prominent advocacy group demanding clinical and policy changes, and little reimbursement for interventions with less severe SUDs,the authors noted. “Nonetheless, the diabetes example shows that an early intervention approach can work given a comprehensive, sustained effort. That example also suggests the potential impact from a parallel strategy to reduce addiction problems by more aggressive efforts to identify and reverse preaddiction.”

Volkow discussed the issue further in her blog on July 6.

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

The U.S. Housing and Urban Development Department (HUD) recently announced $322 million for permanent housing, supportive services, and other costs, and $43 million to fund about 4,000 new incremental housing choice vouchers.

The Initiative for Unsheltered and Rural Homelessness through HUD promotes partnerships with healthcare organizations, public housing authorities and mainstream housing providers, and people with lived experience and expertise of homelessness.

“President Biden is following through on his promise to unite our country by delivering funding for healthcare and services that support individuals who are unhoused,” Rahul Gupta, M.D., director of the White House Office of National Drug Control Policy, said in an announcement. “As a physician I have seen firsthand how important it is to address the social and economic conditions of a person’s life in order for them to realize the health and well-being every American deserves.”

Click here to learn more in the full HUD announcement.

SAMHSA Releases Advisory on Peer Supports Services in Crisis Care

The Substance Abuse and Mental Health Services Administration (SAMHSA) has released an advisory that discusses the role of peer support workers and models that are available to help individuals in crisis.

The 17-page resource includes information about the evidence base for peer support services in crisis care, what peer support workers should do, how the recovery process looks different for everyone, and more.

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

The National Academies’ Forum on Mental Health and Substance Use Disorders will host a public workshop that focuses on early intervention for psychosis, current data on the epidemiology and outcomes for people at high risk for psychosis and those who have experienced a first psychosis, and ways to improve care for these patients.

Sessions will provide an overview of the epidemiology for people with psychosis, discuss what services are available and highlight successful models of care, and examine policy solutions and strategies that the most effective for coordinated specialty services.

The workshop will be held on Monday, July 11 from 11 a.m. to 5 p.m. ET. Click here to register.

Reminder: 2022 Annual Meeting Evaluation

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

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

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CEO Update 199

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

The Substance Abuse and Mental Health Services Administration (SAMHSA) will host a 90-minute webinar for business managers and compliance officers on July 7 to help ensure their organizations comply with SAMHSA’s 42 CFR Part 2 regulations.

The lesson will highlight the latest updates released in January 2018; examine multiple scenarios and frequently asked questions related to SAMHSA’s mental health, substance abuse, and alcohol abuse records; and address proper ways to secure and/or release this information.

SAMHSA urges practice managers, business associates who work with health records, compliance officers, physicians, and other medical professionals to attend the webinar on Thursday, July 7 at 1 p.m. ET.

Click here to register.

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

In its new White House Blueprint for Addressing the Maternal Health Crisis, the Biden administration has recommended 50 actions that more than a dozen federal agencies will take to improve maternal care in the United States, including some related to behavioral health.

Released in June, the 68-page blueprint outlines five goals, starting with Goal #1: Increase Access to and Coverage of Comprehensive High-Quality Maternal Health Services, Including Behavioral Health Services.

“We will continue to invest in maternal behavioral health by launching a 24/7 national support hotline for pregnant individuals and new mothers facing mental health challenges and improving provider education,” the blueprint noted in this first goal. “We will also strengthen access to perinatal addiction services by partnering with hospitals and community-based organizations to implement evidence-based practices,” it continued. “Congress must also take critical steps to bolster access to and coverage of maternal health services.”

Other behavioral health-related action items include strengthening supports and access to perinatal addiction services for individuals with substance use disorder by partnering with hospitals and community-based organizations to implement evidence-based interventions, and appointing a dedicated associate administrator for women’s services at SAMHSA to lead its efforts in promoting positive mental health during pregnancy and in the postpartum period.

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

NABH this week responded to the Agency for Healthcare Research and Quality’s (AHRQ) request for information (RFI) regarding potential Consumer Assessment of Healthcare Providers and Systems (CAHPS) for Inpatient Mental Healthcare Settings.

AHRQ’s detailed RFI seeks to identify the highest priority aspects patient experiences to include in measures and surveys, the benefits of collecting information about a patient’s experience from family members and caregivers, the challenges that exist in collecting this information, and much more.

“During inpatient stays, patients are typically experiencing an increase in psychiatric symptomatology, including, but not limited to, hallucinations, paranoia, delusions, emotional lability, and fragmented cognitive processes,” NABH’s letter said in response to a question about the challenges in administering measures and surveys in mental healthcare settings. “Patients may thus be limited in their ability to express thoughts and feelings, to comprehend written material, or sustain their attention to complete a survey,” the letter continued. “For these reasons, we suggest limiting surveys to 20-25 questions, or 8-10.”

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

The National Academies’ Forum on Mental Health and Substance Use Disorders will host a public workshop that focuses on early intervention for psychosis, current data on the epidemiology and outcomes for people at high risk for psychosis and those who have experienced a first psychosis, and ways to improve care for these patients.

Sessions will provide an overview of the epidemiology for people with psychosis, discuss what services are available and highlight successful models of care, and examine policy solutions and strategies that the most effective for coordinated specialty services.

The workshop will be held on Monday, July 11 from 11 a.m. to 5 p.m. ET. Click here to register.

Reminder: 2022 Annual Meeting Evaluation

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

Fact of the Week

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

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

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

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CEO Update 198

Senate Passes Gun-Control Bill with Mental Health Provisions

The Senate on Thursday passed the most significant gun-control legislation since the mid-1990s in a bill that includes about $15 billion in mental health and school security funding. The House is expected to vote today, June 24, on the measure.

The Bipartisan Safer Communities Act expands the existing Medicaid Certified Community Behavioral Health Clinic (CCBHC) demonstration program to all states; helps states to implement, enhance, and expand school-based health programs under Medicaid through updated guidance, technical assistance, and state planning grants; requires the Centers for Medicare & Medicaid Services (CMS) to provide guidance to states on how they can increase access to behavioral health services through telehealth under Medicaid and CHIP; appropriates $150 million to help implement the upcoming 988 behavioral health crisis hotline; provides $500 million through the School-Based Mental Health Services Grant Program to increase the number of qualified mental health service providers that provide school-based mental health services to students in school districts with demonstrated need; and more.

President Biden said he intends to sign the bill into law.

“Last month, President Biden spent hours with the family members whose lives were forever changed by the recent shootings at a grocery store in Buffalo, New York and an elementary school in Uvalde, Texas,” said a Statement of Administration Policy from the Office of Management and Budget. “The family members delivered a simple message, which the president then relayed to the American people: do something. Do something to stop the carnage of gun violence that leaves behind grief and trauma in communities, both big and small, across the country.”

The statement added that the bill advances President Biden’s agenda to expand access to mental health services and address the trauma of gun violence affecting so many communities.

Click here to read the legislation.

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

In a 402-20 vote Wednesday, the House of Representatives passed H.R. 7666, the Restoring Hope for Mental Health and Well-Being Act, which would reauthorize essential Substance Abuse and Mental Health Services (SAMHSA) and Health Resources and Services Administration (HRSA) programs to address the nation’s mental health and substance use crises.

The bill would reauthorize and modify several programs, including the Community Mental Health Services Block Grant, the Substance Abuse Prevention and Treatment Block Grant, and grants related to suicide prevention and the behavioral health workforce.

In remarks on the House floor, House Majority Leader Steny Hoyer (D-Md.) applauded the House Energy and Commerce Committee and all House members whose legislation was included in the package.

“I hope this strong vote today will help move these critical policies through the Senate and see them quickly enacted into law,” Hoyer added.

On Tuesday, the Biden administration said it supported the bill in a Statement of Administrative Policy.

World Health Organization Releases First World Mental Health Report Since 2001

The World Health Organization (WHO) has released its largest review of world mental health since it released World Health Report 2001: Mental Health: New Understanding, New Hope.

The latest iteration, Transforming Mental Health for All, provides a roadmap for governments, academics, health professionals, and others to support the world in transforming mental health.

“As the world comes to live with, and learn from, the far-reaching effects of the Covid-19 pandemic, we must all reflect on one of its most striking aspects – the huge toll it has taken on people’s mental health,” the nearly 300-page report noted. “Rates of already-common conditions such as depression and anxiety went up by more than 25% in the first year of the pandemic, adding to the nearly one billion people who were already living with a mental disorder,” it continued. “At the same time, we must recognize the frailty of health systems attempting to address the needs of people with newly-presenting as well as pre-existing mental health conditions.”

The report also said that since 2001, countries worldwide have formally adopted international frameworks that guide them to act for mental health. And, it continued, WHO member states have adopted the Comprehensive Mental Health Action Plan 2013-2030, which commits them to meeting 10 global targets for improved mental health.

Categorized in eight sections, the report examines principles and drivers in public mental health, assesses world mental health today, argues for investment in mental health, considers promotion and prevention strategies for change, and explores how to restructure and scale up care.

MACPAC Examines How Medicaid Policy Can Support Adopting Behavioral Health IT

In its June report to Congress, the Medicaid and CHIP Payment and Access Commission (MACPAC) analyzed how Medicaid policy can be used to support adopting health information technology among behavioral healthcare providers.

The report highlighted that Medicaid programs play a critical role in financing behavioral health services and that those programs are focused on ways to provide behavioral health in more integrated settings.

Therefore, the Commission recommended, “…that CMS issue guidance to help states use Medicaid authorities and other federal resources to promote behavioral health IT adoption, and that the Office of the National Coordinator for Health Information Technology and the Substance Abuse and Mental Health Services Administration work together to develop voluntary standards that would encourage health IT uptake appropriate for behavioral health.”

See chapter 4 of the report, Encouraging Health Information Technology Adoption in Behavioral Health: Recommendations for Action, to learn more.

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

The Centers for Disease Control and Prevention (CDC) has launched an alcohol-screening tool for adults to check their drinking, identify barriers to drinking less frequently, and create a personalized plan to make healthier drinking choices—all anonymously.

The resource is part of the Atlanta-based agency’s new Drink Less, Be Your Best campaign that highlights the harmful effects of alcohol and provides resources to help adults drink less.

CDC noted in its announcement that the tool is not intended for medical diagnosis or treatment.

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

Award-winning filmmaker Ken Burns presents Hiding in Plain Sight: Youth Mental Illness, a two-part documentary film by Erik Ewers and Christopher Loren Ewers on Monday and Tuesday, June 27 and 28 at 9 p.m. ET on PBS.

Click here to see a preview of the film, which includes a brief introduction from Burns.

2022 Annual Meeting Presentations Available Online

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

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

The National Academies’ Forum on Mental Health and Substance Use Disorders will host a public workshop this summer that focuses on early intervention for psychosis, current data on the epidemiology and outcomes for people at high risk for psychosis and those who have experienced a first psychosis, and ways to improve care for these patients.

Sessions will provide an overview of the epidemiology for people with psychosis, discuss what services are available and highlight successful models of care, and examine policy solutions and strategies that are the most effective for coordinated specialty services.

The workshop will be held on Monday, July 11 from 11 a.m. to 5 p.m. ET. Click here to register.

Save the Date for the 2023 Annual Meeting!

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

Fact of the Week

In 2019, nearly a billion people – including 14% of the world’s adolescents – were living with a mental disorder, the World Health Organization reports.

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

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CEO Update 197

NABH Annual Meeting Kicks Off on Monday!

We’re pleased to devote this week’s edition of CEO Update to details about our Annual Meeting that starts on Monday, June 13!

Our theme this year is Shaping the Future of Behavioral Healthcare, and our speakers—including HHS Secretary Xavier Becerra— will address topics that affect our industry today and in the years ahead. From parity and access to care, to the Biden’s administration’s behavioral health and drug control strategies, to the 2022 midterm elections, to workforce challenges and solutions, to the upcoming 988 behavioral health crisis hotline, this year’s program is one you won’t want to miss.

On Monday, please be sure to look for an Annual Meeting Alert, which will include a link to our mobile app that contains important details about sessions, events, committee meeting room assignments, exhibitors and sponsors, our priorities for the 117th Congress, restaurant recommendations in the Washington area, and more.

We’ll open our meeting on Monday with two dynamic speakers: Ben Nemtin will discuss his personal battle with clinical depression and how to thrive personally and professionally, and journalist Sam Quinones will share his experiences writing his most recent book, The Least of Us: True Tales of America and Hope in the Time of Fentanyl and Meth. Sam will sign copies of his book after his presentation.

As with previous Annual Meetings, we will post presentations on our website after the meeting ends. Registration opens on Monday at noon, and our first session kicks off in the Mandarin Oriental’s Grand Ballroom at 2:30 p.m. I hope to see you there!

-Shawn Coughlin, President and CEO

HHS Secretary Becerra to Address Attendees on Tuesday, June 14

HHS Secretary Xavier Becerra, the 25th secretary of the U.S. Health and Human Services Department and the first Latino to hold that office, will address Annual Meeting attendees on Tuesday, June 14 at 8:30 a.m. in the Grand Ballroom.

Secretary Becerra will offer brief remarks and then engage in a question-and-answer session with NABH President and CEO Shawn Coughlin.

Previously Secretary Becerra was California’s attorney general and before that served for 12 terms in the U.S. House of Representatives, where he was the first Latino to serve as a member of the powerful House Ways and Means Committee. He also served as chairman of his party’s caucus and as the ranking member of both the Ways and Means Subcommittee on Health and Ways and Means Subcommittee on Social Security.

Secretary Becerra will discuss the Biden administration’s comprehensive strategy to address America’s mental health crisis, which includes promoting the well-being of the nation’s frontline healthcare workforce, piloting new approaches to training behavioral health paraprofessionals, strengthening the country’s crisis care and suicide prevention infrastructure, integrating mental health and substance use treatment into primary care, expanding and strengthening parity, and more.

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

Following Secretary Becerra’s presentation on Tuesday, Office of National Drug Control Policy (ONDCP) Director Rahul Gupta, M.D., M.B.A., FACP will provide a presentation at 9:30 a.m. in the Grand Ballroom.

Dr. Gupta is the first medical doctor to serve as director and lead ONDCP, a component of the Executive Office of the President. ONDCP coordinates the nation’s $40 billion drug budget and federal policies, including prevention, harm reduction, treatment, recovery support, and supply reduction.

Through his work as a physician, a state and local leader, an educator, and a senior leader of a national nonprofit organization, Dr. Gupta has dedicated his career to improving public health and public safety.

He is also a buprenorphine-waivered practitioner, who has provided medication-assisted treatment for people with opioid use disorder.

The son of an Indian diplomat, Dr. Gupta was born in India and grew up in the suburbs of Washington, D.C. At age 21, he completed medical school at the University of Delhi and later completed subspecialty training in pulmonary medicine.

Dr. Gupta earned a master’s degree in public health from the University of Alabama-Birmingham and a global master’s of business administration degree from the London School of Business and Finance.

Panel to Examine Ways to Address Behavioral Healthcare Workforce Challenges

Workforce shortages have challenged NABH members for years before the pandemic worsened the problem. For this year’s Annual Meeting, NABH has developed a panel to discuss potential solutions.

Please join us in the Grand Ballroom on Tuesday, June 14 at 11 a.m. to learn from panelists Megan Baird of the Office of Apprenticeship in the U.S. Labor Department’s Employment and Training Administration; Malissa Lewis, LL.M of the Health Resources and Services Administration; and David Long of Pinnacle Treatment Centers, an NABH member organization.

NABH Director of Quality and Addiction Services Sarah Wattenberg, L.C.S.W. will moderate a discussion that will highlight apprenticeships, loan repayment programs, and more.

Political Commentator Amy Walter to Discuss 2022 Midterm Elections

Be sure to attend this year’s Annual Meeting Luncheon at noon on Tuesday, June 14 in the Oriental Ballroom to learn from political commentator Amy Walter, who will preview this fall’s midterm election season.

Walter, editor in chief of the Cook Political Report with Amy Walter and a political commentator for the PBS NewsHour, provides analysis of the issues, trends, and events that shape the political environment. She is also a regular Sunday panelist on NBC’s Meet the Press and CNN’s Inside Politics and appears frequently on Special Report with Bret Baier on Fox News Channel.

From 2017 until early 2021, Walter was the host of the weekly nationally syndicated program “Politics with Amy Walter” on The Takeaway from WNYC and PRX. She’s also the former political director of ABC News.

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

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

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CEO Update 196

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

The Biden Administration concluded Mental Health Month this week by announcing new actions to advance President Biden’s mental health strategy in three previously announced objectives: strengthening system capacity, connecting more Americans to care services, and creating a continuum of support.

The White House noted that America’s mental health crisis is unprecedented, as two in five American adults report symptoms of anxiety and depression, and more than half of U.S. parents express concern about their children’s mental well-being. Meanwhile, the announcement continued, more than 40% of teenagers report they struggle with persistent feelings of sadness and hopelessness.

“These growing demands have exposed longstanding cracks in our care infrastructure while compounding many other challenges, from criminal justice to homelessness to the labor shortage,” the White House announcement said.

In a new fact sheet, the Biden Administration outlined applicable action steps to address the crisis, such as promoting the well-being of the healthcare workforce, piloting new approaches to training behavioral health paraprofessionals, bolstering the nation’s crisis care and suicide prevention infrastructure, building capacity for long-term care facilities to deliver behavioral health services, making care affordable across all types of health insurance coverage, integrating mental health services in ways that reduce stigma and access barriers, and more.

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

HHS’ Office on Women’s Health is accepting applications for projects designed to strengthen the perinatal (from conception to birth) and postnatal (up to 12 months after birth) to support structures for patients with substance use disorder (SUD) and reduce deaths during those two time periods.

Applicants who receive funding will be expected to partner with hospital and community-based organizations to implement evidence-based interventions that strengthen perinatal and postnatal support structures for patients with SUD; create a technologically innovative education and outreach products to provide support accessible to perinatal and postpartum patients with SUD at home and on the go to reduce triggers, decrease stress, and increase feelings of support; and improve health outcomes and reduce deaths among perinatal and postpartum patients associated with SUD.

Both for-profit and not-for-profit organizations are eligible to apply. Click here to learn more and apply.

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

The National Academies’ Forum on Mental Health and Substance Use Disorders will host a public workshop this summer that focuses on early intervention for psychosis, current data on the epidemiology and outcomes for people at high risk for psychosis and those who have experienced a first psychosis, and ways to improve care for these patients.

Sessions will provide an overview of the epidemiology for people with psychosis, discuss what services are available and highlight successful models of care, and examine policy solutions and strategies that are most effective for coordinated specialty services.

The workshop will be held on Monday, July 11 from 11 a.m. to 5 p.m. ET. Click here to register.

NABH Working to Enhance Denial-of-Care Portal

NABH’s Denial-of-Care Portal is temporarily unavailable as the association works to enhance features of this member-only resource.

NABH developed the portal so members could submit individual examples of claim denials or upload multiple entries via Excel. It also includes sections on appeals and physician participation and is intended to help the association in its advocacy efforts with policymakers and regulators.

NABH will inform members when the updated portal is ready to use.

Learn About Our 2022 Annual Meeting Speakers!

The NABH 2022 Annual Meeting is fewer than two weeks away. Please be sure to learn more about this year’s speakers here on our Annual Meeting homepage.

And please be sure to register for the meeting, if you have not done so yet.

We look forward to seeing you soon in Washington!

Fact of the Week

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

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

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CEO Update 195

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

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CEO Update 194

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

NABH last week requested that the full 9th U.S. Circuit Court of Appeals review a recent ruling from a three-judge panel that erroneously reversed a trial court’s landmark decision last year in the mental health class action, Wit v. United Behavioral Health.  

NABH filed an amicus brief to request a “rehearing en banc.” If granted, a rehearing could vacate the appellate panel’s deeply flawed ruling. The American Hospital Association, American Psychological Association, American Association for the Treatment of Opioid Dependence, California Hospital Association, Federation of American Hospitals, National Association of Addiction Treatment Providers, National Council for Mental Wellbeing, and REDC added their organization names to the amicus brief.

“Unfortunately, the likely consequence of the panel decision is that the gains achieved as a result of the district court’s rulings will be wiped out as even further restrictions are placed on the care patients receive for treatment of mental illness,” the amicus brief states. “Instead of medical necessity determinations based on GASC developed by non-profit expert bodies, the decision-making power will be left to the discretion of for-profit insurers such as UBH.”
 
Click here to read the news release that NABH distributed on Monday, May 16.

SAMHSA Introduces First ‘Behavioral Health Recovery Innovation Challenge’

The Substance Abuse and Mental Health Services Administration (SAMHSA) this week introduced its first “Behavioral Health Recovery Challenge” to identify innovations that peer-run or community-based organizations—and entities that partner with them, including hospitals and health systems—have developed to advance recovery.

SAMHSA defines recovery as “a process of change through which individuals improve their health and wellness, live self-directed lives, and strive to reach their full potential.”

SAMHSA’s announcement noted that the agency encourages participants to share details about the practices they use to advance recovery and also demonstrate how these practices have: 1) expanded on SAMHSA’s definition of recovery, or 2) helped them overcome challenges in incorporating recovery into their behavioral health services or systems.

“By using this vehicle, we hope to gain a better understanding of effective and innovative recovery practices from a very diverse field,” HHS Assistant Secretary for Mental Health and Substance Use Miriam E. Delphin-Rittmon, Ph.D., said in an announcement. Delphin-Rittmon also leads SAMHSA. “We aim to take what works for a small group and scale up to a larger population.”

Click here to learn more from SAMHSA’s Recovery Innovation Challenge webpage.

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

SAMHSA this week announced a funding opportunity that will award $2 million per year up to five years to establish a national Center of Excellence (CoE) that will develop and disseminate information, guidance, and training on the effects of children and youth’s social media use, including both its risks and benefits.

SAMHSA’s grant announcement noted that the new CoE will pay particular attention to the potential risks social media platforms pose to the mental health of children and youth, as well as the clinical and societal interventions that could be used to address those risks.

Eligible applicants include states, political divisions of states, Indian tribes or tribal organizations, health facilities, programs operated by or in accordance with a grant contract with the Indian Health Service, or other public of private, not-for-profit entities.

The deadline to apply is Monday, July 18. Click here to learn more.

SAMHSA Announces $1.5 billion for State Opioid Response Program

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

The use of contingency management for the treatment off stimulant use disorder is a permitted use of grant funds. The application process opened on Thursday, May 19 and will remain open through Monday, July 18. Click here to learn more.

NABH Working to Enhance Denial-of-Care Portal

NABH’s Denial-of-Care Portal is temporarily unavailable as the association works to enhance features of this member-only resource.

NABH developed the portal so members could submit individual examples of claim denials or upload multiple entries via Excel. It also includes sections on appeals and physician participation and is intended to help the association in its advocacy efforts with policymakers and regulators.

NABH will keep members apprised of when the updated portal is ready to use.

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

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

And please visit our Annual Meeting webpage to register for the meeting, if you have not done so yet. We look forward to seeing you in Washington!

Fact of the Week

In a recent Cigna survey of 1,000 parents, 80% said their children are struggling with mental health, and nearly one-fifth (18%) say their child’s needs are negatively affecting their job performance and productivity.

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

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CEO Update 193

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

More than 107,000 Americans died of drug overdoses in 2021, according to provisional data from the Centers for Disease Control and Prevention (CDC) released this week.

The troubling statistic—the CDC predicts the total to be 107,622 lives lost— hit a new record, as the number of predicted overdose deaths in 2021 reflects a 15-percent increase in the previous record set in 2020.

“It is unacceptable that we are losing a life to overdose every five minutes around the clock,” the Office of National Drug Control Policy Director Rahul Gupta, M.D., M.P.H., M.B.A., FACP, said in a White House statement. “That is why President Biden’s new National Drug Control Strategy signals a new era of drug policy centered on individuals and communities, focusing specifically on the actions we must take right now to reduce overdoses and save lives.”

Separately this week, the United States Drug Enforcement Administration (DEA) recognized the first Fentanyl Awareness Day on Monday, May 9. The DEA reports that the synthetic opioid fentanyl is about 50 times more potent than heroin and 100 times more potent than morphine. It is also inexpensive, widely available, and highly addictive.

DEA Administrator Anne Milgram released a video announcement about the dangers of fentanyl and the need for urgent action.

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

HHS’ Health Resources and Services Administration (HRSA) this week announced it has extended the deadline for providers to request to submit a late Provider Relief Fund (PRF) Reporting Period 2 (RP2) report to Wednesday, May 18 at 11:59 p.m. ET.

According to HRSA, providers may submit a request if certain extenuating circumstances prevented them from submitting their RP2 report by the initial deadline of March31.

All requests must be completed through the PRF Reporting Portal.

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

The Center for Connected Health Policy (CCHP) this week released a summary of state telehealth policy changes for Spring 2022.

Covering state telehealth policy updates between January and April 2022, the 11-page summary examines state laws and reimbursement policies, private payors, online prescribing, and more.

The resource also includes a state summary chart and an infographic of CCHP’s essential findings.

NABH Working to Enhance Denial-of-Care Portal

NABH’s Denial-of-Care Portal is temporarily unavailable as the association works to enhance features of this member-only resource.

The portal was developed so NABH members could submit individual examples of claim denials or upload multiple entries via Excel. It also includes sections on appeals and physician participation and is intended to help the association in its advocacy efforts with policymakers and regulators.

NABH will keep members apprised of when the updated portal is ready to use.

NABH 2022 Annual Meeting Preliminary Program Now Available!

The NABH 2022 Annual Meeting online preliminary program is now available. Unless noted otherwise, meeting sessions are open to all Annual Meeting attendees.

Please remember to register for the Annual Meeting and reserve your hotel room today, if you haven’t done so yet.

We look forward to seeing you next month in Washington!

Fact of the Week

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

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CEO Update 192

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

A comprehensive report from HHS’ Assistant Secretary for Planning and Evaluation (ASPE) examines the Covid-19 pandemic’s effects on the nation’s healthcare workforce and offers several recommendations, including removing barriers to practicing to the top of one’s license/certification, retaining Covid-19 flexibilities as appropriate, funding for scholarships, and more.
 
The nearly 30-page report, Impact of the COVID-19 Pandemic on the Hospital and Outpatient Clinician Workforce, found that total employment in the healthcare industry declined during the early months of the pandemic but gradually recovered during the summer of 2020. Many hospitals reported critical staffing shortages during the course of the pandemic—especially when Covid case numbers were high—and during the recent Omicron surge in January and February 2022, the seven-day average of hospitals reporting critical staffing shortages peaked at 22% during mid-January 2022, the report noted.

The report acknowledged that several provider types, including behavioral health providers, experienced staffing shortages before the pandemic began.

“Even after the pandemic, many of the effects the pandemic has had on the health care workforce will likely persist,” the report noted. “Addressing these impacts as well as the underlying challenges that pre-dated the pandemic can help build a stronger and more resilient health care system for the future.”

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

The Joint Commission said it has approved its new Infection Prevention and Control standard and its elements of performance as a response to the interim final rule from the Centers for Medicare & Medicaid Services (CMS) late last year.

According to the Joint Commission, the accrediting organization began surveying to the Omnibus Covid-19 Health Care Staff Vaccination interim final rule—which was released on Nov. 5, 2021—on Jan. 27 this year.

“While changes to Joint Commission standards requirements were under review by CMS, findings related to the COVID-19 staff vaccination regulatory requirements have been scored at Leadership (LD) Standard LD.04.01.01, EP 2, along with the applicable Medicare Conditions of Participation/Conditions for Coverage for each of the deemed programs,” the Joint Commission said in an announcement. “This scoring process will continue until June 30, 2022.

Click here to learn more.

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

NABH will welcome John Palmieri, M.D., M.H.A., senior medical advisor at the Substance Abuse and Mental Health Services Administration (SAMHSA) and acting director for the 988 behavioral health crisis hotline and Behavioral Health Crisis Coordinating Office, at the 2022 Annual Meeting in Washington on Tuesday, June 14.

Prior to his arrival at SAMHSA, Dr. Palmieri was the division chief for behavioral healthcare at the Arlington County (Virginia) Department of Human Services. Dr. Palmieri is a licensed physician in Virginia and is board certified in adult psychiatry. He graduated from Brown University Medical School and completed his adult psychiatry residency at Massachusetts General Hospital.

Please click here to learn about our 2022 Annual Meeting speakers.

National Prevention Week is May 8-14

SAMHSA’s National Prevention Week starts Sunday, May 8, and the agency will commemorate the 18th annual National Prevention Day on Monday, May 9. Click here for an agenda of the day’s events.

The week-long commemoration is part of Mental Health Awareness Month, which kicked off on Sunday, May 1. The White House issued a proclamation honoring Mental Health Awareness Month, and Mental Health America (MHA)—which established the monthly observance in 1949—is recognizing the 2022 observance with the theme “Back to Basics.” The campaign is intended to provide what MHA has referred to as “foundational knowledge” about mental health, mental health conditions, and information about what people can do if their mental health is cause for concern.

Please remember to follow NABH on Twitter @NABHbehavioral and on LinkedIn at the National Association for Behavioral Healthcare throughout the month to learn what NABH members, federal agencies, and advocacy organizations are doing to promote Mental Health Month.

NABH Working to Enhance Denial-of-Care Portal

NABH’s Denial-of-Care Portal is temporarily unavailable as the association works to enhance features of this member-only resource.

The portal was developed so NABH members could submit individual examples of claim denials or upload multiple entries via Excel. It also includes sections on appeals and physician participation and is intended to help the association in its advocacy efforts with policymakers and regulators.

NABH will keep members apprised about the updated portal is ready to use.

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

 NABH appreciates the generous support from its exhibitors and sponsors each year at the association’s Annual Meeting.

To learn who is exhibiting and sponsoring NABH in 2022, please visit the Exhibitors & Sponsors page on our Annual Meeting homepage. The page also includes general information, tips for exhibitors, and details about shipping materials to the Mandarin Oriental Washington, DC.

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

Fact of the Week

Audio-only visits were the leading telehealth modality for primary care and behavioral health throughout the full pandemic study period of February 2019 through August 2021, according to a new research report from RAND. At the end of the study period, however, audio-only visits were eclipsed by in-person visits for primary care, but not for behavioral health, the study showed.
 

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

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CEO Update 191

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

The Centers for Medicare & Medicaid Services (CMS) recently released The CMS Behavioral Health Strategy, a five-goal plan that aims to remove barriers to care and services and also adopt a data-informed approach to evaluate the agency’s behavioral health programs and policies.

Noting that the strategy “will strive to support a person’s whole emotional and mental well-being and promotes person-centered behavioral healthcare,” CMS set the following five goals: 1) strengthen equity and quality in behavioral healthcare, 2) improve access to substance use disorders treatment, prevention, and recovery services, 3) ensure effective pain treatment and management, 4) improve access and quality of mental healthcare and services, and 5) utilize data for effective actions and impact on behavioral health.

Click here to learn about the objectives in each of those goals.

SAMHSA Announces New Director of the Center for Substance Abuse Treatment

The Substance Abuse and Mental Health Services Administration (SAMHSA) this week named Yngvild Olsen, M.D., M.P.H. as the new director of the agency’s Center for Substance Abuse Treatment.

An addiction medicine specialist and general internist, Olsen began her career as the medical director for the outpatient substance use treatment services while serving as a full-time assistant professor in the department of medicine at the Johns Hopkins School of Medicine.

From 2011 to 2021, Olsen served as medical director for the Institutes for Behavior Resources/REACH Health Services, a comprehensive outpatient substance use disorder treatment program in Baltimore City.

ONDCP Director Rahul Gupta to Address Attendees at NABH Annual Meeting

NABH is pleased to announce that Director of National Drug Control Policy Rahul Gupta, M.D., M.P.H., M.B.A., FACP will address attendees at the 2022 Annual Meeting on Tuesday, June 14.

Dr. Gupta is the first medical doctor to serve as director and lead the Office of National Drug Control Policy (ONDCP), a component of the Executive Office of the President. ONDCP coordinates the nation’s $40 billion drug budget and federal policies, including prevention, harm reduction, treatment, recovery support, and supply reduction.

Through his work as a physician, a state and local leader, an educator, and a senior leader of a national nonprofit organization, Dr. Gupta has dedicated his career to improving public health and public safety.

He is also a buprenorphine-waivered practitioner, who has provided medication-assisted treatment for people with opioid use disorder.

The son of an Indian diplomat, Dr. Gupta was born in India and grew up in the suburbs of Washington, D.C. At age 21, he completed medical school at the University of Delhi and later completed subspecialty training in pulmonary medicine. Dr. Gupta earned a master’s degree in public health from the University of Alabama-Birmingham and a global master’s of business administration degree from the London School of Business and Finance.

If you have not done so yet, please visit our Annual Meeting homepage and register today. We look forward to seeing you in Washington!

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

NABH President and CEO Shawn Coughlin participated in a webinar about mental health and substance use disorder treatment parity on Tuesday, April 26 with federal health officials and healthcare organization leaders.

Coughlin joined fellow presenters HHS Secretary Xavier Becerra, Assistant Secretary for Mental Health and Substance Use Miriam Delphin-Rittmon, Ph.D., The Kennedy Forum founder and former U.S. Rep. Patrick J. Kennedy (D-R.I.), and American Medical Association President Patrice Harris, M.D. to discuss the Biden administration’s commitment to ensuring parity implementation, the recent Wit v. United Behavioral Health ruling, and ongoing problems with parity compliance. David Lloyd, senior policy advisor at The Kennedy Forum, moderated the event.

During the webinar, Delphin-Rittmon, who serves as administrator of SAMHSA, discussed three parity resources that SAMHSA has developed to help patient families, providers, and policymakers understand parity: Know Your Rights, Understanding Parity: A Guide to Resources for Families and Caretakers, and The Essential Aspects of Parity: A Training Tool for Policymakers.

NABH was the lead sponsor for this webinar and live Tweeted during the event. Click here to watch the recorded broadcast.

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

The Bipartisan Policy Center (BPC) will host a webinar on Monday, May 2 about new recommendations centered on enhancing federal spending and improving the federal response to America’s ongoing opioid crisis.

Participants include Office of National Drug Control Policy Director Rahul Gupta, M.D., M.P.H., M.B.A., FACP; Sen. Joe Manchin (D-W.Va.); American Medical Association President Patrice Harris, M.D.; former U.S. Surgeon General Jerome Adams, M.D.; and former HHS Secretary Donna Shalala.

The hour-long webinar will begin at 1 p.m. ET. Click here to register. 

Mental Health Awareness Month Starts Sunday!

Mental Health Month kicks off this Sunday, May 1 to raise awareness about mental health in America.

Mental Health America (MHA), which established the monthly observance in 1949, will commemorate Mental Health 2022 with the theme “Back to Basics” to provide what MHA has referred to as “foundational knowledge” about mental health, mental health conditions, and information about what people can do if their mental health is cause for concern.

SAMHSA’s National Prevention Week is May 8-14 and the agency will commemorate the 18th annual National Prevention Day on Monday, May 9. Click here for an agenda of the day’s events.

And please remember to follow NABH on Twitter @NABHbehavioral and on LinkedIn at the National Association for Behavioral Healthcare throughout the month to learn what NABH members, federal agencies, and advocacy organizations are doing to promote Mental Health Month.

NABH Working to Enhance Denial-of-Care Portal

NABH’s Denial-of-Care Portal is temporarily unavailable as the association works to enhance features of this member-only resource.

The portal was developed so NABH members could submit individual examples of claim denials or upload multiple entries via Excel. It also includes sections on appeals and physician participation and is intended to help the association in its advocacy efforts with policymakers and regulators.

NABH will keep members apprised when the updated portal is ready to use.

Fact of the Week

Mental health, developmental disorders, and substance use disorders collectively accounted for 48% of all telehealth claims, according to a new report from FAIR Health, a national, not-for-profit organization that produces data products and consumer resources about transparency in healthcare costs and health insurance.
 

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

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CEO Update 190

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.

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CEO Update 189

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

In a set of draft recommendations this week, the U.S. Preventive Services Task Force (USPTF) recommended screening children 12 and older for depression and children 8 and older for anxiety.

“There is not enough evidence to recommend for or against screening for anxiety and depression in younger children and screening for suicide risk in all youth,” the USPTF announced in a bulletin on April 12.

Both the American Academy of Pediatrics (AAP) and the American Foundation for Suicide Prevention (AFSP) expressed serious concerns about the panel’s conclusion that there is insufficient evidence to weigh the benefits and harms of screening asymptomatic children and adolescents for suicide risk. The AAP is urging clinicians to screen all adolescents for suicide risk despite the panel’s finding that more research is needed.

“Youth may keep suicidal thoughts to themselves and will not bring up the topic unless directly asked,” May Lau, M.D., M.P.H., a member of the AAP Section on Adolescent Health Executive Committee and a lead author of the Blueprint for Youth Suicide Prevention from AAP/AFSP, said in an article in AAP News. “By screening all youth for suicide, we can identify those that are at risk and connect them with the services they need.”

Meanwhile, Christine Moutier, M.D., chief medical officer at the AFSP, told the Associated Press this week that the report “may actually set the field back.”

“We have grave concerns that the recommendation citing ‘insufficient evidence’ to implement routine screening for suicide risk for any age youth is 1) flawed due to the incomplete data sources included in their review, and 2) may confuse the field just as major steps are being taken,” Moutier wrote in an e-mail message to NABH. Moutier added that the Blueprint for Youth Suicide Prevention recommends screening for youth ages 12 and older and outlines evidence-based care steps to take for youth who screen positive.

A public comment period for the USPTF’s draft recommendations is open until May 9. Click here for details.

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

HHS’ Health Resources and Services Administration (HRSA) said it is making available more than $1.75 billion in Provider Relief Fund (PRF) Phase 4 General Distribution payments to more than 3,680 providers nationwide this week.

According to HRSA, on April 13 providers received an email notification if their application was among those processed in this latest round, and the agency is working to process all remaining applications as quickly as possible.

Also this week, HHS Secretary Xavier Becerra extended the PHE for an additional 90 days after the current PHE expires on April 16.

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

HRSA this week said healthcare providers will have the opportunity to submit a “Request to Report Late Due to Extenuating Circumstances for Reporting Period 2” if applicable. Last week, HRSA announced the “extenuating circumstances” option for Reporting Period 1, which lasts from April 11 through April 22.

The agency said providers will receive a notification regarding the process to submit a request for Reporting Period 2 in the coming weeks. For more information, visit the Request to Report Late Due to Extenuating Circumstances webpage, or call the Provider Support Line at (866) 569-352 from 9 a.m. to 11 p.m. CT, Monday through Friday.

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

NABH President and CEO Shawn Coughlin will join HHS Secretary Xavier Becerra and other healthcare leaders in a webinar about expanding access to mental health and addiction treatment coverage later this month.

The webinar on Tuesday, April 26 will also feature Assistant Secretary for Mental Health and Substance Use Miriam Delphin-Rittmon, Ph.D., former U.S. Rep. Patrick J. Kennedy, and American Medical Association President Patrice Harris, M.D.

Click here to learn more and register for the hour-long webinar, which will start at 2 p.m. ET.

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

The American Hospital Association (AHA) and the International Association for Healthcare Security and Safety (IAHSS) have developed a toolkit for hospitals and health systems to establish procedures to prevent violence at all levels.

Creating Safer Workplaces is an 11-page resource that provides a framework to build a safer workplace environment; outlines what leaders should consider to promote physical safety and teamwork; highlights how leaders can mitigate risk; describes the role of hospitals in violence intervention; and more.

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

A National Public Radio (NPR) story this week cited a recent Kaiser Family Foundation report that found just 11 states said they would use text messaging to alert Medicaid recipients about the end of the Covid public health emergency, while 33 states will use the U.S. Postal Service and at least 20 will rely on individual or automated phone calls.

“It’s frustrating that texting is a means to meet people where they are and that this has not been picked up more by states,” Jennifer Wagner, director of Medicaid eligibility and enrollment for research group the Center on Budget and Policy Priorities, said in the story.

NPR also noted that officials at the Centers for Medicare & Medicaid Services (CMS) have told states they should consider texting—along with other methods of communication—when trying to contact enrollees about the end of the public health emergency (PHE), but many states don’t have the technology or information about enrollees to do so.

Reminder: NABH Denial-of-Care Portal is Open to Members 

NABH’s Denial-of-Care Portal is available for members to provide information about their experiences with managed care organizations that impose barriers to care through insurance-claim denials.

This NABH member-only, survey-like tool allows users to add the name of a managed care organization, type of plan, level of care, type of care (mental health or substance use disorder), duration of approved treatment, duration of unapproved treatment, criteria used to deny a claim, and more.

The portal allows members to submit individual examples of claim denials or upload multiple entries via Excel. It also includes sections on appeals and physician participation. In time, the tool could be a valuable resource for the NABH team’s advocacy efforts.

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

Deadline for 2022 NABH Exhibitor & Sponsor Guide Ads is Next Week

The deadline to submit an ad in NABH’s 2022 Exhibitor and Sponsor Guide is Tuesday, April 19. Be sure your organization is included in this year’s edition!

Please click here for details about advertising options, requirements, payment, and more.

We hope to see you in Washington in June!

Fact of the Week 

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

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

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CEO Update 188

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