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.