CEO Update | 13
U.S. House Passes First Stand-Alone IMD Exclusion Repeal Bill
In a 261-155 vote, the House of Representatives this week passed the IMD CARE Act, which partially repeals the Medicaid program’s Institutions for Mental Diseases (IMD) exclusion. The move marks the first time either chamber of Congress has voted on a freestanding IMD bill.
Before passing this NABH-supported bill, House members considered and adopted two amendments, which: 1) add cocaine to the list of “targeted SUDs” (substance use disorders) and apply a minimum loss ratio of 85 percent for Medicaid managed care plans, and 2) add two requirements to the report that states are required to submit. The first of those requirements asks for information about the number of individuals suffering from co-occurring disorders and the type of disorders; and the second requires information regarding access to community care for individuals suffering from a mental illness other than substance use disorder.
The legislation limits eligible patients under the provision to no more than 30 days of treatment in an IMD in a year (whether or not those days are consecutive). While the provision applies to patients with opioid use disorder or cocaine disorder, the bill also includes patients with those conditions and other co-occurring mental health or SUDs.
NABH has advocated to repeal the IMD exclusion for decades, and The Hill newspaper this week published a letter to the editor from NABH President and CEO Mark Covall and behavioral healthcare champion and former U.S. Rep. Patrick Kennedy (D-R.I.). Meanwhile, the Henry J. Kaiser Family Foundation released a document that highlights key questions about payment for services in IMDs.
Moments after passing the IMD CARE Act, the House passed the Overdose Prevention and Patient Safety Act, which amends the Public Health Service Act to align federal privacy standards for SUD patient records more closely with standards under the Health Insurance Portability and Accountability Act (HIPAA). Specifically, this bill—which passed in a 357-57 vote—authorizes the disclosure of SUD patient records without a patient’s written consent to: 1) a covered entity for the purposes of treatment, payment and healthcare operations, as long as the disclosure is made in accordance with HIPAA; and 2) a public health authority, as long as the content of the disclosure meets HIPAA standards regarding de-identified information.
The bill also repeals and replaces criminal penalties for violations involving SUD patient records with the HIPAA civil penalty structure. It also expands the existing prohibition against SUD patient records in criminal proceedings to include any use in specified federal, state, and local criminal and civil actions.
Earlier this week, the White House released a Statement of Administration Policy supporting these critical behavioral healthcare reforms.
CMS Issues Bulletin on EPSDT in 21st Century Cures Act
The Center for Medicare and Medicaid Services (CMS) this week issued an information bulletin about the section of the 21st Century Cures Act (Cures) that requires Medicaid reimbursement for Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) services for children under age 21 in IMDs.
This provision in Cures—which had been a legislative priority for NABH—corrects a long-standing oversight in the “psych under 21” benefit. Historically under EPSDT, CMS had denied coverage for medically necessary services, such as prescription drugs or practitioner services, for children in IMDs. Section 12005 of Cures ends that policy and allows children full access to EPSDT regardless of whether they are placed in an IMD. The EPSDT provision becomes effective on Jan. 1, 2019.
Federal Office of Rural Health Policy to Host Webinar on Opioid Response Funding
The Federal Office of Rural Health Policy will hold a technical assistance webinar for those who want to apply for the Rural Communities Opioid Response Program on Thursday, June 28 at 1 p.m. ET.
Dial-in information is available on page (ii) in the grant program guidance. To find the guidance, visit the Grants.gov, click on the Package tab, then Preview, then choose “Download Instructions.” A recording will be made available for those who cannot attend. Please contact ruralopioidresponse@hrsa.gov if you have questions.
Meanwhile, the Rural Health Information Hub updated its website to highlight a guide with initiatives and funding opportunities, as well as rural-specific program examples, tools, and resources that focus on prevention, harm reduction, and treatment.
SAMHSA to Host Webinar on Preventing Suicides Among Service Members, Veterans and Their Families
The Substance Abuse and Mental Health Services Administration (SAMHSA) will host a two-hour webinar to discuss “military culture-informed strategies” that can be applied to reduce access to lethal means—including poisoning and firearms—for those who are at high risk for suicide on Thursday, June 28 at 2 p.m. ET.
The event is the first in a series on suicide from SAMHSA’s Service Members, Veterans and Their Families Technical Assistance Center.
World Congress Opioid Management: Treatment and Recovery Summit is Aug. 13-14 in Nashville
Sarah Wattenberg, NABH’s director of quality and addiction services, will co-chair the World Congress Opioid Management: Treatment and Recovery Summit in Nashville from Aug. 13-14 in Nashville.
Healthcare executives nationwide will discuss effective strategies to address the opioid epidemic across the continuum of care. Key topic areas include payer-provider partnerships, recovery support services, opioid use disorder medications, neonatal abstinence syndrome protocols, drug courts, successful organizational strategies, and more. Michael Botticelli, the former director of the White House Office of National Drug Control Policy, will also speak at conference.
NABH members can register here and receive $200 off the meeting’s registration fee by using the following promotional code: SPEAKER.
Prepare Early for National Recovery Month in September
SAMHSA’s toolkit to prepare for National Recovery Month in September is available here.
Now in its 29th year, National Recovery Month is meant to promote awareness and understanding about mental and substance use disorders and to celebrate individuals living in recovery. This year’s theme is Join the Voices for Recovery: Invest in Health, Home, Purpose and Community.
For questions or comments about CEO Update, please contact Jessica Zigmond