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:
- 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.
- 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.