Surgeon General Issues Advisory on Nation’s Youth Mental Health Crisis
U.S. Surgeon General Vivek Murthy, M.D. this week issued the
U.S. Surgeon General’s Advisory on Protecting Youth Mental Health, which outlines recommendations to address America’s youth mental health crisis.
“Even before the pandemic, an alarming number of young people struggled with feelings of helplessness, depression, and thoughts of suicide — and rates have increased over the past decade,” Murthy said in a news release. “The Covid-19 pandemic further altered their experiences at home, school, and in the community, and the effect on their mental health has been devastating,” he continued, adding that the future of the country’s well-being depends on how we support and invest in the next generation.
The 53-page advisory recommends that individuals, families, community organizations, technology companies, governments, and others recognize that mental health is an essential part of overall health; empower youth and their families to recognize, manage, and learn from difficult emotions; ensure that every child has access to high-quality, affordable, and culturally competent mental healthcare; support the mental health of children and youth in educational, community, and childcare settings and expand and support the early childhood and education workforce; address the economic and social barriers that contribute to poor mental health for young people, families, and caregivers; and increase timely data collection and research to identify and respond to youth mental health needs more rapidly.
“This includes more research on the relationship between technology and youth mental health, and technology companies should be more transparent with data and algorithmic processes to enable this research,” the Surgeon General’s announcement said.
SAMHSA Announces $30 Million in Harm-Reduction Grant Funding
The Substance Abuse and Mental Health Services Administration (SAMHSA) this week said it will issue about $30 million in
American Rescue Plan funding for the agency’s first harm-reduction grant program to help prevent overdose deaths and reduce the health risks associated with drug use.
SAMHSA will accept applications from state, local, tribal, and territorial governments; tribal organizations; not-for-profit, community-based organizations; and behavioral health organizations to increase access to a range of community services and supports.
“The reality is, evidence-based harm reduction services are out of reach for far too many people,” Rahul Gupta, M.D., director of the Office of National Drug Control Policy, said in SAMHSA’s announcement. “Building on the Biden-Harris Administration’s efforts to expand evidence-based prevention, treatment and recovery support services, this historic funding will help make harm reduction services more accessible, so we can meet people where they are and save lives,” Gupta added.
HHS Report Shows Medicare Telehealth Visits for Behavioral Health Increased 32-Fold in 2020
The number of Medicare fee-for-service (FFS) beneficiary telehealth visits for behavioral health increased to 10.1 million in 2020 from 317,800 in 2019, reflecting a 32-fold increase, according to a new report from the U.S. Health and Human Services’ (HHS) Assistant Secretary for Planning and Evaluation’s (ASPE).
Medicare Beneficiaries’ Use of Telehealth in 2020: Trends by Beneficiary Characteristics and Location
showed that Medicare telehealth flexibilities “mitigated declines in in-person visits during the pandemic in 2020, but there is also evidence of disparities by race/ethnicity and for rural populations.”
Researchers examined claims data from the 34.9 million Medicare FFS beneficiaries who had part A or B coverage and found that the number of Medicare FFS beneficiary telehealth visits rose 63-fold to nearly 52.7 million in 2020 from about 840,000 in 2019. Despite the increase in telehealth visits during the pandemic, total utilization of all Medicare FFS Part B clinician visits declined about 11% in 2020 compared with 2019 levels, the report showed.
“Visits to behavioral health specialists showed the largest increase in telehealth in 2020,” the report noted. “Telehealth comprised a third of total visits to behavioral health specialists. While data limitations preclude clear identification of audio-only telehealth services, up to 70% of these telehealth visits during 2020 were potentially reimbursable for audio-only services,” it added.
CMS Updates State Medicaid & CHIP Telehealth Toolkit
The Centers for Medicare & Medicaid Services (CMS) this week released updates to the agency’s
State Medicaid and Children’s Health Insurance Program (CHIP) Telehealth Toolkit: Policy Considerations for States Expanding Use of Telehealth, Covid-19 Version.
CMS said it updated the resource to clarify that states may deliver covered services via audio-only telehealth both during the Covid-19 public health emergency and beyond. The toolkit provides quick facts, state considerations, pediatric considerations, a state checklist, and an appendix that includes frequently asked questions.
“This guide is intended to help states identify which aspects of their statutory and regulatory infrastructure may impede the rapid deployment of telehealth capabilities in their Medicaid program,” the toolkit noted. “As such, this guide will describe each of these policy areas and the challenges they present below. The toolkit concludes with a list of questions state policymakers can use to ensure they have explored and/or addressed potential obstacles.”
NABH Submits Comments on Surprise Billing to Federal Agencies
NABH this week sent a
letter to five federal agencies that expressed concerns about the second set of regulations issued to implement the
No Surprises Act.
NABH’s main concern in the interim final rule titled “Requirements Related to Surprise Billing; Part II” is the interpretation of the independent dispute resolution (IDF) provisions to highly favor health plans and issuers.
“The interim final rule requires IDR entities to presume that the plan or issuer’s median in-network payment rate is the appropriate out-of-network reimbursement rate,” NABH said in its letter to HHS Secretary Xavier Becerra and top officials at the U.S. Labor Department, U.S. Treasury Department, Internal Revenue Service, and Office of Personnel Management. “This interpretation is contrary to the clear intent of Congress that required IDR arbiters to consider a long list of factors specified in the law including the median in-network rate.
NABH added that it is also concerned about provisions in the interim final rule regarding good-faith estimates for uninsured and self-pay patients about the potential cost of care.
“It is unclear how these requirements align with the price transparency requirements established earlier this year,” NABH wrote. “We urge you to issue additional guidance on how these two sets of rules overlap and differ.
CMS Hosts Open Door Forum to Highlight Provider Requirements in the ‘No Surprises Act’
CMS hosted an open door forum this week to explain provider requirements in the
No Surprise Act that will take effect Jan. 1.
Beginning next month, consumers will have new billing protections when receiving emergency care, non-emergency care from out-of-network providers at in-network facilities, and air ambulance services from out-of-network providers. The requirements apply mostly to items and services provided to people enrolled in group health plans, group or individual health insurance coverage, Federal Employees Health Benefits plans, and the uninsured.
These requirements don’t apply to people with coverage through programs such as Medicare, Medicaid, Indian Health Services, Veterans Affairs Health Care, or TRICARE that have other protections against high medical bills.
Click
here to view the presentation and
here to access the provider requirements and resources page.
Reminder: NABH Denial-of-Care Portal is Open to Members
NABH’s Denial-of-Care Portal is available for members to provide information about their experiences with managed care organizations that impose barriers to care through insurance-claim denials.
NABH’s Managed Care Committee worked for more than a year to develop the Denial-of-Care Portal as a way to collect specific data on insurers who deny care—often without regard for parity or the effects on patients.
This NABH member-only, survey-like tool allows users to add the name of a managed care organization, type of plan, level of care, type of care (mental health or substance use disorder), duration of approved treatment, duration of unapproved treatment, criteria used to deny a claim, and more.
The portal allows members to submit individual examples of claim denials or upload multiple entries via Excel. It also includes sections on appeals and physician participation. In time, the tool could be a valuable resource for the NABH team’s advocacy efforts.
Please e-mail
Emily Wilkins, NABH’s administrative coordinator, if you have questions about the portal.
Fact of the Week
Suicidal behaviors among high school students increased during the decade preceding the Covid-19 pandemic, with 19% seriously considering attempting suicide, a 36% increase from 2009 to 2019, and about 16% having made a suicide plan in the prior year, a 44% increase from 2009 to 2019, according to
data from the Centers for Disease Control and Prevention.
For questions or comments about this CEO Update, please contact Jessica Zigmond.