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CEO Update 230

House Passes Reconciliation Bill That Includes Significant Medicaid Changes

The House early Thursday passed President Trump’s sweeping budget reconciliation bill in a 215-214 vote after the House Rules Committee passed a 42-page amendment to the legislation. Notably, the bill includes several significant restrictions on Medicaid eligibility and financing.
 
The Senate will now consider the legislation and is expected to make changes to it.
 
Meanwhile, the Congressional Budget Office (CBO) has yet to provide information about the effects of the House bill, although the CBO’s latest estimate notes that changes in the House Energy and Commerce Committee’s jurisdiction – which includes Medicaid and Marketplace plans – would produce more than $900 billion in savings during the next decade. An earlier analysis estimated that 8.6 million people could become uninsured by 2034.
 
NABH has several major concerns about the bill, including the:

  • Moratorium on creating new provider taxes;
  • Limits to future state-directed payments;
  • Problematic language in behavioral health exemptions to community engagement requirements; and
  • Lack of extension to enhanced premium tax credits for Marketplace plans.

NABH sent a letter to Senate leaders today, May 23, that articulates these concerns. We are watching this legislative process closely as the Senate considers the bill, and we will continue to provide updates as the situation evolves.

White House Releases Report on Childhood Chronic Diseases

Also on Thursday, the White House released Make Our Children Healthy Again, a 73-page report from President Trump’s Make America Healthy Again Commission that examines four areas: (1) poor diet, (2) aggregation of environmental chemicals, (3) childhood behavior in the digital age, and (4) overmedicalization.
 
The report covers various topics that impact mental health, such as technology and social media use, poor sleep, chronic stress, family dynamics, and nature exposure. It also asserts various ways in which children are over-diagnosed with mental disorders, including attention-deficit/hyperactivity disorder, depression, and anxiety, as well as over-treated with stimulants, antidepressants, and antipsychotics.
 
Finally, the report mentions a controversial theory that some interventions and approaches, including therapy, social-emotional learning, and trauma-informed care, could over-pathologize emotional experiences, leading to increases in anxiety and depression.

CMS Resource Updates Improper Payment Rate and Denial Reasons for 2023 Reporting Period

The Centers for Medicare & Medicaid Services’ (CMS) Medicare Provider Compliance Tips – a resource from the Medicare Learning Network – reports that the improper payment rate for outpatient psychiatry services was 13.5% with a projected improper payment amount of $186.1 million in 2023, according to the 2023 Medicare Fee-for-Service Supplemental Improper Payment Data.
 
The resource – which includes tips for a host of specialty providers – outlines more information and policy requirements for physicians and non-physician practitioners who bill for outpatient psychiatry services.

Help NABH Develop a Behavioral Health Tech Apprenticeship!

The NABH Education and Research Foundation thanks all who attended last week’s NABH Annual Meeting workforce panel about NABH’s new project to develop and sponsor a behavioral health technician registered apprenticeship program with the U.S. Labor Department.

If you didn’t attend the panel discussion – or if you attended and didn’t participate in the panel’s live poll – please take a moment to submit this four-question survey by Wednesday, May 28 to let us know 1) if you would like to help NABH with this new initiative, and 2) if so, how you would like to participate.

For more information, click here to learn why NABH urges its members to support this model and here to learn NABH’s ten steps to apprenticeship. As always, thank you for your time!

ICYMI: NABH Annual Meeting Presentations Are Available

Last week NABH posted all 2025 Annual Meeting speaker presentations for which we received permission on our Speakers & Presentations page. We will send a link to our Annual Meeting photos at a later date.
 
Please mark your calendars for March 2-4, 2026 when we will host the NABH 2026 Annual Meeting at our new location: The Ritz-Carlton Washington, DC!

Fact of the Week

A new study from Avalere Health found opioid use disorder costs businesses, governments, and households almost $1 trillion per year and that treatment with medications can lower costs.

The NABH team thanks all its members who have served in the U.S. Armed Forces and wishes everyone a safe and relaxing Memorial Day weekend!