CEO Update 238
Reps. Tonko & Huizenga Introduce Legislation to Remove Medicare’s 190-day Lifetime Limit
Reps. Paul D. Tonko (D-N.Y.) and Bill Huizenga (R-Mich.) this week reintroduced H.R. 4619, the Medicare Mental Health Inpatient Equity Act, bipartisan legislation that would repeal permanently the Medicare program’s 190-day lifetime limit for inpatient psychiatric care.
Despite the enactment of the landmark Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act in 2008, Medicare continues to discriminate against seniors with mental illnesses through this provision. The 190-day lifetime limit in care disproportionately harms individuals who receive Medicare coverage earlier in life due to disability.
In its March 2025 report, the Medicare Payment Advisory Commission (MedPAC), the independent agency that advises Congress about the Medicare program, recommended that lawmakers eliminate Medicare’s 190-day lifetime limit.
More than three dozen organizations, including NABH, support this critical legislation, which has been referred to the House Ways and Means Committee.
“The National Association for Behavioral Healthcare applauds Reps. Paul Tonko (D-N.Y.) and Bill Huizenga (R-Mich.) for reintroducing the Medicare Mental Health Inpatient Equity Act,” NABH President and CEO Shawn Coughlin said in a statement. “We also thank the bill’s original cosponsors Reps. Lloyd Doggett (D-Texas) and Brian Fitzpatrick (R-Pa.). This bipartisan legislation will bring us closer to mental health parity by eliminating Medicare’s 190-day lifetime limit for inpatient psychiatric hospital services, regardless of a patients’ needs,” Coughlin continued. “Experts agree that demand for inpatient care for individuals with the most difficult-to-treat behavioral health conditions far outstrips supply, and denying care can lead to many adverse consequences if those conditions are not addressed. Congress should align with the Medicare Payment Advisory Commission’s unanimous recommendation to eliminate Medicare’s 190-day lifetime limit,” he added. “NABH looks forward to working with the bill’s sponsors to pass this legislation.”
NABH applauds Reps. Tonko, Huizenga, Doggett and Fitzpatrick for supporting legislation that would remove a lifetime limit on care that does not exist for any other inpatient healthcare service that Medicare covers, and our team is asking Members of Congress to cosponsor H.R. 4619.
We will also issue an Action Alert to you, our members, asking that you contact your congressional representatives and request that they cosponsor this bill. Thank you for your help!
Lawmakers Reintroduce ‘Medicaid Bump Act’ to Increase Reimbursement Rate for Behavioral Healthcare Services
Also this week, Reps. Tonko and Fitzpatrick in the House and Sen. Tina Smith (D-Minn.) in the Senate reintroduced the Medicaid Bump Act, companion legislation that would increase Medicaid’s federal reimbursement rate for mental and behavioral healthcare services.
Traditionally, states receive federal reimbursement rates between 50% and 75%. Under the Medicaid Bump Act, Medicaid would reimburse states for 90% of the cost of providing new mental and behavioral healthcare services.
In addition, the bill would direct the HHS secretary to define which services qualify as eligible behavioral healthcare services for the enhanced FMAP and require HHS to provide annual reports about the effects of increased federal Medicaid reimbursement on the use of behavioral healthcare services in each state.
NABH is one of 34 organizations that supports the Medicaid Bump Act.
Bill numbers have not been assigned to the Medicaid Bump Act; however, the legislation has been referred to the House Energy and Commerce and Senate HELP Committees.
Trump Signs Executive Order to Push Cities to Move Homeless Persons from Streets to Treatment Centers
President Trump on Thursday signed an executive order to push cities and states to remove homeless people from the streets and into treatment centers.
The order, “Ending Crime and Disorder on America’s Streets,” directs U.S. Attorney General Pam Bondi to reverse precedents that limit state and local governments’ ability to commit people on the streets who are at risk to themselves or others, according to a fact sheet that The Hill newspaper obtained.
USA Today first reported on the order, which also requires interagency work on grants for states to enforce prohibitions on open, illicit drug use, urban camping, loitering and squatting, and to track sex offenders. It also requires redirecting funds to ensure people sleeping on streets and causing public disorder – and suffering from serious mental illness or substance use disorder – are moved to treatment centers, although it’s unclear how much federal funding will be allocated for it.
It is part of Trump’s commitment to ending homelessness, according to the fact sheet, and follows a March order that directed the National Park Service to clear homeless encampments and graffiti on federal lands.
Blue Cross Blue Shield Provider Settlement Claim Deadline is Next Tuesday, July 29
A landmark class action antitrust settlement addressing claims that Blue Cross Blue Shield (BCBS) suppressed competition and underpaid providers through its BlueCard Program, according to a BCBS notice.
The notice states that those who provided healthcare services, equipment, or supplies to BCBS-insured patients between July 24, 2008, and Oct 4, 2024 may be eligible to receive a portion of this historic settlement.
Most U.S. providers who treated BCBS-insured patients during the settlement period qualify, unless employed/owned by BCBS or exclusively by government entities, or limited to specific services (e.g., prescription drugs, standalone dental/vision). Compensation will be based on your BCBS reimbursement amounts, adjusted for estimated antitrust impact.
The deadline to submit a claim is Tuesday, July 29. Click here for more information.
Senate Confirms Terry Cole as DEA Administrator
In a party-line vote of 50-47, the Senate this week confirmed Terry Cole to lead the U.S. Drug Enforcement Administration (DEA).
Cole’s job will include enforcing the Trump administration’s approach to marijuana rescheduling, which started during the Biden administration and is now uncertain. Advocates for marijuana rescheduling argue it would allow for more research into cannabis and its health effects.
Most recently Cole served as Virginia’s secretary of public safety from 2023-2025. Previously he spent 22 years at DEA, which included service in various states and on foreign missions in Colombia, Afghanistan, Mexico and the Middle East.
Cole earned his bachelor’s degree from the Rochester Institute of Technology and certificates in leadership from the University of Virginia and the Medoza College of Business at the University of Notre Dame.
Provider Resource: ‘After Your Child’s Suicide Attempt’ Video
The Education Development Center’s Zero Suicide Institute and Parents to Parents, a not-for-profit organization that offers resources to caregivers whose child is struggling with mental health illness, have created After Your Child’s Suicide Attempt, an hourlong movie that addresses the questions parents have and describes best practices in suicide care.
The two organizations urge healthcare professionals, school, and community leaders to share the video and accompanying resources with parents.
ICYMI: HHS Announces Funding Opportunity for Behavioral Health Information Technology Pilot
HHS recently announced a funding opportunity to promote behavioral health data exchange and pilot the implementation of a specified set of behavioral health data elements.
HHS anticipates distributing $5 million across six to 10 participants, which will include a wide range of provider organizations that receive SAMHSA grant funds or partner with recipients. More information can be found in the Request for Application and Frequently Asked Questions document.
The deadline for the expression of interest was Wednesday, July 2. For those who expressed interest, full applications are due Wednesday, Aug. 27.
An HHS representative has offered to schedule a meeting between NABH members and the contractor administering the program to provide more detailed information and answer questions ahead of the application deadline.
Please contact Dan Schwartz if you are interested in attending such a meeting. NABH will schedule a meeting if there is sufficient interest.
Fact of the Week
The 988 Lifeline stopped specialized services for LGBTQ+ youth this week. Since 988 launched three years ago, it has fielded more than 16 million calls, texts and chats, with nearly 10% of those contacts from gay and transgender young people, according to government data. Meanwhile, data from the Centers for Disease Control and Prevention’s Youth Behavior Risk Survey show that LGBTQ+ youth are more likely to experience persistent feelings of sadness and hopelessness compared with their peers, and they are more likely to attempt suicide.
For questions or comments about this CEO Update, please contact Jessica Zigmond.