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House Passes Bipartisan Bill to Address Opioid Crisis     The House of Representatives on Friday overwhelmingly passed the SUPPORT for Patients and Communities Act, an opioid-response legislative package that House and Senate negotiators agreed to earlier in the week. In a 393-8 vote, House members approved a comprehensive bill that includes the first substantive change to Medicaid’s Institutions for Mental Diseases (IMD) exclusion since the early 1970s. Twenty-seven members did not vote on the bill. The measure will now move to the Senate, where it’s expected to pass. The legislation provides an optional benefit for states to pay IMDs for substance use disorder (SUD) treatment for patients between the ages of 21-64 for 30 days each year. In addition, patients with mental illness could be treated under this provision as long as they have at least one SUD, although the bill does not specify if SUD must be a primary or secondary condition. The provision is scheduled to take effect in October 2019 and end in September 2023. Congressional action is required to extend the measure beyond that four-year period. The SUPPORT Act includes a maintenance-of-effort provision that would require states to maintain their current funding levels for both inpatient and outpatient services. In addition, a state would need to show the federal government that it has the full continuum of services, including early intervention, outpatient, intensive outpatient, partial hospitalization, and inpatient/residential transitions of care. All of these requirements are consistent with the recommendations NABH made in Pathways to Care: Treating Opioid and Substance Use Disorder. In addition, eligible IMDs would be required to follow “reliable, evidence-based practices” and offer at least two forms of medication assisted treatment, including one antagonist and one partial agonist. Other NABH priorities are part of the agreement, including a provision that would consider opioid treatment programs as eligible providers under Medicare, as well as a measure that would allow the Centers for Medicare and Medicaid Services (CMS) to test behavioral healthcare information technology (BHIT). Hospitals, community mental health centers, and SUD providers would all be eligible to participate in the BHIT test. After Congress reached a deal earlier this week, NABH distributed a news release and posted a message on Twitter to highlight the efforts of House Energy and Commerce Committee Chairman Greg Walden (R-Ore.), Reps. Mimi Walters (R-Calif.) and Paul Tonko (D-N.Y.), and Sens. Rob Portman (R-Ohio) and Ben Cardin (D-Md.) on this important legislation. The NABH team will continue to analyze the bill’s provisions and will send a summary to NABH members next week. NABH Submits FY 2019 OPPS Comments to CMS The NABH team this week submitted comments to the Centers for Medicare and Medicaid Services (CMS) on the fiscal 2019 outpatient prospective payment system rule. NABH’s comments focused on partial hospitalization programs, site-neutral payments, and behavioral health information technology interoperability. “In previous comment letters, NABH urged CMS to adopt a clear policy that the provisions of Section 603 of the Bipartisan Budget Act of 2015 and the law’s subsequent regulation do not apply to the PHPs,” NABH President and Mark Covall wrote in the letter to CMS. “In those letters we explained that absent such an exemption, CMS risks placing a moratorium on new programs, which have no comparable ‘physician office’ service and are a critical and cost-effective level of care for Medicare beneficiaries living with mental illness and SUD,” he continued. “There are sound policy reasons for our position and CMS has the clear legal authority to adopt this policy.” Report Shows One-Third of Americans Received an Opioid Prescription in the Past Two Years About thirty-two percent of American adults have received a prescription for opioids in the past two years, according to a new survey from NORC at the University of Chicago. Results from the new AmeriSpeak® Spotlight on Health survey also found that nearly one in five adults, or about 18 percent, have received a prescription for opioids in the last year. Meanwhile, among adults who ever received an opioid prescription, 91 percent reported that they filled the prescription when they received it, and 29 percent refilled it more than once. Click here to read the news release and learn more. NABH Committees Discuss Priority Areas at Fall Leadership Forums Three of NABH’s four standing committees discussed top priority areas for their groups when they convened this past week in Naperville, Ill. and Washington, D.C. Meeting at Linden Oaks Behavioral Health in Naperville, Ill. from Sept. 20-21, the Behavioral Health Services within General Healthcare Systems Committee hosted House Ways and Means Health Subcommittee Chairman Peter Roskam (R-Ill.), as well as speakers from the Joint Commission and the American Hospital Association. The group focused on the environment of care and social determinants of health. NABH’s Quality Committee and Addiction Treatment Committees followed with their meetings in Washington, D.C. earlier this week, where the Quality Committee agreed to work on developing new measures for the Inpatient Psychiatric Facility Quality Reporting Program, and the Addiction Treatment Committee discussed emerging services, payment, and quality initiatives taking place at the national level. All three committees heard updates on the federal opioid legislation and discussed the bill’s implications for their facilities and programs. NABH’s Youth Services Committee will meet in Washington in late October. Save the Date for the NABH 2019 Annual Meeting! Please plan to join us at the Mandarin Oriental Washington, D.C. from March 18-20, 2019 for the 2019 NABH Annual Meeting. NABH will provide more information in the coming weeks. For questions or comments about CEO Update, please contact Jessica Zigmond.