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CEO Update | 51

China Bans All Types of Fentanyl, Cutting U.S. Supply China this week announced it would ban all types of the opioid fentanyl, a decision that could slow the supply of the deadly drug to the United States. The decision fulfills a pledge that Chinese leader Xi Jinping made to President Trump in December. House Energy and Commerce Republicans hailed the move in a blog post, noting that fentanyl analogues—synthetic opioids that are 50 times more potent than heroin and 100 times more potent than morphine—are the leading cause of opioid overdose deaths in the United States. ONC Issues Proposed Rule to Revise Conditions of Participation HHS’ Office of the National Coordinator for Health Information Technology (ONC) has issued a proposed rule that would revise the conditions of participation for psychiatric hospitals and require facilities that have electronic health record (EHR) systems “to send electronic patient event notifications of a patient’s admission, discharge, and/or transfer to another health care facility or to another community provider.” The proposal would limit this requirement to only those Medicare- and Medicaid-participating hospitals that possess EHRs systems with the technical capacity to generate information for electronic patient event notifications. NABH is drafting comments on the proposed rule. House and Senate Introduce Bipartisan Bills to Align 42 CFR Part 2 With HIPAA Identical, bipartisan bills were introduced in the House and Senate this week to align 42 CFR Part 2, commonly referred to as Part 2, with the Health Insurance Portability and Accountability Act (HIPAA) for treatment, payment, and healthcare operations, while also strengthening protections against the use of addiction records in criminal, civil, or administrative proceedings. Reps. Earl Blumenauer (D-Ore.) and Markwayne Mullin (R-Okla.) introduced the Overdose Prevention and Patient Safety Act, or OPPS Act, while Senators Shelley Moore Caputo (R-W.V.) and Joe Manchin (D-W.V.) introduced Protecting Jessica Grubb’s Legacy Act, or the Legacy Act. NABH, a member of the Partnership to Amend 42 CFR Part 2, supports both pieces of legislation. GAO Finds Nearly 40 Million American Adults Have Untreated Substance Use Disorders or Mental Health Conditions A recent Government Accountability Office (GAO) report found that nearly 40 million American adults have untreated substance use disorders or mental health conditions, such as depression. According to the national survey, many of these Americans don’t think they need treatment, while others say it’s hard to get care. Left untreated, these behavioral health conditions can cause other health complications—such as drug overdoses—which, in turn, can raise healthcare costs. The GAO noted that the studies it reviewed were limited to specific conditions or locations, and most found higher healthcare costs for adults who didn’t receive behavioral healthcare treatment. There is no generally accepted estimate of the overall costs, the report said. Emergency Medicine News Releases Special Report on Psychiatric Patient Boarding The decline in the number of inpatient psychiatric beds available nationwide could be the most significant factor to help explain the increase in Emergency Department (ED) wait times for psychiatric patients, according to a special report published in Emergency Medicine News. “Those dropped 35 percent between 1998 and 2013,” the report noted, citing JAMA, “And the drop wasn’t just confined to the late 1990s and early aughts; a June 2016 report from the Treatment Advocacy Center, a national nonprofit focusing on making treatment available for severe mental illness, found that the United States had 37,679 state psychiatric beds in 2016, down about 13 percent from 2019,” the report continued. “That comes out to an average of 11.7 psychiatric beds for every 100,00 people, a number far below the 40-60 beds per 100,000 people the center recommends.” CMS Introduces Hospital Provider Burden Tool in April Newsletter The Centers for Medicare and Medicaid Services (CMS) this week introduced its Complexity and Burden of Hospital Reporting Ecosystem map to provide a visual representation of essential reporting interactions between hospital staff and external regulatory agencies, payers, and accrediting organizations. Featured in the April edition of the agency’s Patients Over Paperwork newsletter, the new map is the result of the agency’s work in the field, where CMS made more than 2,000 observations after meeting with 200 hospital leadership, management, and clinical staff last summer. From that research, CMS identified examples of burden, which it narrowed down to 130 themes and 16 insights, such as “hospital staff feel they spend too much time resolving misaligned requirements and interpreting conflicting guidance,” and “hospitals are required to send the same information to different places in slightly different formats. This means hospitals have to hire staff and consultants to manage this complexity.” Federal Leaders to Headline Rx Drug Abuse and Heroin Summit The directors of the National Institutes for Health (NIH) and Centers for Disease Control and Prevention (CDC) are among the plenary speakers at the Rx Drug Abuse and Heroin Summit in Atlanta from April 22-25. Francis Collins, MD, PhD of the NIH and the CDC’s Robert Redfield, MD, as well as Nora Volkow, MD, the director of the National Institute on Drug Abuse (NIDA), will address meeting attendees at this year’s conference. Click here to register for the meeting. IPF PEPPER Review Webinar Scheduled for April 24 A webinar to review the release of the Inpatient Psychiatric Facility (IPF) PEPPER (version Q4FY18)—released today, Friday, April 5—will be held on Wednesday, April 24 at 3 p.m. ET. Click here to register. For those unable to participate, the session will be recorded and posted on PEPPER.CBRPEPPER.org in the “Training and Resources” section. 2019 NABH Annual Survey Available Online The 2019 NABH Annual Survey is available on the association’s website for members who have not completed it yet. Please take a moment to review the instructions for the sruvey before completing it. Respondents will not be able to pause the survey and start again. Thank you for your time! For questions or comments about CEO Update, please contact Jessica Zigmond.