Author: Emily Wilkins (NABH)

ASPE Report Studies Pandemic’s Effects on Hospital and Clinician Workforce

A comprehensive report from HHS’ Assistant Secretary for Planning and Evaluation (ASPE) examines the Covid-19 pandemic’s effects on the nation’s healthcare workforce and offers several recommendations, including removing barriers to practicing to the top of one’s license/certification, retaining Covid-19 flexibilities as appropriate, funding for scholarships, and more.   The nearly 30-page report, Impact of the COVID-19 Pandemic on the Hospital and Outpatient Clinician Workforce, found that total employment in the healthcare industry declined during the early months of the pandemic but gradually recovered during the summer of 2020. Many hospitals reported critical staffing shortages during the course of the pandemic—especially when Covid case numbers were high—and during the recent Omicron surge in January and February 2022, the seven-day average of hospitals reporting critical staffing shortages peaked at 22% during mid-January 2022, the report noted. The report acknowledged that several provider types, including behavioral health providers, experienced staffing shortages before the pandemic began. “Even after the pandemic, many of the effects the pandemic has had on the health care workforce will likely persist,” the report noted. “Addressing these impacts as well as the underlying challenges that pre-dated the pandemic can help build a stronger and more resilient health care system for the future.”

Joint Commission’s Covid-19 Staff Vaccination Standard Takes Effect July 1

The Joint Commission said it has approved its new Infection Prevention and Control standard and its elements of performance as a response to the interim final rule from the Centers for Medicare & Medicaid Services (CMS) late last year. According to the Joint Commission, the accrediting organization began surveying to the Omnibus Covid-19 Health Care Staff Vaccination interim final rule—which was released on Nov. 5, 2021—on Jan. 27 this year. “While changes to Joint Commission standards requirements were under review by CMS, findings related to the COVID-19 staff vaccination regulatory requirements have been scored at Leadership (LD) Standard LD.04.01.01, EP 2, along with the applicable Medicare Conditions of Participation/Conditions for Coverage for each of the deemed programs,” the Joint Commission said in an announcement. “This scoring process will continue until June 30, 2022. Click here to learn more.

SAMHSA Senior Medical Advisor John Palmieri, M.D., M.H.A. to Address Attendees at Annual Meeting 

NABH will welcome John Palmieri, M.D., M.H.A., senior medical advisor at the Substance Abuse and Mental Health Services Administration (SAMHSA) and acting director for the 988 behavioral health crisis hotline and Behavioral Health Crisis Coordinating Office, at the 2022 Annual Meeting in Washington on Tuesday, June 14. Prior to his arrival at SAMHSA, Dr. Palmieri was the division chief for behavioral healthcare at the Arlington County (Virginia) Department of Human Services. Dr. Palmieri is a licensed physician in Virginia and is board certified in adult psychiatry. He graduated from Brown University Medical School and completed his adult psychiatry residency at Massachusetts General Hospital. Please click here to learn about our 2022 Annual Meeting speakers.

National Prevention Week is May 8-14

SAMHSA’s National Prevention Week starts Sunday, May 8, and the agency will commemorate the 18^th annual National Prevention Day on Monday, May 9. Click here for an agenda of the day’s events. The week-long commemoration is part of Mental Health Awareness Month, which kicked off on Sunday, May 1. The White House issued a proclamation honoring Mental Health Awareness Month, and Mental Health America (MHA)—which established the monthly observance in 1949—is recognizing the 2022 observance with the theme “Back to Basics.” The campaign is intended to provide what MHA has referred to as “foundational knowledge” about mental health, mental health conditions, and information about what people can do if their mental health is cause for concern. Please remember to follow NABH on Twitter @NABHbehavioral and on LinkedIn at the National Association for Behavioral Healthcare throughout the month to learn what NABH members, federal agencies, and advocacy organizations are doing to promote Mental Health Month.

NABH Working to Enhance Denial-of-Care Portal

NABH’s Denial-of-Care Portal is temporarily unavailable as the association works to enhance features of this member-only resource. The portal was developed so NABH members could submit individual examples of claim denials or upload multiple entries via Excel. It also includes sections on appeals and physician participation and is intended to help the association in its advocacy efforts with policymakers and regulators. NABH will keep members apprised about the updated portal is ready to use.

Please Visit the NABH 2022 Annual Meeting Exhibitors & Sponsors Page!

 NABH appreciates the generous support from its exhibitors and sponsors each year at the association’s Annual Meeting. To learn who is exhibiting and sponsoring NABH in 2022, please visit the Exhibitors & Sponsors page on our Annual Meeting homepage. The page also includes general information, tips for exhibitors, and details about shipping materials to the Mandarin Oriental Washington, DC. And please remember to register for the Annual Meeting and reserve your hotel room today, if you haven’t done so yet. We look forward to seeing you next month in Washington!

Fact of the Week

Audio-only visits were the leading telehealth modality for primary care and behavioral health throughout the full pandemic study period of February 2019 through August 2021, according to a new research report from RAND. At the end of the study period, however, audio-only visits were eclipsed by in-person visits for primary care, but not for behavioral health, the study showed.   For questions or comments about this CEO Update, please contact Jessica Zigmond.

CMS Behavioral Health Strategy Aims to Strengthen Equity, Improve Quality, and Provide Outreach to Beneficiaries

The Centers for Medicare & Medicaid Services (CMS) recently released The CMS Behavioral Health Strategy, a five-goal plan that aims to remove barriers to care and services and also adopt a data-informed approach to evaluate the agency’s behavioral health programs and policies. Noting that the strategy “will strive to support a person’s whole emotional and mental well-being and promotes person-centered behavioral healthcare,” CMS set the following five goals: 1) strengthen equity and quality in behavioral healthcare, 2) improve access to substance use disorders treatment, prevention, and recovery services, 3) ensure effective pain treatment and management, 4) improve access and quality of mental healthcare and services, and 5) utilize data for effective actions and impact on behavioral health. Click here to learn about the objectives in each of those goals.

SAMHSA Announces New Director of the Center for Substance Abuse Treatment

The Substance Abuse and Mental Health Services Administration (SAMHSA) this week named Yngvild Olsen, M.D., M.P.H. as the new director of the agency’s Center for Substance Abuse Treatment. An addiction medicine specialist and general internist, Olsen began her career as the medical director for the outpatient substance use treatment services while serving as a full-time assistant professor in the department of medicine at the Johns Hopkins School of Medicine. From 2011 to 2021, Olsen served as medical director for the Institutes for Behavior Resources/REACH Health Services, a comprehensive outpatient substance use disorder treatment program in Baltimore City.

ONDCP Director Rahul Gupta to Address Attendees at NABH Annual Meeting

NABH is pleased to announce that Director of National Drug Control Policy Rahul Gupta, M.D., M.P.H., M.B.A., FACP will address attendees at the 2022 Annual Meeting on Tuesday, June 14. Dr. Gupta is the first medical doctor to serve as director and lead the Office of National Drug Control Policy (ONDCP), a component of the Executive Office of the President. ONDCP coordinates the nation’s $40 billion drug budget and federal policies, including prevention, harm reduction, treatment, recovery support, and supply reduction. Through his work as a physician, a state and local leader, an educator, and a senior leader of a national nonprofit organization, Dr. Gupta has dedicated his career to improving public health and public safety. He is also a buprenorphine-waivered practitioner, who has provided medication-assisted treatment for people with opioid use disorder. The son of an Indian diplomat, Dr. Gupta was born in India and grew up in the suburbs of Washington, D.C. At age 21, he completed medical school at the University of Delhi and later completed subspecialty training in pulmonary medicine. Dr. Gupta earned a master’s degree in public health from the University of Alabama-Birmingham and a global master’s of business administration degree from the London School of Business and Finance. If you have not done so yet, please visit our Annual Meeting homepage and register today. We look forward to seeing you in Washington!

In Case You Missed It: Kennedy Forum Parity Webinar Recording Now Available

NABH President and CEO Shawn Coughlin participated in a webinar about mental health and substance use disorder treatment parity on Tuesday, April 26 with federal health officials and healthcare organization leaders. Coughlin joined fellow presenters HHS Secretary Xavier Becerra, Assistant Secretary for Mental Health and Substance Use Miriam Delphin-Rittmon, Ph.D., The Kennedy Forum founder and former U.S. Rep. Patrick J. Kennedy (D-R.I.), and American Medical Association President Patrice Harris, M.D. to discuss the Biden administration’s commitment to ensuring parity implementation, the recent Wit v. United Behavioral Health ruling, and ongoing problems with parity compliance. David Lloyd, senior policy advisor at The Kennedy Forum, moderated the event. During the webinar, Delphin-Rittmon, who serves as administrator of SAMHSA, discussed three parity resources that SAMHSA has developed to help patient families, providers, and policymakers understand parity: Know Your Rights, Understanding Parity: A Guide to Resources for Families and Caretakers, and The Essential Aspects of Parity: A Training Tool for Policymakers. NABH was the lead sponsor for this webinar and live Tweeted during the event. Click here to watch the recorded broadcast.

BPC to Host Webinar Monday on Combating the Opioid Crisis with Smarter Federal Spending

The Bipartisan Policy Center (BPC) will host a webinar on Monday, May 2 about new recommendations centered on enhancing federal spending and improving the federal response to America’s ongoing opioid crisis. Participants include Office of National Drug Control Policy Director Rahul Gupta, M.D., M.P.H., M.B.A., FACP; Sen. Joe Manchin (D-W.Va.); American Medical Association President Patrice Harris, M.D.; former U.S. Surgeon General Jerome Adams, M.D.; and former HHS Secretary Donna Shalala. The hour-long webinar will begin at 1 p.m. ET. Click here to register. 

Mental Health Awareness Month Starts Sunday!

Mental Health Month kicks off this Sunday, May 1 to raise awareness about mental health in America. Mental Health America (MHA), which established the monthly observance in 1949, will commemorate Mental Health 2022 with the theme “Back to Basics” to provide what MHA has referred to as “foundational knowledge” about mental health, mental health conditions, and information about what people can do if their mental health is cause for concern. SAMHSA’s National Prevention Week is May 8-14 and the agency will commemorate the 18^th annual National Prevention Day on Monday, May 9. Click here for an agenda of the day’s events. And please remember to follow NABH on Twitter @NABHbehavioral and on LinkedIn at the National Association for Behavioral Healthcare throughout the month to learn what NABH members, federal agencies, and advocacy organizations are doing to promote Mental Health Month.

NABH Working to Enhance Denial-of-Care Portal

NABH’s Denial-of-Care Portal is temporarily unavailable as the association works to enhance features of this member-only resource. The portal was developed so NABH members could submit individual examples of claim denials or upload multiple entries via Excel. It also includes sections on appeals and physician participation and is intended to help the association in its advocacy efforts with policymakers and regulators. NABH will keep members apprised when the updated portal is ready to use.

Fact of the Week

Mental health, developmental disorders, and substance use disorders collectively accounted for 48% of all telehealth claims, according to a new report from FAIR Health, a national, not-for-profit organization that produces data products and consumer resources about transparency in healthcare costs and health insurance.   For questions or comments about this CEO Update, please contact Jessica Zigmond.

President Biden Sends National Drug Control Policy to Congress

President Biden on Thursday sent his administration’s inaugural National Drug Control Policy to Congress with the goal of using a whole-of-government approach to combat the nation’s overdose crisis. The comprehensive strategy focuses on the main drivers of the crisis—untreated addiction and drug trafficking—as it directs federal agencies to take actions that will expand access to evidence-based prevention, harm reduction, treatment, and recovery services, while also reducing the supply of drugs. The plan comes as the nation continues to produce grim statistics: for the first time in America’s history, the country has passed the milestone of 100,000 deaths resulting from drug overdoses in a 12-month period. Meanwhile, since 1999, drug overdoses have killed approximately 1 million Americans. A message from President Bident to Congress at the beginning of the strategy explains the Office of National Drug Control Policy led the effort to produce the strategy in close collaboration with the 18 national drug control agencies. In addition, the Biden administration involved more than 2,000 leaders and stakeholders, including Congress, all 50 Governors, and advocates representing public safety, public health, community groups, local governments, and Tribal communities. An important component of the strategy is its emphasis on harm reduction, an approach that works with people who use drugs to prevent overdose and infectious disease transmission; improve the physical, mental, and social wellbeing of those served; and offer flexible options for accessing substance use disorder treatment and other health care services. “We are changing how we help people when it comes to drug use, by meeting them where they are with high-impact harm reduction services and removing barriers to effective treatment for addiction,” Rahul Gupta, M.D., M.P.H., M.B.A., director of National Drug Control Policy, said in the document, “while addressing the underlying factors that lead to substance use disorder head on.”

The Kennedy Forum to Host Parity Webinar on Tuesday, April 26

NABH President and CEO Shawn Coughlin will join HHS Secretary Xavier Becerra and other healthcare leaders in a webinar about expanding access to mental health and addiction treatment coverage on Tuesday, April 26. The webinar will also feature Assistant Secretary for Mental Health and Substance Use Miriam Delphin-Rittmon, Ph.D., former U.S. Rep. Patrick J. Kennedy, and American Medical Association President Patrice Harris, M.D. Click here to learn more and register for the hourlong webinar, which will start at 2 p.m. ET.

NABH Sends Comments to CMS About Access to Coverage in Medicaid & CHIP

NABH this week responded to a request for information from the Centers for Medicare & Medicaid Services (CMS) regarding access to coverage for Medicaid and the Children’s Health Insurance Program (CHIP). In the letter, NABH emphasized that inadequate access to acute care has led to a strong reliance on hospital emergency rooms to treat people with serious mental illness, even though these settings are not well-suited to address those particular patient needs. NABH also emphasized how the Covid-19 pandemic has heightened the already-increased need for mental health and addiction services. NABH outlined a series of recommendations, including strengthening network adequacy for the full continuum of mental health and addiction treatment; requiring Medicaid programs and plans to implement parity compliance documentation requirements in Medicaid and CHIP; improving Medicaid reimbursement for mental health and addiction treatment providers; and more.

CMS Opens Federal Independent Dispute Resolution Process for Providers

CMS late last week opened the Federal Independent Dispute Resolution (IDR) process for healthcare providers, facilities, health plans, and issuers to resolve payment disputes for certain out-of-network charges. According to CMS, an initiating party will need the following in order to start a dispute: information to identify the qualified IDR items or services; dates and location of items or services; type of items or services such as emergency services and post-stabilization services; codes for corresponding service and place-of-service; attestation that items or services are within the scope of the Federal IDR process; and the initiating party’s preferred certified IDR entity. A list of certified entities is available here. After the 30-business-day open negotiation period ends, initiating parties will have four business days to initiate a dispute via the portal.

BJA Accepting Applications for Variety of Behavioral Health-Related Grant Opportunities

The U.S. Justice Department’s Bureau of Justice Assistance (BJA) is accepting applications for a range of grant programs—eligible to both for-profit and not-for-profit organizations— that seek to improve outcomes for people with mental health and substance use disorders. BJA’s Residential Substance Abuse Treatment (RSAT) for State Prisoners Training and Technical Assistance Program offers funding to provide training and technical assistance (TTA) to grantees and practitioners to improve correctional substance use disorder treatment programming and post-release outcomes for individuals who are incarcerated. Of the four grant opportunities noted in this news item, this grant is the only one for which for-profit organizations other than small businesses are eligible. The Connect and Protect: Law Enforcement Behavioral Health Response Program is seeking applications for funding to support law enforcement-behavioral health cross-system collaboration to improve public health and safety responses and outcomes for people with mental health and substance use disorders. BJA is also accepting applications for its Improving Substance Use Disorder Treatment and Recovery Outcomes for Adults in Reentry for funding to establish, expand, and improve treatment and recovery support services for people with substance use disorders during their incarceration and upon reentry into the community. And the department is accepting applications for its Justice and Mental Health Collaboration Program to support cross-system collaboration to improve public safety responses and outcomes for individuals with mental health disorders or co-occurring mental health and substance use disorders who come into contact with the justice system. Please click on the hyperlinks above for more information and grant deadlines. Political Analyst Amy Walter to Address Attendees at 2022 Annual Meeting Luncheon NABH is pleased to welcome on-air political analyst Amy Walter as the association’s Annual Meeting Luncheon keynote speaker in Washington on Tuesday, June 14. For more than 20 years, Amy Walter has built a reputation as an accurate, objective, and insightful political analyst with unparalleled access to campaign insiders and decision-makers. Known as one of the best political journalists covering Washington, she is the publisher and editor-in-chief of the non-partisan Cook Political Report with Amy Walter, where she provides analysis of the issues, trends, and events that shape the political environment. As a contributor to the PBS NewsHour, Ms. Walter provides weekly political analysis for the popular “Politics Monday” segment. She is also a regular Sunday panelist on NBC’s Meet the Press and CNN’s Inside Politics and appears frequently on Special Report with Bret Baier on Fox News Channel. Please plan to join us for this year’s Annual Meeting luncheon. And if you haven’t done so yet, please remember to register for the meeting and reserve your hotel room today. We look forward to seeing you in Washington! Fact of the Week People with schizophrenia made up a lower proportion of telehealth encounters relative to in-person visits (1.7% versus 2.7%), while those with anxiety and fear-related disorders accounted for a higher proportion (27.5% versus 25.5%), according to a new study published in the April edition of Health Affairs. Researchers concluded the findings highlight the importance of broadening access to services through new modalities without supplanting necessary in-person care for certain groups. For questions or comments about this CEO Update, please contact Jessica Zigmond.

U.S. Preventive Services Task Force Issues Draft Recommendations on Screening for Anxiety, Depression, and Suicide Risk in Children and Adolescents

In a set of draft recommendations this week, the U.S. Preventive Services Task Force (USPTF) recommended screening children 12 and older for depression and children 8 and older for anxiety. “There is not enough evidence to recommend for or against screening for anxiety and depression in younger children and screening for suicide risk in all youth,” the USPTF announced in a bulletin on April 12. Both the American Academy of Pediatrics (AAP) and the American Foundation for Suicide Prevention (AFSP) expressed serious concerns about the panel’s conclusion that there is insufficient evidence to weigh the benefits and harms of screening asymptomatic children and adolescents for suicide risk. The AAP is urging clinicians to screen all adolescents for suicide risk despite the panel’s finding that more research is needed. “Youth may keep suicidal thoughts to themselves and will not bring up the topic unless directly asked,” May Lau, M.D., M.P.H., a member of the AAP Section on Adolescent Health Executive Committee and a lead author of the Blueprint for Youth Suicide Prevention from AAP/AFSP, said in an article in AAP News. “By screening all youth for suicide, we can identify those that are at risk and connect them with the services they need.” Meanwhile, Christine Moutier, M.D., chief medical officer at the AFSP, told the Associated Press this week that the report “may actually set the field back.” “We have grave concerns that the recommendation citing ‘insufficient evidence’ to implement routine screening for suicide risk for any age youth is 1) flawed due to the incomplete data sources included in their review, and 2) may confuse the field just as major steps are being taken,” Moutier wrote in an e-mail message to NABH. Moutier added that the Blueprint for Youth Suicide Prevention recommends screening for youth ages 12 and older and outlines evidence-based care steps to take for youth who screen positive. A public comment period for the USPTF’s draft recommendations is open until May 9. Click here for details.

HRSA Announces More Than $1.75 Billion in Provider Relief Fund Phase 4 Distribution Payments

HHS’ Health Resources and Services Administration (HRSA) said it is making available more than $1.75 billion in Provider Relief Fund (PRF) Phase 4 General Distribution payments to more than 3,680 providers nationwide this week. According to HRSA, on April 13 providers received an email notification if their application was among those processed in this latest round, and the agency is working to process all remaining applications as quickly as possible. Also this week, HHS Secretary Xavier Becerra extended the PHE for an additional 90 days after the current PHE expires on April 16.

HRSA Announces it Will Offer ‘Extenuating Circumstances’ Option to Providers for PRF Reporting Period 2

HRSA this week said healthcare providers will have the opportunity to submit a “Request to Report Late Due to Extenuating Circumstances for Reporting Period 2” if applicable. Last week, HRSA announced the “extenuating circumstances” option for Reporting Period 1, which lasts from April 11 through April 22. The agency said providers will receive a notification regarding the process to submit a request for Reporting Period 2 in the coming weeks. For more information, visit the Request to Report Late Due to Extenuating Circumstances webpage, or call the Provider Support Line at (866) 569-352 from 9 a.m. to 11 p.m. CT, Monday through Friday.

The Kennedy Forum to Host Parity Webinar Featuring Leaders from HHS, SAMHSA, NABH, & AMA

NABH President and CEO Shawn Coughlin will join HHS Secretary Xavier Becerra and other healthcare leaders in a webinar about expanding access to mental health and addiction treatment coverage later this month. The webinar on Tuesday, April 26 will also feature Assistant Secretary for Mental Health and Substance Use Miriam Delphin-Rittmon, Ph.D., former U.S. Rep. Patrick J. Kennedy, and American Medical Association President Patrice Harris, M.D. Click here to learn more and register for the hour-long webinar, which will start at 2 p.m. ET.

AHA & IAHSS Release Toolkit to Help Mitigate Violence in Healthcare Settings

The American Hospital Association (AHA) and the International Association for Healthcare Security and Safety (IAHSS) have developed a toolkit for hospitals and health systems to establish procedures to prevent violence at all levels. Creating Safer Workplaces is an 11-page resource that provides a framework to build a safer workplace environment; outlines what leaders should consider to promote physical safety and teamwork; highlights how leaders can mitigate risk; describes the role of hospitals in violence intervention; and more.

NPR Story Reports Most State Medicaid Programs Won’t Text Enrollees Despite Urgency to Renew Coverage

A National Public Radio (NPR) story this week cited a recent Kaiser Family Foundation report that found just 11 states said they would use text messaging to alert Medicaid recipients about the end of the Covid public health emergency, while 33 states will use the U.S. Postal Service and at least 20 will rely on individual or automated phone calls. “It’s frustrating that texting is a means to meet people where they are and that this has not been picked up more by states,” Jennifer Wagner, director of Medicaid eligibility and enrollment for research group the Center on Budget and Policy Priorities, said in the story. NPR also noted that officials at the Centers for Medicare & Medicaid Services (CMS) have told states they should consider texting—along with other methods of communication—when trying to contact enrollees about the end of the public health emergency (PHE), but many states don’t have the technology or information about enrollees to do so.

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. 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. Deadline for 2022 NABH Exhibitor & Sponsor Guide Ads is Next Week The deadline to submit an ad in NABH’s 2022 Exhibitor and Sponsor Guide is Tuesday, April 19. Be sure your organization is included in this year’s edition! Please click here for details about advertising options, requirements, payment, and more. We hope to see you in Washington in June!

Fact of the Week 

A recent National Institute of Mental Health-funded study showed that Stepped Care Trauma-Focused (TF) Cognitive Behavioral Therapy (CBT)—in which step one is a parent-led therapist-assisted treatment and step two provides therapist-led TF-CBT for children who did not benefit from step one and require more intensive treatment—can reduce costs by nearly 54%. For questions or comments about this CEO Update, please contact Jessica Zigmond.

HRSA Announces ‘Extenuating Circumstances’ Option for Provider Relief Fund Reporting

HHS’ Health Resources and Services Administration (HRSA) this week said it will allow healthcare providers to submit a Request to Report Late Due to Extenuating Circumstances for the Provider Relief Fund (PRF) Reporting Period 1 if one or more certain extenuating circumstances apply to their situations. Starting Monday, April 11 and continuing through Friday, April 22 at 11:59 p.m. ET, providers who did not submit their PRF Period 1 report by the required deadline may request to submit a late Reporting Period 1 report, via a DocuSign form, if the following extenuating circumstances exist:

• Severe illness or death: if a severe medical condition or death of a provider or key staff member responsible for reporting hindered the organization’s ability to complete the report during the reporting period

• Impacted by natural disaster: if a natural disaster occurred during or in proximity to the end of the reporting period and damaged the organization’s records or information technology

• Lack of receipt of reporting communications: if an incorrect email or mailing address on file with HRSA prevented the organization from receiving instructions prior to the reporting period deadline

• Failure to click “submit”: if the organization registered and prepared a report in the PRF Reporting Portal, but failed to take the final step to click “submit” prior to deadline

• Internal miscommunication or error: if an internal miscommunication or error regarding the individual who was authorized and expected to submit the report on behalf of the organization and/or the registered point of contact in the PRF Reporting Portal

• Incomplete Targeted Distribution payments: if the organization’s parent entity completed all General Distribution payments, but a Targeted Distribution(s) was not reported on by the subsidiary

According to HRSA, requests to report late due to extenuating circumstances must indicate and attest to a clear and concise explanation, although the agency will not require supporting documents. If HRSA approves an organization’s request, the organization will receive a notification to proceed with completing the Reporting Period 1 report. Providers will have 10 days from the date they receive the notification to submit a report in the PRF Reporting Portal. Click here to learn more about reporting requirements, or call the Provider Support Line at (866) 569-3522 between 9 a.m. to 11 p.m. ET for additional information.

CMS Releases Two Sets of FAQ About ‘No Surprises Act’ Requirements

The Centers for Medicare & Medicaid Services (CMS) this week released two sets of frequently asked questions (FAQ) regarding requirements enacted in the No Surprises Act. CMS issued an FAQ on April 6 that provides additional explanation about the law’s requirements and prohibitions, as well as clarification regarding the independent dispute resolution process and associated fees. A day earlier, CMS released an FAQ with additional information about developing good-faith estimates for uninsured or self-pay patients.

Thorn Run Partners Memo Highlights Medicare & Medicaid Flexibilities During the PHE

Thorn Run Partners, a bipartisan lobbying firm that works with NABH, recently highlighted a host of flexibilities in the Medicare and Medicaid programs during the ongoing Covid-19 public health emergency (PHE). The 14-page memo includes information about recent guidance from CMS, PHE extensions, PHE-related policies in the $1.5 trillion omnibus spending package that President Biden recently signed into law, and more. Click here to read the memo.

NABH Supports ‘Behavioral Health Information Technology Now Act’

NABH is pleased to support the Behavioral Health Information Technology Now Act, a new bill that would offer financial incentives to behavioral healthcare providers for health information technology adoption. Reps. Doris Matsui (D-Calif.) and Markwayne Mullin (R-Okla.) introduced the bill in an effort to coordinate care between physical and mental healthcare—and also include behavioral healthcare providers from a key resource that they have been excluded from for years. “The National Association for Behavioral Healthcare applauds Reps. Matsui and Mullin for recognizing that for far too long, behavioral healthcare providers have not received health information technology funding that other providers have benefited from,” NABH President and CEO Shawn Coughlin said in a news release about the legislation on April 6. “Their legislation would enable behavioral healthcare providers to coordinate care across behavioral healthcare service systems, primary care facilities, and specialty medicine providers more efficiently.” Specifically, the bill would:

• Finance behavioral health information technology (IT) adoption at $250 million

• Condition funding allocations to providers based on: 1) acquisition of health IT systems that comply with 2015 certification standards, and 2) attestation of provider compliance with Trump Administration Interoperability and Data Blocking regulations

• Direct the Office of the National Coordinator for Health Information Technology and the Substance Abuse and Mental Health Services Administration to develop voluntary behavioral health IT standards.

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. 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.

Register Today for the 2022 Annual Meeting!

NABH will host its 2022 Annual Meeting—Shaping the Future of Behavioral Healthcare—from June 13-15 at the Mandarin Oriental Washington, DC. Please remember to register for the meeting and reserve your hotel room today!

Fact of the Week

Veterans who take medications for opioid use disorder (OUD) for at least 15 days have more than a 50% decreased risk of dying by suicide compared with those not taking OUD medications, according to a study in the April issue of the American Journal of Psychiatry. For questions or comments about this CEO Update, please contact Jessica Zigmond.

CMS Proposes 2.7% Increase to Inpatient Psychiatric Facilities in 2023

The Centers for Medicare & Medicaid Services (CMS) on Thursday proposed increasing payment rates to the nation’s inpatient psychiatric facilities by 2.7% in fiscal year (FY) 2023, reflecting a 1.5% increase in payments, or about $50 million, relative to FY 2022. According to the agency’s inpatient psychiatric facility prospective payment system (IPF PPS) proposed rule for FY 2023, the IPF PPS federal, per-diem base rate would increase to $856.80 from $832.94 and the electroconvulsive therapy payment rate would increase to $368.87 per treatment from $358.60 per treatment. CMS said the increase is based on the proposed IPF market basket update of 3.1% less a 0.4% percentage point productivity adjustment. For FY 2023 and subsequent years, CMS has proposed to apply a 5% cap on decreases in the IPF PPS wage index in order to mitigate instability in IPF PPS payments due to significant wage index decreases that may affect providers in any given year. CMS did not propose any changes for the IPF Quality Reporting Program for FY 2023. Meanwhile, the agency is seeking comments via a request for information (RFI) about what CMS should consider when advancing the use of measurement and stratification as tools to address healthcare disparities and advance healthcare equity. Specifically, CMS would like comments related to goals and approaches for measuring disparities and using measure stratification across CMS Quality Reporting Programs; guiding principles for selecting and prioritizing measures for disparity reporting; principles for social risk factor and democratic data selection and use; identification of meaning performance differences; guiding principles for reporting disparity measures; and measures related to health equity. CMS is considering and requesting comment about applying the following measures of health equity in the Inpatient Psychiatric Facility Quality Reporting Program: Health Equity Summary Score (HESS) and a structural measure assessing the degree of hospital leadership engagement in health equity performance data. Both of these measures are under consideration for the Medicare Inpatient Quality Reporting Program. Please send any comments that your organization may have to Kirsten Beronio, NABH’s director of policy and regulatory affairs.

President Biden’s 2023 Budget Seeks to Transform U.S. Behavioral Healthcare Delivery

President Biden proposed new, mandatory investments totaling $51.7 billion over 10 years to enhance behavioral healthcare in America in the fiscal year (FY) 2023 budget proposal that he released on March 28. Among the budget blueprint’s most notable behavioral health provisions is the president’s request of $697 million for the Substance Abuse and Mental Health Services Administration (SAMHSA) to ensure that 100% of contacts are answered for the new 988 behavioral health crisis hotline that will begin to operate in July. This is an increase of $590 million from what was enacted for fiscal year 2022. Another significant provision is the president’s proposal for a new, $7.5 billion Mental Health System Transformation Fund through Medicaid to increase access to mental health services through workforce development and service expansion, including the development of non-traditional health delivery sites, the integration of quality mental health and substance use care into primary care settings, and the dissemination of evidence-based practices. NABH is pleased to see President Biden’s 2023  budget proposal calls for improving compliance with behavioral health parity standards by requiring plans and issuers to use medical necessity criteria for behavioral health services that are consistent with the criteria developed by not-for-profit medical specialty associations. The proposal would also place limits on the consideration of profit in determinations of medical necessity. The president’s budget would authorize the secretaries of the U.S. Health and Human Services, Labor, and Treasury Departments to regulate behavioral health network adequacy, and to issue regulations on a standard for parity in reimbursement rates based on the results of comparative analyses submitted by plans and issuers at a cost of $720 million over 10 years. To learn more, please read the NABH Analysis that the association sent to members earlier this week.

Senate Finance Committee Releases ‘Mental Health Care in the United States: The Case for Federal Action’

In a bipartisan report released this week, the Senate Finance Committee concluded that “overwhelmingly, access to affordable, reliable, and high-quality behavioral health care escapes Americans when they need it most” and offered some potential solutions to address the nation’s myriad behavioral healthcare challenges. The 36-page report is divided into eight chapters and examines behavioral health definitions, prevalence, and spending; workforce; children, adolescents, and young adults; access, integration, and coordination; mental health and substance use disorder (SUD) parity; telehealth; and next steps. “As Chairman of the Senate Finance Committee, I am partnering with Ranking Member Mike Crapo on a major bipartisan effort to bring behavioral health care to the forefront of the U.S. health system by leveraging the programs under this Committee’s jurisdiction, including Medicare, Medicaid, and the Children’s Health Insurance Program,” Senate Finance Committee Chairman Ron Wyden (D-Ore.) said in a letter at the start of the report. Wyden added that 10 members of this committee, including five Democrats and five Republicans, are working on policy areas that Wyden deemed “vital for a path forward.”

The Center of Excellence for Protected Health Information Video Offers Guidance about SUD Personnel and 42 CFR Part 2

The Center of Excellence for Protected Health Information (CoE-PHI) has released a video that offers guidance about when identified SUD personnel within a general medical facility must follow the federal privacy protections for SUD treatment known as 42 CFR Part 2. The Substance Abuse and Mental Health Services Administration funds CoE-PHI to help people and organizations understand and apply federal health privacy laws and regulations at work that are specific to certain tasks and roles. CoE-PHI also works to help patients and families understand their rights when seeking treatment for SUD and mental health.

MHA, American Psychological Association, and American Psychiatric Association to Host Webinar on Digital Therapeutics in Mental Health and SUD

Mental Health America, the American Psychological Association, and the American Psychiatric Association will host a webinar next Wednesday, April 6 that examines the role digital therapeutics have in addressing America’s mental health and SUD crises. Participants will learn from Meena Seshamani, M.D., Ph.D., director of the Center for Medicare at CMS; Bakul Patel, director of the Digital Health Center of Excellence at the U.S. Food and Drug Administration; and other experts in the field. The hourlong webinar will begin at 2 p.m. ET. Click here to register.

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. 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.

Register Today for the 2022 Annual Meeting!

NABH will host its 2022 Annual Meeting—Shaping the Future of Behavioral Healthcare—from June 13-15 at the Mandarin Oriental Washington, DC. Please remember to register for the meeting and reserve your hotel room today!

Fact of the Week 

Of the approximately 5.9 million adults living with severe bipolar disorder in the United States in 2020, about 51%, or 3 million adults, were untreated at any given time, the Treatment Advocacy Center reports. For questions or comments about this CEO Update, please contact Jessica Zigmond.

Three-Judge Panel in 9th U.S. Circuit Court of Appeals Overturns Wit v. United Behavioral Health

In a blow to parity, a three-judge panel of the 9^th U.S. Circuit Court of Appeals this week overturned a trial court’s Wit v. United Behavioral Health (UBH) decision, asserting that UBH’s interpretation that health insurance plans do not require consistency with generally accepted standards of care (GASC) “was not unreasonable.” On Thursday, NABH sent its members an NABH Issue Brief that highlighted the following main points of the earlier decision from the trial court and the three-judge panel’s reversal of that decision in its seven-page ruling:

• The original Witdecision determined that patients’ health and safety are protected when clinicians provide services consistent with GASC that are established by not-for-profit, professional associations, rather than insurance companies whose financial incentives often conflict with what is best for patients.

• The three-judge panel said it is “not unreasonable” for health insurers’ coverage determinations to be inconsistent with GASC; however, the trial court’s decision, including two 100-page decisions, described how UBH made medical coverage decisions based on financial interests.

• In its ruling, the appellate court’s three-judge panel did not cite one holding or one fact that the trial court concluded, despite the trial court’s exhaustive trial findings.

• The trial court’s decision explained UBH’s misrepresentation to regulators that UBH used American Society of Addiction Medicine (ASAM) criteria when, in fact, the company modified and ultimately undercut the actual ASAM criteria.

• The appellate court’s three-judge panel ruled that UBH is not obligated to cover treatment consistent with GASC if the treatment is not a covered benefit; however, the plaintiffs did not argue that UBH was obligated to cover all services consistent with GASC. Instead, the plaintiffs argued that if services—such as outpatient, intensive outpatient, and residential treatment—are covered benefits, UBH must make medical necessity determinations that are consistent with GASC.

This flawed ruling has the potential to worsen America’s mental health and addiction crises as the critical need for mental health and addiction treatment services continues to rise during the ongoing Covid-19 pandemic. NABH will continue to fight for true mental health addiction treatment parity and expanded access to care for all who need it.

DEA Expands Access to Medication-Assisted Treatment for People with SUD

The U.S. Drug Enforcement Administration (DEA) on Wednesday announced a new option intended to broaden access for medication-assisted treatment (MAT) for people suffering from substance use disorder (SUD). The new option applies to DEA-registered practitioners working in hospitals, clinics, or emergency rooms, and also for DEA-registered hospitals and clinics that allow practitioners to operate under their registration number. Under this new option, the DEA will grant requests for an exception to the one-day supply limitation in 21 CFR 1306.07(b) to allow for the dispensing of up to a three-day supply of narcotic drugs, including buprenorphine and methadone, “to a person for the purpose of relieving acute withdrawal symptoms when necessary while arrangements are being made for referral for treatment.” Adhering to The Further Continuing Appropriations Act of 2021 and Other Extensions Act, DEA will grant such exception requests while it works to amend 21 CFR 1306.07(b) that the law directs. As part of this effort to save lives in the opioid overdose crisis, the DEA also announced that it is working to make permanent its Covid-19 public health emergency temporary regulations that allow for the initiation of buprenorphine to treat opioid use disorder via telemedicine. Finally, the DEA said it is partnering with the U.S. Health and Human Services Department (HHS) to engage “in regular outreach with pharmacists and practitioners to express support for the use of medication-assisted treatment for those suffering from substance use disorder.”

Provider Relief Fund Reporting Period 2 Deadline is Next Week

The Health Resources and Services Administration’s (HRSA) Provider Relief Fund (PRF) reporting portal remains open for healthcare providers who need to report their use of PRF funds in Reporting Period 2 (RP2) by the deadline next Thursday, March 31. According to HRSA, providers who received one or more payments totaling greater than $10,000 in the aggregate during a Payment Received Period must use the funds by the deadline and report for each application reporting period. HRSA’s announcement also said that providers who received PRF payments exceeding $10,000 in the aggregate between July 1, 2020 and Dec. 2020 and who do not submit a report on use of the funds by 11:59 p.m. ET on March 31, 2022 will be required to return all funds. HRSA said it will not grant grace periods or extensions. Click here to read HRSA’s PRF Reporting Non-Compliance fact sheet. 

BJA Announces Adult Drug Court Discretionary Grant Program Funding Opportunity

The U.S. Justice Department’s Bureau of Justice Assistance (BJA) is seeking applications to plan, implement, and enhance drug court services, including service coordination, management of drug court participants, and recovery support services. Adult drug courts integrated evidence-based SUD treatment, mandatory drug testing, incentives, and sanctions, and transitional services in judicially supervised criminal court setting that have jurisdiction over persons with SUD treatment needs to reduce recidivism, increase access to treatment and support, and prevent overdoses. City or township governments, county governments, federally recognized Native American tribal governments, special district governments, and state governments, and others are eligible to apply for this grant opportunity. The deadline to apply is Friday, May 20. Click here to learn more and apply.

Commonwealth Fund Podcast Examines Closing the Mental Healthcare Gap for Black Teens

In its podcast The Dose, the Commonwealth Fund this week featured Boston Children’s Hospital psychiatrist Kevin Simon, M.D., who discussed how providers can work with families to help address the mental healthcare gap for Black and brown teenagers in America. The Commonwealth Fund notes that in the current overwhelming demand for behavioral health services, the unmet need for Black and brown teenagers stands out. One reason is they are not getting the care they need due to a shortage of child and adolescent mental health providers—especially providers of color—in the United States. Worsening the problem are the racial stereotypes that exist in how school officials, healthcare providers, and others perceive Black and brown teens. Simon suggests that the country diversify the mental healthcare provider workforce to correct the problem in the long term. In the short term, he adds, providers can work with families and teachers to strengthen the system and start by demonstrating “cultural humility” and a genuine curiosity about the lived experiences of Black and brown youth.

 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. 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.

Register Today for the 2022 Annual Meeting!

NABH will host its 2022 Annual Meeting—Shaping the Future of Behavioral Healthcare—from June 13-15 at the Mandarin Oriental Washington, DC. Please remember to register for the meeting and reserve your hotel room today!

Fact of the Week

Only 20% of U.S. adults received mental health treatment since the start of the Covid-19 pandemic, but 80% of those agreed they benefited from this care, the America Psychological Association reports. For questions or comments about this CEO Update, please contact Jessica Zigmond.

CEO Alliance for Mental Health Announces Rollout to Prepare for 988 Hotline Launch

The CEO Alliance for Mental Health this week announced the start of coordinated effort to help prepare state and municipal officials for the nationwide 988 behavioral crisis hotline that will launch on July 16. NABH is a member of the CEO Alliance, a collaborative of 15 of the nation’s leading mental health professional organizations, advocacy groups, and funders that will push for leaders to adopt A Consensus Approach and Recommendations for the Creation of a Comprehensive Crisis Response System, a roadmap that outlines seven “pillars” for transforming mental health and substance use care in the United State. These are: early identification and prevention; emergency and crisis response; equity and inclusion; integration and partnership; fair and equivalent coverage; standards for care; and workforce capacity. The Alliance released the roadmap last November. The Alliance’s outreach efforts leading to the 988 hotline launch this summer include a social media campaign intended to direct state and municipal elected officials, civic leaders, policymakers, and advocates to the roadmap. In his State of the Union address earlier this month, President Biden announced his administration’s mental health strategy, of which the 988 hotline is a critical component.

Provider Relief Fund Reporting Period 2 Deadline is March 31

The Health Resources and Services Administration’s (HRSA) Provider Relief Fund (PRF) reporting portal remains open for healthcare providers who need to report their use of PRF funds in Reporting Period 2 (RP2) by the deadline on Thursday, March 31. According to HRSA, providers who received one or more payments totaling greater than $10,000 in the aggregate during a Payment Received Period must use the funds by the deadline and report for each application reporting period. HRSA’s announcement also said that providers who received PRF payments exceeding $10,000 in the aggregate between July 1, 2020 and Dec. 2020 and who do not submit a report on use of the funds by 11:59 p.m. ET on March 31, 2022 will be required to return all funds. HRSA said it will not grant grace periods or extensions. Click here to read HRSA’s PRF Reporting Non-Compliance fact sheet.

SAMHSA Announces $25.6 Million in MAT Grant Programs

The Substance Abuse and Mental Health Services Administration (SAMHSA) this week announced two grant programs totaling $25.6 million intended to expand access to medication-assisted treatment (MAT) for opioid use disorder and prevent the misuse of prescription drugs. One is the Strategic Prevention Framework for Prescription Drugs program, which provides funding for state agencies, territories, and tribal entities that have completed a Strategic Prevention Framework State Incentive Grant plan—or similar state plan—to target prescription drug misuse. This program is intended to raise awareness about the dangers of sharing medications, fake or counterfeit pills sold online, and over-prescribing. This grant will fund a total of $3 million over five years for up to six grantees. Applications for this grant are due by Monday, April 25. The other is the Medication-Assisted Treatment-Prescribing Drug and Opioid Addiction grant program, which provides resources to help expand and improve access to medications for opioid use disorder. This program is intended to increase the number of individuals with opioid use disorder receiving medications for opioid use disorder and decrease illicit opioid use and prescription drug opioid misuse. This grant will fund a total of $22.6 million over five years for up to 30 grantees. According to SAMHSA, no less than $11 million will be awarded to Native American tribes, tribal organizations, or consortia. Applications for this program are due by Friday, April 29.   DOJ Announces ‘Second Chance Act Pay for Success Initiative’ The U.S. Justice Department’s Bureau of Justice Assistance (BJA) is seeking applications to fund state, local, and tribal governments to either enhance or implement performance-based programs that reduce recidivism and address substance use disorders (SUD) that affect people who have been incarcerated. Specifically, the funds will be used in contracts with reentry, permanent supportive housing, or recovery housing providers in this effort. The Pay for Success Initiative is a performance-based and outcomes-based program that ties payment for services to reaching agreed-upon goals. Click here for more information.

O’Neil Institute Releases ‘Maximizing the Impact of Opioid Litigation to Address the Overdose Crisis’

The O’Neill Institute for National and Global Health Law at Georgetown University Law Center this week released Maximizing the Impact of Opioid Litigation to Address the Overdose Crisis, a five-page issue brief that describes the themes discussed during the Opioid Litigation Summit held at Georgetown Law Center in September 2021. The resource emphasizes that opioid litigation settlement proceeds must be used to advance a public health response to the nation’s opioid crisis. It also explains how the country can learn from its own history in this regard. “The tobacco litigation settlements of the 1990s evince the need for a comprehensive strategy of oversight and accountability to distribute and manage opioid litigation proceeds,” the issue brief states. “Despite the intent of the settling states’ Attorneys General that funds be used primarily for tobacco-related health initiatives, the lack of specificity in the settlement agreements led to less than 10% of the $206 billion award funding tobacco-related public health strategies.” According to the brief, these five themes emerged from last year’s opioid litigation summit: intentional collaboration leads to actionable policy; community needs should be reflected when distributing proceeds; existing opioid-related funding should be supplemented, not supplanted; oversight should be sustained; and other sources of funding should be maximized and coordinated to create a comprehensive plan to address SUDs.

Senate HELP Committee to Host Mental Health Hearing Next Week

The Senate Health, Education, Labor & Pensions (HELP) Committee will examine how to improve federal mental health and SUD programs in a hearing next week. Senators will hear from Assistant Secretary for Mental Health and Substance Use Miriam Delphin-Rittmon, Ph.D.; Joshua Gordon, M.D., Ph.D., director of the National Institute of Mental Health; Carole Johnson, administrator at the Health Resources and Services Administration; and Nora Volkow, M.D., director of the National Institute on Drug Abuse. Delphin-Rittmon addressed attendees at the 2021 NABH Annual Meeting last October. The hearing, “Strengthening Federal Mental Health and Substance Use Disorder Programs: Opportunities, Challenges, and Emerging Issues,” will be held Wednesday, March 23 at 10 a.m. ET.

National Drug and Alcohol Facts Week Starts Monday

National Drug and Alcohol Facts Week is from March 21-27, and The National Institute on Drug Abuse (NIDA) invites organizations to participate in the national observance meant to empower teens and young adults about making informed decisions about drugs, alcohol, and addiction. NIDA has developed five steps to hosting a NDAFW event and created lesson plans and other materials for educators, counselors, and prevention specialists. Please click here to learn how to register your organization’s event online.

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. 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.

Register Today for the 2022 Annual Meeting!

NABH will host its 2022 Annual Meeting—Shaping the Future of Behavioral Healthcare—from June 13-15 at the Mandarin Oriental Washington, DC. Please remember to register for the meeting and reserve your hotel room today!

Fact of the Week

Telehealth represented less than 1% of outpatient care before the Covid-19 pandemic for both mental health and substance use and other concerns. At its pandemic peak, telehealth represented 40% of mental health and substance use outpatient visits and 11% of other visits (during the March- August 2020 period), according to research from the Kaiser Family Foundation. For questions or comments about this CEO Update, please contact Jessica Zigmond.

Provider Relief Fund Reporting Period 2 Deadline is March 31

The Health Resources and Services Administration’s (HRSA) Provider Relief Fund (PRF) reporting portal remains open for healthcare providers who need to report their use of PRF funds in Reporting Period 2 (RP2) by the deadline on Thursday, March 31. According to HRSA, providers who received one or more payments totaling greater than $10,000 in the aggregate during a Payment Received Period must use the funds by the deadline and report for each application reporting period. HRSA’s announcement also said that providers who received PRF payments exceeding $10,000 in the aggregate between July 1, 2020 and Dec. 2020 and who do not submit a report on use of the funds by 11:59 p.m. ET on March 31, 2022 will be required to return all funds. HRSA said it will not grant grace periods or extensions. Click here to read HRSA’s PRF Reporting Non-Compliance fact sheet.

NABH Submits Comments to CMS about Network Adequacy in Medicare Advantage

NABH this week submitted comments to the Centers for Medicare & Medicaid Services (CMS) regarding the agency’s proposed rule about technical changes to the Medicare Advantage (MA) and Medicare Prescription Drug Benefit programs for the contract year 2023. In a letter to CMS Administrator Chiquita Brooks-LaSure, NABH described how MA plans can increase the number of behavioral healthcare providers and facilities in their networks and improve access to mental health and addiction treatment. “Unfortunately, Medicare beneficiaries do not have adequate access to mental health and addiction treatment,” NABH’s noted. “According to a CMS Data Brief, ‘[b]eneficiaries with depression, regardless of age, were more likely to report having trouble getting healthcare, obtaining prescription medicines, and not seeing doctors than those without depression.’ In addition, Medicare ‘[b]eneficiaries with depression regardless of age, were more likely to report that they have no usual source of care due to high cost.’ These difficulties accessing behavioral healthcare undoubtedly result from MA plans disproportionately lacking in-network behavioral healthcare providers,” NABH’s letter continued. “A recent study found that MA networks included only 23% of psychiatrists in a county on average — lower than all other medical specialties. Not surprisingly, MA enrollees with depressive symptoms report more difficulty accessing needed treatment and rated their experience with the MA plans as worse than in traditional Medicare.” NABH also provided a series of recommendations, such as establishing specific network adequacy standards for the full continuum of mental health and addiction treatment and requiring those standards be met prior to approval for participation in Medicare; requiring MA plans to demonstrate reimbursement rates for behavioral healthcare providers are comparable with rates for other similar healthcare services; and requiring MA plans to comply with parity requirements and use generally accepted standards of care for utilization management.

OSHA Launches Program to Protect Healthcare Workers at Facilities that Treat Covid-19 Patients

The U.S. Labor Department’s Occupational Safety and Health Administration (OSHA) has launched an initiative to protect healthcare workers who work in hospitals and skilled nursing facilities that treat or handle patients with Covid-19. An announcement from OSHA said the goal is to expand its presence to ensure “continued mitigation to control the spread of Covid-19 and future variants of the SARS-CoV-2 virus” and to protect the health and safety of healthcare workers. OSHA also said it will initiate focused inspections to emphasize monitoring for current and future readiness to protect workers from Covid-19 and will conduct follow-up inspections at sites that previously received citations. “OSHA intends to expand its presence in targeted high-hazard healthcare facilities during a three-month period from March 9, 2022 to June 9, 2022,” the announcement said. “Through this focused enforcement initiative, the agency will verify and assess hospital and skilled nursing care employers’ compliance actions taken, including their readiness to address any ongoing or future Covid-19 surges.” 

Congressional Addiction, Treatment, and Recovery Caucus to Host Webinar on Opioid Crisis  Next Week

The Congressional Addiction, Treatment, and Recovery Caucus will host a webinar titled “The Changing Landscape & New Challenges of the Opioid Epidemic” next Thursday, March 17 at 3 p.m. ET. Presenters include award-winning actor Michael Keaton; Beau Kilmer, Ph.D., director of RAND’s Drug Policy Research Center; and Arnold Alier Martinez, Ed.D., NRP, director of the division of pre-hospital medicine research and overdose prevention at the South Carolina Department of Health and Environment Control. Click here to register.

The Joint Commission to Host Webinar About Behavioral Health and Human Services Accreditation on March 22

The Joint Commission will host a complimentary webinar about behavioral health and human services accreditation on Tuesday, March 22 from 10 am. – 12:30 p.m. ET. In a live executive training, the Joint Commission will address the process, cost, requirements, and resources for assistance and will also leave time for questions. The Joint Commission’s announcement also said attendees will leave with a free, 90-day trial of the Joint Commission’s requirements and a copy of the webinar’s slides. Click here to register.

Register for National Drug and Alcohol Facts Week: March 21-27, 2022

National Drug and Alcohol Facts Week is approaching, and The National Institute on Drug Abuse (NIDA) invites organizations to participate in the national observance meant to empower teens and young adults about making informed decisions about drugs, alcohol, and addiction. NIDA has developed five steps to hosting a NDAFW event and created lesson plans and other materials for educators, counselors, and prevention specialists. Please click here to learn how to register your organization’s event online.

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.

Advertise in the 2022 NABH Exhibitor and Sponsor Guide!

NABH will distribute the 2022 NABH Exhibitor and Sponsor Guide to all registrants at the Annual Meeting from June 13–15, 2022 at the Mandarin Oriental Washington, D.C. Be sure your organization is included in it! All ads are due by April 19, 2022. Please click here for details about advertising options, requirements, payment, and more. NABH will also post the 2022 NABH Exhibitor and Sponsor Guide on the association’s website after the Annual Meeting. If you haven’t done so yet, please register for the Annual Meeting and reserve your hotel room today!

Fact of the Week

Between April 2021 and October 2021, the highest rates of telehealth visits were among those with Medicaid (29.3%) and Medicare (27.4%), Black individuals (26.8%), and those earning less than $25,000 (26.7%), according to data from HHS’ Assistant Secretary for Planning and Evaluation. For questions or comments about this CEO Update, please contact Jessica Zigmond.

HHS Secretary Becerra Launches National Tour to Strengthen Mental Health

U.S. Health and Human Services (HHS) Secretary Xavier Becerra on Thursday kicked off the National Tour to Strengthen Mental Health as a way to hear directly from Americans about their behavioral health challenges and engage with local officials to strengthen the mental health and crisis care systems in the United States. The move came two days after President Biden announced his administration’s strategy to address America’s mental health crisis during the president’s first State of the Union address. Part of a broader “unity agenda,” the strategy aims to strengthen system capacity, connect more Americans to care, and create healthy environments where the country’s health and social services infrastructure addresses mental health holistically and equitably. “The pandemic has not only taken a physical toll on all of us, but also brought on greater behavioral health challenges for everyone,” Becerra said in an announcement. “From small towns to big cities, I’ll be traveling nationwide with members of my leadership team to meet with people who have been hit particularly hard and partnering with local leaders to find ways to save lives in our communities.” In the coming months, Becerra will make announcements about new initiatives and resources from HHS, such as increasing the number of behavioral health professionals and community and behavioral health supporter workers in underserved and under-resourced communities, expanding pediatric mental healthcare access through telehealth services, and transitioning to the national 988 behavioral health crisis hotline that will begin operating in July.

New CDC Data Show U.S. Suicides Peaked in 2018

The Centers for Disease Control and Prevention (CDC) this week reported that after rising from 2000 to 2018, the age-adjusted suicide rate in the United States declined after peaking in 2018. Suicide dropped to the 10^th leading cause of death from the 12^th leading cause in 2020, “due to the emergence of Covid–19 deaths and increases in deaths from chronic liver disease and cirrhosis,” the CDC reported in Suicide Mortality in the United States, 2000-2020. The new findings also showed that suicide rates were three to four times higher for males compared with females from 2000 through 2020. And for females, firearm-related suicide recently replaced poisoning as the leading means of suicide.

CMS Publishes Report to Congress on Medicaid Managed Care Regulations

The Centers for Medicare & Medicaid Services (CMS) recently released a report to Congress that focuses on coverage of services received in Institutions for Mental Diseases (IMD) by managed care plans through states in lieu of services (ILOS) authority. Required by the 21^st Century Cures Act, the report found that the majority of states that cover inpatient behavioral health treatments through risk-based managed care use the IMD ILOS authority, and that states primary rationale for using this authority is to increase access to behavioral health services.

Joint Commission Issues Statement on Dr. Lorna Breen Health Care Provider Protection Act

The Joint Commission recently released a statement after Congress passed the Dr. Lorna Breen Health Care Provider Protection Act. Passed in February, the legislation seeks to reduce and prevent suicide, burnout, and mental and behavioral health conditions among healthcare professionals. Lorna Breen was a physician who served as emergency room director at New York Presbyterian Hospital and died by suicide in April 2020 while on a break visiting family in Virginia. “The Covid-19 pandemic has increased to a devastating degree with the amount of burnout and stress among physicians, nurses and other health care providers,” Ana Pujols McKee, M.D. said in the statement. Pujols McKee serves as The Joint Commission’s interim president and CEO, executive vice president, chief medical officer, and chief diversity, equity, and inclusion officer. “While we share in the deep sadness of Dr. Breen’s death from across the health care community, it is not without hope for positive change,” Pujols McKee continued. “It is critical that we increase awareness and provide resources to support our nation’s health care providers as they continue to work tirelessly into the third year of the pandemic.” The Joint Commission’s announcement said research has shown that clinicians fear seeking mental health treatment because of questions related to their mental health history. Click here to read a statement from The Joint Commission about removing barriers to mental health for clinicians and other providers; here to read a “Quick Safety” on promoting psychosocial well-being of healthcare staff during a crisis; and here to read the organization’s sentinel alert regarding the well-being of healthcare staff. The Dr. Lorna Breen Health Care Provider Protection Act is awaiting President Biden’s signature.

Register for National Drug and Alcohol Facts Week: March 21-27, 2022

The National Institute on Drug Abuse (NIDA) invites organizations to participate in National Drug and Alcohol Facts Week (NDAFW), a national health observance meant to empower teens and young adults about making informed decisions about drugs, alcohol, and addiction. NIDA has developed five steps to hosting a NDAFW event and created lesson plans and other materials for educators, counselors, and prevention specialists. Please click here to learn how to register your organization’s event online.

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.

Register Today for NABH’s 2022 Annual Meeting!

Please visit our Annual Meeting homepage to view the 2022 Annual Meeting At-A-Glance for preliminary meeting details, register for the meeting, and reserve a hotel room. We hope to see you in Washington from June 13-15!

Fact of the Week

For the first time, Black Americans are dying from drug overdoses at a higher rate than white Americans, according to a new study in JAMA. The report suggests that the high potency of the illicit drug supply may be disproportionately harming racial and ethnic minoritized communities. For questions or comments about this CEO Update, please contact Jessica Zigmond.

HHS Pays More Than $560 Million to Providers in PRF Phase 4 Distribution This Week

HHS on Thursday announced that the department’s Health Resources and Services Administration (HRSA) is making more than $560 million in Provider Relief Fund (PRF) Phase 4 Distribution payments to more than 4,100 healthcare providers nationwide this week. With this latest announcement, nearly $11.5 billion in PRF Phase 4 payments have now been distributed to more than 78,000 providers in all 50 states, Washington, D.C., and five territories, according to HHS. This is in addition to HRSA’s distribution of American Rescue Plan Rural Payments totaling about $7.5 billion in funding to more than 44,000 providers since November 2021. Click here to view a state-by-state breakdown of all Phase 4 distributions to date and here for a state-by-state breakdown of all American Rescue Plan Rural Payments to date. For more information about the PRF, click here.

Federal Judge in Texas Blocks Part of HHS’ Surprise Billing Rule

A federal judge in Texas on Wednesday struck down part of the Biden administration’s interpretation of a part of the federal law banning surprise medical bills. Siding with the Texas Medical Association, Judge Jeremy Kernodle of the Eastern District of Texas struck down a narrow part of the surprising billing rule that outlines how to resolve payment disputes between payers and providers regarding out-of-network claims. The ruling maintains the protections for patients against receiving bills for thousands of dollars in situations such as going to a hospital emergency room and later learning one of the physicians was not covered by the patient’s insurance. Click here to read news coverage about the ruling.

Neuroscientist and Former NIMH Director Tom Insel’s Book ‘Healing’ Now Available

Healing: Our Path From Mental Illness To Mental Health, the new book by former National Institute of Mental Health (NIMH) Director Tom Insel, M.D., was released this week. Insel, a neuroscientist and psychiatrist who led the NIMH from 2002 to 2015, spoke with The New York Times about this new book, which highlights failures in our nation’s behavioral healthcare system, including ineffective delivery of care, gaps in community services, and a reliance on police and jails for crises services. Insel—who addressed attendees at NABH’s Annual Meeting last year—said in the interview that he hopes his new book will sound an alarm for the country. “I want to ring the bell to tell people that we can do so much better today,” Insel said in the interview, “and there is no excuse for allowing people with these brain disorders to languish on our streets like this and die at age 55, eating out of trash bins.” Register for National Drug and Alcohol Facts Week: March 21-27, 2022 The National Institute on Drug Abuse (NIDA) invites organizations to participate in National Drug and Alcohol Facts Week (NDAFW), a national health observance meant to empower teens and young adults about making informed decisions about drugs, alcohol, and addiction. NIDA has developed five steps to hosting a NDAFW event and created lesson plans and other materials for educators, counselors, and prevention specialists. Please click here to learn how to register your organization’s event online.

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.

Register Today for NABH’s 2022 Annual Meeting!

Please visit our Annual Meeting homepage to view the 2022 Annual Meeting At-A-Glance for preliminary meeting details, register for the meeting, and reserve a hotel room. We hope to see you in Washington from June 13-15!

Fact of the Week

Between 1990 and 2019, the global number of disability-adjusted life-years (DALYS) due to mental disorders increased to 125.3 million from 80.8 million, according to a recent study in the journal The Lancet. For questions or comments about this CEO Update, please contact Jessica Zigmond.

Biden Administration Announces RFI on Access to Care for Medicaid and CHIP Enrollees

The Biden administration this week announced a request for information (RFI) in its effort to develop a comprehensive access strategy to ensure equitable access to healthcare for Medicaid and Children’s Health Insurance Program (CHIP) beneficiaries. According to the announcement, this strategy will require the Centers for Medicare & Medicaid Services (CMS) to use regulations, guidance, and other tools to apply a multi-faceted approach to reducing health disparities. The agency is seeking feedback on topics such as enrolling in and maintaining coverage, accessing healthcare services and supports, and ensuring adequate provider payment rates. “With this RFI, we are taking a first step towards a broader perspective of what ‘access’ to Medicaid means,” Daniel Tsai, director of the Center for Medicaid and CHIP Services, said in an announcement. “Ensuring access to Medicaid includes addressing a range of barriers current and potential Medicaid beneficiaries may experience, from enrolling in Medicaid to maintaining coverage, to accessing care across both fee-for-service and managed care delivery systems,” Tsai continued. “Access must also cross physical healthcare, behavioral health, and home and community-based services.” Click here to learn more about the process and how to provide information to CMS. The 60-day comment period opened Feb. 17.

White House Issues Proclamation for National Eating Disorders Awareness Week: Feb. 21-25

President Biden on Friday issued a proclamation that announced National Eating Disorders Awareness Week next week to build awareness around this serious behavioral health issue that has increased in recent years. According to the announcement, nearly 1 in 10 Americans are expected to develop an eating disorder in their lifetime. Eating disorders include binge-eating, bulimia nervosa, and anorexia nervosa and can have serious or fatal consequences if left untreated. Please remember to follow NABH on Twitter @NABHbehavioral and on Linkedin for social media posts during National Eating Disorders Awareness Week.

ASAM Releases ASAM Criteria® Interview Guide

This week the American Society of Addiction Medicine (ASAM) and the University of California, Los Angeles Integrated Substance Abuse Programs (UCLA ISAP) released a paper-based resource to support more consistent and effective implementation of The ASAM Criteria, a national framework for patient-centered, evidence-based addiction care. The ASAM Criteria Assessment Interview Guide is the first publicly available, standardized version of The ASAM Criteria assessment. An announcement about the new resource said both ASAM and UCLA hope to increase both the quality and consistency of patient assessments and treatment recommendations. Center for Rural Opioid Prevention, Treatment & Recovery to Host Contingency Management Webinar on March 2 The Center for Rural Opioid Prevention, Treatment & Recovery will host Introduction to Contingency Management—a webinar that highlights the intervention in which tangible incentives are provided in exchange for evidence of drug or alcohol abstinence—on Wednesday, March 2 at 4 p.m. ET. Led by Michael McDonnell, Ph.D. and Sara Parent, ND, both of Washington State University, the webinar will be available on Zoom and will educate participants on how to describe contingency management; summarize evidence supporting contingency management as an intervention for stimulant use disorders; review guidelines for implementing contingency management; and formulate strategies for overcoming barriers to contingency management implementation. Click here to register.

Register for National Drug and Alcohol Facts Week: March 21-27, 2022

The National Institute on Drug Abuse (NIDA) invites organizations to participate in National Drug and Alcohol Facts Week (NDAFW), a national health observance meant to empower teens and young adults about making informed decisions about drugs, alcohol, and addiction. NIDA has developed five steps to hosting an NDAFW event and created lesson plans and other materials for educators, counselors, and prevention specialists. Please click here to learn how to register your organization’s event online.

Action Alliance to Host Webinar About 988 Hotline Messaging Framework on March 22

The National Action Alliance for Suicide Prevention (Action Alliance) will release a 988 Messaging Framework next month to help people transition to the national 988 behavioral health crisis hotline that takes effect in July. The hourlong webinar is free and will highlight how to use the resource in public messaging efforts. The Action Alliance will host the event on Tuesday, March 22 at 2 p.m. ET. Click here to register.

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.

NABH 2022 Annual Meeting At-A-Glance Available Online

Registration is open for NABH’s 2022 Annual Meeting—Shaping the Future of Behavioral Healthcare—and this week NABH posted the meeting’s At-A-Glance online. Please visit our Annual Meeting homepage to view the At-A-Glance for preliminary meeting details, register for the meeting, and reserve a hotel room. We hope you join us from June 13-15 in Washington!

Fact of the Week

A new estimate from Forbes, the cost of America’s opioid crisis is now more than $1.3 trillion and rising.   For questions or comments about this CEO Update, please contact Jessica Zigmond.

2022 NABH Annual Meeting Registration is Open!

NABH is pleased to announce that registration opened this week for the 2022 NABH Annual Meeting: Shaping the Future of Behavioral Healthcare. Please join us from Monday, June 13 – Wednesday, June 15 at the Mandarin Oriental Washington, DC, and visit our Annual Meeting webpage to register for the meeting and reserve your hotel room. We look forward to seeing you in Washington!

U.S. Surgeon General Vivek Murthy, MD Testifies to Senate Panel About Youth Mental Health

U.S. Surgeon General Vivek Murthy, MD offered four recommendations to address the nation’s growing youth mental health crisis when he testified before the influential Senate Finance Committee this week. Speaking not only as the nation’s doctor, but also as someone who experienced bullying as a child, and as a parent, Murthy said there are number of longstanding, preventable factors that are driving feelings of loneliness and hopelessness among American youth. “The recent ubiquity of technology platforms, especially social media platforms, has had harmful effects on many children,” Murthy said. “Though undoubtedly they serve as a benefit to the lives of many in important ways, these platforms have also exacerbated feelings of loneliness, futility, and low self-esteem for some youth,” he continued. Murthy offered four recommendations to address the myriad youth mental health challenges in the United States: first, ensure that every child has access to high-quality, affordable, and culturally competent mental health care; next, focus on prevention, by investing in school and community-based programs that gave been shown to improve the mental health and emotional well-being of children at low cost and high benefit; third, better understand the impact that technology and social media have on mental health; and, finally, overcome stigma. For that last recommendation, Murthy said this area concerns both individual and community engagement, and it requires understanding the role we each have to play in overcoming stigma.

CDC, FDA Release Draft Guidance for Opioid Prescribing

The Centers for Disease Control and Prevention (CDC) on Thursday released its anticipated draft guidance on opioid prescribing for acute pain, subacute pain, and chronic pain in adults. The guidance includes recommendations on clinician-patient communication, improved safety and effectiveness, and reduction in risks of developing an opioid use disorder (OUD), overdose, and death. It also recommends periodic review of the state prescription drug monitoring program data, consideration for toxicology testing, caution when co-prescribing benzodiazepines, and arrangement of medication treatment for patients with OUD. This clinical practice guideline provides recommendations and does not require mandatory compliance. Public comments on the recommendations are due April 11. Also this week, the U.S. Food and Drug Administration (FDA) released guidance to develop non-addictive alternatives to opioids for acute pain, in response to the statutory requirements of section 3001(b) of the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities (SUPPORT) Act. The FDA said it expects to address chronic pain in future guidance. Comments on the FDA guidance are also due April 11.

Register for National Drug and Alcohol Facts Week: March 21-27, 2022

The National Institute on Drug Abuse (NIDA) invites organizations to participate in National Drug and Alcohol Facts Week (NDAFW), a national health observance meant to empower teens and young adults about making informed decisions about drugs, alcohol, and addiction. NIDA has developed five steps to hosting a NDAFW event and created lesson plans and other materials for educators, counselors, and prevention specialists. Please click here to learn how to register your organization’s event online.

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

Beyond nursing home care, members of racial and ethnic minority groups are more likely to reside in areas that suffer from physician shortages, including shortages of primary care doctors, surgeons, and mental health providers, which is also a product of structural racism. Learn more in the February 2022 edition of Health Affairs, a theme issue devoted to system racism and its effects on health. For questions or comments about this CEO Update, please contact Jessica Zigmond.

Federal Lawmakers Examine U.S. Mental Health Crisis in Committee Hearings

The influential Senate Health, Education, Labor & Pensions (HELP) and House Ways and Means Committees learned about the nation’s persistent mental health and substance use crises in separate hearings on Capitol Hill this week. On Tuesday, senators heard from five expert witnesses, including Mitch Prinstein, Ph.D., chief science officer at the American Psychological Association; Michelle Durham, M.D., M.P.H., vice chair of education in the psychiatry department and clinical associate professor of psychiatry and pediatrics at Boston Medical Center, Boston University School of Medicine; and Sara Goldsby, M.S.W., M.P.H., director of South Carolina’s Department of Alcohol and Other Drug Abuse Services. Senate HELP Committee Chairwoman Patty Murray (D-Wash.) acknowledged that the Covid-19 pandemic has worsened the country’s existing mental health and substance use crises and emphasized more than once that the behavioral healthcare workforce is stretched too thin. Murray also said it’s time to increase access to behavioral healthcare services. “If we’re going to respond to the behavioral health issues the pandemic has made worse … that will take legislative action,” Murray said. In a hearing the following day, members of the House Ways and Means Committee heard from experts representing UConn Health, the Legal Action Center, and the North Carolina Division on Mental Health, Developmental Disabilities, and Substance Abuse Services. The Senate Finance Committee will host a hearing on protecting youth mental health on Tuesday, Feb. 8 at 10 a.m. ET. Click here to watch the hearing next week.

CMS Releases Reminder About ‘Extraordinary Circumstance’ Exception to Quality Data Reporting

The Centers for Medicare & Medicaid Services (CMS) has released a notice to remind healthcare providers that CMS offers a process for hospitals or facilities to request exceptions to the reporting of quality data, including data for electronic clinical quality measures, for one or more quarters when providers experience an extraordinary circumstance beyond their control. Click here to read the announcement, which also includes information about performance-related extraordinary circumstance exception requests and promoting interoperability hardship requests.

Satcher Health Leadership Institute Adds ‘Behavioral Health’ Category and Indicators to Health Equity Tracker

The Satcher Health Leadership Institute (SHLI) has expanded its Health Equity Tracker (HET) outcomes to include a “behavioral health” category and six corresponding indicators. Named for David Satcher, M.D., the nation’s 16^th U.S. surgeon general, the SHLI works to transform health equity through policy, leadership development, and research as it focuses on three priority areas: the political determinants of health, health system transformation, and mental and behavioral health. The six indicators for the new behavioral health category include: frequent mental distress, depression, suicide, illicit opioid use, non-medical drug use, and alcohol use (excessive drinking). Click here to learn more.

National Academy of Medicine Releases Discussion Proceedings for Stigma of Addiction Summit

The National Academy of Medicine has released the discussion proceedings of the Stigma of Addiction Summit that the Academy held last summer. The summit’s six sessions cover topics including how stigma presents itself and interventions to prevent it. The new publication also outlines priorities to guide future actions.

Register Today for National Drug and Alcohol Facts Week: March 21-27, 2022

The National Institute on Drug Abuse (NIDA) invites organizations to participate in National Drug and Alcohol Facts Week (NDAFW), a national health observance meant to empower teens and young adults about making informed decisions about drugs, alcohol, and addiction. NIDA has developed five steps to hosting an NDAFW event and created lesson plans and other materials for educators, counselors, and prevention specialists. Click here to learn how to register your organization’s event online.

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

U.S. universities are developing creative ways to provide mental health resources on their campuses. For example, the University of California-Davis embeds counselors in student groups such as the Cross-Cultural Center and the LGBTQIA Resource Center, while Stanford University’s Bridge Peer Counseling Center offers anonymous counseling 24/7 to students who are more comfortable speaking with a trained fellow student. For questions or comments about this CEO Update, please contact Jessica Zigmond.

HHS, Treasury, and Labor Departments Release Parity Report to Congress

The Departments of Labor (DOL), Health and Human Services (HHS), and Treasury issued a report and fact sheet on Tuesday, Jan. 25 documenting widespread lack of compliance with federal parity rules among commercial health plans. The report specifically highlights lack of compliance with a new requirement enacted in late December 2020 that plans must document how their non-quantitative treatment limitations (NQTLs) comply with the Mental Health Parity and Addiction Equity Act (MHPAEA). During a webinar on Wednesday, Jan. 26, DOL representatives stressed that none of the responses to requests for documentation the agency sent to 156 plans and issuers were sufficient to demonstrate compliance with MHPAEA. Furthermore, despite insufficient documentation, DOL has already issued initial determination letters finding 48 NQTLs imposed on mental health or substance use disorder (MH/SUD) benefits violate parity. HHS reported that all the responses to requests for documentation of compliance with parity from issuers in states where the agency has direct enforcement authority and non-federal government plans similarly were insufficient. HHS has issued initial determination letters finding 16 NQTLs were out of compliance with parity. DOL officials also mentioned that the agencies plan to amend the federal regulations implementing MHPAEA. The Departments included a set of legislative recommendations for Congress in the report including authorizing the Departments to impose civil monetary penalties for parity violations and directly pursue parity violations by entities that provide administrative services to group health plans. In addition, the report recommends that Congress consider ways to permanently expand access to telehealth. The report also recommends that Congress amend MHPAEA to ensure that MH/SUD benefits are “defined in an objective and uniform manner pursuant to external benchmarks that are based in nationally recognized standards”. These developments regarding possible regulatory and legislative changes point to the importance of NABH member submissions to the denial-of-care portal. Please see additional information about the portal below.

CMS Issues Updated Guidance on Covid-19 Vaccination Requirements for Healthcare Workers

The Centers for Medicare and Medicaid Services (CMS) issued updated guidance and resources regarding Covid-19 vaccination requirements for personnel in Medicare-participating facilities including psychiatric hospitals and psychiatric residential treatment facilities. This updated information responds to the Supreme Court’s decision earlier this month to overturn the lower court decisions blocking implementation of CMS’ Covid-19 vaccination requirements in almost half of the states. These requirements now apply in all 50 states with various deadlines. In the 25 states not affected by the litigation, CMS had previously clarified that healthcare facility personnel had to have at least one dose of a Covid-19 vaccine (or be exempt due to religious conviction or medical condition) by Jan. 27, 2022, and a second dose (of any two dose regimen) by Feb. 28, 2022. New deadlines for healthcare facility personnel in states previously under a stay on enforcement are Feb. 14, 2022, for a first dose and March 15, 2022, for a second dose. Texas was affected by separate litigation and the new deadlines for Medicare-regulated healthcare facilities in that state are Feb. 22, 2022, for the first dose and March 21, 2022, for the second. Below are links to updated CMS guidance on the Covid-19 vaccination requirements:

• Guidance memo (cms.gov) – This memo provides guidance for assessing and maintaining compliance with this new regulatory requirement for certain Medicare and Medicaid providers and suppliers.
• CMS Omnibus COVID-19 Health Care Staff Vaccination Requirements FAQ (PDF cms.gov) (PDF) – These FAQs have been updated to explain the recent ruling and how it impacts employee vaccination requirements.
• IFC-6 Vaccination Requirements Infographic (cms.gov) (PDF) – This infographic visually shows the types of providers and suppliers the vaccine requirement applies to, how the requirement can be met, and associated requirement enforcement actions.
• Vaccine Requirement Implementation Timeline (cms.gov) (PDF) – This infographic illustrates the phases of the vaccination rule implementation, state-by-state, and their associated deadlines. Note that the phased deadlines vary by state.
• Vaccine Requirement Decision Tree (cms.gov) (PDF) – This handy decision tree visually explains the steps in determining to which providers and suppliers the vaccine requirement applies.

OSHA Withdraws Vaccine-or-Test Requirement

The U.S. Supreme Court, on Jan. 13, 2022, blocked implementation of the Occupational Safety and Health Administration’s (OSHA’s) vaccination and testing requirements for employers with 100 or more employees. Accordingly, the agency withdrew its emergency temporary standard (ETS) on this topic. However, the agency clarified that “[a]though OSHA is withdrawing the ETS as an enforceable emergency temporary standard, the agency is not withdrawing the ETS to the extent that it serves as a proposed rule.” In a statement on the withdrawal, the agency clarified it is “prioritizing its resources to focus on finalizing a permanent Covid-19 Healthcare Standard.”

HHS Distributes More Than $2 Billion in PRF Phase 4 Funding

HHS’ Health Resources and Services Administration (HRSA) this week is making more than $2 billion in Provider Relief Fund (PRF) Phase 4 general distribution payments to more than 7,600 healthcare providers nationwide. These payments follow nearly $9 billion that HRSA released to providers last month. According to HRSA, a total of more than $11 billion in PRF Phase 4 payments have been distributed to more than 74,000 providers in all 50 states, Washington, D.C., and five territories. HRSA clarified that these payments reflect “full processing of approximately 82 percent of Phase 4 applications. The remaining applications require additional review as part of the risk mitigation and cost containment safeguards previously outlined in the Phase 4 methodology”.

NABH and Other Behavioral Health Groups Send Letter to CMS about ‘No Surprises Act’ Rules

NABH and 10 other behavioral health organizations this week sent a letter to the Centers for Medicare & Medicaid Services (CMS) expressing concern that the agency’s No Surprises Act regulations will have a disproportionately negative effect on behavioral healthcare providers and add to their administrative burdens. The No Surprises Act’s, signed into law in late 2020, requirements became effective this year. NABH and other groups have requested that CMS issue a stay on enforcement of the interim final rules (IFR) that affect routine mental and behavioral health services. If the agency insists on retaining the existing regulations, NABH and the other groups requested an exemption for behavioral healthcare providers. “The duty to furnish a “Good Faith Estimate” (“GFE”) of costs outlined in Part 2 of the regulations imposes an undue administrative burden on our members,” the letter said. “Our providers have a long-standing practice of being transparent about fees with their patients because it is required by their professional ethics. Requiring clinicians to fill out the GFE form and update it every time there is a minor change in the treatment plan that may or may not have an impact on costs takes away from valuable treatment time – which is in extremely high demand as more and more people are struggling with the mental health impact of the COVID pandemic,” it continued. “Demand is already so high that many patients are finding it difficult to find a provider with enough availability to meet their needs.”

ONC Seeks Request for Information on EHR Standards for Prior Authorization and More

HHS’ Office of the National Coordinator (ONC) on Jan. 24, 2022, requested information about electronic health record standards for prior authorization, implementation specifications, and certification criteria for the ONC certification program to inform future rulemaking.   The request for information builds on a set of recommendations made in November 2020 from the HHS Intersection of Clinical and Administrative Data Task Force (ICAD) of the Health Information Technology Advisory Committee (HITAC). The task force is addressing methods for improving data interoperability across the health ecosystem.   “We support efforts that can serve to advance electronic prior authorization for patients, providers, and payers,” Mary Greene, M.D., director of CMS’ Office of Burden Reduction and Health Informatics, said in an announcement. “We look forward to reviewing the input received on this RFI and to exploring opportunities for alignment between future ONC policymaking and ongoing CMS initiatives on this critical topic.” Click here to learn more about how to submit comments, which must be submitted by March 25.

CMS Releases Third Publication of T-MSIS-based Medicaid SUD Data Book

The percentage of Medicaid beneficiaries treated for a substance use disorder (SUD) who received any medication-assisted treatment increased by 7.8 percentage points to 31.6% in 2019 from 23.8% in 2018, according to CMS’ third publication of the Transformed Medicaid Statistical Information System (T-MSIS)-based Medicaid Substance Use Disorder (SUD) Data Book. Required by the Substance Use–Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act (SUPPORT) that Congress passed in 2018, the resource is meant to help policymakers, researchers, and others better understand where to focus drug-prevention and treatment efforts. The data book contains 2019 data on Medicaid beneficiaries treated for SUD, the services they received by both type and setting, delivery system, and progression of care.

Register Today for National Drug and Alcohol Facts Week: March 21-27, 2022

The National Institute on Drug Abuse (NIDA) invites organizations to participate in National Drug and Alcohol Facts Week (NDAFW), a national health observance meant to empower teens and young adults about making informed decisions about drugs, alcohol, and addiction. NIDA has developed five steps to hosting a NDAFW event and created lessons plans and other materials for educators, counselors, and prevention specialists. Click here to learn how to register your organization’s event online

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

A new study found that 62% of Americans surveyed prefer in-person mental health services. For questions or comments about this CEO Update, please contact Jessica Zigmond.

HHS Announces $103 Million to Reduce Burnout and Promote Wellness in Healthcare Workforce

The U.S. Health and Human Services Department (HHS) this week announced it will award $103 million in American Rescue Plan funding for evidence-informed programs, practices, and training to retain healthcare workers, reduce burnout, and promote health and wellness among the nation’s healthcare workforce. HHS’ Health Resources and Services Administration (HRSA) will disburse the funding to 45 grantees and focus especially on healthcare providers in underserved and rural communities, according to HHS. “I have traveled to many health centers across the country and know that the Covid-19 pandemic has intensified issues that have long been a source of stress for frontline healthcare workers — from increased patient volumes to long working hours,” HHS Secretary Xavier Becerra said in an announcement. “This funding reflects the Biden-Harris administration’s commitment to ensuring we have enough critical frontline workers by supporting healthcare providers now and beyond as they face burnout and mental health challenges. We will continue to promote the well-being of those who have made so many sacrifices to keep others well.” HRSA is awarding the funds through the following three programs: Promoting Resilience and Mental Health Among Health Professional Workforce, Health and Public Safety Workforce Resiliency Training Program, and Health and Public Safety Workforce Resiliency Technical Assistance Center. Click here to see the list of award recipients. Also this week, the National Academy of Medicine released a Resource Compendium for Health Care Worker Well-Being, a collection that highlight tools and strategies to address healthcare worker burnout.

HHS Announces $13 Million to Improve Behavioral Healthcare Access in Rural America

HHS this week also announced it will award $13 million through HRSA to increase access to behavioral healthcare services in rural America, including through evidence-based, trauma-informed treatment for substance use disorder. These funds, similar to the funds to address healthcare worker burnout and wellness, are available through last year’s American Rescue Plan. “Our response to the Covid-19 pandemic must include meeting the behavioral health needs of individuals experiencing substance use disorder,” HRSA Administrator Carole Johnson said in an announcement. “In rural areas, accessing the care and services to address these needs can be a particular challenge,” she added. “The funding we are announcing today is directly targeted to the community needs of rural areas and will help expand access to behavioral health services to meet these needs.” HRSA’s Federal Office of Rural Health Policy will make the awards available through the Rural Communities Opioid Response Program-Behavioral Health Care Support. Interested applicants must apply by Tuesday, April 19 at 11:59 p.m. ET. Click here for more information.

CMS Seeks Comments on Time and Distance Standards for Network Adequacy in Marketplace Insurance Plans

The Centers for Medicare & Medicaid Services (CMS) is requesting comments on proposals that the agency made regarding specific standards for outpatient, clinical behavioral health providers, psychiatrists, and inpatient or residential behavioral health facilities among other provider types in qualified health plans offered in the federally qualified health insurance exchanges. Earlier this month, CMS released its Qualified Health Plan Notice of Benefit and Payment Parameters proposed rule for 2023. In it, CMS proposed specific time and distance standards for measuring network adequacy in qualified health plans offered in federally facilitated exchanges. Federally facilitated exchanges are offered in Alabama, Alaska, Arizona, Delaware, Florida, Georgia, Hawaii, Illinois, Indiana, Kansas, Louisiana, Michigan, Mississippi, Missouri, Montana, Nebraska, New Hampshire, North Carolina, North Dakota, Ohio, Oklahoma, South Carolina, South Dakota, Tennessee, Texas, Utah, West Virginia, Wisconsin, and Wyoming. The agency proposed time and distance standards for behavioral healthcare providers in a draft letter to issuers that clarifies specific provisions in the proposed rule. See pages 11 and 12 in the letter for proposed time and distance standards. Please send any comments regarding these proposals to Kirsten Beronio, NABH’s director of policy and regulatory affairs, Director of Policy and Regulatory Affairs, before next Thursday, Jan. 27.

The Joint Commission Publishes Covid-19 Vaccination Requirement FAQs

The Joint Commission (TJC) has released a series of Covid-19 vaccination requirement resources and frequently asked questions (FAQs) for providers. Beginning Jan. 27, TJC will start surveying to CMS’ Covid-19 vaccination healthcare staff vaccination interim final rule in all of the Commission’s applicable program surveys. As TJC noted in its announcement about the FAQs, “the CMS Covid-19 vaccination requirements apply to organizations that elect to use Joint Commission accreditation for deemed status purposes.”   

Register Today for National Drug and Alcohol Facts Week: March 21-27, 2022

The National Institute on Drug Abuse (NIDA) invites organizations to participate in National Drug and Alcohol Facts Week (NDAFW), a national health observance meant to empower teens and young adults about making informed decisions about drugs, alcohol, and addiction. NIDA has developed five steps to hosting a NDAFW event and created lessons plans and other materials for educators, counselors, and prevention specialists. Click here to learn how to register your organization’s event online

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

During 2015-2019, an estimated 10.6 million adults in the United States, or about 4.3% of the adult population, reported having had suicidal thoughts during the preceding year. For questions or comments about this CEO Update, please contact Jessica Zigmond.

U.S. Supreme Court Allows Covid-19 Vaccine Mandate for Healthcare Workers

In a 5-4 vote Thursday, the U.S. Supreme Court ruled it will allow the Centers for Medicare & Medicaid Services’ (CMS) regulation to proceed that mandates the Covid-19 vaccine for about 10.3 million workers at approximately 76,000 healthcare facilities that accept money from the Medicare and Medicaid programs. Chief Justice John Roberts and Justice Brett Kavanaugh joined the Court’s liberal justices in the majority decision. In its other ruling, the Court voted 6-3 to block the Occupational Safety and Health Administration’s (OSHA) vaccine-or-test mandate for large businesses. CMS Administrator Chiquita Brooks-LaSure said in a statement that the agency is “extremely pleased” with the Court’s decision for healthcare workers and added that giving patients assurance of safe care is a critical responsibility for CMS. “CMS is already implementing its healthcare worker vaccination rule in 25 states and territories that were not covered by preliminary injunctions,” Brooks-LaSure continued in her Jan. 13 statement. “Today’s decision will enable us to fully implement this rule, and we look forward to working with healthcare providers and their workers to protect patients,” she continued. “We will continue our extensive outreach and assistance efforts encouraging individuals working in healthcare to get vaccinated.” As a result of Thursday’s decision, healthcare providers subject to the Omnibus Health Care Staff Vaccination rule in the 24 states (Alabama, Alaska, Arizona, Arkansas, Georgia, Idaho, Indiana, Iowa, Kansas, Kentucky, Louisiana, Mississippi, Missouri, Montana, Nebraska, New Hampshire, North Dakota, Ohio, Oklahoma, South Carolina, South Dakota, Utah, West Virginia, and Wyoming) covered by this decision will now need to establish plans and procedures to ensure their staff are vaccinated. CMS also said the decision does not affect compliance timelines for providers in the District of Columbia, the territories, and the 25 states where the preliminary injunction was previously lifted. CMS released guidance about this on Dec. 28, 2021.

Becerra Extends Covid Public Health Emergency for 90 Days

HHS Secretary Xavier Becerra has extended the Covid-19 public health emergency (PHE) for an additional 90 days, effective Jan. 16. Former HHS Secretary Alex Azar made the original determination on Jan. 31, 2020. Azar renewed the Covid-19 PHE four times, and this recent determination is the fourth time Becerra has renewed it.

SAMHSA and Partner Groups Launch National Survey of Mobile Crisis Teams

The Substance Abuse and Mental Health Services Administration (SAMHSA) has partnered with other groups to launch a survey that will gather information about mobile crisis teams (MCTs) across the United States. SAMHSA, along with organizations including the National Association of State Mental Health Program Directors and Vibrant Emotional Health (formerly the Mental Health Association of New York City) has released the survey to better understand the organization, operation, and financing of MCTs. The organizations encourage all mobile crisis, co-responder, and other field-based mental health crisis response teams to complete the 10-minute survey by Tuesday, Feb. 28 and to share the survey widely.

CMS Requests Information on Behavioral Health Networks Within Medicare Advantage Plans

CMS on Wednesday published a proposed rule that includes a request for information about how to improve behavioral health networks within Medicare Advantage (MA) health plans. NABH will develop a response to the regulation and welcomes comments from NABH members. Although all comments are welcome, CMS asked specifically for  comments related to the following topics:

• Challenges for behavioral healthcare providers to establish contracts with MA health plans;

• Providers’ inability or unwillingness to contract with MA plans, including issues related to provider reimbursement; and

• Opportunities to expand services for the treatment of opioid addiction and substance use disorders.

Please send comments to Kirsten Beronio, NABH’s director of policy and regulatory affairs. Public comments are due March 7.

GAO Offers Recommendations to Improve State Opioid Response Grant Program Assessment

In its recent review of SAMHSA’s State Opioid Response (SOR) grant program, the Government Accountability Office (GAO) concluded that SAMHSA did not fully leverage available information to adequately assess the program, and that the agency did not identify the program’s potential limitations. The GAO noted that SAMHSA assesses the SOR grant program through two annual performance reports, and it recommended that SAMHSA make those reports more useful by first identifying potential limitations and how those limitations may affect the conclusions that can and cannot be drawn; and second by further analyzing existing program information to provide a more comprehensive, in-depth assessment of the program to identify opportunities for improvement.

Register Today for National Drug and Alcohol Facts Week: March 21-27, 2022

The National Institute on Drug Abuse (NIDA) invites organizations to participate in National Drug and Alcohol Facts Week (NDAFW), a national health observance meant to empower teens and young adults about making informed decisions about drugs, alcohol, and addiction. NIDA has developed five steps to hosting a NDAFW event and created lessons plans and other materials for educators, counselors, and prevention specialists. Click here to learn how to register your organization’s event online.

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

A new analysis in the JAMA Network Open found there were 10,292 fatal overdoses among people over the age of 55 in 2019, compared with 518 overdoses in the same age group in 1999. The study examined disparities by sex, race, and ethnicity in death rates due to opioid overdose during this time period. For questions or comments about this CEO Update, please contact Jessica Zigmond.

CMS Issues Guidance on Covid-19 Vaccination Requirements for Most Medicare- and Medicaid-Certified Providers

The Centers for Medicare & Medicaid Services (CMS) on Dec. 29 issued guidance regarding the Interim Final Rule (IFR) regarding Covid-19 vaccination requirements for healthcare staff that the agency published in early November. In the Dec, 29 memo, CMS specified that this guidance does not apply to the following states that are still subject to preliminary injunctions that federal courts issued to block implementation of the IFR in those states: Alabama, Alaska, Arizona, Arkansas, Georgia, Idaho, Indiana, Iowa, Kansas, Kentucky, Louisiana, Mississippi, Missouri, Montana, Nebraska, New Hampshire, North Dakota, Ohio, Oklahoma, South Carolina, South Dakota, Texas, Utah, West Virginia, and Wyoming. To learn more, please read the NABH Issue Brief that NABH sent to members this week.

OSHA Withdraws Non-Recordkeeping Portions of Covid-19 Healthcare ETS

The U.S. Labor Department’s Occupational Safety and Health Administration (OSHA) last week said it is withdrawing the non-recordkeeping portion of the Covid-19 healthcare emergency temporary standard (ETS) that it adopted last June. Separate from a Covid-19 vaccine mandate, the healthcare ETS required that employers provide personal protective equipment, physical barriers, and ventilation, and also require screening of each individual who enters the facility. The temporary standard also provided paid leave to workers who must quarantine due to infections or exposure. “OSHA announces today that it intends to continue to work expeditiously to issue a final standard that will protect healthcare workers from COVID-19 hazards and will do so as it also considers its broader infectious disease rulemaking,” OSHA’s announcement said on Dec. 27. “However, given that OSHA anticipates a final rule cannot be completed in a timeframe approaching the one contemplated by the OSH Act, OSHA also announces today that it is withdrawing the non-recordkeeping portions of the healthcare ETS.

HHS’ Provider Relief Fund Reporting Portal for Reporting Period #2 Open Through March 31

HHS’ Health Resources and Services Administration (HRSA) announced the Provider Relief Fund (PRF) Reporting Portal for Reporting Period 2 (RP2) opened on Jan. 1 and will remain open through March 31, 2022. According to HRSA’s announcement, healthcare providers who received one or more general and/or targeted PRF payments exceeding $10,000, in the aggregate, from July 1, 2020 to Dec. 31, 2020 must report on their use of funds during RP2. In addition, HRSA created a stakeholder toolkit with content to share information about RP2 within organizations and networks. The agency has also developed the following resources for providers: What’s New in Reporting Period 2 Fact Sheet, Lost Revenues Guide, and a webpage for reporting on nursing home and infection control payments. To learn more, register for either of HRSA’s upcoming webinars: one for new reporting entities on Jan. 12 at 3 p.m. ET and one for returning reporting entities on Jan. 13 at 3 p.m. ET.

SAMHSA Invests $282 Million to Implement 988 Behavioral Health Crisis Hotline

The Substance Abuse and Mental Health Services Administration (SAMHSA) announced it has invested $282 million in American Rescue Plan funding to help transition the current National Suicide Prevention Lifeline to the 988 three-digit dialing code from its current 10-digit number. Congress designated the new 988 dialing code in 2020 to operate through the existing National Suicide Prevention Lifeline. The new code will be available national for calls, texts, and chats, beginning in July 2022. According to SAMHSA, it has allotted $177 million to strengthen and expand the existing Lifeline network operations and infrastructure, including chat and text response, backup center capacity, and special services, such as a sub-network for Spanish language-speakers. The agency has invested $105 million to develop staffing across states’ local crisis call centers. SAMHSA is recruiting for a director for the crisis coordination office.

California’s Medicaid Program Receives CMS Approval to Implement Contingency Management

California Medi-Cal, the state’s Medicaid program, has received approval from the Centers for Medicaid & Medicare Services (CMS) to implement contingency management (CM) through a Section 1115 waiver. Several insurance companies are financing CM, an evidence-based intervention for stimulant use disorders, and some states have engaged in pilot programs for the practice. CMS’ approval of the California CM pilot represents the first time the treatment intervention has been approved formally as a benefit in a Medicaid program. While there is substantial research supporting the efficacy of CM, implementation has lagged for decades due to an Office of Inspector General opinion that raised concerns about fraud and abuse.

OSHA Publishes Workplace Violence Prevention Standard Fact Sheet

OSHA has announced it will convene a Small Business Advocacy Review (SBAR) panel of small entity representatives early this year to help OSHA in its work to develop a potential Prevention of Workplace Violence in Healthcare and Social Assistance standard. In the meantime, OSHA has published a fact sheet that describes who might be covered by a new workplace violence prevention standard, why OSHA is considering the standard, what the standard might include, what a small entity representative would do, and how small businesses and local government entities can participate.

NIMH to Host Webinar on School-based Suicide Prevention on Jan. 14

The National Institute of Mental Health (NIMH) will host a webinar next week about new practices in school-based suicide prevention for school administrators, researchers, practitioners, policymakers, and other stakeholders. The presentation will focus on identifying and supporting high-risk youth, as well as opportunities to evaluate these efforts. NIMH will host the webinar next Friday, Jan. 14 from 2 p.m. to 3:30 p.m. ET. Click here to register.

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

A meta-analysis of 21 studies that analyzed interventions in prisons to address the needs of people with co-occurring serious mental illness and substance use disorders generally showed decreases in substance use and lower odds of committing a substance use-related offense after reentry into the community for those who were in a treatment program compared with those who were not, according to research published in Psychiatric Services. For questions or comments about this CEO Update, please contact Jessica Zigmond.

President Biden Signs Debt Ceiling Increase, Staving Off Medicare Provider Cuts  

President Biden on Thursday signed legislation that permits a federal debt ceiling increase and also forestalls expected Medicare payment cuts to providers. Passed by Congress this week, the bill to raise the federal government’s borrowing limit by about $2.5 trillion—and cover its obligations into 2023—also delays through March 2022 the 2% Medicare sequestration cuts that were to take effect in January. After the first quarter of 2022, a phased-in, 1% cut will take effect for the second quarter, followed by the full 2% cut for the third and fourth quarters of the year. Under the legislation, the sequestration will be increased to 2.25% for the first two quarters of 2030, increasing to 3% in quarters three and four of 2030. The bill would also extend the Medicare conversion factor through calendar year 2022 at a rate of 3%, marking a reduction in provider reimbursement by 0.75 percent from the 3.75 conversion factor in 2021.

Senate Majority Leader Schumer Says More Time Needed for ‘Build Back Better Act’

Senate Majority Leader Charles Schumer (D-N.Y.) on Friday signaled that the Biden administration’s Build Back Better Act will be delayed as discussions continue about the $1.7 trillion climate and social spending plan. Reports have noted that Democrats are continuing to push for action on the legislation before Christmas, but that ongoing conversations between the White House and Sens. Joe Manchin (D-W.Va.) and Kyrsten Sinema (D-Ariz.)—both of whom have expressed concern about passing another trillion-dollar spending bill—will push the legislation into 2022. “The president requested more time to continue his negotiations, and so we will keep working with him, hand in hand, to bring this bill over the finish line and deliver on these much-needed provisions,” Schumer said on the Senate floor.” Schumer did not say when the Senate will consider the measure.

HHS Releases 2022 Regulatory Priorities

The U.S. Health and Human Services Department (HHS) has included behavioral health in the department’s recently released Statement of Regulatory Priorities for 2022. Beginning on page 5 of the 15-page document, HHS noted it will propose two rules intended to extend telehealth flexibilities for substance use disorder treatments granted during the Covid-19 public health emergency. One rule will propose revisions to the Substance Abuse and Mental Health Services Administration’s (SAMHSA) regulations that would make permanent regulatory flexibilities for opioid treatment programs to provide extended take-home doses of methadone to patients when it is safe to do so. In the other telehealth rule, HHS will propose revisions to SAMHSA regulations to permanently allow opioid treatment programs to provide buprenorphine via telehealth services. The document also describes HHS’ plans to work with the U.S. Labor Department on a rule related to the Mental Health Parity and Addiction Treatment Equity Act and the Consolidated Appropriations Act, 2021 related to compliance. Finally, the HHS plan said it will work on revisions related to Part 2 requirements to align rules about the confidentiality of SUD treatment records with rules that the Health Insurance Portability and Accountability Act of 1996 and the Coronavirus Aid, Relief, and Economic Security Act of 2020 require.

CMS Adds Mental Health and SUD Measures to Children’s Core Healthcare Quality Measurement Set

The Centers for Medicare & Medicaid Services (CMS) has added two measures to the 2022 updates to the core set of children’s healthcare quality measures. In Follow-Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence: Ages 13-17, the measure assesses the percentage of emergency department (ED) visits for beneficiaries aged13 and older with a principal diagnosis of alcohol or other drug (AOD) abuse or dependence who had a follow-up visit for AOD abuse or dependence. The other measure, Follow-Up After Emergency Department Visit for Mental Illness: Ages 6-17, assesses the percentage of ED visits for beneficiaries aged 6 and older with a principal diagnosis of mental illness or intentional self-harm and who had a follow-up visit for mental illness.

CDC Data Show Drug Overdose Deaths Involving Fentanyl Increasing

A new report from the Centers for Disease Control and Prevention (CDC) shows that in 2019 and 2020, deaths involving illegal fentanyl increased 94% in the West, 65% in the South, and 33% in the Midwest. “Pressed into counterfeit pills made to look like oxycodone or other painkillers, illegally made fentanyl has been showing up east of the Mississippi where heroin is sold and in two-thirds of drug overdose deaths charted by CDC through April,” the report noted. Meanwhile, HHS’ Office of the Inspector General (OIG) this week released a data brief that reported many Medicare beneficiaries are not receiving medication to treat their opioid use disorder. “About 1 million Medicare beneficiaries were diagnosed with opioid use disorder in 2020. Yet less than 16 percent of these beneficiaries received medication to treat their opioid use disorder, raising concerns that beneficiaries face challenges accessing treatment,” the OIG’s data brief noted. “Furthermore, less than half of the beneficiaries who received medication to treat their opioid use disorder also received behavioral therapy. These services may be provided in-person or via telehealth; however, the full extent to which beneficiaries use telehealth for behavioral therapy is unknown as Medicare does not require opioid treatment programs to report this information.”

SAMHSA Releases New Prescribing Tools for Buprenorphine in Primary Care Settings

SAMHSA has published a new resource to provide primary care providers with information on how to implement opioid use disorder treatment using buprenorphine. The publication highlights common barriers and identifies strategies to address them and also includes specific tactics to support buprenorphine implementation.

SAMHSA to Host Webinar on Harm Reduction Grant Program on Monday

SAMHSA is accepting applications for its first harm-reduction program and will host a webinar Monday, Dec. 20 to review the program’s requirements. The agency said it expects to award about $30 million in grants with funding from the American Rescue Plan for programs intended to increase access to a range of community harm-reduction services and to support harm-reduction providers as they work to prevent overdose deaths. The webinar will be held on Monday at 2 p.m. ET. Click here to register.

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

From August 2019 to April 2021, only 7.4% of people in an emergency department for an opioid overdose received a prescription for naloxone within 30 days of the visit, according to a new study in Open Minds.

Happy Holidays from NABH!

NABH will not publish CEO Update for the next two weeks and will resume on Friday, Jan. 7, 2022. The entire NABH team wishes you, your families, and your teams a very happy, healthy, and safe holiday season!   For questions or comments about this CEO Update, please contact Jessica Zigmond.

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.

U.S. Overdose Deaths Reach Record High During Covid-19 Pandemic

More than 100,000 Americans died of overdoses for the 12-month period that ended in April 2021, marking the first time the number of U.S. overdose deaths has surpassed 100,000 in a year, according to provisional data from the National Center for Health Statistics (NCHS). This record number represents a nearly 30% increase from the 78,000 deaths in the prior year. Meanwhile, the NCHS data show that overdose deaths in the United States have more than doubled since 2015. “This translates to an American perishing from a drug overdose death every five minutes,” Rahul Gupta, M.D., M.P.H., M.B.A., director of the Office of National Drug Control Policy (ONDCP) told National Public Radio in an interview on Wednesday. “This is unacceptable, and it requires an unprecedented response.” Also this week, Gupta’s office released a state model law to help make access to the prescription naloxone consistent nationwide. The law offers a template of recommended legislative provisions that states can enact so they can offer access to the life-saving treatment. The model law maps out ways to expand access to naloxone; addresses the need to provide uniformity in the ability of citizens to access antagonists such as naloxone; protects individuals administering opioid antagonists such as naloxone from unjust persecution; requires health insurance coverage of opioid antagonists, and more. “No one should die from an overdose, and naloxone is one of the most effective tools we have to save lives,” Gupta said in ONDCP’s announcement. “But sadly, today, people with substance use disorders are overdosing and dying across the country because naloxone access depends a great deal on where you live.”

SAMHSA Extends Take-Home Methadone Flexibilities to OTPs for One Year

The Substance Abuse and Mental Health Services Administration (SAMHSA) on Thursday said it will extend for one year the methadone take-home flexibilities it provided to opioid treatment programs (OTPs) at the start of the Covid-19 pandemic in March 2020 and is “considering mechanisms to make this flexibility permanent.”   This flexibility has allowed OTPs to dispense 28 days of take-home methadone doses for stable patients and up to 14 days of take-home methadone medication to less stable patients, based on provider assessments. SAMHSA’s announcement said it is extending the flexibilities for a year “effective upon the eventual expiration of the Covid-19 Public Health Emergency. Click here to read SAMHSA’s announcement.

Provider Relief Fund Reporting Period 1 Ends Nov. 30

The Health Resources and Services Administration (HRSA) this week reminded providers that the 60-day grace period for the Provider Relief Fund (PRF) Reporting Period 1 ends Tuesday, Nov. 30. Non-compliant providers still have time to complete their reporting requirements, HRSA noted, by submitting their report to the PRF reporting portal by Nov. 30. Providers who fail to meet the deadline will be required to return their PRF payments by Dec. 30, 2021. HRSA also provided a Returning Funds Fact Sheet and additional information is available on the PRF Reporting Resources webpage.

OSHA Suspends Enforcement of Vaccine Mandate for Businesses

The U.S. Labor Department’s Occupational Safety and Health Administration (OSHA) announced it has suspended enforcement of its vaccine mandate for businesses, pending litigation. Earlier this month OSHA released an Emergency Temporary Standard that requires employers with 100 or more employees to develop, implement, and enforce a mandatory Covid-19 vaccination policy to minimize the risk of the deadly virus. “While OSHA remains confident in its authority to protect workers in emergencies, OSHA has suspended activities related to the implementation and enforcement of the ETS pending future developments in the litigation,” the agency announced on its website.

NABH and Other Behavioral Health Groups Release Plan for 988 Crisis Hotline Response

NABH and 14 other behavioral health organizations and advocacy groups this week released A Consensus Approach and Recommendations for the Creation of a Comprehensive Crisis Response System to help guide the mental health and substance crisis response mandated in the National Suicide Hotline Designation Act of 2020. The 17-page roadmap outlines the scope of implementing the 988 Crisis Hotline that will begin operating in July 2022. It also highlights the following seven pillars for transforming mental health and substance use care: early identification and prevention, emergency and crisis response, equity and inclusion, integration and partnership, fair and equivalent coverage, standards for care, and workforce capacity. “988 is not just a new number to call,” the guide states. “It is an opportunity to rethink how we approach mental health, substance use disorders, and suicide prevention in our communities.”

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

In fiscal year 2020, SAMHSA’s Projects for Assistance in Transition from Homelessness (PATH) grantees enrolled 60,000 individuals and connected nearly 40,000 to community mental health services. Nearly 40% of these individuals reported co-occurring disorders and approximately 39% of these individuals experienced chronic homelessness.   For questions or comments about this CEO Update, please contact Jessica Zigmond.

CMS Freezes CY 2022 Methadone Reimbursement Rates in Interim Final Rule

In an interim final rule (IFR), the Centers for Medicare & Medicaid Services (CMS) said it will freeze methadone reimbursement rates for calendar year (CY) 2022. CMS is establishing a limited exception to the current CMS methodology for determining rates for the drug episode of care for methadone (HCPCS G2067-weekly bundle) and the add-on take-home for methadone (HCPCS G2708) by freezing rates at the CY2021 rate. The most recent average sale price (ASP) quarterly rates for oral methadone decreased by just more than 50% over last year’s rate, resulting in a reimbursement rate of 17.64 versus the CY 2021 rate of 37.38 (100% of ASP). CMS said the reduction is due to the inclusion of methadone tablets, where previously only the oral concentrate form was reflected in ASP sales. In addition, because ASP is not required for oral methadone, only a small number of manufacturers report ASP data. Moreover, CMS is not clear about OTP utilization rates for the oral and tablet forms of methadone; however, the agency has heard anecdotally that OTPs use oral methadone exclusively. CMS said that collectively, these three factors raised concerns about implementing such a “sudden and significant decrease in the rate for methadone” [that] could affect the ability of OTPs to continue to offer services to Medicare beneficiaries, thereby impeding access to treatment for OUD, at a time when overdose deaths are at an all-time high.” The freeze of reimbursement rates at the CY 2021 rates will allow time for further research and discussion with stakeholders to develop a new payment methodology in time for the CY 2023 payment rate determination. CMS requested information from stakeholders on the following are of interest:

• The exception being made
• Frequency of use of methadone oral concentrate compared with tablets, and how this should factor into rate setting
• How the reduced payment changes (discussed above) will affect operations and beneficiary access to treatment

Public comments are due by Jan. 3, 2022. The rule will be published in the Federal Register on Nov. 19 and will become effective on Jan. 1, 2022.

NABH Sends Letters to U.S. Senate Finance and HELP Committees

NABH recently sent letters to members of the influential Senate Finance and Senate Health, Education, Labor, & Pensions (HELP) Committees that provided detailed information and recommendations about how to improve access to mental health and addiction treatment. The first letter to Senate Finance Committee Chairman Ron Wyden (D-Ore.) and Ranking Member Mike Crapo (R-Idaho) was a response to a request for information from the senators this summer. In it, NABH emphasized ensuring parity; expanding telehealth; strengthening workforce; increasing integration, coordination, and access; improving access for children and youth; and increasing Medicare Advantage accountability for mental health and addiction treatment. NABH also sent a letter to Senators Christopher Murphy (D-Conn.) and Bill Cassidy, M.D. (R-La.) of the Senate HELP Committee regarding their request for feedback on the programs authorized in the Mental Health Reform Act of 2016. “The pandemic has highlighted and amplified the need for improved access to mental health and addiction treatment,” NABH President and CEO Shawn Coughlin explained in both letters. “Studies have consistently found significantly higher levels of anxiety and depression and suicidal ideation. In addition, alcohol consumption has increased significantly,” he added. “Drug overdose deaths increased almost 30% in 2020 to more than 90,000 deaths, the highest number ever recorded over a 12-month period. Although suicide rates seemed to have leveled off and decreased last year, there have been troubling increases in suicides and suicidal ideation among certain subgroups including Black Americans and adolescent girls.” Both letters also noted that experts expect mental health and substance use disorders to remain elevated long after the Covid-19 pandemic ends.

NABH and Other Behavioral Health Groups Send Letter to OSHA on Workplace Violence

NABH led development of a stakeholder group letter to the U.S. Labor Department’s Occupational Safety and Health Administration (OSHA) about ensuring the safety of personnel in healthcare settings, including those focused on behavioral health. The letter from NABH, the American Nurses Association, the American Psychiatric Association, the National Alliance on Mental Illness, the National Association of State Mental Health Program Directors, and the National Council for Mental Wellbeing followed an early August meeting with representatives from all of the organizations and OSHA that focused on settings where people access mental health or substance use disorder treatment. NABH and the other organizations highlighted a variety of issues, including incorporating trauma-informed care to inform both environmental interventions and settings; conducting debriefing sessions when incidents do occur, including the patient’s perspective to inform additional prevention measures; and providing clinician and staff development/training on de-escalation techniques.

The Commonwealth Fund and Council of State Governments Release Policy Options to Advance Mental Health

The Commonwealth Fund and the Council of State Governments have released Mental Health Resource Guide for State Policymakers, a new resource based on state priorities, best practices, and perspectives from leaders in the field of mental health. Overseen by an advisory group of state legislators, health officials, and experts, the guide focuses on four policy areas: social isolation and loneliness, maternal mental health, social determinants of mental health, and mental health insurance parity. “The resource guide addresses the issue of workforce shortages, and also highlights ways to stretch existing resources, including, for instance, providing peer support and consultation between primary care and behavioral health providers,” The Commonwealth Fund noted in its announcement about the guide. “Some strategies include expanding telehealth psychiatric services and incorporating mental health screening and interventions into various settings like schools, senior centers, workplaces, primary care offices, and in law enforcement.”

ASAM and Well Being Trust Release Toolkit for Strengthening Patient-Centered Addiction Care

The American Society of Addiction Medicine (ASAM) and the Well Being Trust this week released Speaking the Same Language: A Toolkit for Strengthening Patient-Centered Addiction Care in the United States, a toolkit written by Manatt Health Strategies to emphasize the need for adopting a common framework to addiction care in the United States. The toolkit is meant to educate stakeholders about the strategies and tools available to support more effective implementation of The ASAM Criteria and also provide legislative, regulatory, and contractual language that interested states can use.

SAMHSA to Host Webinar on Behavioral Health Equity on Tuesday, Nov. 16

The Substance Abuse and Mental Health Services Administration (SAMHSA) will host Advancing Behavioral Health Equity: National CLAS Standards in Action on Tuesday, Nov. 16 at 2:30 p.m. ET. The webinar will examine real-world examples of behavioral health service providers who use the National Standards for Culturally and Linguistically Appropriate Services (CLAS) and the Behavioral Health Implementation Guide.   Presenters include Assistant Secretary for Mental Health and Substance Use Miriam Delphin-Rittmon, Ph.D. and Rear Admiral Felicia Collins, M.D., M.P.H., director of the U.S. Health and Human Services Department’s Office of Minority Health. Click here to register.

NABH 2021 Annual Meeting Photos and Recorded Sessions Now Available!

Photos and recorded sessions from last month’s Annual Meeting are now available on the association’s Annual Meeting webpage. NABH looks forward to welcoming members to the 2022 Annual Meeting in Washington from June 13-15, 2022!

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

A new study shows that the Centers for Disease Control and Prevention’s 2016 Guideline for Prescribing Opioids for Chronic Pain was associated with substantial reductions in dispensing opioids, including a reduction in patients’ rate of receiving at least one opioid prescription by about 20 percentage points by December 2018 with the counterfactual, no-guideline scenario.   For questions or comments about this CEO Update, please contact Jessica Zigmond.

CMS Issues Emergency Rule Requiring Covid-19 Vaccination for Medicare & Medicaid Providers

The Centers for Medicare & Medicaid Services (CMS) on Thursday issued an emergency regulation requiring Covid-19 vaccination for eligible staff at certain healthcare facilities that participate in the Medicare and Medicaid programs. Facilities covered under this regulation must establish a policy that ensures all eligible staff have received the first dose of a two-dose Covid-19 vaccine or a one-dose Covid-19 vaccine by Dec. 5, 2021 before they provide any care or treatment, CMS said in its announcement. All eligible staff must have received the necessary shots to be vaccinated—either two doses of the Pfizer or Moderna vaccines or one dose of the Johnson & Johnson vaccine—by Jan. 4, 2022. The regulation provides exemptions based on recognized medical conditions, religious beliefs, observances, or practices. “Ensuring patient safety and protection from Covid-19 has been the focus of our efforts in combatting the pandemic and the constantly evolving challenges we’re seeing,” CMS Administrator Chiquita Brooks-LaSure said in the announcement. “Today’s action addresses the risk of unvaccinated healthcare staff to patient safety and provides the stability and uniformity across the nation’s healthcare system to strengthen the health of people and the providers who care for them.” The regulations became effective today, Friday, Nov. 5, and CMS will accept comments on this interim final rule until Jan. 4, 2022. Click here for details about submitting comments.

OSHA Releases Covid-19 Vaccination and Testing Requirements in the Workplace

The Occupational Safety and Health Administration (OSHA) on Thursday released an emergency temporary standard (ETS) that requires employers with 100 or more employees to develop, implement, and enforce a mandatory Covid-19 vaccination policy to minimize the risk of the deadly coronavirus. In the highly anticipated rule, OSHA noted an exception for employers who instead adopt a policy that requires employees to choose either to get vaccinated or to undergo Covid-19 testing at least once per week in the workplace and wear a face covering at work. The testing requirement for unvaccinated workers is scheduled to begin on Jan. 4, 2022, and employers must comply with all other requirements in the ETS—such as providing paid time off for employees to get vaccinated and “reasonable time and paid sick leave” to recover from the vaccination’s potential side effects—by Dec. 6, 2021. Employees who fall under the ETS rule must have their final vaccination dose by Jan. 4, 2022. “We must take action to implement this emergency temporary standard to contain the virus and protect people in the workplace against the grave danger of Covid-19,” U.S. Labor Secretary Marty Walsh said in a news release. “Many businesses understand the benefits of having their workers vaccinated against Covid-19, and we expect many will be pleased to see this OSHA rule go into effect.” According to the rule, states and U.S. territories that have their own OSHA-approved occupational and health plans must “either amend their standards to be identical or ‘at least as effective’ as the new standard or show that an existing state plan standard covering this area is ‘at least as effective’ as the new federal standard.” Of the 28 states and territories with OSHA-approved state plans, 22 cover both public and private sector employees and six states and territories (Connecticut, Illinois, Maine, New Jersey, New York, and the Virgin Islands) cover only state and local governments. OSHA released a fact sheet about the ETS and will accept written comments about any aspect of the rule by Dec. 6, 2021. Click here to submit comments and attachments.

CMS Releases Final Medicare Physician Fee Schedule and OPPS Rules for 2022

CMS this week released both the final Medicare Physician Fee Schedule (PFS) and final hospital outpatient prospective payment system (OPPS) regulations for 2022. Highlights for both regulations are included below. PFS Highlights: The final PFS for next year includes a cut to practitioner rates due to a statutory budget neutrality requirement. In addition, a 3.75% payment increase provided in the Consolidated Appropriations Act for 2021 is expected to expire. Click here for additional details about the agency’s payment provisions. For telehealth services, the Medicare program will continue covering mental health and substance use disorder services via telehealth after the public health emergency ends. The frequency of in-person visits that will be required for those receiving care via telehealth has been modified to lessen the frequency. Instead of every six months, CMS changed its proposal to require in-person visits once every 12 months for those receiving behavioral health treatment via telehealth. CMS also will allow for exceptions to this 12-month interval if both the provider and patient agree the risks and burdens outweigh the benefits and this is documented. The requirement that beneficiaries receiving mental health treatment via telehealth must have been seen in-person during the prior six months before the first telehealth service will be maintained because this previous in-person visit requirement was established in the statute. Meanwhile, Medicare will continue to cover audio-only telehealth for mental health. CMS also clarified that MH services include treatment of substance use disorders for purposes of Medicare coverage of audio-only telehealth. Providers must have the capacity to offer telehealth via audio and visual technology. CMS is requiring use of a service-level modifier for services provided via audio-only telehealth. Medicare will continue to cover a long list of services covered via telehealth on a temporary basis during the pandemic until the end of CY 2023. Click here to see the telehealth services that will be covered for 2022. For the nation’s Opioid Treatment Programs (OTPs), the Medicare program will continue to cover individual and group therapy and substance use counseling provided by OTPs via audio-only, telehealth technology after the public health emergency ends. This coverage of audio-only is limited to situations when video is not available to the beneficiary or they do not consent to the use of video. In addition, CMS made final the proposal that new service-level modifier be appended to claims submitted for the counseling and therapy add-on code when services are furnished via audio-only. The agency is not finalizing the prior proposal to require additional documentation in the medical record to support the use of audio-only services. CMS also finalized its proposals to provide annual updates and locality adjustments for the add-on payments for the non-drug components for opioid antagonist medication (i.e., naloxone) that were new for CY 2021, to provide a new code for a higher dose of the naloxone nasal spray, pricing methodologies for this higher dose naloxone product; reaffirmed recoupment of duplicative payments for naloxone (where separately paid under Medicare Part B or D) from the OTP; and finalized a new code (G1028) for a higher dose 8mg naloxone nasal spray. The agency also published an interim final rule, the “Opioid Treatment Programs: CY2022 Methadone Payment Exception” in which CMS proposes to extend 2021 OTP reimbursement rates for methadone under the OTP benefit through 2023. OPPS Rule Highlights: In this rule, CMS made final its earlier proposal to set a minimum civil monetary penalty of $300 per day that would apply to smaller hospitals with bed counts of 30 or fewer beds and apply a penalty of $10 per bed, per day for hospitals with a bed count greater than 30 beds, not to exceed a maximum daily dollar amount of $5,5500. The maximum would be imposed if hospitals do not provide documentation of bed counts. CMS also finalized its proposal to maintain the existing methodology for per diem partial hospitalization rates using calendar year (CY) 2019 claims and cost report data to develop the CY 2022 rates. CMS will also use the CY 2021 finalized per diem costs as cost floors for CY 2022. CMS did not specify that Medicare will continue coverage of services by partial hospitalization programs (PHPs) via telehealth. The agency noted comments, including some from NABH, that expressed strong support for continued coverage and said it will consider these comments in future rulemaking. The agency did not address whether Medicare would continue to cover PHP facility fees for telehealth services, which could require a legislative change.

NABH Supports Sound the Alarm for Kids! Campaign

NABH is proud to be one of more than 75 organizations to support Sound the Alarm for Kids!, a campaign from the Children’s Hospital Association, American Academy of Pediatrics, and the American Academy of Child and Adolescent Psychiatrists to urge Congress to enact legislation and increase funding to address children’s mental health. The campaign notes there has been a 25% increase in overall mental health-related emergency department visits for kids between the ages of 5 and 11 between 2019 and 2020, while emergency department visits for youth between the ages of 12 and 17 have seen a 31% increase in that same period. “The latest data from SAMHSA show that almost 3 million adolescents had serious thoughts of suicide last year, with more than 1 million who said they made suicide plans,” NABH President and CEO Shawn Coughlin said in the campaign’s news release on Nov. 2. “These statistics are even more troubling as we face significant shortages across behavioral healthcare professions and treatment settings,” he added. “We are eager to work with policymakers, workforce agencies, and partner organizations to identify where the gaps in access to care are—and how we can fill those gaps.”

Aaron Beck, M.D., ‘Father of Cognitive Therapy’ Dies at 100

NABH remembers with grateful appreciation psychiatrist Aaron Beck, M.D., who died Nov. 1 in Philadelphia, for his pragmatic approach to psychotherapy that changed the treatment of depression, anxiety, and other mental disorders in the United States. “He took a hundred years of dogma, found that it didn’t hold up, and invented something brief, lasting and effective to put in its place,” Steven Hollon, a psychologist at Vanderbilt University, told The New York Times. “He basically saved psychotherapy from itself.”

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

Grant funding from the National Institute of Mental Health (NIMH) for research into bipolar disorder is lower than funding for other serious mental illness research and focuses heavily on basic science research instead of clinical research, according to an article published in Journal of Affective Disorders. For questions or comments about this CEO Update, please contact Jessica Zigmond.

Provider Relief Fund Phase 4 Application Deadline is Next Week

The U.S. Health and Human Services Department (HHS) will accept applications for Phase 4 of the Provider Relief Fund (PRF) and American Rescue Plan (ARP) rural payments through next Tuesday, Oct. 26 by 11:59 p.m. ET. PRF Phase 4 is open to a broad range of healthcare providers affected by the Covid-19 pandemic, and ARP Rural is open to Medicare, Medicaid, or the Children’s Health Insurance Program (CHIP) providers who serve rural patients. Click here for more information and here to apply. And if you missed it, HHS hosted a briefing session to provide information about these funding opportunities. Click here to watch the video.

CDC Estimates About 20% of Adults Received Some Mental Health Treatment in 2020

A new report from the Centers for Disease Control and Prevention’s (CDC) National Center for Health Statistics estimates that 20.3% of adults received any mental health treatment in 2020, including 16.5% who had taken prescription medication for their mental health and 10.1% who received counseling or therapy from a mental health professional. The data also showed that women were more likely than men to have received any mental health treatment, and that non-Hispanic white adults (24.4%) were more likely than non-Hispanic black (15.3%), Hispanic (12.6%), and non-Hispanic Asian (7.7%) adults to have received any mental health treatment. Meanwhile, as the level of urbanization decreased, the percentage of adults who had taken medication for their mental health increased, and the percentage who had received counseling or therapy decreased, the report showed.

Bipartisan Policy Center Webinar Discusses Mental Health Workforce Shortage

The Bipartisan Policy Center this week hosted a panel of healthcare and policy experts to discuss solutions to the nation’s mental health workforce shortage, including workforce expansion, community training, and behavioral healthcare and primary care service integration. Panelists included Benjamin Miller, Psy.D., president of the Well Being Trust; former U.S. Surgeon General Regina Benjamin, M.D., who is also founder and CEO of BayouClinic, Inc.; and Shekhar Saxena, M.D., professor of the Practice of Global Mental Health, Harvard T.H. Chan School of Public Health. Click here to watch the recorded webinar.

Urban Institute Study Examines Commercial Insurance Markups Over Medicare Prices

Psychiatry was among a group of medical specialties that had the lowest commercial markups relative to Medicare prices, according to a new study from the Urban Institute. The report shows that family medicine, obstetrics and gynecology, dermatology, ophthalmology, and psychiatry averaged about 110% of Medicare rates or less, while the following nine specialties received commercial payments between 120% and 150% of Medicare rates, on average: gastroenterology, cardiology, general surgery, and orthopedics. Researchers analyzed March 2019 to February 2020 data from FAIR Health’s private health insurance claims database covering more than 150 million people nationwide. The sample included 17 physician specialties and about 20 services per specialty that represent about 40% of total professional spending. FAIR Health is an independent, national, not-for-profit organization that provides information to consumers.

NABH Wants to Hear from You: Please Evaluate the 2021 Annual Meeting

NABH this week sent Annual Meeting attendees a survey to evaluate the 2021 Annual Meeting. If you attended the meeting and have not submitted an evaluation, please take a moment to complete the survey. As a reminder, our Speakers & Presentations page includes presentations that NABH has permission to post publicly, and the 2021 Exhibitor & Sponsor Guide is available on both the NABH Resources and Exhibitors & Sponsors pages on our website. Annual Meeting photos and videos will be posted to our Annual Meeting page later this month. We look forward to seeing everyone in Washington from June 13-15, 2022 for next year’s Annual Meeting!

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

A new study published in Health Affairs found that people with mental health disorders had 50% higher rates of severe maternal morbidity compared with people without mental health disorders, and $458 higher costs per delivery hospitalization. For questions or comments about this CEO Update, please contact Jessica Zigmond.

HHS Hosts Technical Webinars as Provider Relief Fund Phase 4 Application Deadline Approaches

The U.S. Health and Human Services Department (HHS) will accept applications for Phase 4 of the Provider Relief Fund (PRF) through Tuesday, Oct. 26. HHS’ Health Resources and Services Administration (HRSA) administers provider relief programs and is using a single application portal to make $17 billion in PRF phase 4 general distribution payments and $8.5 billion in American Rescue Plan Act (ARP) rural payments available to the nation’s providers. To offer guidance for providers, HRSA has produced a series of webinars for Phase 4 and ARP rural applications on how to navigate the application portal and provide the required financial documentation. These sessions include:

• Phase 4 and ARP Rural: Overview and Portal Demonstration
  • Thursday, Sept. 30: View the recorded webcast.
  • Tuesday, Oct. 5: View the recorded webcast.
  • Download the slides.

• Phase 4 and ARP Rural: Providing Supporting Documentation
  • Wednesday, Oct. 13: View the recorded webcast.
  • Thursday, Oct. 21: 3 p.m. to 4 p.m. ET: Register to attend.

HHS also hosted a briefing session to provide information about these funding opportunities. Click here to watch the video.

NASHP Examines How States are Spending American Rescue Plan Act Funds

The National Academy for State Health Policy (NASHP) has developed a state-by-state analysis to show how states are using funds from the $1.9 trillion American Rescue Plan Act (ARP) that became law on March 11, 2021. The ARP provides considerable funding for continued pandemic response, including $195.3 billion in Coronavirus State Fiscal Recovery Funds for the 50 states and Washington, D.C. Those funds must be obligated by Dec. 31, 2024 and expended by Dec. 31, 2026. Click here to view NASHP’s map and accompanying state profiles to see the status of the State Fiscal Recovery Fund.

Palo Alto University Announces Training to Incorporate Digital Therapy Tools in Mental Health Practices

Palo Alto University has announced it will begin offering a 50-hour training program for incorporating digital therapy tools into mental health practices. According to the university, the new program—Foundations of Digital Mental Health— will offer “foundational knowledge, training, and best practices necessary” for delivering mental health services online. Course topics include Technology and Mental Health for Children and Adolescents: Screen Time, Digital Interventions, and Teletherapy; Suicide, Risk Assessment & Treatment Planning Via Tele-Mental Health; and Evidence-Based Internet Interventions to Reduce Health Disparities. Click here to learn more and to register.

NABH 2021 Annual Meeting Presentations & Exhibitor & Sponsor Guide Available Online

Thank you to all who attended NABH’s 2021 Annual Meeting in Washington last week! NABH was pleased to welcome in person top officials from SAMHSA and the U.S. Labor Department, former National Institute of Mental Health Director Tom Insel, M.D., New York Times bestselling author and four-time Emmy winner Larry Sabato, Ph.D. of the University of Virginia, award-winning singer and mental health advocate Judy Collins, and others. Please visit our Speakers & Presentations page to view the presentations that included slides and that NABH has permission to post publicly. Also, NABH mailed copies of the 2021 Exhibitor & Sponsor Guide to members this week, and the guide’s online version is available on both the NABH Resources and Exhibitors & Sponsors pages on our website. Annual Meeting photos and videos will be posted to our Annual Meeting page later this month. We look forward to seeing everyone in Washington from June 13-15, 2022 for next year’s Annual Meeting!

Please Nominate Members to the 2022 NABH Board of Trustees Slate of Candidates Today!

Please help the NABH Selection Committee identify potential candidates for Board Chair-Elect and two Board seats that will become available in 2022 The Selection Committee is particularly interested in identifying senior managers who represent the broad diversity within the NABH membership, including various levels of care, organizational structures, and size. Please download a nomination form to share your recommendations of individuals you would like to see included in the single-slate ballot for 2022. Please attach a curriculum vitae (CV) for each individual you recommend. This will help the Selection Committee in its deliberations. You are welcome to suggest yourself. Please return this form and candidates’ CVs to maria@nabh.org by the end of today, Oct. 15.

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

An analysis of electronic health records of nearly 580,000 fully vaccinated people in the United States found that the risk of SARS-CoV-2 breakthrough infection among vaccinated patients with substance use disorders was low overall, but higher than the risk among vaccinated people without substance use disorders.   For questions or comments about this CEO Update, please contact Jessica Zigmond.

Reminder: Provider Relief Fund Phase 4 Application Deadline is Oct. 26

The U.S. Health and Human Services Department (HHS) is accepting applications for phase 4 of the Provider Relief Fund (PRF) through Tuesday, Oct. 26. HHS’ Health Resources and Services Administration (HRSA) administers provider relief programs and is using a single application portal to make $17 billion in PRF phase 4 general distribution payments and $8.5 billion in American Rescue Plan rural payments available to the nation’s providers. Click here to learn more about the programs and how to apply.

President Biden Honors Everyone in Recovery in Video Message

President Biden helped to conclude National Recovery Month this week with a brief video celebrating all Americans in recovery. The president acknowledged that about 23 million Americans are in recovery and millions more are affected by addiction. He also sent a clear message to people who are not in recovery, and to people with loved ones who are not in recovery. “You are not alone. This is personal to millions of families,” President Biden said. “This is personal to my family. My son has written about it. And I know—I know there is hope,” he added. “Treatment works. Recovery is possible. And my administration is here to support every person and their family on their journey to recovery.”

SAMHSA to Establish New Office of Recovery

The Substance Abuse and Mental Health Services Administration (SAMHSA) is launching an Office of Recovery within the Office of the Assistant Secretary for Mental Health and Substance Use to advance the agency’s commitment to recovery for all Americans. “We have identified recovery as a crosscutting principle throughout SAMHSA’s policies and programs,” Assistant Secretary for Mental Health and Substance Use Miriam Delphin-Rittmon, Ph.D. said in an announcement. “In standing up this new office, SAMHSA is committed to growing and expanding recovery support services nationwide.” SAMHSA’s announcement said the new office will have a dedicated team with an understanding of recovery to promote policies, programs, and services to those in or seeking recovery.

NABH 2021 Annual Meeting is Next Week

NABH is pleased to welcome attendees to the NABH 2021 Annual Meeting in Washington Oct.6-8! Please join us at the Mandarin Oriental hotel and hear from our speakers, including Acting Assistant Secretary Ali Khawar from the U.S. Labor Department’s Employee Benefits Security Administration, SAMHSA Administrator Miriam Delphin-Rittmon, Ph.D., former National Institute of Mental Health Director Tom Insel, M.D., folk singer and mental health advocate Judy Collins, and more. Learn more about our speakers on our Annual Meeting webpage, and please be sure to register if you have not done so yet. We look forward to seeing you next week!

Please Nominate Members to the 2022 NABH Board of Trustees Slate of Candidates

Please help the NABH Selection Committee identify potential candidates for Board Chair-Elect and two Board seats that will become available in 2022 The Selection Committee is particularly interested in identifying senior managers who represent the broad diversity within the NABH membership, including various levels of care, organizational structures, and size. Please download a nomination form to share your recommendations of individuals you would like to see included in the single-slate ballot for 2022. Please attach a curriculum vitae (CV) for each individual you recommend. This will help the Selection Committee in its deliberations. You are welcome to suggest yourself. Please return this form and candidates’ CVs to maria@nabh.org by Friday, Oct. 15, 2021.

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

Physicians have prescribed 44% fewer opioids over the past decade, yet fatal and non-fatal drug overdoses have continued to climb, according to a new report from the American Medical Association.

CEO Update Will Publish Next on Friday, Oct. 15

NABH will not publish CEO Update next week due to the Annual Meeting. Please look for our next edition on Friday, Oct. 15.   For questions or comments about this CEO Update, please contact Jessica Zigmond.

NABH to Welcome SAMHSA Administrator Miriam Delphin-Rittmon, Ph.D. at 2021 Annual Meeting

Assistant Secretary for Mental Health and Substance Use Miriam Delphin, Rittmon, Ph.D. will address attendees at the 2021 NABH Annual Meeting on Thursday, Oct. 7 at 1:30 p.m.   Dr. Miriam Delphin-Rittmon serves as administrator of the Substance Abuse and Mental Health Services Administration (SAMHSA). She previously served for six years as commissioner of the Connecticut Department of Mental Health and Addiction Services. Prior to her appointment at SAMHSA, Dr. Delphin-Rittmon was an adjunct associate professor at Yale University, where she served on faculty for 20 years. At Yale, Dr. Delphin-Rittmon served as the director of Cultural Competence and Research Consultation with the Yale University Program for Recovery and Community Health. In May 2014, Dr. Delphin-Rittmon completed a two-year White House appointment working as a senior advisor to the administrator at SAMHSA. In that position, she worked on a range of policy initiatives addressing behavioral health equity, workforce development, and healthcare reform. Throughout her career in the behavioral health field, Dr. Delphin-Rittmon has extensive experience in the design, evaluation, and administration of mental health, substance use and prevention services and systems and has received several awards for advancing policy in these areas. Please visit our Annual Meeting homepage to learn more about our speakers and register for the meeting, if you have not done so yet. We look forward to seeing you in Washington!

Joint Commission Names HCA’s CMO Jonathan Perlin, M.D., Ph.D. as Next President

The Joint Commission’s Board of Commissioners this week named Jonathan Perlin, M.D., Ph.D. as the organization’s next president, effect March 1, 2022. Perlin serves currently as president of clinical operations and chief medical officer of Nashville-based HCA Healthcare, where he leads a team of clinicians and data scientists in setting clinical and professional policy, implementing clinical data tools, and working to improve outcomes. Before he joined HCA in 2006, Perlin served as the under secretary for health at the U.S. Veterans Affairs Department and later served as chair of the Veterans Affairs’ secretary’s special medical advisory group. Perlin earned a master of science degree in health administration and a doctorate in pharmacology with his medical degree as part of the physician scientist training program at the Medical College of Virginia.

Joint Webinar to Present New Directions for Substance Use Prevention is Sept. 27

The National Institute on Drug Abuse (NIDA), the Partnership to End Addiction, and the American Psychological Association will host a webinar on Monday, Sept. 27 that will highlight how to establish a framework for an earlier and broad approach to substance use prevention. Former NIDA Director Nora Volkow, M.D. will serve as one of the speakers during the presentation, which will also help participants learn how to implement an earlier and broader approach using today’s policy environment. The webinar will begin at noon ET. Click here to register.

CMS to Host Webinar on Hospital Restraint and Seclusion on Sept. 28

The Centers for Medicare & Medicaid Services (CMS) will host a webinar titled “CMS Hospital Restraint and Seclusion: Navigating the Most Problematic CMS Standards and Proposed Changes” on Tuesday, Sept. 28. Webinar instructor Laura Dixon served as director of facility patient safety and risk management and operations for COPIC, a professional medical liability insurance provider, from 2014 until 2020. Dixon will lead the webinar, which will define the CMS restraint requirement of what hospitals must document in internal logs if a patient dies within 24 hours with having two soft restraints on; describe that CMS has restraint-education requirements for staff; discuss specific items that must be documented in the medical record for the one-hour, face-to-face evaluation on patients who are violent or self-destructive; and more. The hourlong webinar will begin at 1 p.m. ET on Sept. 28. Click here to learn more and register.

Please Nominate Members to the 2022 NABH Board of Trustees Slate of Candidates

Please help the NABH Selection Committee identify potential candidates for Board Chair-Elect and two Board seats that will become available in 2022. The Selection Committee is particularly interested in identifying senior managers who represent the broad diversity within the NABH membership, including various levels of care, organizational structures, and size. Please download a nomination form to share your recommendations of individuals you would like to see included in the single-slate ballot for 2022. Please attach a curriculum vitae (CV) for each individual you recommend. This will help the Selection Committee in its deliberations. You are welcome to suggest yourself. Please return this form and candidates’ CVs to maria@nabh.org by Friday, Oct. 15, 2021.

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 

From 2014 to 2018, emergency department visits made by adults with alcohol and substance use disorders increased by 30%, while hospitalizations among patients with those disorders increased by 57%, according to a new study in the Journal of General Internal Medicine. For questions or comments about this CEO Update, please contact Jessica Zigmond.

HHS Provides More Information About Latest Covid Provider Relief Fund Announcement

The U.S. Health and Human Services Department (HHS) this week hosted a webinar to provide details about the department’s recent announcement that it is making available $25.5 billion in new Covid relief funding for providers. The department also released some fact sheets, including one about the payment methodology for phase three funding, information about the application process and eligibility, and provider relief funding reporting requirements. These materials are posted on NABH’s Covid-19 resources page.

NABH Comments on 2022 Medicare Physician Payment Schedule & OPPS Proposed Rules

NABH this week sent comment letters to the Centers for Medicare & Medicaid Services (CMS) about two proposed rules for fiscal year 2022: the Physician Payment Schedule and Hospital Outpatient Prospective Payment System. In the physician payment schedule letter, NABH provided an overview and statistics to support what behavioral healthcare providers have managed during the Covid-19 pandemic as the need for mental health and addiction treatment services continues to rise. NABH strongly supported Medicare coverage of audio-only telehealth mental health services and opioid treatment program services; opposed the agency’s in-person requirement for coverage of telehealth for mental health services; opposed the CMS’ proposal to reduce reimbursement for behavioral health providers to implement budget-neutrality requirements; encouraged CMS to seek comments on reimbursing for contingency management services; and more. Commenting on CMS’ hospital outpatient prospective payment system rule, NABH supported the agency’s proposals to use the 2021 calendar year reimbursement rates for partial hospital as the cost floor for 2022 rates and to use 2019 data to calculate the 2022 rates. The association also recommended that CMS continue to cover partial hospitalization program services via audio-only telehealth. “Our members are concerned that many of their more vulnerable patients are unemployed or under-employed and sometimes homeless and do not have access to video technology. Moreover, access to broadband service to support video and audio technology is often very limited in rural areas,” NABH’s letter said. “These regions also face the most severe shortages of behavioral healthcare providers— particularly PHP providers,” it continued. “Limiting coverage to PHP services via telehealth to video and audio technology will limit the utility of telehealth for reaching individuals that face the greatest barriers to accessing PHP providers.

Virtual Congressional Briefing Next Week to Highlight How Recovery Supports Save Lives 

Substance Abuse and Mental Health Services Administration (SAMHSA) Administrator Miriam Delphin-Rittmon, Ph.D. will offer remarks at “Turning Policy Into Action—How Recovery Supports Save Lives,” a virtual congressional briefing on Tuesday, Sept. 21 at 2 p.m. ET. Other speakers will include U.S. Surgeon General Vivek Murthy, M.D., Rep. Paul Tonko (D-N.Y.), Rep. David McKinley, (R-W.Va.), and leaders from some addiction and recovery organizations. Click here to register.

Joint Webinar to Present New Directions for Substance Use Prevention is Sept. 27

The National Institute on Drug Abuse (NIDA), the Partnership to End Addiction, and the American Psychological Association will host a webinar on Monday, Sept. 27 that will highlight how to establish a framework for an earlier and broad approach to substance use prevention. Former NIDA Direct Nora Volkow, M.D. will serve as one of the speakers during the presentation, which will also help participants learn how to implement an earlier and broader approach using today’s policy environment. The webinar will begin at noon ET. Click here to register.

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.

2021 NABH Annual Meeting Hotel Cut-Off Date is Today!

Please be sure to reserve your hotel room today at the Mandarin Oriental Washington, DC for the 2021 NABH Annual Meeting. The hotel’s room reservation cut-off date is today, Friday, Sept. 17, 2021. And please visit our Annual Meeting webpage to register for the meeting, learn about our speakers, and view the list of our exhibitors and sponsors. We look forward to seeing you in Washington!

Fact of the Week

A new survey of 1,250 U.S. military veterans who served in Afghanistan sometime between the period 2001-2021 showed that 90% of those veterans with a history of mental illness are experiencing new or worsening mental health systems since the Taliban takeover in late August. For questions or comments about this CEO Update, please contact Jessica Zigmond.

HHS Announces $25.5 Billion in Covid-19 Provider Funding

The Biden administration announced Friday that the U.S. Health and Human Services Department (HHS) is making available $25.5 billion in new funding for healthcare providers affected by the Covid-19 pandemic. According to an announcement, the funding—which HHS is making available through the Health Resources and Services Administration (HRSA)—includes $8.5 billion in American Rescue Plan resources for providers who serve rural Medicaid, Children’s Health Insurance Program (CHIP), or Medicare patients, and an additional $17 billion for Provider Relief Fund (PRF) Phase 4 for a wide range of providers who can document revenue loss and expenses associated with the pandemic. “This funding critically helps healthcare providers who have endured demanding workloads and significant financial strains amidst the pandemic,” HHS Secretary Xavier Becerra said in the announcement. “The funding will be distributed with an eye towards equity, to ensure providers who serve our most vulnerable communities will receive the support they need.” HHS also said that consistent with requirements included in the Coronavirus Response and Relief Supplemental Appropriations Act of 2020, PRF Phase 4 payments will be based on providers’ lost revenues and expenditures between July 1, 2020 and March 31, 2021. The combined application for American Rescue Plan funding and PRF Phase 4 will open on Sept. 29.

Biden Administration to Expand Vaccination Requirements for Healthcare Facilities

The Biden administration on Thursday announced it will require Covid-19 vaccinations for staff within all Medicare and Medicaid-certified facilities to protect both healthcare workers and patients from the deadly virus and its more contagious Delta variant. The Centers for Medicare & Medicaid Services (CMS) said it is developing an interim final rule with comment period that it expects to release in October. “As the Delta variant continues to spread, we know the best defense against it lies with the Covid-19 vaccine,” CMS Administrator Chiquita Brooks-LaSure said in a news release. “Data show that the higher the level of vaccination rates among providers and staff, the lower the infection rate is among patients who are dependent upon them for care,” she continued. “Now is the time to act. I’m urging everyone, but especially those fighting this virus on the front lines, to get vaccinated and protect themselves, their families, and their patients from Covid-19.” The NABH team will continue to learn more and keep members apprised of how the new rule will affect providers who work in psychiatric facilities and addiction treatment centers.

SAMHSA Awards $17.8 Million for Mental Health Awareness Training

The Substance Abuse and Mental Health Services Administration (SAMHSA) announced it has released 145 awards totaling $17.8 million to help communities build mental health awareness among individuals who interact with people who experience or exhibit symptoms of a mental health disorder and refer them to appropriate services. Each Mental Health Awareness Training grant recipient will receive up to $125,000 for the first year of this five-year grant program, which will train school personnel, emergency first responders, law enforcement, veterans, armed services members, and their families to recognize the signs and symptoms of mental health disorders, particularly serious mental illness and/or serious emotional disturbances, to respond safely and appropriately. Click here to read the list of grant recipients.

NABH Sends Comments to CMS on Surprise Billing

In a letter to CMS this week, NABH highlighted the increased need for mental health and addiction treatment during the pandemic and asked the agency to mitigate the extent to which new surprise billing rules impose additional burdens on behavioral healthcare providers. “Many psychiatric hospitals have negative net operating margins despite offering services that are in high demand in communities across the country,” NABH said in its letter about CMS’ requirements related to surprise billing. “The Covid-19 pandemic has added to the strain on these facilities with additional financial losses and unexpected costs, including those related to greatly increased use of personal protective equipment, increased screening of individuals coming into the facilities with additional staffing needs for screening, and other infection-control measures, including isolation rooms and units, software and hardware purchases to facilitate telework for administrative staff and telehealth for patients, and lost revenue due to 2 decreased patient volume because of infection concerns and reduced referrals.” NABH added that it supports the position in the agency’s rules to “exclude behavioral healthcare services from the prohibition on notice and consent to balance bill.” Click here to read CMS’ July news release about the surprise billing requirements and here to read the interim final rule.

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.

2021 NABH Annual Meeting Hotel Cut-Off Date is Next Week

Please be sure to reserve your hotel room today at the Mandarin Oriental Washington, DC for the 2021 NABH Annual Meeting! The hotel’s cut-off date is next Friday, Sept. 17, 2021. And please visit our Annual Meeting webpage to register for the meeting, if you have not done so yet. We look forward to seeing you in Washington!

Fact of the Week

Findings from a new study suggest a co-response team could lead to a lower chance of an individual entering into the criminal justice system during a crisis call with police, which has major implications for reducing the criminalization of mental illness if alternatives to police response for people with serious mental illness continues to spread throughout the United States. For questions or comments about this CEO Update, please contact Jessica Zigmond.

SAMHSA’s Distress Helpline Available for Victims of Hurricane Ida

The Substance Abuse and Mental Health Services Administration’s (SAMHSA) Disaster Distress Helpline (DDH) is providing immediate crisis counseling to people who have experienced Hurricane Ida, including survivors, first responders, witnesses, or those who have seen related media reports. In a statement, Assistant Secretary for Mental Health and Substance Use Miriam Delphin-Rittmon, Ph.D. urged people to access the helpline, adding that people who have lived through a traumatic event can experience anxiety, worry, or insomnia. Disaster survivors and responders can call the DDH at 1-800-985-5990 24 hours a day, seven days a week, 365 days a year. Click here for more information. NABH appreciates and thanks its members who have continued to provide quality behavioral healthcare services in regions of the United States that Hurricane Ida has affected.

MACPAC Publishes Briefs on Healthcare Needs in Criminal and Juvenile Justice Systems

The Medicaid and CHIP Payment and Access Commission (MACPAC) has released a series of fact sheets on topics related to behavioral healthcare, including two focused on the healthcare needs of adults in the criminal justice system and adolescents in the juvenile healthcare system. In its brief Health Care Needs of Adults in the Criminal Justice System, MACPAC reported that, “with few exceptions, Medicaid beneficiaries under community supervision reported higher rates of behavioral health conditions than their privately insured or uninsured peers. They also reported receiving mental health or substance use disorder (SUD) treatment at higher rates. However, Black beneficiaries with behavioral health conditions reported receipt of treatment at lower rates than their white peers.” Meanwhile, nearly one third (31.0%) of those with mental illness reported that they needed mental health treatment or counseling but did not receive it. These rates did not differ by coverage type. Female beneficiaries with a mental health condition who were under community supervision reported higher rates (41.0%) of unmet need than their male counterparts (21.3%). In addition, beneficiaries under community supervision with SUD were more likely to engage in treatment compared with those with private insurance, or adults who are uninsured (see Table 9 in the brief). Specifically, they were nearly twice as likely as privately insured or uninsured peers to report receiving such treatment in the past year. In its brief Health Care Needs and Use of Services by Adolescents Involved with the Juvenile Justice System, MACPAC concluded the following findings:

• Roughly 21.7% of youth who stayed in jail or juvenile detention reported experiencing a major depressive episode (MDE) at some point in their lifetime, and approximately 16.4% reported experiencing one in the past year.

• Among Medicaid beneficiaries who stayed in jail or juvenile detention, females were nearly three times as likely to experience a MDE in the past year compared with their male peers. They also reported receipt of specialty mental health treatment at higher rates.

• Few Medicaid beneficiaries report receipt of mental health treatment while in jail or juvenile detention.

•  Roughly one in five beneficiaries who stayed in jail or juvenile detention had a substance use disorder in the past 12 months. However, only 16.9% received treatment in the past year.

MACPAC also released Medicaid Coverage of Qualified Residential Treatment Programs for Children in Foster Care, which offered a brief summary of the Centers for Medicare & Medicaid Services’ September 2019 guidance on the Institutions for Mental Diseases (IMD) exclusion and Qualified Residential Treatment Program (QRTPs), as well as information about how states are implementing changes to the Family First Prevention Services Act.

CAHPS Program Releases Questions to Ask Patients About Accessing Mental Healthcare Services

The Agency for Healthcare Research and Quality (AHRQ)’s Consumer Assessment of Healthcare Providers and Systems (CAHPS^®) program has released new questions to gather information about patients’ experiences with access to mental healthcare services, including therapy and medication. An announcement noted that the six questions can be added to either the CAPHS Health Plan Survey or the CAHPS Clinician & Group Survey. Click here to review the mental healthcare questions for the Health Plan Survey 5.0 and 5.1, and here to review the mental healthcare questions for the Clinician & Group Survey 3.0 and 3.1. The agency noted that the new questions complement the CAHPS research team’s ongoing work to develop and test a standalone survey designed to assess patient experience with care for mental or behavioral health issues. Click here to learn more about CAHPS mental health surveys.

HRSA Reorganizes to Meet Priorities in Changing Healthcare Landscape

After a decade of growth, the Health Resources and Services Administration (HRSA) announced it has reorganized the agency to better meet its priorities. As part of that restructuring, HRSA has established a Provider Relief Bureau (PRB) to manage and distribute financial support for the nation’s healthcare providers as they continue to respond to the Covid-19 pandemic. HRSA also created an Office for the Advancement of Telehealth (OAT) within the Office of the Administrator to serve as HHS’ focal point for fostering telehealth use more broadly, and an Office of Special Health Initiatives (OSHI) to oversee the 340B Drug Pricing Program. Click here to see HRSA’s new organization chart and here for more details in the Federal Register.

U.S. Researchers Find Increased Likelihood of Arrhythmia Hospitalization in Youth With CUD

A new study from the American Academy of Addiction Psychiatry shows Cannabis Use Disorder (CUD) was associated with a 47% to 52% increased likelihood of arrhythmia hospitalizations in the younger population. The large, national study compared 570,000 patients between the ages of 15 and 54 who were admitted to the hospital between 2010-2014 for a primary diagnosis of arrhythmia, or an irregular heart rate, with 67,662,082 non-arrhythmia inpatients. According to the findings, atrial fibrillation was the most prevalent arrhythmia raising concerns for stroke and other embolic events. “The fact that atrial fibrillation is the most prevalent arrhythmia is of special concern since it can result in stroke and other embolic events,” researchers noted in the study. “Physicians need to familiarize themselves with cannabis abuse or dependence as a risk factor for arrhythmia.”

Reminder: NABH Denial-of-Care Portal is Open to Members

NABH’s Denial-of-Care Portal is a new resource 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.

2021 NABH Annual Meeting Hotel Cut-Off Date is Now Sept. 17!

Please be sure to reserve your hotel room today at the Mandarin Oriental Washington, DC for the 2021 NABH Annual Meeting! The hotel’s cut-off date is now Friday, Sept. 17, 2021. And please visit our Annual Meeting webpage to register for the meeting, if you have not done so yet. We look forward to seeing you in Washington!

Fact of the Week 

Denver, Salt Lake City, and Minneapolis are reported to be the three best U.S. cities for mental health, while Dallas, Houston, and Jacksonville are the three worst, according to a new survey from telehealth company CertaPet. Researchers examined the following seven factors to determine the rankings: therapy session rate by state, total prescription charges by state, mandatory treatment laws grade by state, criminalization of mental illness by state, number of residents per one mental health provider by county,  poor mental health days by county, and overall community wellbeing. For questions or comments about this CEO Update, please contact Jessica Zigmond.

Mental Health Companies Headspace and Ginger Plan $3 Billion Merger

Mental health companies Headspace and Ginger this week announced plans to merge, forming a new company called Headspace Health with a reported value of $3 billion. A story in the publication Stat reported that the move will place the new company in the top echelon of companies competing for significant pieces of the mental health market. In addition, the pair of companies offer complementary services. Headspace sells directly to consumers and businesses and focuses on self-directed meditation, a way for companies to offer a basic mental health resource to workers. Meanwhile, Ginger is a mental health app that offers users an opportunity to chat with a trained behavioral health coach within seconds and meet with a licensed therapist or psychiatrist via video within days. Both companies were established in 2010 and claim to cover more than 100 million people worldwide, according to Stat.

Analysis of Multi-District Litigation Settlement Agreement Highlights Implications for Nation’s Overdose Crisis 

A new report from two public health experts examines the implications from the recent settlement agreement that seven attorneys general announced with the three largest opioid distributors and  Johnson & Johnson over lawsuits filed against them for their role in the nation’s opioid crisis. A bipartisan group of seven state attorneys general announced the settlement in July, and a key question has been whether the settlement funds—and other funds from opioid litigation—will be used wisely. The report noted that more than 50 organizations endorsed five principles to outline the process that states and local jurisdictions should implement when deciding how to use the money they will receive. NABH was among those organizations. The principles include spending the money to save lives; using evidence to guide spending; investing in youth prevention; focusing on racial equity; and developing a fair and transparent process for where to spend the funds. “Many parts of the settlement agreement are generally consistent with these principles,” wrote authors Josh Rising, M.D., a pediatrician and public health physician and Sara Whaley, a research associate at Johns Hopkins University. “However, considerable discretion in state and local implementation leaves a major role for advocacy. The best use of billions of dollars to address addiction and overdose are at stake.”

Ohio State Seeks Providers for Study on Traumatic Brain Injury Screening in Behavioral Healthcare Organizations 

The Ohio State University College of Social Work is conducting a study to understand behavioral health providers’ attitudes and beliefs about screening for traumatic brain injury (TBI) in behavioral healthcare organizations. The university is currently seeking licensed behavioral health providers in the United States (i.e., psychologists, social workers, counselors, nurses, psychiatrists) to participate in this web-based study. Survey respondents will be asked to complete an online training on how to screen for TBI (approximately 30-45 minutes) and complete a 15-minute survey. Participants will receive a certificate of completion for one continuing education (CE) credit for completing the training, and also will be enrolled for the chance to win a $50 gift card. There will be 55 winners from the gift card drawing. The National Institute of Neurological Disorders and Stroke is funding the study (Grant #1F31NS124263-01), and Ph.D. candidate Kathryn A. Coxe is leading it. For additional information or questions, please contact Kathryn at: coxe.6@osu.edu. Click here to participate in the study.

Joint Commission to Start 11-part Behavioral Healthcare Accreditation Webinar Series on Aug. 28

The Joint Commission will present an 11-part Behavioral Healthcare and Human Services Accreditation Webinar Series to help providers prepare their staffs to maintain compliance. Session topics include information management, medication management, infection prevention and control, patient safety, environment of care, and more. The Joint Commission will present the series—which will be made available Aug. 28—on demand so that organization teams can view the webinars when it’s convenient for them. Click here to learn more, including information about special healthcare system discounts.

Center for Rural Opioid Prevention, Treatment & Recovery to Host Webinar Aug. 31

The Center for Rural Opioid Prevention, Treatment & Recovery (CROP+TR) will host a webinar later this month to review the prevalence of methamphetamine use and co-use with opioids, the effect of methamphetamine on the health of people with opioid use disorder, and potentially effective interventions for methamphetamine. The webinar will be held on Tuesday, Aug. 31 at 4 p.m. ET. Click here to register.

Reminder: NABH Denial-of-Care Portal is Open to Members

NABH’s Denial-of-Care Portal is a new resource 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.

Singer Judy Collins and Former NIMH Director Tom Insel, M.D. to Kick Off 2021 Annual Meeting

Join us at the NABH 2021 Annual Meeting on Wednesday, Oct. 6 to hear from award-winning singer, songwriter, and author Judy Collins. A strong mental health and suicide-prevention advocate, Ms. Collins wrote Sanity and Grace in 2003 about her 33-year-old son’s death by suicide in 1992. NABH is also pleased to welcome Thomas R. Insel, M.D., co-founder and president of Mindstrong Health and former director of the National Institute of Mental Health (NIMH) at the National Institutes of Mental Health. If you have not done so yet, please register for the Annual Meeting and reserve your hotel room today. Our new hotel cut-off date is Friday, Sept. 17. We look forward to seeing you in Washington!

Fact of the Week

Research shows Black youth younger than age 13 die by suicide at nearly twice the rate of white kids, and, over time, their suicide rates have grown even as rates have decreased for white children. For questions or comments about this CEO Update, please contact Jessica Zigmond.