Public Policy Update: April 1, 2010
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April 1, 2010
President Obama Signs Healthcare Reconciliation Bill; National Council Provides Resources on Implementation
President Obama on Tuesday signed into law the Healthcare and Education Reconciliation Act of 2010, which outlines the final components of a comprehensive overhaul of the nation’s healthcare system. With the legislative battles behind, advocates have now turned their attention to implementation of the new law. The National Council will continue to keep you updated on implementation as it progresses. We have released a new fact sheet on the implementation timeline for the Medicaid provisions of the law. This week we also held the first webinar in our new healthcare reform implementation series, “Healthcare Reform: What Happens Next?” The slides and recording of this webinar are available on our website. Stay tuned to the PPU, National Council Action Alerts, and our webinar offerings to learn the latest news about health reform implementation.
Additional helpful resources for community behavioral health providers include:
- Healthcare Reform and Mental Health Parity: Healthcare reform expands the Wellstone-Domenici Parity Law to cover even more Americans. The New York Times on Tuesday published an article detailing the impact the new law’s parity provisions will have on behavioral health providers and consumers.
- Maintenance of Eligibility (MOE): The new law requires states to maintain current Medicaid and CHIP eligibility levels through 2014 (Medicaid) and 2019 (CHIP). This FamiliesUSA publication provides useful information about the MOE requirements for state legislators and advocates, particularly in states that are considering cuts to Medicaid and CHIP as they seek to balance their budgets.
- HHS Webcast Series: The Department of Health and Human Services has announced it will hold a series of free webcasts open to the public to discuss the implementation of healthcare reform. HHS is seeking public input on the topics of the webcasts and questions that should be addressed. More information is available on the HHS health reform website.
Action Needed: The National Council encourages you to thank your Members of Congress who worked so hard to enact healthcare reform! Click here to take action and send your representatives an email today.
A new legal analysis of the Mental Health Parity and Addiction Equity Act (MHPAEA) regulations by the DC-based legal and advocacy firm Patton Boggs, was released this week by the Parity Implementation Coalition, of which the National Council is a member. The regulations divide health benefits into six classifications: Inpatient, in-network; Inpatient, out-of-network; Outpatient, in-network; Outpatient, out-of-network; Emergency Care; and Prescription Drugs. The analysis found that insurers that provide mental health or substance use services in one category of services must provide MH/SUD benefits in all categories.
Coalition Steering Committee member Chuck Ingoglia, Vice President for Public Policy of the National Council, said, “The Coalition is pleased that the analysis of the regulations reflects Congress’ intent to improve access to non-discriminatory mental health substance use disorder benefits.” The Parity Implementation Coalition will be incorporating many of the legal points contained in the legal analysis in comments that will be submitted to the Departments of Health and Human Services, Labor and Treasury by May 3, 2010.
File an Official Complaint: The U.S. Department of Health and Human Services has set up a Help Line to answer your questions or hear your concerns about your health plan’s compliance with the law. The number for the Help Line is:1-877-267-2323 ext. 6-5511. In addition, Department of Labor benefits advisors are available to answer your questions about the parity law and provide assistance in obtaining your benefits. Call 1-866-444-3272 or use this online form.
Share Your Concerns: We want to hear from you about whether your insurance provider is complying with the law. Your stories will help us monitor the implementation of the law and identify critical concerns or patterns across the country. Click here to complete a brief survey and return to Rebecca Farley at the National Council. Thank you!
Action Needed: Sign on to Letter in Support of Bill to Protect Therapeutic Foster Care, Rehabilitative Services
On March 9, Reps. Tammy Baldwin (D-WI), Dan Boren (D-OK), and John Sullivan (D-OK) introduced the Medicaid Services Restoration Act (H.R. 4787). This bill would provide important protections for providers of therapeutic foster care and rehabilitative services by:
- Clarifying that states may provide therapeutic foster care (TFC) as a reimbursable service under Medicaid;
- Amending the definition of rehabilitative services to explicitly include care for the attainment or retention of an individual’s best possible functional status; and
- Permitting states to use “reasonable and efficient” payment methodologies for TFC, rehabilitative services, and targeted case management (TCM), including bundled daily rates or other forms of capitated payment.
The National Council and our partner organizations are circulating a sign-on letter for national and state organizations in support of this bill. To sign your state association on, please contact Laura Boyd at lboyd5@cox.net. The deadline for signatures is April 15, 2010.
The Medicaid Services Restoration Act arose from the fight against 7 proposed Bush Administration regulations that would have dramatically restricted states’ ability to provide TFC, rehabilitation, and TCM. Although the Obama Administration has now rescinded the harmful regulations, the Medicaid Services Restoration Act will protect these services from future attempts to limit or restrict their availability. H.R. 4787 has been referred to the House Energy and Commerce Committee. A companion bill was introduced in the Senate last year by Sen. Debbie Stabenow (D-MI) and 5 cosponsors.
National Council, NAMI Submit Comments to SSA on Disability Determinations and Substance Use Disorders
In response to a request for comments issued by the Social Security Administration (SSA) this year, the National Council and the National Alliance on Mental Illness (NAMI) have submitted suggestions on federal policies related to substance use disorders and disability determinations. In current practice, individuals with substance use disorders are often found ineligible to receive Supplemental Security Income benefits, even if they also suffer from a co-morbid condition (such as physical disability or mental illness) that would normally make them eligible for these benefits. The National Council and NAMI comments provide information and recommendations on:
- The critical need among people disabled by mental illnesses, especially those with co-occurring disorders, for SSI income and insurance
- The types of evidence that SSA should consider to be medical evidence of drug abuse and alcoholism (DAA)
- How SSA should evaluate the claims of people who have a combination of DAA and at least one other mental impairment
- Our opposition to a period of abstinence or nonuse to determine whether DAA is material to the determination of disability
The full text of the National Council/NAMI comments is available on our website.
National Alliance to End Homelessness, National Council, and Other Advocacy Organizations Host Congressional Briefing on Policy Alternatives To Address Chronic Homelessness
The National Alliance to End Homelessness, with the National Council and other supporting organizations, this month hosted a congressional briefing on policy alternatives to end chronic homelessness. Chronic homelessness affects about 124,000 U.S. residents, many of whom have mental illnesses and substance use disorders. The March 23rd briefing was sponsored by Sen. Richard Burr (R-NC) and Rep. Alcee Hastings (D-FL) and attended by staff members from 25 congressional offices, five executive agencies, and representatives from mental health, addiction, and other advocacy groups. During the briefing, the National Alliance also released a new policy brief, “Chronic Homelessness: Policy Solutions,” which outlines effective federal policy strategies for chronic homelessness and provides information on the cost savings associated with permanent supportive housing programs.
Panelists at the briefing discussed the progress their communities have made in efforts to address chronic homelessness and the need for increased federal resources for permanent supportive housing programs. Speakers included Nan Roman, President and CEO of the National Alliance, Paul Lambros, Executive Director of the Plymouth Housing Group in Seattle, WA; Thomas Gregory, Director of Supportive Housing in the Office of the City Manager in Worcester, MA; and Katrina Van Valkenburgh, Director of the Illinois and Indiana Program of the Corporation for Supportive Housing in Chicago, IL. In addition, Phillip Colbert, a participant in the permanent supportive housing program operated by Pathways to Housing in Washington, DC, spoke about his personal experience with chronic homelessness and the impact the program had on his life.
This article was written by Josh Kotzman, Public Policy Intern at the National Council.
The Senate on March 18 voted by unanimous consent to approve the Fair Sentencing Act of 2009 (S. 1789). This bill would reduce the disparity in criminal penalties for the possession of crack cocaine and powder cocaine so that the quantity of powder cocaine that triggers an automatic prison sentence is only 18 times greater than the amount of crack cocaine that triggers the same sentence. Currently, the ratio is 100:1. An earlier version of the bill would have equalized the criminal penalties for the two kinds of cocaine, but this provision was removed during consideration by the Senate Judiciary Committee. Although the bill as passed does not provide for full equality in sentencing, it is a major step forward in sentencing policy. S. 1789 has been sent to the House, where a similar bill (H.R. 3245, the Fairness in Cocaine Sentencing Act), has been approved by the House Judiciary Committee with bipartisan support and is awaiting a hearing by the House Energy and Commerce Committee.
