Returning to Washington from its Thanksgiving recess, the House voted to pass a one-month Medicare pay fix that had been approved by the Senate several days earlier. The legislation delays for one month a scheduled 23% reimbursement cut, giving lawmakers some time to negotiate a longer-term fix. Physicians’ groups support a permanent solution to the Sustainable Growth Rate (SGR) formula that would cut Medicare reimbursement each year were it not for Congress stepping in to block the cuts. However, it has been difficult for lawmakers to find spending cuts to offset the cost of such a solution. The most recent legislation is the 5th pay fix to be enacted this year.

 

Congress is also continuing its work on the Fiscal Year 2011 budget, with a vote likely this week on a continuing resolution (CR) that would fund federal government operations at current levels through Dec. 17. The CR is necessary because the current budget authority expires on Dec. 3. House appropriators are working on a longer-term stopgap budget bill, while the Senate is exploring options to pass an omnibus budget bill during the lame-duck session. Stay tuned to the Public Policy Update and the Federal Budget page of our website for the most up-to-date news as it becomes available.

 

 

 

Recent regulations issued by CMS allow children with serious emotional disturbances, individuals with disabling mental disorders, and individuals with mental disabilities that prevent them from performing tasks of daily living to be exempted from enrolling in Medicaid benchmark plans. While most individuals who are newly eligible for Medicaid under health reform will be enrolled in benchmark coverage, these individuals with severe needs may instead be enrolled in standard comprehensive Medicaid. 

 

The National Council has released a new fact sheet, “Medicaid Benchmark Benefits in Health Reform: Improvements and Exemptions,” which describes the differences between benchmark and standard coverage, the improvements to benchmark coverage under health reform, and the implications of these changes for individuals with disabilities. Sates will need to develop processes to identify which individuals meet the criteria of having a disabling mental disorder or functional impairment. These processes will have to incorporate both those applying for Medicaid for the first time as well as those who are currently enrolled. The National Council encourages community behavioral health organizations to work with their state Medicaid departments to ensure that the needs of individuals with mental illness and substance use disorders are addressed throughout this process.

 

 

 

The Director of the National Institutes of Health (NIH), Dr. Francis Collins, issued a press release on November 18, 2010 indicating that a proposal to reorganize the federal government’s research agencies on substance abuse and addictions into a single entity “makes scientific sense.” Dr. Collins stated that a single Institute would improve NIH’s efforts in addressing substance abuse and addiction. A task force will be assessing all 27 of the NIH Institutes (including the National Institute on Drug Abuse (NIDA) and the National Institute on Alcohol Abuse and Alcoholism (NIAAA)) to identify research programs that should be moved into the new Institute. A detailed restructuring plan is expected in the summer of 2011. The Office of the Director is the central office at NIH and is responsible for setting policy. Additional information on this office is available at http://www.nih.gov/icd/od.

 

If the restructuring plan is accepted by Dr. Collins, it then moves to Secretary Sebelius of the Department of Health and Human Services. If the Secretary approves, she will notify Congress which would then have six months to block the restructuring by passing legislation. 

 

 

 

The National Council has joined other national behavioral health groups in signing on to a draft letter to the Government Accountability Office (GAO). The letter commends GAO for selecting a talented and accomplished array of individuals to serve on the new National Health Care Workforce Commission, which was created by the Patient Protection and Affordable Care Act. However, the letter also expresses the groups’ about the lack of representation for mental health, addiction and behavioral health given the Commission’s critical role in influencing national policy regarding the nation’s health care workforce. For future selections to the Commission, the groups urge the GAO to select at least one representative of the behavioral health community. The draft of the letter is available online.

 

 

 

The National Council has nominated Dr. Thomas Doub of Centerstone Research Institute to serve on the United States Preventive Services Task Force (USPSTF). The USPSTF conducts scientific evidence reviews of a broad range of clinical preventive health care services and makes recommendations about evidence-supported interventions. The task force consists of an independent panel of experts in prevention and evidence-based medicine and is composed of primary care providers (such as internists, pediatricians, family physicians, gynecologists/obstetricians, nurses, and health behavior specialists). In our nomination letter, the National Council encourages the Comptroller General, who selects the membership of the task force, to ensure that behavioral health concerns are represented and strongly recommends Dr. Doub for his extensive experience and expertise in preventive healthcare.

 

 

 

The Centers for Medicare and Medicaid Services has released a new resource for new enrollees in the Medicare program. The “Welcome to Medicare” fact sheet, available in English and Spanish, provides tips to recent enrollees on how to sign up for your “Welcome to Medicare” physical exam, how to register at MyMedicare.gov, and more. It also provides helpful links to additional information about open enrollment and other Medicare resources.