Public Policy Update: June 9, 2011
Sign up to receive the weekly Public Policy Update e-newsletter, with the latest Congressional healthcare legislation and National Council news on mental health and addictions treatment.
June 9, 2011
Congress Continues Debating Spending Cuts, Future of Medicaid: New Series of Fact Sheets Highlight Local Impact of Proposed Medicaid Cuts
Congress this week continued its negotiations on proposals to raise the debt ceiling limit while instituting major cuts to federal spending. No new ground was broken this week on the primary sticking point that has held up a compromise: the extent to which reduced spending would be achieved by spending cuts alone or by a combination of cuts and revenue raisers such as tax increases. Republicans and fiscal conservatives have consistently argued for a global cap on federal spending that would be enforced by automatic, across the board cuts when the cap was in danger of being breached. Democrats, on the other hand, have continued to demand that tax increases be considered as part of the package. This week for the first time some Democrats appeared to indicate their support for a plan to impose mandatory and automatic reductions when the debt ceiling is in danger of being breached – but insisted that such reductions include both spending cuts and revenue raisers.
Meanwhile, a number of Senators have signed on to letters to President Obama stating their opposition to block grant, cap, or otherwise eliminate or slash Medicaid coverage for our nation’s most vulnerable citizens. 36 Senators signed on to a letter by Senator Jay Rockefeller (D-WV) urging the President to continue to oppose any efforts to scale back Medicaid and to fight against any deficit reduction proposals that would slash federal Medicaid spending. Four other Senators sent separate letters to the President.
Several new resources are available with information on Medicaid and the budget/debt debate. The consumer advocacy group FamiliesUSA has released a resource designed to help the public understand the impact that various budget reduction plans would have on Medicaid. “Medicaid, the Budget and Deficit Reduction: Keeping Score of the Threats” cuts through the complex language of debt reduction, global spending caps, and a balanced budget amendment to describe the key points that advocates should look for in each proposal in order to determine how it would affect the Medicaid program.
In addition, a new series of fact sheets highlights the district-by-district impact of the House-passed plan to convert Medicaid to a block grant. Each fact sheet details the number of beneficiaries who would likely lose Medicaid coverage under a block grant scenario. The fact sheets also describe the likely impact on seniors, children, hospitals, and the economy in each Congressional district.
The National Council is pleased to announce that Pamela Hyde, Administrator of the Substance Abuse and Mental Health Services Administration, will join us to speak at the 7th Annual Public Policy Institute and Hill Day, July 19-20 in Washington, DC. Ms. Hyde will discuss SAMHSA’s activities and priorities and join a conversation with Hill Day attendees about the most pressing issues in community behavioral health. And that’s not all – our lineup of influential speakers also includes:
- Political and Budget Outlook: Jim VandeHei, co-founder of the influential POLITICO newspaper will offer an insider’s perspective on what’s in store as Congress continues to debate the budget and funding for key programs.
- Fighting the Attacks on Medicaid: Judy Solomon and Ellen Nissenbaum of the Center on Budget and Policy Priorities will explain how recent proposed cuts (http://www.thenationalcouncil.org/cs/latest_issue#medicaid) to Medicaid will impact the healthcare safety net – and what YOU can do to fight back!
- CMS Center on Medicare and Medicaid Innovation: A critical component of health reform, the new CMS Center on Innovation will be a laboratory for payment reform and delivery redesign. Join CMS’ Daniel Farmer as he explains the mission and activities of the Center on Innovation.
Additional speakers from the Obama Administration and key Congressional offices will share the latest policy news and offer insights into what it all means for community mental health and addictions providers.
We’re also bringing back our popular advocacy workshops, where you can learn the best strategies for maximizing your influence on Capitol Hill. And in response to popular demand, this year we will hold two sessions on how to successfully apply for federal grants funding. If you have not already done so, click here to register today – then make your hotel reservation and begin setting up meetings with your Members of Congress.
Several Senators have joined Senator Sheldon Whitehouse (D-RI) in co-sponsoring S. 539, the Behavioral Health Information Technology Act of 2011. This legislation, introduced by Whitehouse in April, would extend federal incentive payments for the adoption and meaningful use of health IT to certain behavioral health professionals and facilities that were not included as eligible entities in the original incentive program. Click here to read a summary of the bill.
As of today, the following Senators have signed on to co-sponsor S. 539: Jeff Bingaman (D-NM), Richard Blumenthal (D-CT), Susan Collins (R-ME), John Kerry (D-MA), Robert Menendez (D-NJ), Jack Reed (D-RI), and Charles Schumer (D-NY). If you live in one of these states, please contact your Senator today to thank them for signing on to this important legislation!
The National Council this week submitted comments to the Centers for Medicare and Medicaid Services (CMS) on a recently issued regulation outlining requirements for the establishment of Accountable Care Organizations (ACOs). Created under healthcare reform, ACOs are coordinated networks of healthcare providers sharing a common focus on improving care for their population through integrated and coordinated provision of services.
In our comments, the National Council identified several areas of the proposed rule that should be improved to address the needs of Medicare enrollees with mental health and substance use disorders. We recommended some language edits to increase the mentions of mental health and substance use disorders and recommended the addition of quality measures that address MH/SUD. As currently written, the proposed rule only includes one quality measure for mental health and none for substance use disorders in its list of 65 quality measures. Our comments urged the inclusion of Depression Care Quality Treatment Measures, Substance Use Disorder Care Quality Treatment Measures, Suicidality Care Quality in Patient Safety Care Indicators, and Quality Measures for Psychosis Spectrum Disorders.
In addition, the National Council encouraged CMS to include non-physician primary care professionals in addition to physicians as ACO professionals in the assignment of Medicare fee-for-service beneficiaries to ACOs. We also urged CMS to ensure participation of MH/SUD providers in ACOs, understanding that ACOs must address the MH/SUD needs of enrollees if they are to be successful in improving healthcare and reducing costs. Our comments suggest that CMS include Person-Centered Healthcare Homes and not-for-profit Community Mental Health Centers as ACO providers/suppliers.
To help prepare community behavioral health providers for the advent of ACOs, the National Council has made several resources available on our website and blog:
- “Partnering with Health Homes and Accountable Care Organizations,” a report from the National Council
- “Partnering with Health Homes and ACOs: A How To Guide,” a National Council LIVE webinar with Dale Jarvis and Laurie Alexander; offers information on how behavioral health organizations can form successful partnerships with ACOs. Recording and slides
- Live Blog Webchat with Dale Jarvis and Laurie Alexander; delves further into the issues discussed during the webinar
- “What is an Accountable Care Organization and Why Should I Care?” National Council LIVE webinar with Dale Jarvis; provides an overview of ACOs. Recording and slides
- Collaborative Care section of our website, with resources and information on a range of topics related to ACOs and health homes
- Delivery System Reform section of our blog, with resources and reports from the National Council and other organizations outlining the basic components of an ACO, barriers to integrated care, and more.
We strongly encourage members to use these resources to familiarize themselves with the concept of ACOs.
The Centers for Medicare and Medicaid Services (CMS) has issued a request for public comments on how to better coordinate benefits and services for individuals who are eligible for both Medicaid and Medicare. These dually eligible beneficiaries have among the highest rates of disability and co-occurring chronic conditions, making them among the most costly and vulnerable populations in the healthcare system.
As part of the Affordable Care Act, CMS created a new Federal Coordinated Health Care Office to try to find ways to better coordinate care between Medicare and Medicaid, with the goal of improving the health of beneficiaries and reducing costs to the system. The recent request for comments includes a chart summarizing how benefits are now covered for dual eligibles as a guide for people who want to suggest ways to improve the coordination of those benefits. CMS is asking those commenting to focus on the following questions:
- How can the Medicare and Medicaid programs better ensure dual eligible individuals are provided full access to the program benefits?
- What steps can CMS take to simplify the processes for dual eligible individuals to access the items and services guaranteed under the Medicare and Medicaid programs?
- Are there additional opportunities for CMS to eliminate regulatory conflicts between the rules under the Medicare and Medicaid programs?
- How can CMS best work to improve care continuity and ensure safe and effective care transitions for dual eligible beneficiaries?
- How can CMS work to eliminate cost-shifting between the Medicare and Medicaid programs? How about between related health care providers?
Comments are due July 11, 2011.
On Thursday, June 16 from 2:00-3:30 p.m. eastern time, the National Council will hold a webinar entitled “Compliance 101: Understanding Health Reform’s New Compliance Requirements.” The Affordable Care Act strengthens the government’s ability to pursue fraud and abuse and, for the first time, requires all Medicare and Medicaid providers to have a compliance program. Webinar presenter Uri Bilek, an associate in the health law and federal grants law practice groups at Feldesman, Tucker, Leifer, Fiddell, LLP in Washington, DC, will outline the major provisions in health reform related to fraud and abuse enforcement, identify key legal risks, and recommend steps to update and enhance the effectiveness of your organization’s corporate compliance program. Click here for more information and to register.
