Public Policy Update: March 31, 2011
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March 31, 2011
Congressional Negotiators Continue to Debate 2011 Budget; Hints Emerge on Medicaid Budget Reforms in 2012
With an April 8 deadline for a government shutdown looming, congressional negotiators have not yet reached a compromise that would allow Congress to finally enact a budget for the remainder of fiscal year 2011. As of Thursday morning, negotiators appeared to have agreed on a top-line level of $33 billion in spending cuts, although that number could change. There is no consensus yet on the question of whether the final bill will include so-called “policy riders” that make non-budgetary changes to federal policy. A particularly controversial policy rider would prohibit any additional federal funding from being allocated to health reform.
With $33 billion in spending reductions, the 2011 deal would come in at $29 billion less than what House Republicans had previously enacted and $23 billion more than what Senate Democrats have already agreed to in the two continuing resolutions that have kept the government funded since March 4. In crafting any deal, the House leadership is likely to face strong opposition from the most conservative members of the caucus, who have steadfastly argued for at least $61 billion in cuts this year – a level of cuts that included over $200 million in reductions to SAMHSA funding as enacted by the House earlier this year. However, without some level of compromise, the 2011 budget will not win approval in the Senate.
Meanwhile, the House Budget Committee continues its work on a proposed framework for the 2012 budget. Recent reports from the House indicate that the proposal is likely to include levels of funding for Medicaid that can only be achieved if the program is converted to a block grant. This move would stabilize long-term federal spending commitments to the program but could have a devastating effect on states, beneficiaries, and providers who will be left bearing the risk if demand for services exceeds the federal funding allocated for the program. For more information about this proposed change, please see last week’s edition of the Public Policy Update. Stay tuned to communications from the National Council to learn more as this issue develops and take advantage of opportunities to take action against this change.
Sen. Whitehouse Circulates Dear Colleague Letter on Behavioral Health IT; Urge Your Senators to Cosponsor!
Senator Sheldon Whitehouse (D-RI), who this month introduced the Behavioral Health Information Technology Act (S.539), has circulated a letter to his colleagues in the Senate urging their support for the bill. S. 539 would extend financial incentives for the adoption and meaningful use of health IT to include certain mental health and addictions treatment providers and facilities. Under current law, many types of behavioral health providers are not eligible to receive these payments – yet establishing a nationwide interoperable system of electronic health information is critical to coordinating care and improving outcomes.
If you have not done so already, please contact your Senators today and urge them to cosponsor S. 539. For more information about this important legislation, please see the National Council’s fact sheet on behavioral health IT.
Under changes announced by the Centers for Medicare and Medicaid Services last November, beginning in calendar year 2012, certain types of health professionals who are not successful electronic prescribers based on claims submitted between January 1, 2011 – June 30, 2011, may be subject to a payment adjustment on their Medicare Part B covered professional services. These changes apply only to “eligible professionals” – which include physicians, nurse practitioners, and physician assistants – along with clinical social workers and clinical psychologists who have prescribing authority. The adjustment will apply regardless of whether these eligible professionals are planning to participate in the eRx Incentive Program.
In 2012, the payment adjustment for not being a successful electronic prescriber will result in an eligible professional or group practice receiving 99% of the Medicare Part B amount that would otherwise apply to such services. In 2013, this percentage will drop to 98.5%, and in 2014 it will be 98%. Eligible professionals can avoid the adjustment by becoming successful electronic prescribers. For more information about which professionals are eligible, and how to become involved in the program, see the CMS eRx Incentive Program website.
The Centers for Medicare and Medicaid Services (CMS) has announced it will hold two national teleconferences to provide information on registration for the health information technology incentive payments program. Eligible professionals may receive payments for the adoption and meaningful use of health information technology, but in order to do so, providers must register with CMS. These phone calls will cover important information regarding registration.
The first call, on Friday, April 1 from 1:30-3:00 p.m. eastern time, will cover information related to the Medicare incentive program. Topics covered will include eligibility, switching between the Medicare and Medicaid Incentive Programs, reassigning payments to a healthcare facility, pre-registration, registration, and where to find helpful resources. Click here to register for the call.
The second call, on Wednesday, April 6 from 1:30-3:00 p.m. eastern time, will cover information related to eligible hospitals under the Medicaid and Medicare incentive programs. Topics will include eligibility for incentive payments, special considerations for dually eligible hospitals, registration, and where to find helpful resources for eligible hospitals. Click here to register for the call.
Prior to each call, presentation materials will be available in the Upcoming Events section of the Spotlight Page on the CMS EHR website. Registration will close at 1:30 p.m. eastern time on the day before each of the calls is scheduled, or when all available space has been filled. Space is limited, so CMS encourages providers to register early.
On Tuesday, April 12 from 2:00-3:30 pm eastern time, SAMHSA’s Co-Occurring Disorders Initiative (CODI) will hold the next in its Building Blocks webinar series. “Using Data to Inform and Guide Services to Persons with Co-Occurring Disorders” will provide concrete suggestions on using data to assess the quality of services to persons with co-occurring mental health and substance use disorders.
Three levels of data-based information and strategies will be described: system and program level data, patient-level data, and treatment process measures of co-occurring patient access, engagement, retention and continuity in services. These process measures are sometimes more cost-efficient to gather, and can provide excellent information about the effectiveness of program services for persons with co-occurring disorders. Free registration is available online. For more information and a full overview of the webinar, click here.
The Department of Health and Human Services today released its notice of proposed rulemaking (NPRM) on Medicare contracting with Accountable Care Organizations. The HHS rulemaking process is likely to have a significant effect on the structure and development of ACOs, which were created under health reform as a mechanism for improving care quality while reducing costs.
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. In the coming weeks, the National Council will release additional news and analyses about the ACO regulation issued today. Stay tuned to the Public Policy Update and MentalHealthcareReform.org for the most up to date information.
