November 5, 2009

House Healthcare Reform Bill Includes Strong Provisions for Mental Health and Substance Use Disorders

ACTION NEEDED: House Healthcare Reform Bill Needs Your Rep’s Support!

Take 2 Minutes to Fill Out Medication Access Survey

FTC Postpones Effective Date of Red Flags Rule to June 1, 2010

Bill to Treat Depression and Bipolar Disorders Introduced in Senate
 

House Healthcare Reform Bill Includes Strong Provisions for Mental Health and Substance Use Disorders

Late last week, House Speaker Nancy Pelosi unveiled H.R. 3962, the Affordable Health Care for America Act, which merges slightly different committee versions of a healthcare reform bill.  H.R. 3962 includes many strong provisions for mental health and substance use treatment.  In its current form, the bill would:

• Extend the FMAP increase originally passed in the American Recovery and Reinvestment Act through June 2011 (the increase is currently set to expire in Dec. 2010).
• Expand Medicaid eligibility to 150% FPL, including childless adults
• Require all health plans participating in the health insurance exchange to offer mental health and substance abuse benefits, and require these benefits to comply with the Wellstone-Domenici Mental Health Parity Act
• Add institutions receiving funding through the mental health and substance abuse block grant to the list of health facilities eligible for 340B discount drug pricing
• Create a new long-term care insurance program, the Community Living Assistance Services and Support (CLASS) program
• Clarify that federal Medicaid law does not prohibit states from covering therapeutic foster care through Medicaid
• Create a $75M 3-year demonstration project for test reimbursement of private psychiatric hospitals for the stabilization of emergency medical conditions
• Increase payment for primary care services in Medicaid to parity with the payments for primary care services in Medicare, with the extra cost to be borne by the federal government
• Require that states suspend, not terminate, Medicaid benefits for youths age 18 and younger who are incarcerated in a public institution
• Require the government to conduct outreach about the health insurance exchange to specific populations, including people with mental illness and cognitive impairments
• Provide for the auto-enrollment of individuals eligible for Medicare low income subsidies in plans that fit their quality and cost needs (individuals have the right to change plans)
• Create a definition of and criteria for Federally Qualified Behavioral Health Centers (FQBHCs)

Meanwhile, Senate Majority Leader Harry Reid has sent the merged Senate health bill to the Congressional Budget Office to be analyzed for its cost.  The timing of the Senate’s consideration of the bill will likely depend on how quickly CBO can produce a score, but Reid has said he does not expect the Senate to vote on the measure until after Thanksgiving.  The language of the Senate bill has not yet been released.

The National Council has sent a letter of support for the House healthcare bill to Speaker Nancy Pelosi.  For additional resources and information on healthcare reform, see the healthcare reform section of our website.  This page includes recent news about healthcare reform, letters and fact sheets, and the slides and recordings of our healthcare reform webinar series.


ACTION NEEDED: House Healthcare Reform Bill Needs Your Rep’s Support!

The House healthcare reform bill, released late last week, contains several important provisions for mental health and addiction treatment.  The Affordable Health Care for America Act (H.R. 3962) protects and expands the mental health and addiction disorders safety net by increasing Medicaid eligibility to 150% of the federal poverty line, applying mental health and addiction treatment parity to all insurance plans offered through the health insurance exchange, and establishing criteria for the certification of federally qualified behavioral health centers (FQBHCs).

Some Democratic Representatives have expressed reservations about supporting the Affordable Health Care for America Act (H.R. 3962).  Send your Rep an email NOW to encourage them to vote for H.R. 3962 when it moves to the House floor for debate (expected to begin this Friday, Nov. 6).  A National Council action alert on this issue was originally sent to constituents whose Representatives are on the fence about supporting health care reform, but we invite everyone to contact their member of Congress and urge him or her to support this bill.


Take 2 Minutes to Fill Out Medication Access Survey

Data from the Centers for Medicare and Medicaid Services (CMS) indicates that since 2007, Medicare Part D plans are subjecting more prescription medications to utilization management techniques: from 18% of medications in 2007 to 28% in 2009. While cost-sharing requirements vary across plans, the data indicates that there is an increasing financial burden on Part D beneficiaries to accessing prescription medications.

The National Council is currently in the process of assessing whether this data is indicative of the experience of Part D beneficiaries (including dual-eligibles) attempting to access needed mental health prescription drugs.  Please take 2 minutes to complete a very brief survey by Friday, November 6, 2009.


FTC Postpones Effective Date of Red Flags Rule to June 1, 2010

The Federal Trade Commission (FTC) has again delayed the implementation of the Red Flags Rule, pushing back the effective date from Nov. 1, 2009 to June 1, 2010.  The FTC announced that the delay came as a result of a request from members of Congress, who are considering a bill that would exempt some types of creditors from complying with the rule.  The bill, H.R. 3763, would exclude healthcare practices and certain other small businesses with 20 or fewer employees from being defined as “creditors.” It would also allow all businesses to apply to the FTC for an exemption from the rule.  The FTC had previously ruled that healthcare providers qualify as creditors due to their billing process.  H.R. 3763 has been approved by the House and is currently awaiting a hearing in the Senate, where it has been referred to the Committee on Banking, Housing, and Urban Affairs.


Bill to Treat Depression and Bipolar Disorders Introduced in Senate

A group of Democratic and Republican Senators has introduced legislation to establish national centers of excellence for the treatment of depression and bipolar disorders.  The bill, known as the ENHANCED Act (S. 1857), is sponsored by Sen. Debbie Stabenow (D-MI), George Voinovich (R-OH), Sherrod Brown (D-OH), John Kerry (D-MA), and Kay Bailey Hutchison (R-TX).  In addition to establishing centers of excellence, it also authorizes federal support for the development of evidence-based treatment standards and clinical guidelines for improving the detection of depression and bipolar disorder.  The bill provides further support to individuals with these disorders by establishing resources for professional education and training and the reduction of the stigma associated with mood disorders.

The National Council has written a letter to Senator Stabenow in support of the ENHANCED Act.