Public Policy Update: September 1, 2011
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September 1, 2011
Democrats, Republicans Begin Talks on Deficit Committee; National Council Signs on to Letter to Protect Medicaid
Democrats and Republicans have begun separate talks to review the issues around federal debt reduction and the upcoming negotiations of the Joint Select Committee on Deficit Reduction. The committee is slated to hold its first meeting after Congress returns from its Labor Day recess.
News reports on the parties’ meetings yielded little new information about what to expect from the deficit committee. Some analysts viewed the committee’s recent appointment of a longtime Hill staffer and well-known tax expert to the position of Staff Director as a signal that the committee may consider significant changes to the tax code as a means to meeting its $1.2 trillion spending reduction goal. However, fiscal conservatives in Congress have remained steadfastly opposed to any tax changes that would raise federal revenue – and it is still far from clear whether the committee members could reach agreement on changes to the tax code. To get a sense of how the 12 committee members may approach the issues at hand in the deficit reduction negotiations, the consumer advocacy group Families USA has published a fact sheet outlining members’ past positions on Medicaid, Medicare, deficit control, and the Affordable Care Act.
Meanwhile, Medicaid remains at risk under a variety of possible outcomes of the debt committee’s negotiations. The National Council has signed on to a letter being circulated by Families USA that urges the members of the committee to protect health care coverage for America’s most vulnerable families, especially those who depend on the Medicaid program for their lifeline.
The Department of Health and Human Services has announced it is awarding $137 million for programs to strengthen local programs supported through the Substance Abuse and Mental Health Services Administration (SAMHSA) and the Centers for Disease Control and Prevention (CDC). Much of the funding for these grants came from the Prevention and Public Health Fund, created under the Affordable Care Act.
The new grant funding included:
- Nearly $5 million to help states and territories enhance and expand the national network of tobacco cessation quitlines to increase the number of tobacco users who quit. Quitlines are the toll-free numbers people can call to obtain smoking cessation treatments and services.
- Up to $75 million to fund nine Screening, Brief Intervention, Referral and Treatment programs over the next five years. These programs will allow communities throughout the nation to provide more comprehensive substance abuse screening, secondary prevention, early intervention and referrals to treatment for people at higher risk for substance abuse.
In a statement on the awards, HHS Secretary Kathleen Sibelius said, “More than ever, it is important to help states fight disease and protect public health. These awards are an important investment and will enable states and communities to help Americans quit smoking, get immunized and prevent disease and illness before they start.”
“These funds will allow us to bolster public health services to communities and build on successful programs that have helped people lead healthier lives. Today’s investments will help us prevent future health care costs from problems such as tobacco-related illness and substance abuse,” said Pamela Hyde, Administrator of SAMHSA. A full list of grantees is available online.
The U.S. Department of the Treasury is phasing out paper checks as a payment option for federal benefit payments. People who receive Social Security, Supplemental Security Income or other federal benefit checks for themselves or on behalf of someone else, must switch to an electronic payment option by March 1, 2013. The move to electronic payments is designed to enhance beneficiary safety by eliminating the risk of lost or stolen checks, improve the ease and efficiency of the payment process, and provide beneficiaries with faster access to their payments.
There are two electronic payment options available:
- Direct deposit: People with a checking or savings account can sign up to receive their money through direct deposit. Their money will go straight into their checking or savings account on payment day each month and be accessible from virtually anywhere.
- Direct Express Debit MasterCard: This is a prepaid debit card; money is posted to the card account on payment day each month. Cardholders can make purchases, pay bills and get cash anywhere Debit MasterCard is accepted. No bank account or credit check is required.
Beneficiaries may switch to direct deposit or the Direct Express card any time before March 1, 2013. The National Council encourages behavioral health agencies to inform consumers about these changes and direct them to www.GoDirect.org (or the Electronic Payment Solution Center at 800-333-1795) to sign up.
National Council Submits Comments on Partial Hospitalization Rates, Medicare Coverage Of Alcohol Screening, Comparative Effectiveness Research
The National Council recently submitted comments to several federal agencies regarding issues of concern to the behavioral health field:
Proposed Partial Hospitalization Rate Cut: The Centers for Medicare and Medicaid Services has CMS proposed to cut the 2012 community mental health center-based partial hospitalization rates by 27.2% for three services per day (from $129.64 to $97.78), and by 34% for four or more services per day (from $164 to $113.62). The National Council’s comments express our deep concern about these proposed cuts, particularly in light of the additional burden that CMS’ recent proposed conditions of participation would impose on partial hospitalization providers. Our comments request CMS to suspend implementation of the proposed rate cut and keep the current rates in place until such time as CMS can establish a Rate Setting Task Force to develop a new rate methodology that captures all relevant data and reflects the real time costs to providers to deliver these services.
Medicare Coverage of Alcohol Misuse Screening: In a recent Decision Memo, CMS stated its intent to cover annual alcohol screening and behavioral counseling interventions (when indicated in the screening). The National Council’s comments commend CMS for recognizing the importance of screening and providing brief interventions for individuals with at-risk alcohol behaviors. However, the proposal as written applies only to physicians practicing in a primary care setting. We also encourage CMS to strengthen the proposal by expanding the types of providers who may provide counseling, to include a licensed behavioral health providers working in primary care.
Initial Topics for Patient-Centered Outcomes Research Institute (PCORI): Established under the Affordable Care Act, PCORI is responsible for synthesizing and evaluating research to inform health care decisions by providing evidence on the effectiveness, benefits and harms of different treatment options for different patients. PCORI is currently engaged in planning pilot projects that will focus on methods and approaches appropriate to outcomes research, including observational methodologies, systematic reviews, mixed methods and qualitative methodologies, simulations, small pragmatic pilot trials and survey methods. The National Council’s comments focus on the importance of a consumer-centered approach and offer suggestions for ways to incorporate consumer advisory boards and consumer values, and lived experience into the pilot projects.
Check out the National Council’s healthcare reform blog (http://mentalhealthcarereform.org/) for the latest news about reform implementation, along with resources to help you learn about the law and take advantage of its many provisions. New this week on MentalHealthcareReform.org:
- Opportunities for Behavioral Health Agencies to Take Advantage of Health Reform
- Dr. Karen Davis on “Smarter Ways to Pay for Healthcare”
- And much more!
