Capitol Connector

Stephanie Pellitt

Policy Associate, National Council for Behavioral Health

Last week, the Centers for Medicare and Medicaid Services (CMS) released its proposed rules for the 2019 Medicare Physician Fee Schedule (MPFS) and Quality Payment Program (QPP). The proposed rules update payment rates and key policies applicable to physicians and other professionals under Medicare. Among the key changes, the proposed rule would reduce billing documentation requirements, expand telehealth options and potentially create a bundled payment for the care and management of substance use disorders (SUD) in Medicare.

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Michael Petruzzelli

Manager, Policy and Advocacy, National Council for Behavioral Health

The 2018 Midterm Elections are fast approaching, NOW is the time to get out the vote!

In political advocacy, the first and most important step is deciding who will represent you and your community in Washington, D.C. The National Council for Behavioral Health is committed to helping increase voter engagement among Americans living with mental illness and addiction and their families. To this end, National Council is calling on its members to get out the vote and run Voter Registration drives in their organizations this summer and fall.

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Stephanie Pellitt

Policy Associate, National Council for Behavioral Health

On June 29th, a district court judge blocked Kentucky’s waiver request to require Medicaid enrollees to work or participate in a job-related activity for at least 80 hours per month or lose their health coverage. The court ruled that the Centers for Medicare and Medicaid Services (CMS) had not properly considered whether the initiative would violate Medicaid’s central objective of providing medical assistance to the state’s citizens. The decision could have broad implications for other states hoping to limit Medicaid enrollment through work requirements.

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Shelley Starkey

Just before the July 4th recess, the Senate Appropriations Committee advanced 12 bills as a first step to setting funding levels across the federal government for Fiscal Year 2019, including a package for key health, education, and labor programs. A key focus in the proposal is combating opioid addiction, which marks a 1,275% increase in funding over the past 4 years for prevention, treatment, recovery, and research programs. As currently written, the National Institutes of Health and the Substance Abuse and Mental Health Services Administration would see significant increases in their topline budgets.

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Stephanie Pellitt

Policy Associate, National Council for Behavioral Health

The House Appropriations Committee approved its Labor-HHS budget for fiscal year 2019, funding key federal health, education and labor programs for the year ahead. The Substance Abuse and Mental Health Services Administration (SAMHSA) saw increases of more than $400 million to its programming, though several key programs maintained level funding to prior years, and a fund to support the expansion of Certified Behavioral Community Health Clinics (CCBHCs) faces elimination.

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Shelley Starkey

After months of work on the topic, the House of Representatives last Friday passed a wide-ranging package of legislation aimed at addressing various facets of the opioid crisis. The bipartisan Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities (SUPPORT) Act (H.R. 6) combines 58 individual previously-passed bills that focus on topics ranging from expanding access to opioid addiction treatment to encouraging the adoption of alternative forms of pain management and more. Attention now turns to the Senate as legislators are building their own version of an opioid package, which will need to be reconciled with the House version before being signed into law by the president.

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Stephanie Pellitt

Policy Associate, National Council for Behavioral Health

Congress’ investment of $1 billion for opioid addiction services is now available for states to access through a grant application with the Substance Abuse and Mental Health Services Administration (SAMSHA). This funding was allocated in the recent omnibus budget agreement and is in addition to the $500 million provided in the Opioid State Targeted Response (Opioid STR) grants for FY 2018. State agencies will have until August 13th to submit an application to SAMHSA detailing how they will use the funds to support current state efforts to combat opioid abuse. While providers cannot apply for the funds directly, they should engage with their state officials to discuss addiction services that could be strengthened in their community.

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Stephanie Pellitt

Policy Associate, National Council for Behavioral Health

The Health Resources and Services Administration (HRSA) is currently accepting provider applications to become a National Health Service Corps (NHSC)-approved site. New this year, the NHSC has added addiction treatment facilities to the list of eligible sites for loan forgiveness, providing an incentive for professionals to seek jobs at these facilities. This move represents a change to the NHSC program that the National Council has been advocating for on behalf of its members. The NHSC provides loan forgiveness to over 10,000 eligible health care professionals across the country in exchange for their service in underserved communities. 

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Shelley Starkey

Last week, the White House released a proposal to make sweeping changes to the Executive Branch of the government, reorganizing agencies such as the Department of Health and Human Services (HHS), the National Institute of Health (NIH) and the Food and Drug Administration (FDA), among others. Among the more notable proposed changes is to consolidate certain public assistance programs under HHS and rebrand the agency as the Department of Health and Public Welfare. Congress’s approval will be needed to make most of the large-scale changes, which poses a significant challenge to the plan’s enactment.

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Stephanie Pellitt

Policy Associate, National Council for Behavioral Health

This week, the Trump Administration released a final rule that would allow small businesses and trade groups to band together to purchase health insurance, known as “association health plans”. This move is strongly opposed by the National Council because it will expose more consumers to limited coverage health plans, including plans that lack mental health and substance use disorder (SUD) benefits. This final rule is the result of a 2017 executive order President Trump signed that directed federal agencies to loosen restrictions on association health plans (AHPs) and short-term health insurance to create less comprehensive coverage options.

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Shelley Starkey

The House of Representatives this week picked up where it left off in its efforts to advance legislation to address the opioid crisis. The latest House-passed bills will be combined with those that were passed last week to create a comprehensive package for the Senate to consider. Bills that advanced this week include some controversial measures to loosen the Institutions for Mental Disease (IMD) rule and 42 CFR Part 2, which governs the privacy of substance use treatment records. Other measures that passed related to the expansion of parity protection, and prevention, treatment, and recovery for opioid use disorders.

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Stephanie Pellitt

Policy Associate, National Council for Behavioral Health

Last Friday, the appropriations subcommittee that covers health care programs approved funding levels for federal health spending for FY 2019. Earlier this year, Congress set federal spending levels for FY 2019, boosting both defense and non-defense spending by a combined $300 billion. As currently written, the Labor, Health and Human Services, Education and Related Agencies (Labor-HHS) appropriations bill would prioritize efforts to address the opioid crisis and increase medical research.

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Katiri Zuluaga

Manager, State Initiatives

The National Alliance on Mental Illness (NAMI) recently released a report “Mental Health Parity at Risk” highlighting disparities in health coverage for behavioral health services. Parity ensures that patients have access to health plans that cover mental health and substance use disorder treatment, in addition to medical/surgical services, and that they are not charged more for using such services. The report finds that parity was very weak prior to the passage of the Affordable Care Act’s (ACA) consumer protections, which limited consumers’ access to treatment. The report underscores how current efforts to weaken the individual insurance market could mean returning to a time when Americans with behavioral health conditions could be denied coverage or offered coverage that excludes services they need.

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Stephanie Pellitt

Policy Associate, National Council for Behavioral Health

This week, the House of Representatives kicked off a two-week focus on legislation to address the nation’s opioid crisis. The House passed dozens of measures this week and is slated to vote on more opioid legislation next week with the hopes of advancing a comprehensive package to the Senate. Bills that advanced this week included efforts to expand: telemedicine prescribing for medication-assisted treatment, student loan forgiveness for addiction treatment professionals, the use of electronic health records by behavioral health providers and recovery housing best practices.

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Shelley Starkey

A bipartisan bill that would incentivize behavioral health providers to adopt electronic health records (EHRs) passed the House on Tuesday, following passage of a similar bill by the Senate last month. The Improving Access to Behavioral Health Information Technology Act (H.R. 3331), a long-standing National Council priority, would incentivize behavioral health providers to incorporate electronic health records (EHRs) into their practices. The House and Senate versions of the bill must now be reconciled before moving to the President’s desk for his signature.

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Shelley Starkey

As a part of the Senate’s larger efforts to address the ongoing opioid epidemic, two committees discussed their own legislative solutions this week. The Senate Finance Committee considered and approved the Helping to End Addiction and Lessen (HEAL) Substance Use Disorders Act of 2018 on Tuesday, and the Senate Judiciary advanced the Preventing Drug Diversion Act. These bills will join a host of others that are making their way to the Senate floor, although a timeline on their further consideration is currently unclear.

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Michael Petruzzelli

Manager, Policy and Advocacy, National Council for Behavioral Health

The Department of Justice (DOJ) has declined to defend the Affordable Care Act (ACA) from a challenge by 20 GOP-led states, and instead asked a Texas court to invalidate many of the law’s key insurance reforms, including its prohibition against discriminating against persons with pre-existing conditions. The Texas court will likely render a decision in the coming months. Legal experts suggest that this decision does not put the law into immediate jeopardy as any decision handed down by the court will likely be challenged and appealed to the Supreme Court.

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Shelley Starkey

The Substance Abuse and Mental Health Services Administration (SAMHSA) has released a funding opportunity for nonprofit organizations, including community mental health and addiction treatment providers, in certain states and tribal communities to improve access to medication-assisted treatment (MAT), a highly effective, evidence-based treatment for opioid use disorder (OUD). Eligible organizations wishing to compete for up to almost $525,000 per year must submit their applications by July 9th.

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Shelley Starkey

Earlier this month, Representatives Chris Smith (R-NJ) and Henry Cuellar (D-TX) introduced the Charitable Giving Tax Deduction Act (H.R. 5771), a bipartisan bill that would help to incentivize individuals’ charitable giving, an important revenue source for community behavioral health organizations. If passed, this bill would likely help offset expected reductions in charitable giving resulting from the newly-enacted tax reform law.

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Shelley Starkey

Following an action-packed week for opioid-related legislation in the House, multiple Senate committees took up the mantle this week, hosting hearings, releasing new bills and considering legislation ahead of the Memorial Day recess. As bills advance out of committees, the full Senate is expected to consider the large package of opioid legislation later this summer. Meanwhile, similar efforts in the House are expected to make it to the floor in the coming weeks. The collective work of both chambers of Congress seek to address the opioid crisis from a number of fronts including prevention, treatment and recovery.

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