Capitol Connector

Stephanie Pellitt

Policy Associate, National Council for Behavioral Health

On Thursday, the House Energy and Commerce Committee reviewed remaining opioid legislation to be included in a large package aimed at addressing the opioid crisis, an effort which began last week in the full Committee. The Committee approved 32 bills, a week after approving another 25 opioid measures, bringing the total up to 57. Bills that advanced this week include provisions to loosen both the Institution for Mental Disease (IMD) rule on residential substance use disorder (SUD) treatment and privacy rules governing SUD treatment records, promote best practices for recovery housing and to ensure mental health and SUD parity in the Children’s Health Insurance Program (CHIP).

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Stephanie Pellitt

Policy Associate, National Council for Behavioral Health

Last Friday, President Trump announced the Administration’s plan to lower drug prices in a speech entitled ‘American Patients First,’ which highlights steps the Administration has taken, outlines future actions, and requests public comment on “even bolder actions” to bring down drug prices. The wide-ranging proposals include reforms to Medicare Part D and Part B, Medicaid, the Food and Drug Administration (FDA), the 340B Drug Discount program, and more.

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Samantha Sears

Behavioral Health Policy and Practice Intern

The House Committee on Ways & Means Wednesday approved seven bipartisan bills aimed at reducing opioid misuse and abuse in Medicare. The package would expand Medicare coverage of medication-assisted treatment (MAT), promote non-opioid alternatives for pain management and require Part D plans to have drug management plans for Medicare beneficiaries at risk of opioid addiction. The bills now move to the House floor, joining dozens of other opioid-related bills approved by the House Energy and Commerce Committee.

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Shelley Starkey

On Wednesday, the House Energy and Commerce Committee held its first of two hearings to consider a large package of legislation aimed at addressing the opioid crisis. The full Committee approved 25 of the 56 bills that had advanced from the Health Subcommittee, and is slated to review the remaining legislation next week with the hopes of advancing a comprehensive package to the House floor by Memorial Day. Bills that advanced this week included efforts to expand: telemedicine prescribing for medication-assisted treatment, student loan forgiveness for addiction treatment professionals and use of electronic health records by behavioral health providers.

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Shelley Starkey

A bipartisan bill that would incentivize behavioral health providers to adopt electronic health records (EHRs) has passed the Senate, and is onto the House for consideration. The Improving Access to Behavioral Health Information Technology Act (S. 1732), a National Council Hill Day 2018 ask, would incentivize behavioral health providers to incorporate electronic health records (EHRs) into their practices. A companion bill is also moving forward in the House as part of a large package of legislation to address the opioid epidemic.

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Michael Petruzzelli

Manager, Policy and Advocacy, National Council for Behavioral Health

On Tuesday, the House Energy and Commerce Health Subcommittee convened a hearing on 42 CFR Part 2 – regulations pertaining to the disclosure and sharing of a patient’s substance use treatment records. The bill in question, the Overdose Prevention and Patient Safety Act (H.R. 3545) intends to amend federal regulation related to substance use health records, aligning it with the Health Information Portability and Accountability Act or HIPAA, the law that governs privacy standards for other health care records. The Subcommittee is expected to vote on this legislation in the near future.

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Stephanie Pellitt

Policy Associate, National Council for Behavioral Health

On Tuesday, May 8th, the National Council for Behavioral Health hosted briefings on Capitol Hill to highlight the importance of Mental Health First Aid training in helping communities respond to opioid overdoses and other substance use and mental health crises. The briefing introduced Congressional staff to Mental Health First Aid’s opioid overdose education and naloxone training component. The day’s panel included law enforcement, firefighters/paramedics and community educators from across the U.S. who discussed the impact that Mental Health First Aid has had on their communities and departments.

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Samantha Sears

Behavioral Health Policy and Practice Intern

A little-known provision in the recent budget deal included new federal funding for social impact bonds (or pay-for-success contracts) that are meant to spur innovation and lower government spending. Social impact bonds are financing program contracts where privately funded initiatives receive government spending only if the program achieves its targeted outcomes. Social impact bonds are used in behavioral health care to improve clinical outcomes, yield savings and share risk in financing new approaches to treatment.

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Stephanie Pellitt

Policy Associate, National Council for Behavioral Health

Last week, several federal agencies issued guidance to enhance the enforcement of the federal parity law, which requires that insurance coverage of mental health and addiction services be equal to medical/surgical health services. The new guidance is the result of requirements included in the 21st Century Cures Act to improve behavioral health coverage. The guidance released by Health and Human Services (HHS), Departments of Labor and Treasury is intended to help employers and insurers implement parity, improve the coordination of parity enforcement between the agencies and to provide Congress with recommendations for improving parity compliance moving forward.

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Stephanie Pellitt

Policy Associate, National Council for Behavioral Health

On Wednesday, the House Energy and Commerce Health Subcommittee approved 56 of the 63 opioid bills pending before the Committee in a largely bipartisan fashion. The wide-ranging package of opioid bills includes many National Council priorities such as expanding access to substance abuse treatment through telemedicine, building up the addiction treatment workforce and encouraging quality standards for recovery housing. This week’s Subcommittee vote keeps the full Committee on track to advance legislation to the House floor no later than Memorial Day.

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Shelley Starkey

On Wednesday, the Senate Health, Education, Labor, and Pensions (HELP) Committee unanimously voted to approve the Opioid Crisis Response Act of 2018, a large, bipartisan package of potential solutions to the ongoing crisis. The bill (S. 2680), introduced by Committee Chairman Lamar Alexander (R-TN) and Ranking Member Patty Murray (D-WA), would next have to be approved by the full Senate before heading to the House for additional consideration and debate.

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Stephanie Pellitt

Policy Associate, National Council for Behavioral Health

On Monday, April 23, the National Council for Behavioral Health published the first-ever policy guide for expanding quality recovery housing entitled Building Recovery: State Policy Guide for Supporting Recovery Housing. It calls on states to adopt recovery housing quality standards, establish a certification program and support recovery residences as they work to meet nationally-recognized standards. In the guide, the National Council recommends concrete policies and practices that policymakers can enact to strengthen the road to recovery from addiction.

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Katiri Zuluaga

Manager, State Initiatives

On Wednesday, the National Council for Behavioral Health, along with 18 Hill Day partner organizations, hosted over 600 advocates who took to Capitol Hill for Hill Day 2018. The National Council and Hill Day partners thank these advocates for unifying their voices in support of key legislative priorities, including the continuation and expansion of Certified Community Behavioral Health Clinics (CCBHCs). Advocates were energized by two days of NatCon18 and a rousing call to action from Senator Debbie Stabenow (D-MI) before flooding congressional offices to voice their support on a host of mental health and addiction-focused legislative issues.

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Samantha Sears

Behavioral Health Policy and Practice Intern

Last Saturday, thousands assembled on the steps of Capitol Hill to support Congressional bills related to suicide prevention and quality mental health care. Hosted by the National Council for Suicide Prevention (NCSP), the Rally to Prevent Suicide featured speakers from suicide prevention organizations, families from those lost to suicide, and individuals with previous suicide attempts.

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Samantha Sears

Behavioral Health Policy and Practice Intern

The Congressional Budget Office (CBO) projects the country’s annual budget deficit will reach $1 trillion by 2020 in a new report released this week. The annual report was delayed this year to incorporate analysis on the impact of the Tax Cuts and Jobs Act passed in late 2017. The report highlights not only growing deficits but also growing health care spending for programs like Medicare, Medicaid and social safety net programs.

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Shelley Starkey

Last week, the American Psychological Association (APA) and the RAND Corporation hosted a Congressional briefing to discuss the complex behavioral health needs of American veterans and their families. The expert panel included researchers, veterans, and clinicians who highlighted nongovernmental programs that are working in the space. Much of the day’s discussion centered on how to better engage the 40 percent of veterans that need care, but are not connected to the Veterans Health Administration (VHA).

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Stephanie Pellitt

Policy Associate, National Council for Behavioral Health

This week, both chambers of Congress spent time negotiating legislation to combat the opioid crisis. The Senate Health, Education, Labor, & Pensions (HELP) Committee held a second hearing on the draft Opioid Crisis Response Act of 2018. Simultaneously, the House Energy & Commerce Health Subcommittee held its final opioid-focused hearing to review 30-plus bills focused on opioid-related coverage and payment issues in the Medicare and Medicaid programs. Committee leaders Chairman Walden (R-OR) and Chairman Alexander (R-TN) appear to want to move quickly, aiming for floor votes by the summer.

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Stephanie Pellitt

Policy Associate, National Council for Behavioral Health

On Monday, the Centers for Medicare and Medicaid Services (CMS) released the final 2018 health insurance marketplace rule, which includes proposals affecting the individual and small group markets. Overall, the rule shifts decision making authority for several significant exchange policies to the states, including the scope of the Essential Health Benefits (EHB). Most importantly, the EHB changes will allow states to choose less comprehensive coverage for mental health and addiction services, hindering patient access to care and raising out-of-pocket costs for many consumers.

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Stephanie Pellitt

Policy Associate, National Council for Behavioral Health

On Tuesday, President Trump signed an executive order directing federal agencies to initiate a review of social safety-net programs, including Medicaid. The stated goal of the review is to have fewer individuals enrolled in Medicaid and other safety-net programs and increase their workforce participation. The order will likely provide momentum to Medicaid work requirement proposals from states and could expand to large-scale entitlement reform. The National Council strongly opposes work requirements and any other proposal that would seek to limit ability of individuals with mental illness and addiction to receive care through Medicaid.

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Katiri Zuluaga

Manager, State Initiatives

The Centers for Medicare and Medicaid Services (CMS) released final rules for Medicare Part D and Medicare Advantage (MA) plans for calendar year 2019 that are meant to tackle the opioid crisis and decrease drug costs. The CY19 Rate Announcement and Call Letter represents CMS’ priorities for the next year, and will implement new requirements on opioid prescribing and monitoring, require lower co-payments for prescription drugs under Part D, increase availability to generics and, hopefully, decrease costs for consumers and the federal government.

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