Capitol Connector

Stephanie Pasternak

, National Council for Behavioral Health

Earlier this week, Senator Elizabeth Warren (D-MA) and Representative Joe Kennedy III (D-MA) reintroduced the Behavioral Health Coverage Transparency Act (H.R. 2874/S. 1576) with the aim of strengthening Americans’ access to mental health and substance use disorder (SUD) treatment. Specifically, the bill would increase oversight and enforcement of the federal parity law, which requires that insurance coverage of mental health and SUD services be equal to the coverage of medical and surgical health services. 

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Michael Petruzzelli

, National Council for Behavioral Health

On Thursday, the National Council hosted nearly 100 advocates from 16 states to build support for legislation to extend and expand the Certified Community Behavioral Health Clinic (CCBHC) demonstration program in Medicaid. The Excellence in Mental Health and Addiction Treatment Expansion Act (S. 824/ H.R. 1767) would extend the demo in the original eight states for two years, while expanding the program to the other 11 that applied but were not originally selected. The CCBHC program will expire on June 30, 2019 without Congressional action.

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Shelley Starkey

Policy & Advocacy Coordinator

The Centers for Medicare and Medicaid Services (CMS) released a final rule on Thursday aimed at addressing rising drug prices and out-of-pocket expenses under Medicare Part D and Medicare Advantage. Notably, the final rule did not include previously-proposed measures that would have provided exceptions to Medicare’s “six protected classes,” a policy that ensures beneficiaries with complex health conditions, including mental illness, have access to a full range of medication treatment options. The announcement comes after six months of opposition to the proposals from Members of Congress and patient and provider advocates, including the National Council for Behavioral Health.

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Stephanie Pasternak

, National Council for Behavioral Health

The House Appropriations Committee approved its Labor-HHS budget for Fiscal Year 2020 on Wednesday, funding key federal health, education and labor programs for the year ahead. The Substance Abuse and Mental Health Services Administration (SAMHSA) saw increases of $115 million to its programming which includes level funding for several key programs as well as new funding for the Community Mental Health Services Block Grant and substance use disorder workforce initiatives. The appropriations bill now heads to the House floor for consideration and a vote.

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Shelley Starkey

Policy & Advocacy Coordinator

This week, a group of 95 Democrats in the House and Senate re-introduced a bill that would invest $100 billion in federal funds over ten years to better address the opioid overdose epidemic, which took almost 48,000 American lives in 2017. The Comprehensive Addiction Resources Emergency (CARE) Act (S. 1365/H.R. 2569) includes provisions to strengthen standards for recovery residences, establish new grant programs to help individuals living with addictions find or maintain employment, and incentivize states to cover the full range of addiction services in their Medicaid programs. The National Council thanks the CARE Act’s sponsors for their work to provide desperately needed resources that will expand addiction treatment capacity nationwide.

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Shelley Starkey

Policy & Advocacy Coordinator

The Office of National Drug Control Policy (ONDCP), a component of the White House responsible for coordinating the nation’s response to drug-related issues such as the opioid overdose epidemic, released its Performance Reporting System last week, which established nine measurable goals and objectives meant to be achieved by 2022. The goals include reducing the number of drug overdose deaths, increasing prescriber education on best practices and clinical guidelines, and expanding access to evidence-based addiction treatment options.

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Katiri Zuluaga

Manager, State Initiatives

A bipartisan piece of legislation has been introduced in the House that would remove restrictions on health providers to prescribe buprenorphine, a medication proven effective in treating opioid use disorder. The Mainstreaming Addiction Treatment Act (H.R.2482) would eliminate the requirement for medical providers to obtain a waiver from the Drug Enforcement Administration (DEA) to treat opioid use disorder with buprenorphine or any other Schedule III, IV or V drug. Currently, practitioners must apply for the waiver in order to prescribe buprenorphine specifically to treat addiction, even though they may be able to prescribe the medication for other reasons.

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Michael Petruzzelli

, National Council for Behavioral Health

Last week, the Tennessee legislature passed a bill that would make it the first state in the nation to transform its Medicaid program into a single lump sum block grant. The legislation was passed after continued promises from the Trump Administration to provide states greater flexibility in running their state Medicaid programs. The bill now heads to Governor Bill Lee’s desks for his review and approval.

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Stephanie Pasternak

, National Council for Behavioral Health

On Tuesday, the appropriations subcommittee that covers health care programs approved funding levels for federal health spending for Fiscal Year (FY) 2020. As expected, the bill largely ignores proposed cuts from President Trump’s budget and assumes that Congress will reach a deal to avoid upcoming budget caps. 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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Shelley Starkey

Policy & Advocacy Coordinator

A bill introduced in the House this week would establish a loan repayment program for mental health care providers who commit to working in designated communities with a lack of accessible care. The Mental Health Professionals Workforce Shortage Loan Repayment Act of 2019 (H.R. 2431), introduced by Representatives John Katko (R-NY) and Grace Napolitano (D-CA), seeks to address a critical shortage in the number of mental health care providers across the country.

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Stephanie Pasternak

, National Council for Behavioral Health

This week, the Medicaid and CHIP Payment and Access Commission (MACPAC) issued a request for comments from stakeholders on requirements, standards, and payments for institutions for mental disease (IMDs) under Medicaid. This announcement builds on recent moves by Congress and the Centers for Medicare and Medicaid (CMS) to provide opportunities for states to waive the IMD Medicaid payment exclusion for mental health and addiction services delivered in IMD settings. Specifically, the request comes in response to a provision from the SUPPORT Act that requires MACPAC to issue a report on IMDs and the services furnished by such providers. Providers interested in commenting have until May 31st at 5:30pm ET to submit comments.

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Michael Petruzzelli

, National Council for Behavioral Health

If you don’t speak up, how can you be heard? Our voices are louder – and more powerful – together. But only if we use them. Use your voice this year with hundreds of your fellow advocates at Hill Day 2019 – September 17-18 in Washington, D.C.

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Katiri Zuluaga

Manager, State Initiatives

This month, three veterans completed suicide at  Veterans Affairs (VA) facilities over the course of five days, bringing an alarming trend into the national consciousness. The rising rate of suicides and suicide attempts at VA facilities has prompted new legislation to be introduced in Congress. H.R. 2340, proposed by Army combat veteran Representative Max Rose (D-NY), would require the VA to track deaths and suicide attempts on VA property and provide that information to Congress, along with medical, financial and housing information for any individuals who die by suicide at the VA.

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Stephanie Pasternak

, National Council for Behavioral Health

The National Council has been a longtime advocate for changing federal regulations that restrict how behavioral health medications that are controlled substances can be prescribed via telemedicine. Recognizing the urgent need to expand access to medication-assisted treatment (MAT) and other behavioral health medications, the National Council worked closely with Members of Congress to secure a provision in the opioid legislative package (SUPPORT Act) that would address this problem. The Drug Enforcement Administration (DEA) now has until October 1, 2019 to clarify when the agency can issue prescribers a special registration that would enable them to treat patients for the first time via telemedicine.

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Stephanie Pasternak

, National Council for Behavioral Health

Last week, the National Council provided official comments to the Substance Abuse and Mental Health Services Administration (SAMHSA) on the agency’s proposed Recovery Housing Guidelines. The guidelines are the result of requirements included in the SUPPORT Act of 2018, a wide-ranging opioid package, for the federal government to identify and disseminate best practices for operating recovery housing. While the guidance is intended to help states increase the availability of quality recovery housing, the National Council raised numerous concerns that the guidance would instead reduce access to recovery housing and undermine existing recovery housing standards and certification programs.

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Shelley Starkey

Policy & Advocacy Coordinator

The Mental Health Services for Students Act (S. 1122/H.R. 1109), introduced in the Senate earlier this week and in the House earlier this year, would increase access to evidence-based comprehensive mental health programs for the nation’s youth in local schools and communities. The bill would build on youth-focused programs that incorporate promising practices in education, social services, local primary health care, and trauma-informed behavioral health care to help communities take action to help youth and adolescents in need. The National Council applauds Senator Tina Smith (D-MN) and Representatives Grace Napolitano (D-CA) and John Katko (R-NY) for their leadership on this important issue.

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Shelley Starkey

Policy & Advocacy Coordinator

Last week, a bipartisan group of lawmakers reintroduced a bill in both the House and the Senate that would amend federal laws related to the sharing of substance use disorder (SUD) treatment records. The bills (S. 1012/H.R. 2062) would change 42 CFR Part 2, the section of the federal code related to this issue, to align it with the Health Information Portability and Accountability Act (HIPAA). Identical bills have been introduced in previous sessions of Congress but have subsequently failed to pass due to opposition from privacy advocacy groups and a handful of legislators.

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Michael Petruzzelli

, National Council for Behavioral Health

The Senate approved a bill by voice vote on Tuesday that extends the Certified Community Behavioral Health Clinic (CCBHC) demonstration program in Oregon and Oklahoma, among other Medicaid programs. H.R. 1839, which passed the House last week, provides both states with an additional three months of participation in the CCBHC initiative, funding them both through June 30, 2019. Oregon and Oklahoma were set to conclude their two-year demonstration and lose their funding on March 31, but this extension will align them with the other six CCBHC demonstration states that began the program three months after OR and OK in 2017.

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Shelley Starkey

Policy & Advocacy Coordinator

A final rule released last year that allowed for the proliferation of association health plans (AHPs) that do not comply with requirements in the Affordable Care Act (ACA) was ruled illegal by a District Judge last week. AHPs allow small businesses and trade groups to band together to purchase health insurance plans that are exempt from many critical ACA consumer protections, such as the requirement to provide certain health benefits which include mental health and substance use disorder treatment, and to do so at parity with physical and surgical health benefits. The National Council applauds U.S. District Judge John D. Bates for reversing these harmful AHPs.

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Stephanie Pasternak

, National Council for Behavioral Health

On Wednesday, a district court judge issued a pair of decisions blocking Medicaid work requirements in Kentucky and Arkansas. Consistent with an earlier ruling, the court found that the federal government had failed to justify how adding employment requirements advanced Medicaid’s central statutory objective to provide medical assistance to the state’s citizens. The impact of the ruling is likely to extend beyond these two states and complicate Trump Administration plans to expand Medicaid work requirements more broadly.

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