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Progress Report on the Excellence in Mental Health Act

Capitol Connector
Your source for the latest updates from Capitol Hill. We translate policy into practice so you can learn how policy trends will affect your work and how best to prepare.

Chuck Ingoglia

, National Council for Behavioral Health

Progress Report on the Excellence in Mental Health Act

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As I was sitting down to write this update I was searching for the right analogy to describe the legislative process in Washington.  My first thought was to compare it to a roller coaster with all of the highs and lows, starts and stops.  But the more I thought about it, I think the Tilt-A-Whirl is more apt – you know, that is the ride in which you sit in a little car, and it spins very fast in every direction, unpredictably.  That is sure how it feels sometimes!

We recently reported that the Senate Finance Committee in December 2013 considered legislation to revamp the way that physicians are paid in Medicare.  This bill is called the “SGR” bill here in Washington.  You may also remember that while a very large number of amendments were filed (137) only 7 were passed, including a demonstration project based on the Excellence in Mental Health Act legislation introduced by Senators Stabenow (D-MI) and Blunt (R-MO).  The National Council and the rest of the behavioral health community was very proud of this achievement, as this demonstration program would set the stage for new federal standards for the delivery, monitoring and reimbursement  of mental health and outpatient substance use treatment services in Medicaid.

And as the legislative process continued into January, many of you responded to our action alerts urging the House of Representatives to keep the Excellence Act Demo in the final SGR bill.  Late last week, we learned that the House and Senate Committees that have jurisdiction over this bill reached agreement on the SGR bill, but in a legislative twist, the agreement only addresses physician payment and not any other Medicare and Medicaid payment issues that would usually be addressed in this bill, including the Excellence Act.

So that does this mean regarding next steps?  To be honest, we are not 100% sure.  There is possibility that Congress will be able to reach a deal on the Medicare and Medicaid payment provisions (called the “Extenders package” in Washington) sometime this year, and we hope that the Excellence Act would be included in that bill.  We will certainly be watching and waiting, and will let you know as soon as we hear something.

And while this process is confusing, and less than straightforward, we should not lose sight of the fact that we have made tremendous and significant progress this year.  Your contacts with Congress and with the media have elevated behavioral health issues and this legislation to an unprecedented level.  Senators Stabenow and Blunt and Representatives Matsui and Lance have been tremendous champions for the Excellence Act.

We are grateful to our members, and advocates around the country for your hard work and for your willingness to enter the Tilt-A-Whirl with us.  Just hang on!