NCQA Medical Home Standards Incorporate Behavioral Health Integration
Late on Monday, the National Committee for Quality Assurance (NCQA) released its updated 2014 Patient-Centered Medical Home (PCMH) standards, including heightened standards for behavioral health integration and collaboration with mental health and substance use providers. NCQA recognizes more than 7,000 practices as PCMHs.
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New York Reaches Settlement with Insurer for Parity Violations
New York Attorney General Eric T. Schneiderman last week announced a settlement with a health insurance company based on its violations of state and federal parity law. This settlement is groundbreaking because it is one of the first to be reached under the 2008 parity law, which prohibited insurance plans from placing restrictions on behavioral health coverage that are more stringent than those placed upon medical/surgical coverage.
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House Passes Medicare Bill Including Excellence Act; Bill Goes to Senate
Congressional negotiators released a final Medicare SGR Repeal bill on Tuesday that includes $900 million to fund the bipartisan Excellence in Mental Health Act. The Excellence Act, sponsored by Senators Debbie Stabenow (D-MI) and Roy Blunt (R-MO) along with Representatives Doris Matsui (D-CA) and Leonard Lance (R-NJ), would improve quality and expand access to mental health care and substance use treatment through community behavioral health clinics.
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CMS Releases Home and Community-Based Services Compliance Toolkit
The Centers for Medicare & Medicaid Services (CMS) today issued an informational bulletin announcing the availability of a Home and Community-based (HCB) Settings Toolkit (available here under “Settings Requirements Compliance Toolkit”) intended to assist states and stakeholders in developing Home and Community-Based Services (HCBS) 1915(c) waivers and 1915(i) State Plan Amendment (SPA) or renewal applications.
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Countdown: 10 Days to End of Open Enrollment
With the March 31st enrollment deadline fast approaching, the Obama Administration this week reported that the number of individuals enrolled through the state and federal marketplaces has surged to 5 million. Officials hope that a massive wave of enrollments will bring the total to 6 million by the end of open enrollment.
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Latest Maneuver in “Doc Fix” Debate Includes Excellence in Mental Health Act
Senator Ron Wyden (D-OR), chairman of the influential Senate Finance Committee, has introduced a bill to permanently repeal the unpopular Medicare physician payment formula, while enacting a Medicaid demonstration program that would bolster the nation’s community behavioral health system.
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CMS Clarifies Expanded Hardship Exemption for Medicare Electronic Health Record Use
The Centers for Medicare and Medicaid Services (CMS) has released new details explaining a recently announced expansion of the hardship exemption for healthcare providers who are unable to meet electronic health record Meaningful Use requirements this year.
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Health Insurance Enrollment Rises in February as Uninsured Rate Drops
Enrollment in the state and federal health insurance marketplaces slowed slightly in February even as a new Gallup poll showed a drop in the uninsured rate for the second consecutive month.
Data from the Department of Health and Human Services (HHS) this week showed that 942,000 Americans signed up for health coverage through the state and federal marketplaces in February, a number that was slightly down from January selections (1.15 million).
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Medicare to Rescind Part D Mental Health Drug Restrictions
The Centers for Medicare and Medicaid Services announced today that it will abandon its recent proposal to strip mental health and immunosuppressant drugs of their protected status in Medicare Part D.
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Medicare Sustainable Growth Rate Formula & Doc Fix Explained
Since 2003, Congress has passed more than a dozen temporary fixes to Medicare’s Sustainable Growth Rate (SGR) formula – often referred to as the “doc fix.” This winter, Congress has made unprecedented progress toward repealing the complex and unpopular formula used to determine Medicare reimbursement rates for physicians. Two committees in the House – the Ways […]
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25 Days Left Until End of Open Enrollment; Send Us Your Feedback!
The open enrollment period for health insurance plans sold on the state and federal Marketplaces is set to end on March 31. The Obama Administration this week announced that this deadline would not be extended to accommodate consumers who had difficulty accessing the healthcare.gov site during its first troubled month.
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Dozens of Lawmakers Call on CMS to Rescind Drug Restrictions
A bipartisan group of 50 lawmakers this week called on the Centers for Medicare and Medicaid Services (CMS) to preserve patients’ access to important mental health and immunosuppressant medications in Medicare Part D.
The letter, written by members of the House Ways & Means and Energy & Commerce Committees, noted that the six protected classes policy is “a critically important component of what has made Part D successful over the past eight years.”
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Obama Releases 2015 Budget Request
President Obama this week released the first installment of information about his 2015 budget request. The request includes $3.568 billion in funding for Substance Abuse and Mental Health Services Administration programs, a decrease of $63 million from FY 2014.
While full details on all budget line items will not be available until the comprehensive Congressional Justifications are released later this week, information has emerged about several key substance abuse and mental health priorities:
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