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Rebecca Farley

Director, Policy & Advocacy, National Council for Behavioral Health

Senators Murphy, Cassidy Introduce Comprehensive Mental Health Reform Bill

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Today, Senators Chris Murphy (D-CT) and Bill Cassidy (R-LA) introduced the Mental Health Reform Act of 2015, comprehensive legislation to reform the U.S. mental health care system. The legislation reauthorizes a number of programs within the Substance Abuse and Mental Health Services Administration (SAMHSA), establishes workforce training and education programs for behavioral health providers, and affirms a commitment to providing evidence-based treatment services throughout federally funded mental health programs.

Of particular note for community behavioral health providers, the Mental Health Reform Act contains a number of important and long-sought priorities in the mental health field:

  • Clarifies billing procedures for integrated care models in Medicaid, expressly permitting clinics to bill for mental and physical health services provided on the same day (known as same-day billing).
  • Requires the Government Accountability Office to conduct a paperwork reduction study evaluating the burden that paperwork requirements place on community mental health providers and offering recommendations to reduce this burden.
  • Makes several modifications to HIPAA to clarify when providers may disclose patients’ information and establishes training programs to educate providers, lawyers, patients, and families on their rights and responsibilities under HIPAA.
  • Codifies the 5% set-aside for early intervention activities in the Mental Health Block Grant; these funds are used for intervention models based on the findings from the NIMH-funded Recovery After an Initial Schizophrenia Episode (RAISE) study.
  • Strengthens parity compliance and enforcement by requiring federal agencies to issue additional clarifying guidance on the parity law, authorizing random plan audits to ensure compliance, and commissioning a GAO study on the status of parity compliance and enforcement.
  • Reauthorizes the Primary Care-Behavioral Health Integration (PBHCI) program at $50 million per year and includes program modifications to increase statewide adoption of integrated care models and remove barriers to integration at the state level.
  • Authorizes a PBHCI technical assistance center to disseminate best practices in integrated care; though Congress typically funds this center yearly, the statutory authorization will strengthen the future of this technical assistance.

This bill generally aligns with similar legislation introduced in the House by Rep. Tim Murphy, though it includes a number of key differences. Among the National Council-supported provisions from Rep. Tim Murphy’s bill that were not included in the Sen. Murphy-Cassidy legislation are the 2-year extension of the Excellence in Mental Health Act demonstration program, the expansion of the health IT Meaningful Use program to behavioral health providers, codification of protected classes of mental health drugs in Medicare and Medicaid, and grants for mental health awareness training. Many of these provisions fall under the jurisdiction of a different Senate committee and could not be included in this legislation, which has been referred to the Senate Committee on Health, Education, Labor, and Pensions.

Among their other differences, the Sen. Murphy-Cassidy bill takes a more limited approach to SAMHSA reform than Rep. Tim Murphy’s Helping Families in Mental Health Crisis Act. It also leaves out the provisions related to assisted outpatient treatment that are a mainstay of Rep. Murphy’s bill, opting instead for policies that promote psychiatric advanced directives and assertive outreach programs to engage patients in treatment. Finally, it carves out a narrower repeal of the Institutes for Mental Disease (IMD) exclusion. Whereas the Rep. Tim Murphy bill permits Medicaid payment for services provided in both residential and inpatient IMD settings, the Sen. Murphy-Cassidy bill allows payment only for certain inpatient settings.

For more information, read Senator Murphy and Cassidy’s bill summary.