Lame Duck ‘Cures’ Package Could Include Opioid Funding
When Congress returns to session after Election Day, it will have a short window in which to finalize a number of legislative initiatives. To leaders in both chambers and on both sides of the aisle, passing the 21st Century Cures Act looks to be a top priority. The bill is a comprehensive package designed to foster improvements and innovation throughout the U.S. health system. It invests millions in medical research and technology advances in medicine and could serve as a potential vehicle on which Congress approves funding to address the opioid epidemic.
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Court Settlement Removes Barrier to Opioid Addiction Medication
The health insurer, Cigna, will no longer require doctors to request prior authorization for prescribing buprenorphine to patients with opioid use disorder. The decision will apply to all Cigna customers and is expected to help patients access medication-assisted treatment (MAT) more quickly. Cigna made the policy change under the terms of a court settlement with the state of New York last week.
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Congressional Staff Briefing on Advancing Addiction Recovery Supports
On Monday, the Addiction Policy Forum hosted a briefing entitled “Strategies for Advancing Recovery Supports Nationwide” for Congressional staff on Capitol Hill. Panelists spoke about innovative recovery programs currently being implemented in states and localities that have shown promising results, including: community recovery support programs, sober living activities, recovery coaching in emergency rooms, family peer support, and jail-based peer support models and diversion programs.
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CMS Finalizes Medicare Payment Rule
On Friday, October 14th, the Centers for Medicare and Medicaid Services (CMS) released the final Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) rule, which makes sweeping reforms to how physicians are paid under Medicare Part B. The final rule will apply to the vast majority of eligible behavioral health providers when MACRA goes into effect in 2017 and includes several positive changes made in response to the National Council’s written comments.
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Health Insurance Premiums to Increase for Some in Medicare Part B
Health insurance premiums are expected to increase significantly for about 30% of Medicare Part B beneficiaries, as the result of a 0.3 percent Social Security Cost of Living Adjustment (COLA) announced earlier this week. While most Medicare Part B beneficiaries will not be affected by this change, the impacted group includes: high-income beneficiaries, new enrollees, enrollees not collecting Social Security benefits, and the millions of dually eligible beneficiaries whose Part B premiums are paid by state Medicaid programs.
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New Rural Health Bill Expands Access to Care under Medicare
A new bill introduced by Senator Pat Roberts (R-KS) would provide a robust and comprehensive answer to a myriad of issues facing health care access in rural communities. Among its many provisions including grant reauthorization and provider trainings, the bill – the Craig Thomas Rural Hospital and Provider Equity Act (R-HoPE) – would expand the eligible provider pool by allowing marriage and family therapists (MFTs) and licensed mental health counselors to directly bill Medicare for their services. These provisions are identical to a longtime National Council legislative priority and 2016 Hill Day ask – the Mental Health Access Improvement Act of 2015 (S. 1830/H.R. 2759).
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Health Home Participants: Build the Case for Integration Through Data
At a recent BHECON forum in Normal, Illinois, attendees heard from legislators and experts in primary and behavioral health care integration about the growing importance of data in making the case for increased investment in services. With Illinois facing a continued budget crisis amid the rollout of its planned Medicaid transformation, the takeaway was clear: behavioral health providers should begin planning how they can collect and report data on cost and quality of care in order to position themselves for success.
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Fate of Mental Health Bills Unknown in Lame Duck Session
Congress is on recess until after the November election. When they return to Washington, legislators will be faced with a number of high priority decisions that must be made in short order. From funding the federal government beyond December 9 to determining which legislative initiatives to vote on and pass before the year is out, advocates hope that Congress will take up a number of mental health bills before legislators close the books on the 114th Congress.
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SAMHSA Finalizes Reporting Requirements on Medication-Assisted Treatment
Last month, the Substance Abuse and Mental Health Services Administration (SAMHSA) finalized its rule detailing annual reporting requirements for prescribers of medication-assisted treatment (MAT). Earlier this year, SAMHSA increased the patient cap for MAT up to 275 patients per physician. The final rule outlines specific reporting requirements necessary to treat patients at this higher limit, including: annual caseload of patients by month, number of patients provided or referred to behavioral health services, and the features of the physicians’ diversion control plan.
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Every Student Succeeds Act Creates Funding Opportunities for Behavioral Health in Schools
The newly enacted Every Student Succeeds Act (ESSA) provides schools with federal resources that can be used to carry out behavioral awareness trainings for educators, such as Mental Health First Aid, and to implement school-based behavioral health services. The law, enacted in December 2015, replaces the previous version of the U.S. national education law known as No Child Left Behind. Full implementation of ESSA is scheduled for the 2017-2018 school year, but funding is still moving through the Congressional appropriations process.
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