Federal Judge Rules Against Association Health Plans
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.
Read More on Federal Judge Rules Against Association Health Plans
Court Blocks Medicaid Work Requirements in Arkansas, Kentucky
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.
Read More on Court Blocks Medicaid Work Requirements in Arkansas, Kentucky
New Report Details How Opioid Crisis Funds Are Being Used
The Bipartisan Policy Center (BPC) has published the first comprehensive report reviewing the estimated $11 billion allocated by the federal government for 57 different federal programs to address the opioid epidemic in 2017 and 2018. Funding has been used for a wide array of state-based programs, but states have primarily focused on creating treatment networks for opioid use disorder (OUD), financing treatment for at-risk individuals, making naloxone accessible and bolstering the addiction workforce. Unsurprisingly, the report found that Medicaid and Medicaid expansion have been critical in addressing the opioid epidemic. BPC recommends the federal government focus on sustainability, transparency, improved coordination among federal offices, and increased flexibility for states to address their unique needs.
Read More on New Report Details How Opioid Crisis Funds Are Being Used
NatCon19 Showcases Behavioral Health Policy Landscape
This past week, over 6,000 attendees gathered in Nashville, TN for NatCon19, behavioral health’s premier conference. From inspiring fireside chats and keynotes to line dancing, NatCon19 had it all and provided the latest insights into policy challenges, solutions and guidance for behavioral health advocates. The consensus among health care leaders, government officials and innovative experts is that Medicaid waivers, state plan amendments, parity, and telehealth policy will continue to dominate the 2019 policy landscape for mental health and addiction treatment. NatCon19 attendees can access all presentation slides here with their badge number.
Read More on NatCon19 Showcases Behavioral Health Policy Landscape
CMS Releases Guidance on Work Requirement Waivers
The Trump Administration this week continued encouraging states to weave work requirements into their Medicaid programs by releasing guidance on implementing, monitoring, and evaluating such changes. The new tools from the Centers for Medicare and Medicaid Services (CMS) are meant to provide guidance on creating effective demonstrations under Medicaid waiver authorities, particularly for waivers permitting states to implement work requirements and other experimental eligibility and coverage policies. As the Administration moves toward approving such waivers in more states, the National Council remains vehemently opposed to these harmful policies as they restrict access to needed mental health and addiction services.
Read More on CMS Releases Guidance on Work Requirement Waivers
Ohio Becomes 9th State to Receive Approval for Medicaid Work Requirements
The Centers for Medicare and Medicaid Services (CMS) has approved Ohio’s Medicaid waiver to enact work requirements, even with legal challenges still pending in Kentucky and Arkansas for similar programs. Starting in 2021, Medicaid beneficiaries in Ohio not meeting certain exemptions will need to report 80 hours of “community engagement” per month to maintain coverage. Estimates indicate that approximately 18,000 people, about half of all eligible Medicaid beneficiaries, could lose coverage due to these new work requirements. The National Council for Mental Wellbeing remains strongly opposed to work requirements and other barriers that restrict access to needed behavioral health services.
Read More on Ohio Becomes 9th State to Receive Approval for Medicaid Work Requirements
Excellence in Mental Health and Addiction Treatment Expansion Act Reintroduced
A bipartisan bill that would extend and expand the Certified Community Behavioral Health Clinic (CCBHC) model was introduced Thursday (3/14) in both chambers of Congress by Senators Debbie Stabenow (D-MI) and Roy Blunt (R-MO) and Representatives Doris Matsui (D-CA) and Markwayne Mullin (R-OK). The Excellence in Mental Health and Addiction Treatment Expansion Act (S. 824/ […]
Read More on Excellence in Mental Health and Addiction Treatment Expansion Act Reintroduced
President Trump Releases FY 2020 Budget Proposal
On Monday, President Trump unveiled his Fiscal Year (FY) 2020 budget request — calling for $4.7 trillion decrease in federal spending and detailing his Administration’s priorities for next year. The document revives efforts to block grant Medicaid and restrict eligibility, maintains spending to combat opioid addiction, and outlines other major health care priorities. As with most presidential budgets, this proposal stands little chance of being enacted into law as written. Instead, the President’s budget proposal will act more as a messaging tool to Congress, which is currently working to develop and pass a budget for FY 2020 over the next few months
Read More on President Trump Releases FY 2020 Budget Proposal
Congressional Briefings Discuss Threats to Mental Health Medication Access
A recently proposed rule from the Centers for Medicare and Medicaid Services (CMS), if enacted, would threaten Medicare Part D participants’ access to critical prescription drugs including those often needed by individuals living with mental illness. The Partnership for Part D Access, of which the National Council for Mental Wellbeing is a founding member, hosted […]
Read More on Congressional Briefings Discuss Threats to Mental Health Medication Access
Push to Expand Certified Community Behavioral Health Clinics Continues
The National Council for Mental Wellbeing has been at the forefront of developing a national model for mental health and addiction treatment called Certified Community Behavioral Health Clinics (CCBHCs), created under the Protecting Access to Medicare Act of 2014. CCBHCs have been filling the gap in the unmet need for addiction care, supporting local criminal justice systems by providing effective diversion and reentry solutions, and increasing access to evidence-based behavioral health treatment across the country. As the end of the CCBHC demonstration looms, the National Council remains committed to expanding this critical and effective model.
Read More on Push to Expand Certified Community Behavioral Health Clinics Continues
Congressional Briefing Urges Congress to Empower Addiction Workforce
Addiction workforce advocates presented on the Hill this week as part of a congressional staff briefing exploring opportunities for Congress to better equip front-line providers to prevent and treat opioid and other addictions. The hearing featured testimony from Mary-Catherine Bohan, representing a Certified Community Behavioral Health Clinic (CCBHC) from New Jersey, who shared how the CCBHC model is transforming her clinic’s ability to hire addiction treatment professionals and serve more patients.
Read More on Congressional Briefing Urges Congress to Empower Addiction Workforce
Mental Health Treatment Wrongly Denied by Insurance Giant
In a landmark ruling, a federal court held Tuesday that health insurance giant United Behavioral Health (UBH), which serves over 60 million members and is owned by UnitedHealth Group, used flawed internal guidelines to unlawfully deny beneficiaries access to mental health and substance use treatment in an effort to cut costs. The ruling marks a validation for patients and providers who have long raised concerns that health plans were not fulfilling the requirements set forth in the Mental Health Parity and Addiction Equity Act of 2008, which established parity between the coverage of behavioral health and medical/surgical benefits.
Read More on Mental Health Treatment Wrongly Denied by Insurance Giant
Tonko, Turner Reintroduce Bipartisan Addiction Treatment Bill
A bipartisan bill that would allow states to restart Medicaid coverage for eligible incarcerated individuals up to 30 days before their release from jail or prison was introduced this week by Representatives Paul Tonko (D-NY) and Michael Turner (R-OH). The Medicaid Reentry Act (H.R. 1329) is an important step toward improving access to much-needed mental health and substance use services for one of the most vulnerable populations in the country.
Read More on Tonko, Turner Reintroduce Bipartisan Addiction Treatment Bill
CMS’ Medicaid Guidance Describes Non-Opioid Options for Pain Management
A new informational bulletin from the Centers for Medicare and Medicaid Services (CMS) suggests a range of strategies for states to promote non-opioid chronic pain management options within their Medicaid programs by leveraging waivers, bundled payments, and other mechanisms. The bulletin builds upon previous CMS guidance to highlight successful programs already in place in some states and to describe Medicaid authorities at states’ disposal.
Read More on CMS’ Medicaid Guidance Describes Non-Opioid Options for Pain Management
White House ONDCP Releases First National Strategy under Trump
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, last week released its first National Drug Control Strategy since President Trump took office. The strategy calls on federal agencies to focus their efforts on preventing individuals from initiating use of illicit drugs, providing adequate evidence-based treatment for individuals living with addiction, and reducing the availability of illicit drugs via law enforcement activities.
Read More on White House ONDCP Releases First National Strategy under Trump
New Legislation Enhances Medicare Mental Health Workforce
New bipartisan legislation in the House and Senate would create greater access to mental health care, particularly for rural areas. The bill – the Mental Health Access Improvement Act (H.R. 945/S. 286) – would allow marriage and family therapists (MFTs) and licensed mental health counselors to directly bill Medicare for their services. Similar legislation has been introduced in previous sessions of Congress and again has the strong support of the National Council.
Read More on New Legislation Enhances Medicare Mental Health Workforce
CMS Releases 2020 Medicare Advantage and Part D Draft Call Letter
On Thursday, the Centers for Medicare and Medicaid Services (CMS) released its Medicare Advantage (MA) and Part D draft call letter for 2020, which outlines changes to Medicare plan policies and payments each year.
Read More on CMS Releases 2020 Medicare Advantage and Part D Draft Call Letter
National Council Urges CMS to Strengthen Network Adequacy Standards for Medicaid Managed Care
State Medicaid programs should work with managed care organizations to ensure beneficiaries have timely access to robust provider networks, the National Council urged the Centers for Medicare and Medicaid Services in comments submitted Monday. Our comments were submitted in response to a Notice of Proposed Rulemaking issued by CMS in November that proposed to roll back prior regulations on Medicaid and CHIP managed care. While CMS indicated the new proposed rules are intended to “increase state flexibility,” the National Council is concerned they would result in loss of access to mental health and addiction treatment providers.
Read More on National Council Urges CMS to Strengthen Network Adequacy Standards for Medicaid Managed Care
What to Watch in Health Care in 2019
The 116th Congress began on Thursday amid a government funding lapse that has shut down roughly 25 percent of the federal government. Democrats are set to lead the House chamber for the first time since 2010, while Republicans remain in control in the Senate. While legislation may be move less quickly in the new divided Congress, lawmakers will still face a number of “must-pass” bills that include health care priorities. Additionally, the Trump Administration will continue to shape the health care landscape with Medicaid waivers and potential payment reforms. Here is a preview of what’s ahead in health policy in 2019.
Read More on What to Watch in Health Care in 2019
Trump Administration Approves Medicaid Work Requirements in Maine, Michigan
The Centers for Medicare and Medicaid Services (CMS) approved waivers from Michigan and Maine last month that would allow the states to implement requirements for Medicaid enrollees to report work or “community engagement” activities each month or risk losing health coverage. Michigan and Maine join five other states that have had Medicaid work requirement waivers approved, while more than ten others are in the process of requesting similar changes to their Medicaid programs. The National Council stands strongly opposed to any provisions that create barriers to health coverage for individuals with mental health or substance use disorders, including Medicaid work requirements.
Read More on Trump Administration Approves Medicaid Work Requirements in Maine, Michigan