HHS, Treasury, and Labor Departments Release Parity Report to Congress

The Departments of Labor (DOL), Health and Human Services (HHS), and Treasury issued a report and fact sheet on Tuesday, Jan. 25 documenting widespread lack of compliance with federal parity rules among commercial health plans. The report specifically highlights lack of compliance with a new requirement enacted in late December 2020 that plans must document how their non-quantitative treatment limitations (NQTLs) comply with the Mental Health Parity and Addiction Equity Act (MHPAEA).

During a webinar on Wednesday, Jan. 26, DOL representatives stressed that none of the responses to requests for documentation the agency sent to 156 plans and issuers were sufficient to demonstrate compliance with MHPAEA. Furthermore, despite insufficient documentation, DOL has already issued initial determination letters finding 48 NQTLs imposed on mental health or substance use disorder (MH/SUD) benefits violate parity. HHS reported that all the responses to requests for documentation of compliance with parity from issuers in states where the agency has direct enforcement authority and non-federal government plans similarly were insufficient. HHS has issued initial determination letters finding 16 NQTLs were out of compliance with parity. DOL officials also mentioned that the agencies plan to amend the federal regulations implementing MHPAEA.

The Departments included a set of legislative recommendations for Congress in the report including authorizing the Departments to impose civil monetary penalties for parity violations and directly pursue parity violations by entities that provide administrative services to group health plans. In addition, the report recommends that Congress consider ways to permanently expand access to telehealth. The report also recommends that Congress amend MHPAEA to ensure that MH/SUD benefits are “defined in an objective and uniform manner pursuant to external benchmarks that are based in nationally recognized standards”.

These developments regarding possible regulatory and legislative changes point to the importance of NABH member submissions to the denial-of-care portal. Please see additional information about the portal below.

CMS Issues Updated Guidance on Covid-19 Vaccination Requirements for Healthcare Workers

The Centers for Medicare and Medicaid Services (CMS) issued updated guidance and resources regarding Covid-19 vaccination requirements for personnel in Medicare-participating facilities including psychiatric hospitals and psychiatric residential treatment facilities. This updated information responds to the Supreme Court’s decision earlier this month to overturn the lower court decisions blocking implementation of CMS’ Covid-19 vaccination requirements in almost half of the states. These requirements now apply in all 50 states with various deadlines.

In the 25 states not affected by the litigation, CMS had previously clarified that healthcare facility personnel had to have at least one dose of a Covid-19 vaccine (or be exempt due to religious conviction or medical condition) by Jan. 27, 2022, and a second dose (of any two dose regimen) by Feb. 28, 2022.

New deadlines for healthcare facility personnel in states previously under a stay on enforcement are Feb. 14, 2022, for a first dose and March 15, 2022, for a second dose. Texas was affected by separate litigation and the new deadlines for Medicare-regulated healthcare facilities in that state are Feb. 22, 2022, for the first dose and March 21, 2022, for the second.

Below are links to updated CMS guidance on the Covid-19 vaccination requirements:

• Guidance memo (cms.gov) – This memo provides guidance for assessing and maintaining compliance with this new regulatory requirement for certain Medicare and Medicaid providers and suppliers.
• CMS Omnibus COVID-19 Health Care Staff Vaccination Requirements FAQ (PDF cms.gov) (PDF) – These FAQs have been updated to explain the recent ruling and how it impacts employee vaccination requirements.
• IFC-6 Vaccination Requirements Infographic (cms.gov) (PDF) – This infographic visually shows the types of providers and suppliers the vaccine requirement applies to, how the requirement can be met, and associated requirement enforcement actions.
• Vaccine Requirement Implementation Timeline (cms.gov) (PDF) – This infographic illustrates the phases of the vaccination rule implementation, state-by-state, and their associated deadlines. Note that the phased deadlines vary by state.
• Vaccine Requirement Decision Tree (cms.gov) (PDF) – This handy decision tree visually explains the steps in determining to which providers and suppliers the vaccine requirement applies.

OSHA Withdraws Vaccine-or-Test Requirement

The U.S. Supreme Court, on Jan. 13, 2022, blocked implementation of the Occupational Safety and Health Administration’s (OSHA’s) vaccination and testing requirements for employers with 100 or more employees. Accordingly, the agency withdrew its emergency temporary standard (ETS) on this topic. However, the agency clarified that “[a]though OSHA is withdrawing the ETS as an enforceable emergency temporary standard, the agency is not withdrawing the ETS to the extent that it serves as a proposed rule.” In a statement on the withdrawal, the agency clarified it is “prioritizing its resources to focus on finalizing a permanent Covid-19 Healthcare Standard.”

HHS Distributes More Than $2 Billion in PRF Phase 4 Funding

HHS’ Health Resources and Services Administration (HRSA) this week is making more than $2 billion in Provider Relief Fund (PRF) Phase 4 general distribution payments to more than 7,600 healthcare providers nationwide.

These payments follow nearly $9 billion that HRSA released to providers last month. According to HRSA, a total of more than $11 billion in PRF Phase 4 payments have been distributed to more than 74,000 providers in all 50 states, Washington, D.C., and five territories.

HRSA clarified that these payments reflect “full processing of approximately 82 percent of Phase 4 applications. The remaining applications require additional review as part of the risk mitigation and cost containment safeguards previously outlined in the Phase 4 methodology”.

NABH and Other Behavioral Health Groups Send Letter to CMS about ‘No Surprises Act’ Rules

NABH and 10 other behavioral health organizations this week sent a letter to the Centers for Medicare & Medicaid Services (CMS) expressing concern that the agency’s No Surprises Act regulations will have a disproportionately negative effect on behavioral healthcare providers and add to their administrative burdens.

The No Surprises Act’s, signed into law in late 2020, requirements became effective this year. NABH and other groups have requested that CMS issue a stay on enforcement of the interim final rules (IFR) that affect routine mental and behavioral health services. If the agency insists on retaining the existing regulations, NABH and the other groups requested an exemption for behavioral healthcare providers.

“The duty to furnish a “Good Faith Estimate” (“GFE”) of costs outlined in Part 2 of the regulations imposes an undue administrative burden on our members,” the letter said. “Our providers have a long-standing practice of being transparent about fees with their patients because it is required by their professional ethics. Requiring clinicians to fill out the GFE form and update it every time there is a minor change in the treatment plan that may or may not have an impact on costs takes away from valuable treatment time – which is in extremely high demand as more and more people are struggling with the mental health impact of the COVID pandemic,” it continued. “Demand is already so high that many patients are finding it difficult to find a provider with enough availability to meet their needs.”

ONC Seeks Request for Information on EHR Standards for Prior Authorization and More

HHS’ Office of the National Coordinator (ONC) on Jan. 24, 2022, requested information about electronic health record standards for prior authorization, implementation specifications, and certification criteria for the ONC certification program to inform future rulemaking.
 
The request for information builds on a set of recommendations made in November 2020 from the HHS Intersection of Clinical and Administrative Data Task Force (ICAD) of the Health Information Technology Advisory Committee (HITAC). The task force is addressing methods for improving data interoperability across the health ecosystem.
 
“We support efforts that can serve to advance electronic prior authorization for patients, providers, and payers,” Mary Greene, M.D., director of CMS’ Office of Burden Reduction and Health Informatics, said in an announcement. “We look forward to reviewing the input received on this RFI and to exploring opportunities for alignment between future ONC policymaking and ongoing CMS initiatives on this critical topic.”

Click here to learn more about how to submit comments, which must be submitted by March 25.

CMS Releases Third Publication of T-MSIS-based Medicaid SUD Data Book

The percentage of Medicaid beneficiaries treated for a substance use disorder (SUD) who received any medication-assisted treatment increased by 7.8 percentage points to 31.6% in 2019 from 23.8% in 2018, according to CMS’ third publication of the Transformed Medicaid Statistical Information System (T-MSIS)-based Medicaid Substance Use Disorder (SUD) Data Book.

Required by the Substance Use–Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act (SUPPORT) that Congress passed in 2018, the resource is meant to help policymakers, researchers, and others better understand where to focus drug-prevention and treatment efforts.

The data book contains 2019 data on Medicaid beneficiaries treated for SUD, the services they received by both type and setting, delivery system, and progression of care.

Register Today for National Drug and Alcohol Facts Week: March 21-27, 2022

The National Institute on Drug Abuse (NIDA) invites organizations to participate in National Drug and Alcohol Facts Week (NDAFW), a national health observance meant to empower teens and young adults about making informed decisions about drugs, alcohol, and addiction.

NIDA has developed five steps to hosting a NDAFW event and created lessons plans and other materials for educators, counselors, and prevention specialists. Click here to learn how to register your organization’s event online

Reminder: NABH Denial-of-Care Portal is Open to Members

NABH’s Denial-of-Care Portal is available for members to provide information about their experiences with managed care organizations that impose barriers to care through insurance-claim denials.

NABH’s Managed Care Committee worked for more than a year to develop the Denial-of-Care Portal as a way to collect specific data on insurers who deny care—often without regard for parity or the effects on patients.

This NABH member-only, survey-like tool allows users to add the name of a managed care organization, type of plan, level of care, type of care (mental health or substance use disorder), duration of approved treatment, duration of unapproved treatment, criteria used to deny a claim, and more.

The portal allows members to submit individual examples of claim denials or upload multiple entries via Excel. It also includes sections on appeals and physician participation. In time, the tool could be a valuable resource for the NABH team’s advocacy efforts.

Please e-mail Emily Wilkins, NABH’s administrative coordinator, if you have questions about the portal.

Fact of the Week

A new study found that 62% of Americans surveyed prefer in-person mental health services.

For questions or comments about this CEO Update, please contact Jessica Zigmond.

HHS Announces $103 Million to Reduce Burnout and Promote Wellness in Healthcare Workforce

The U.S. Health and Human Services Department (HHS) this week announced it will award $103 million in American Rescue Plan funding for evidence-informed programs, practices, and training to retain healthcare workers, reduce burnout, and promote health and wellness among the nation’s healthcare workforce.

HHS’ Health Resources and Services Administration (HRSA) will disburse the funding to 45 grantees and focus especially on healthcare providers in underserved and rural communities, according to HHS.

“I have traveled to many health centers across the country and know that the Covid-19 pandemic has intensified issues that have long been a source of stress for frontline healthcare workers — from increased patient volumes to long working hours,” HHS Secretary Xavier Becerra said in an announcement. “This funding reflects the Biden-Harris administration’s commitment to ensuring we have enough critical frontline workers by supporting healthcare providers now and beyond as they face burnout and mental health challenges. We will continue to promote the well-being of those who have made so many sacrifices to keep others well.”

HRSA is awarding the funds through the following three programs: Promoting Resilience and Mental Health Among Health Professional Workforce, Health and Public Safety Workforce Resiliency Training Program, and Health and Public Safety Workforce Resiliency Technical Assistance Center. Click here to see the list of award recipients.

Also this week, the National Academy of Medicine released a Resource Compendium for Health Care Worker Well-Being, a collection that highlight tools and strategies to address healthcare worker burnout.

HHS Announces $13 Million to Improve Behavioral Healthcare Access in Rural America

HHS this week also announced it will award $13 million through HRSA to increase access to behavioral healthcare services in rural America, including through evidence-based, trauma-informed treatment for substance use disorder.

These funds, similar to the funds to address healthcare worker burnout and wellness, are available through last year’s American Rescue Plan.

“Our response to the Covid-19 pandemic must include meeting the behavioral health needs of individuals experiencing substance use disorder,” HRSA Administrator Carole Johnson said in an announcement. “In rural areas, accessing the care and services to address these needs can be a particular challenge,” she added. “The funding we are announcing today is directly targeted to the community needs of rural areas and will help expand access to behavioral health services to meet these needs.”

HRSA’s Federal Office of Rural Health Policy will make the awards available through the Rural Communities Opioid Response Program-Behavioral Health Care Support.

Interested applicants must apply by Tuesday, April 19 at 11:59 p.m. ET. Click here for more information.

CMS Seeks Comments on Time and Distance Standards for Network Adequacy in Marketplace Insurance Plans

The Centers for Medicare & Medicaid Services (CMS) is requesting comments on proposals that the agency made regarding specific standards for outpatient, clinical behavioral health providers, psychiatrists, and inpatient or residential behavioral health facilities among other provider types in qualified health plans offered in the federally qualified health insurance exchanges.

Earlier this month, CMS released its Qualified Health Plan Notice of Benefit and Payment Parameters proposed rule for 2023. In it, CMS proposed specific time and distance standards for measuring network adequacy in qualified health plans offered in federally facilitated exchanges. Federally facilitated exchanges are offered in Alabama, Alaska, Arizona, Delaware, Florida, Georgia, Hawaii, Illinois, Indiana, Kansas, Louisiana, Michigan, Mississippi, Missouri, Montana, Nebraska, New Hampshire, North Carolina, North Dakota, Ohio, Oklahoma, South Carolina, South Dakota, Tennessee, Texas, Utah, West Virginia, Wisconsin, and Wyoming.

The agency proposed time and distance standards for behavioral healthcare providers in a draft letter to issuers that clarifies specific provisions in the proposed rule. See pages 11 and 12 in the letter for proposed time and distance standards.

Please send any comments regarding these proposals to Kirsten Beronio, NABH’s director of policy and regulatory affairs, Director of Policy and Regulatory Affairs, before next Thursday, Jan. 27.

The Joint Commission Publishes Covid-19 Vaccination Requirement FAQs

The Joint Commission (TJC) has released a series of Covid-19 vaccination requirement resources and frequently asked questions (FAQs) for providers.

Beginning Jan. 27, TJC will start surveying to CMS’ Covid-19 vaccination healthcare staff vaccination interim final rule in all of the Commission’s applicable program surveys. As TJC noted in its announcement about the FAQs, “the CMS Covid-19 vaccination requirements apply to organizations that elect to use Joint Commission accreditation for deemed status purposes.”   

Register Today for National Drug and Alcohol Facts Week: March 21-27, 2022

The National Institute on Drug Abuse (NIDA) invites organizations to participate in National Drug and Alcohol Facts Week (NDAFW), a national health observance meant to empower teens and young adults about making informed decisions about drugs, alcohol, and addiction.

NIDA has developed five steps to hosting a NDAFW event and created lessons plans and other materials for educators, counselors, and prevention specialists. Click here to learn how to register your organization’s event online

Reminder: NABH Denial-of-Care Portal is Open to Members

NABH’s Denial-of-Care Portal is available for members to provide information about their experiences with managed care organizations that impose barriers to care through insurance-claim denials.

NABH’s Managed Care Committee worked for more than a year to develop the Denial-of-Care Portal as a way to collect specific data on insurers who deny care—often without regard for parity or the effects on patients.

This NABH member-only, survey-like tool allows users to add the name of a managed care organization, type of plan, level of care, type of care (mental health or substance use disorder), duration of approved treatment, duration of unapproved treatment, criteria used to deny a claim, and more.

The portal allows members to submit individual examples of claim denials or upload multiple entries via Excel. It also includes sections on appeals and physician participation. In time, the tool could be a valuable resource for the NABH team’s advocacy efforts.

Please e-mail Emily Wilkins, NABH’s administrative coordinator, if you have questions about the portal.

Fact of the Week

During 2015-2019, an estimated 10.6 million adults in the United States, or about 4.3% of the adult population, reported having had suicidal thoughts during the preceding year.

For questions or comments about this CEO Update, please contact Jessica Zigmond.

U.S. Supreme Court Allows Covid-19 Vaccine Mandate for Healthcare Workers

In a 5-4 vote Thursday, the U.S. Supreme Court ruled it will allow the Centers for Medicare & Medicaid Services’ (CMS) regulation to proceed that mandates the Covid-19 vaccine for about 10.3 million workers at approximately 76,000 healthcare facilities that accept money from the Medicare and Medicaid programs.

Chief Justice John Roberts and Justice Brett Kavanaugh joined the Court’s liberal justices in the majority decision. In its other ruling, the Court voted 6-3 to block the Occupational Safety and Health Administration’s (OSHA) vaccine-or-test mandate for large businesses.

CMS Administrator Chiquita Brooks-LaSure said in a statement that the agency is “extremely pleased” with the Court’s decision for healthcare workers and added that giving patients assurance of safe care is a critical responsibility for CMS.

“CMS is already implementing its healthcare worker vaccination rule in 25 states and territories that were not covered by preliminary injunctions,” Brooks-LaSure continued in her Jan. 13 statement. “Today’s decision will enable us to fully implement this rule, and we look forward to working with healthcare providers and their workers to protect patients,” she continued. “We will continue our extensive outreach and assistance efforts encouraging individuals working in healthcare to get vaccinated.”

As a result of Thursday’s decision, healthcare providers subject to the Omnibus Health Care Staff Vaccination rule in the 24 states (Alabama, Alaska, Arizona, Arkansas, Georgia, Idaho, Indiana, Iowa, Kansas, Kentucky, Louisiana, Mississippi, Missouri, Montana, Nebraska, New Hampshire, North Dakota, Ohio, Oklahoma, South Carolina, South Dakota, Utah, West Virginia, and Wyoming) covered by this decision will now need to establish plans and procedures to ensure their staff are vaccinated.

CMS also said the decision does not affect compliance timelines for providers in the District of Columbia, the territories, and the 25 states where the preliminary injunction was previously lifted. CMS released guidance about this on Dec. 28, 2021.

Becerra Extends Covid Public Health Emergency for 90 Days

HHS Secretary Xavier Becerra has extended the Covid-19 public health emergency (PHE) for an additional 90 days, effective Jan. 16.

Former HHS Secretary Alex Azar made the original determination on Jan. 31, 2020. Azar renewed the Covid-19 PHE four times, and this recent determination is the fourth time Becerra has renewed it.

SAMHSA and Partner Groups Launch National Survey of Mobile Crisis Teams

The Substance Abuse and Mental Health Services Administration (SAMHSA) has partnered with other groups to launch a survey that will gather information about mobile crisis teams (MCTs) across the United States.

SAMHSA, along with organizations including the National Association of State Mental Health Program Directors and Vibrant Emotional Health (formerly the Mental Health Association of New York City) has released the survey to better understand the organization, operation, and financing of MCTs.

The organizations encourage all mobile crisis, co-responder, and other field-based mental health crisis response teams to complete the 10-minute survey by Tuesday, Feb. 28 and to share the survey widely.

CMS Requests Information on Behavioral Health Networks Within Medicare Advantage Plans

CMS on Wednesday published a proposed rule that includes a request for information about how to improve behavioral health networks within Medicare Advantage (MA) health plans.

NABH will develop a response to the regulation and welcomes comments from NABH members.
Although all comments are welcome, CMS asked specifically for  comments related to the following topics:

• Challenges for behavioral healthcare providers to establish contracts with MA health plans;

• Providers’ inability or unwillingness to contract with MA plans, including issues related to provider reimbursement; and

• Opportunities to expand services for the treatment of opioid addiction and substance use disorders.

Please send comments to Kirsten Beronio, NABH’s director of policy and regulatory affairs. Public comments are due March 7.

GAO Offers Recommendations to Improve State Opioid Response Grant Program Assessment

In its recent review of SAMHSA’s State Opioid Response (SOR) grant program, the Government Accountability Office (GAO) concluded that SAMHSA did not fully leverage available information to adequately assess the program, and that the agency did not identify the program’s potential limitations.

The GAO noted that SAMHSA assesses the SOR grant program through two annual performance reports, and it recommended that SAMHSA make those reports more useful by first identifying potential limitations and how those limitations may affect the conclusions that can and cannot be drawn; and second by further analyzing existing program information to provide a more comprehensive, in-depth assessment of the program to identify opportunities for improvement.

Register Today for National Drug and Alcohol Facts Week: March 21-27, 2022

The National Institute on Drug Abuse (NIDA) invites organizations to participate in National Drug and Alcohol Facts Week (NDAFW), a national health observance meant to empower teens and young adults about making informed decisions about drugs, alcohol, and addiction.

NIDA has developed five steps to hosting a NDAFW event and created lessons plans and other materials for educators, counselors, and prevention specialists. Click here to learn how to register your organization’s event online.

Reminder: NABH Denial-of-Care Portal is Open to Members

NABH’s Denial-of-Care Portal is available for members to provide information about their experiences with managed care organizations that impose barriers to care through insurance-claim denials.

NABH’s Managed Care Committee worked for more than a year to develop the Denial-of-Care Portal as a way to collect specific data on insurers who deny care—often without regard for parity or the effects on patients.

This NABH member-only, survey-like tool allows users to add the name of a managed care organization, type of plan, level of care, type of care (mental health or substance use disorder), duration of approved treatment, duration of unapproved treatment, criteria used to deny a claim, and more.

The portal allows members to submit individual examples of claim denials or upload multiple entries via Excel. It also includes sections on appeals and physician participation. In time, the tool could be a valuable resource for the NABH team’s advocacy efforts.

Please e-mail Emily Wilkins, NABH’s administrative coordinator, if you have questions about the portal.

Fact of the Week

A new analysis in the JAMA Network Open found there were 10,292 fatal overdoses among people over the age of 55 in 2019, compared with 518 overdoses in the same age group in 1999. The study examined disparities by sex, race, and ethnicity in death rates due to opioid overdose during this time period.

For questions or comments about this CEO Update, please contact Jessica Zigmond.

CMS Issues Guidance on Covid-19 Vaccination Requirements for Most Medicare- and Medicaid-Certified Providers

The Centers for Medicare & Medicaid Services (CMS) on Dec. 29 issued guidance regarding the Interim Final Rule (IFR) regarding Covid-19 vaccination requirements for healthcare staff that the agency published in early November.

In the Dec, 29 memo, CMS specified that this guidance does not apply to the following states that are still subject to preliminary injunctions that federal courts issued to block implementation of the IFR in those states: Alabama, Alaska, Arizona, Arkansas, Georgia, Idaho, Indiana, Iowa, Kansas, Kentucky, Louisiana, Mississippi, Missouri, Montana, Nebraska, New Hampshire, North Dakota, Ohio, Oklahoma, South Carolina, South Dakota, Texas, Utah, West Virginia, and Wyoming.

To learn more, please read the NABH Issue Brief that NABH sent to members this week.

OSHA Withdraws Non-Recordkeeping Portions of Covid-19 Healthcare ETS

The U.S. Labor Department’s Occupational Safety and Health Administration (OSHA) last week said it is withdrawing the non-recordkeeping portion of the Covid-19 healthcare emergency temporary standard (ETS) that it adopted last June.

Separate from a Covid-19 vaccine mandate, the healthcare ETS required that employers provide personal protective equipment, physical barriers, and ventilation, and also require screening of each individual who enters the facility. The temporary standard also provided paid leave to workers who must quarantine due to infections or exposure.

“OSHA announces today that it intends to continue to work expeditiously to issue a final standard that will protect healthcare workers from COVID-19 hazards and will do so as it also considers its broader infectious disease rulemaking,” OSHA’s announcement said on Dec. 27. “However, given that OSHA anticipates a final rule cannot be completed in a timeframe approaching the one contemplated by the OSH Act, OSHA also announces today that it is withdrawing the non-recordkeeping portions of the healthcare ETS.

HHS’ Provider Relief Fund Reporting Portal for Reporting Period #2 Open Through March 31

HHS’ Health Resources and Services Administration (HRSA) announced the Provider Relief Fund (PRF) Reporting Portal for Reporting Period 2 (RP2) opened on Jan. 1 and will remain open through March 31, 2022.

According to HRSA’s announcement, healthcare providers who received one or more general and/or targeted PRF payments exceeding $10,000, in the aggregate, from July 1, 2020 to Dec. 31, 2020 must report on their use of funds during RP2.

In addition, HRSA created a stakeholder toolkit with content to share information about RP2 within organizations and networks. The agency has also developed the following resources for providers: What’s New in Reporting Period 2 Fact Sheet, Lost Revenues Guide, and a webpage for reporting on nursing home and infection control payments.

To learn more, register for either of HRSA’s upcoming webinars: one for new reporting entities on Jan. 12 at 3 p.m. ET and one for returning reporting entities on Jan. 13 at 3 p.m. ET.

SAMHSA Invests $282 Million to Implement 988 Behavioral Health Crisis Hotline

The Substance Abuse and Mental Health Services Administration (SAMHSA) announced it has invested $282 million in American Rescue Plan funding to help transition the current National Suicide Prevention Lifeline to the 988 three-digit dialing code from its current 10-digit number.

Congress designated the new 988 dialing code in 2020 to operate through the existing National Suicide Prevention Lifeline. The new code will be available national for calls, texts, and chats, beginning in July 2022.

According to SAMHSA, it has allotted $177 million to strengthen and expand the existing Lifeline network operations and infrastructure, including chat and text response, backup center capacity, and special services, such as a sub-network for Spanish language-speakers. The agency has invested $105 million to develop staffing across states’ local crisis call centers. SAMHSA is recruiting for a director for the crisis coordination office.

California’s Medicaid Program Receives CMS Approval to Implement Contingency Management

California Medi-Cal, the state’s Medicaid program, has received approval from the Centers for Medicaid & Medicare Services (CMS) to implement contingency management (CM) through a Section 1115 waiver.

Several insurance companies are financing CM, an evidence-based intervention for stimulant use disorders, and some states have engaged in pilot programs for the practice. CMS’ approval of the California CM pilot represents the first time the treatment intervention has been approved formally as a benefit in a Medicaid program.

While there is substantial research supporting the efficacy of CM, implementation has lagged for decades due to an Office of Inspector General opinion that raised concerns about fraud and abuse.

OSHA Publishes Workplace Violence Prevention Standard Fact Sheet

OSHA has announced it will convene a Small Business Advocacy Review (SBAR) panel of small entity representatives early this year to help OSHA in its work to develop a potential Prevention of Workplace Violence in Healthcare and Social Assistance standard.

In the meantime, OSHA has published a fact sheet that describes who might be covered by a new workplace violence prevention standard, why OSHA is considering the standard, what the standard might include, what a small entity representative would do, and how small businesses and local government entities can participate.

NIMH to Host Webinar on School-based Suicide Prevention on Jan. 14

The National Institute of Mental Health (NIMH) will host a webinar next week about new practices in school-based suicide prevention for school administrators, researchers, practitioners, policymakers, and other stakeholders.

The presentation will focus on identifying and supporting high-risk youth, as well as opportunities to evaluate these efforts.

NIMH will host the webinar next Friday, Jan. 14 from 2 p.m. to 3:30 p.m. ET. Click here to register.

Reminder: NABH Denial-of-Care Portal is Open to Members

NABH’s Denial-of-Care Portal is available for members to provide information about their experiences with managed care organizations that impose barriers to care through insurance-claim denials.

NABH’s Managed Care Committee worked for more than a year to develop the Denial-of-Care Portal as a way to collect specific data on insurers who deny care—often without regard for parity or the effects on patients.

This NABH member-only, survey-like tool allows users to add the name of a managed care organization, type of plan, level of care, type of care (mental health or substance use disorder), duration of approved treatment, duration of unapproved treatment, criteria used to deny a claim, and more.

The portal allows members to submit individual examples of claim denials or upload multiple entries via Excel. It also includes sections on appeals and physician participation. In time, the tool could be a valuable resource for the NABH team’s advocacy efforts.

Please e-mail Emily Wilkins, NABH’s administrative coordinator, if you have questions about the portal.

Fact of the Week

A meta-analysis of 21 studies that analyzed interventions in prisons to address the needs of people with co-occurring serious mental illness and substance use disorders generally showed decreases in substance use and lower odds of committing a substance use-related offense after reentry into the community for those who were in a treatment program compared with those who were not, according to research published in Psychiatric Services.

For questions or comments about this CEO Update, please contact Jessica Zigmond.