Miriam Delphin-Rittmon Sworn in As Assistant Secretary for Mental Health and Substance Use

The Substance Abuse and Mental Health Services Administration (SAMHSA) announced that Miriam Delphin-Rittmon, Ph.D., former commissioner of the Connecticut Department of Mental Health and Addiction Services, is the new assistant secretary for mental health and substance use and agency’s administrator.

In May 2014, Delphin-Rittmon completed a two-year White House appointment working as a senior adviser to the then-assistant secretary for mental health and substance use and SAMHSA administrator.

“Miriam’s experience in creating and administering mental health, substance use, and prevention services and systems will serve the nation well as we work to tackle the impact of the pandemic on behavioral health,” HHS Secretary Xavier Becerra said in a statement. “On top of that, her strong leadership at federal, state and local levels offers her considerable perspective,” he added.

Delphin-Rittmon earned her bachelor’s degree in social science from Hofstra University in 1989, and her master and doctoral degrees in clinical psychology from Purdue in 1992 and 2001, respectively. Click here to read her full biography.

Experts Provide Advice and Templates on Writing a Medical Necessity Letter

Authors with medical, legal, public policy, and personal experience have published advice in the Journal of Psychiatric Practice on how to provide a routine, medical necessity letter as a way to improve access to care.

Mark DeBofsky, M.D., Joseph Feldman, M.B.A., NABH member Eric Plakun, M.D., and Cheryl Potts, M.B.A. authored the eight-page article, which also includes a template letter for providers.

JAMA Psychiatry Publishes Study on Contingency Management for Patients Receiving Medication for OUD

JAMA Psychiatry this week published a study of the results from an investigation of contingency management for patients who receive medication for opioid use disorder (MOUD).

The purpose of the study was to examine the association of contingency management, a behavioral intervention in which patients receive material incentives contingent on objectively verified behavior change, with end-of-treatment outcomes related to stimulant use, polysubstance use, illicit opioid use, cigarette smoking, therapy attendance, and medication adherence

The study’s authors noted that the results provide evidence that supports using contingency management in addressing key clinical problems among patients receiving MOUD, including the ongoing problems of comorbid psychomotor stimulant misuse. The study importantly notes that a) CM is most effective with higher earnings potential, confirming that the level of financial incentives are critical to the success of the intervention; b) cases of Medicaid fraud have never been found involving CM; and c) targeting too many drugs simultaneously decreases the effect size, although the effect remains statistically significant.

“Policies facilitating integration of contingency management into community MOUD services are sorely needed,” the authors wrote.

CMS to Host Webinar on Price Transparency on Wednesday, Aug. 11 

CMS will host a Medicare National Stakeholder Webinar on Price Transparency next week to discuss how hospitals can meet the requirements of the Hospital Price Transparency Final Rule that became effective on Jan. 1, 2021.

As a result of the rule, U.S. hospitals are required to 1) provide publicly accessible standard charge information online about the items and services with a comprehensive machine-readable file with all items and services, and 2) a display of 300 shoppable services in a consumer-friendly format.

The agency will review the document “8 Steps to a Machine-Readable File of All Items & Services” and highlight both good and bad examples of hospital compliance.

CMS will host the webinar on Wednesday, Aug. 11 from 2 p.m. to 3:30 p.m. ET. Click here to register.

SAMHSA to Host Virtual Roundtable about Creating a Diverse Behavioral Health Workforce on Aug. 18 

SAMHSA’s National Network to Eliminate Disparities in Behavioral Health will host a virtual roundtable later this month to discuss strategies that motivate racially and ethnically diverse individuals to consider behavioral healthcare as a career path.

The event will address how community-based organizations are working to diversify the behavioral health workforce, such as recruiting and retaining a racially and ethnically diverse staff.

SAMHSA will host the virtual roundtable on Wednesday, Aug. 18 at 1 p.m. ET. Click here to learn more and register.

Joint Commission to Start 11-part Behavioral Healthcare Accreditation Webinar Series on Aug. 28 

The Joint Commission will present an 11-part Behavioral Healthcare and Human Services Accreditation Webinar Series to help providers prepare their staffs to maintain compliance.

Session topics include information management, medication management, infection prevention and control, patient safety, environment of care, and more. The Joint Commission will present the series—which will be made available Aug. 28—on demand so that organization teams can view the webinars when it’s convenient for them.

Click here to learn more, including information about special healthcare system discounts.

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

NABH’s Denial-of-Care Portal is a new resource 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.

Register Today for the NABH 2021 Annual Meeting!

Registration is open for the NABH 2021 Annual Meeting from Wednesday, Oct. 6 – Friday, Oct. 8, 2021 at the Mandarin Oriental Washington, DC.

We hope you join us as we recognize our meeting theme, Expanding Access: Right Care. Right Setting. Right Time.

Please visit our Annual Meeting webpage to register for the meeting and to reserve your hotel room. We look forward to seeing you in Washington!

Fact of the Week

In 2019, 22.1% of U.S. adults with chronic pain used a prescription opioid in the past three months, according to a new report from the Centers for Disease Control and Prevention.
 
For questions or comments about this CEO Update, please contact Jessica Zigmond.

CMS to Raise IPF PPS Payment Rates by 2% in 2022

The Centers for Medicare & Medicaid Services (CMS) said it will update payment rates for IPFs by 2.0% next year in the fiscal year (FY) 2022 Inpatient Psychiatric Facility Prospective Payment System (IPF PPS) final rule the agency released Thursday.

The calculation is based on the final IPF market basket estimate of 2.7% less a 0.7 percentage point productivity adjustment. CMS said it will also update the outlier threshold to maintain outlier payments at 2% of total payments, which will result in a 0.1% overall increase to aggregate payments.

CMS said it estimates total payments to IPFs to increase by 2.1%, or about $80 million, in 2022 compared with payments in 2021.

The final rule also made updates to the Inpatient Psychiatric Facility Quality Reporting Program (IPF QRP), including a final proposal to adopt the Covid-19 Vaccination Coverage Among Healthcare Personnel (HCP) measure to the IPF QRP for the FY 2023 payment determination. The Centers for Disease Control and Prevention (CDC) developed the process measure to track Covid-19 vaccination coverage among HCP in IPFs. The measure will be reported using the Covid-19 Modules on the CDC’s National Healthcare Safety Network web portal.

In addition, the final rule said that for the FY 2024 payment determination, CMS is finalizing its proposal to adopt the Follow-up After Psychiatric Hospitalization (FAPH) measure to the IPF QRP. This measure uses an expanded cohort based on the Follow-up After Hospitalization for Mental Illness (FUH) measure—which is currently in the IPF QRP—to include patients with substance use disorders.

The final rule also said CMS is not finalizing removal of the Alcohol Use Brief Intervention Provided or Offered and Alcohol Use Brief Intervention (SUB-2/2a) measure or the Tobacco Use Treatment Provided or Offered and Tobacco Use Treatment (TOB-2/2a) measure. This was a response to public comments that indicated these measures still provide benefits that outweigh the costs of retaining them in the IPF QRP measure set.

More information is available in the agency’s fact sheet, and the final rule will be published in the Federal Register on Wednesday, Aug. 4.

NABH and Other Advocacy Groups Urge Congress to Invest in Children’s Mental Health

NABH and more than two dozen other advocacy organizations sent a letter to Senate leaders this week urging federal lawmakers to invest more funding in children’s mental health.

The letter recommended that Congress strengthen Medicaid; extend and preserve telehealth flexibilities; strengthen systems of care through better coordination and integration; invest in infrastructure to promote care in the appropriate setting; and support growing the pediatric mental health workforce.

The Children’s Hospital Association spearheaded the letter, and other organizations that signed on include the American Academy of Family Medicine, the American Academy of Pediatrics, the American Hospital Association, the American Association of Medical Colleges, Mental Health America, and the National Alliance on Mental Illness.

CMS to Host Webinar on Price Transparency on Wednesday, Aug. 11

CMS will host a Medicare National Stakeholder Webinar on Price Transparency to discuss how hospitals can meet the requirements of the Hospital Price Transparency Final Rule that became effective on Jan. 1, 2021.

As a result of the rule, U.S. hospitals are required to 1) provide publicly accessible standard charge information online about the items and services with a comprehensive machine-readable file with all items and services, and 2) a display of 300 shoppable services in a consumer-friendly format.

The agency will review the document “8 Steps to a Machine-Readable File of All Items & Services” and highlight both good and bad examples of hospital compliance.

CMS will host the webinar on Wednesday, Aug. 11 from 2 p.m. to 3:30 p.m. ET. Click here to register.

SAMHSA Resource Summarizes How States Regulate Underage Drinking 

The Substance Abuse and Mental Health Resources Administration (SAMHSA) has released Learn the Law: How Does Your State Prevent Underage Drinking?, a new publication that includes 24 legal policy summaries to help people track how states regulate underage drinking as a way to help inform prevention work.

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

NABH’s Denial-of-Care Portal is a new resource 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.

Register Today for the NABH 2021 Annual Meeting!

Registration is open for the NABH 2021 Annual Meeting from Wednesday, Oct. 6 – Friday, Oct. 8, 2021 at the Mandarin Oriental Washington, DC.

We hope you join us as we recognize our meeting theme, Expanding Access: Right Care. Right Setting. Right Time.

Please visit our Annual Meeting webpage to register for the meeting and to reserve your hotel room. We look forward to seeing you in Washington!

Fact of the Week

Regardless of the primary medical risk factors for severe Covid-19, patients with mental illness were more likely to die of Covid-19 than their peers, according to new research consisting of 16 observational studies from seven countries that involved more than 19,000 patients.
 
For questions or comments about this CEO Update, please contact Jessica Zigmond.

CMS Accepting Grant Applications for SUPPORT Act Demonstration Project

The Centers for Medicare & Medicaid Services (CMS) on Friday released a notice of funding opportunity to solicit applications for the Substance Use Disorder Prevention that Promotes Opioid Recovery and Treatment Act (SUPPORT) 36-month demonstration project.

Open only to the 15 states receiving planning grants, the demonstration project is intended to increase treatment capacity of Medicaid-participating providers to provide substance use disorder (SUD) treatment and recovery services.

CMS also released a technical supplement that provides information about how the agency will implement the SUPPORT Act payment provision for those states selected for the demonstration.

The agency will host an informational webinar for applicants on Thursday, July 29 (and will provide information on that later) and is expected to issue awards on Sept. 10. The period of performance is between September 2021 and September 2024.

Survey Shows 84% of Americans Want to Continue Receiving Mental Health Treatment via Telehealth After Pandemic

A recent online survey of more than 1,000 Americans shows that 74% of respondents said their provider made virtual mental health services available during the Covid-19 pandemic, while 84% said they want to continue receiving mental health treatment via telehealth services after the pandemic ends.

Market research company Propeller Insights conducted the survey on behalf of DrFirst, which published a survey last October that found 44% of Americans used telehealth services during the pandemic, although some admitted they multitasked and did not pay close attention during their appointments.

In the May 2021 survey, 68% of respondents said the pandemic had worsened their mental health, while 17% said they sought mental health assistance for the first time.

NABH Sends Comments to ONDCP on National Drug Control Strategy

NABH this week provided a series of recommendations to the Office of National Drug Control Policy (ONDCP) on the office’s biennial National Drug Control Strategy.

In a letter to Regina LaBelle, ONDCP’s acting director, NABH offered detail suggestions related to telehealth and the Covid-19 pandemic, Medicare and Medicaid, contingency management, workforce management, and medication assisted treatment (MAT).

“The Centers for Medicare & Medicaid Services (CMS) should review Medicare, Medicare Advantage, and Qualified Health Plan reimbursement levels and strategies for substance use treatment services (for telehealth and non-telehealth services alike) to bring reimbursement for addiction providers to levels that are more consistent with their education, credentialing, and medical peers,” NABH President and CEO Shawn Coughlin wrote, adding later that Medicare should cover all intermediate levels of care for addiction treatment (e.g., freestanding intensive outpatient, partial hospitalization, residential) for substance use disorders and reimburse facility fees; collaborate with stakeholders to establish new conditions of participation.

Other suggestions include recommending that all workforce data collection and reporting efforts at the U.S. Labor Department separate substance use from mental health providers and services, and that the U.S. Justice Department assure individuals with a substance use disorder have access to all forms of MAT while in jail and prison.

NABH Asks OSHA to Delay ETS Compliance Deadline

NABH on July 1 sent a letter to the U.S. Labor Department’s Occupational Safety and Health Administration (OSHA) requesting that the agency delay the compliance deadline for its workplace safety rule.

Last month OSHA released the rule, known as the Covid-19 Health Care Emergency Temporary Standard (ETS), to protect workers from exposure to the virus that causes Covid-19. Essential requirements of the ETS include, but are not limited to: developing and implementing a plan for each workplace; designating workplace safety coordinator(s), knowledgeable in infection control principles and practices, with the authority to implement, monitor, and ensure compliance with the plan; conducting a workplace-specific hazard assessment; and seeking the involvement of nonmanagerial employees and their representatives in the hazard assessment and plan’s development and implementation.

“The new Covid-19 ETS final rule is long and complex,” NABH President and CEO Shawn Coughlin wrote in the association’s letter to James Frederick, acting assistant secretary of labor at OSHA. “It establishes many very specific requirements related to patient screenings, personal protective equipment, physical barriers, cleaning and disinfection, ventilation, vaccination, training, recordkeeping, reporting, etc. These provisions will likely require significant changes in the policies and procedures healthcare providers have already implemented to prevent Covid-19 infection.”

The letter also said it’s important to consider the effects of the new requirements in the context of the challenges behavioral healthcare providers are currently facing. “Mental health and addiction treatment providers continue to experience increased need for their services as indicated by the dramatic increase in drug overdose deaths over the past year and continued elevated levels of anxiety and depression and suicidal ideation,” the letter said, adding that emergency department visits for mental health reasons were up 31% among children and adolescents earlier this year, and suspected suicide attempts were up 51% among teenage girls.

NABH requested that OSHA delay the compliance deadline for the ETS—which became effective immediately when it was published in the Federal Register on June 17— for at least an additional six months.

SAMHSA to Host Third Webinar on Future of Telehealth Services in Drug Courts on July 21

The Substance Abuse and Mental Health Services Administration (SAMHSA) will host the final installment of its virtual learning community series on the future of telehealth services in drug courts on Wednesday, July 21.

This last part of this three-part series will provide guidance on what to consider when delivering treatment court services in virtual formats, including both court proceedings and treatment services. The webinar will also feature a brief review of essential services elements, policies, and procedures necessary to support effective delivery, as well as strategies for ongoing quality assurance and ideas on how to track appropriate outcomes.

The webinar will be held on Wednesday, July 21 at 1 p.m. ET, and a discussion segment will follow at 2 p.m. ET. Click here to register.

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

NABH’s Denial-of-Care Portal is a new resource 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.

Register Today for the NABH 2021 Annual Meeting!

Registration is open for the NABH 2021 Annual Meeting from Wednesday, Oct. 6 – Friday, Oct. 8, 2021 at the Mandarin Oriental Washington, DC.

We hope you join us as we recognize our meeting theme, Expanding Access: Right Care. Right Setting. Right Time.

Please visit our Annual Meeting webpage to register for the meeting and to reserve your hotel room. We look forward to seeing you in Washington!

Fact of the Week

A new study in JAMA Psychiatry found that of the 14.1 million adults reported having alcohol use disorder (AUD), only 7.3% reported receiving any AUD treatment, and an even smaller percentage—1.6%–reported using medications for AUD.