CMS Expects FY 2021 IPF Payments to Increase by 2.4%

The Centers for Medicare & Medicaid Services (CMS) on April 10 said it expects payments to inpatient psychiatric facilities to increase by 2.4% in fiscal year 2021, boosting the federal per diem base rate to $817.59 from $798.55.

An announcement about CMS’ proposed inpatient psychiatric facility prospective payment system (IPF-PPS) rule said the agency estimates total IPF payments to increase by $100 million next year. The rule was published in the Federal Register on Tuesday, April 14.

 According to the proposed rule, CMS will adopt the Office of Management and Budget guidelines regarding geographic delineation of statistical areas, which CMS said should result in wage index values better representing the actual labor costs in a given area.

“CMS is proposing that all IPF providers negatively impacted in their wage index, regardless of the circumstance causing the decline, be capped at a 5-percent decrease for FY 2021,” the announcement said. Table 6 at the start of page 57 in the proposed rule shows changes in 2021 from 2020 for different facility types.

The agency said it is not making changes to the IPF Quality Reporting Program.

NABH is analyzing the proposed rule and will submit comments by the June 9 deadline.

HHS Opens CARES Act Emergency Fund Attestation Portal

HHS has opened its Coronavirus Aid, Relief, and Economic Security (CARES) Act emergency fund attestation portal for healthcare providers who receive funds from the $100 billion Public Health and Social Services Emergency Fund within 30 days of receipt to attest that they received the funds and agree to payment terms and conditions.

HHS began distributing the first $30 billion from the fund on April 10 to reimburse providers for healthcare-related expenses and lost revenue related to Covid-19.

New Coalition Launches Initiative to Match PPE Donors with Hospitals

A coalition of organizations including the American Hospital Association (AHA), Kaiser Permanente, UPS, and Microsoft has launched the Protecting People Everywhere initiative to support a national exchange that matches personal protective equipment (PPE) donors with the hospitals in greatest need.

Powered by the HealthEquip™ app, the initiative is meant to ensure these critical supplies are distributed equitably. Click here to learn more.

NABH Sends Urgent OTP Requests to HHS and SAMHSA

NABH this week asked HHS and the Substance Abuse and Mental Health Services Administration (SAMHSA) to make changes in telehealth service delivery and payment rates for opioid treatment programs (OTPs) during Covid-19.

In a letter to HHS Secretary Alex Azar and SAMHSA Administrator Elinore McCance-Katz, M.D., Ph. D., NABH requested that the Trump administration support an NABH-proposed telehealth service-delivery model for new patients that addresses SAMHSA’s clinical concerns while also protecting patients and physicians.

The letter also asked the federal health officials to support OTP providers at a standardized rate during the pandemic period to mitigate the loss in revenue and increase in expenditures for OTPs during Covid-19.

Click here to read the letter, which is posted on NABH’s Covid-19 resources page.

AHA to Host Behavioral Health Webinar Featuring Sheppard Pratt Leaders Next Week

The AHA will host a webinar about behavioral health challenges during Covid-19 on Wednesday, April 22 featuring senior leaders from NABH member Sheppard Pratt Health System.

Harsh Trivedi, M.D., M.B.A., an NABH board member and an AHA trustee, along with Sheppard Pratt’s chief medical officer, chief nursing officer, and chief strategy officer, will discuss how the system re-engineered care processes and developed new care protocols for agitated patients during the pandemic. The team will also discuss the system’s efforts to support staff and build resistance during the national emergency.

The hourlong webinar will begin at 2 p.m. ET. Click here to register.

O’Neill Institute Covid-19 and Addiction Policy Webinar Includes Pinnacle Treatment Centers CEO

The O’Neil Institute for National and Global Health Law at Georgetown last week hosted a webinar on Covid-19 and addiction policy that featured Joe Pritchard, CEO of NABH member Pinnacle Treatment Centers and a member of NABH’s Addiction Treatment Committee.

Panelists discussed the current state of access to treatment and harm reduction services for people with substance use disorders. Topics included recently waived federal regulations related to medications and telehealth, as well as the availability of harm reduction and recovery support services.

Fact of the Week

Between 1999 and 2018, suicide rates were lowest among females aged 10-14. The rate for this age group increased to 2.0 in 2018 from 0.5 in 1999.

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

President Trump Signs $2 Trillion Stimulus Bill to Address Covid-19 Pandemic

President Trump on Friday signed a $2 trillion stimulus package to address the Covid-19 pandemic’s devastating effects on the nation.

Earlier Friday, the House passed the Senate-approved Coronavirus Aid, Relief, and Economic Security Act (CARES), which includes several provisions to address costs and other burdens on healthcare providers related to Covid-19—and improve access for mental health and substance use disorder treatment.

The legislation includes tax rebates, expanded unemployment benefits, tax relief provisions, and grants focused on financially supporting individuals, families, businesses, and states. It also includes $100 billion for healthcare providers who provide care for individuals who may have or are diagnosed with Covid-19. These funds can be used for expenses or lost revenues that are attributable to the coronavirus. This funding is allocated to the Public Health and Social Services Emergency Fund that HHS’ Office of the Secretary manages.

Here are other key provisions from the CARES Act for behavioral healthcare providers:

• $16 billion is included for the Strategic National Stockpile for personal protective equipment and other medical supplies for federal and state response efforts.

• $3.5 billion is included for childcare with a clarification that states can use these funds to provide childcare for healthcare workers, including those who may not ordinarily qualify for services at federally funded sites.

• $425 million to the Substance Abuse and Mental Health Services Administration (SAMHSA), including:

• $250 million for the Certified Community Behavioral Health Center (CCBHC) grant program;

• $50 million for suicide prevention programs; and

• $100 million for emergency response grants—flexible funding to address mental health, substance use disorders and provide resources and support to local communities.

• Extends original CCBHC demonstration program funding for participating sites through November 2020 and directs HHS to select two additional states to include in the demo.

• Additional flexibility for Medicare to cover telehealth—eliminating the limitation on telehealth coverage to providers that had treated the patient in the last three years. Lifting this restriction will enable beneficiaries to access services via telehealth from a broader range of providers.

• Improved care coordination for patients with substance use disorders. This provision allows patients to consent to their records being shared for healthcare treatment, payment, and operations in accordance with the privacy requirements established through the Health Insurance Portability and Accountability Act (HIPAA). Patients will still be able to restrict disclosure by withholding consent, and the legislation contains anti-discrimination provisions and restrictions on law enforcement use of the records.

The NABH team will continue to analyze the bill and advocate for several unresolved behavioral healthcare issues, such as ensuring that providers have access to the emergency funds as soon as possible; repealing the Institutions for Mental Diseases (IMD) exclusion in Medicaid and 190-day lifetime limit in Medicare to allow psychiatric hospitals to serve patients who have been displaced from other healthcare settings; and continuing to request guidance on telehealth related to IOP and PHP settings, EMTALA waivers, staffing ratios, and OTP services.

Please visit NABH’s Covid-19 resources page for guidance and links, and be sure to follow us on Twitter @NABHBehavioral and on LinkedIn to learn best practices from fellow NABH members during the pandemic.

NABH and APA to Host Joint Webinar on Addressing Covid-19 in Multiple Settings

NABH and the American Psychiatric Association (APA) will host a joint webinar on Wednesday, April 1 that features experts working in inpatient, residential, and other non-ambulatory care settings who will discuss how they are assessing the current environment and developing new protocols to care for their patients during the Covid-19 pandemic.

NABH Board members Frank Ghinassi, Ph.D., A.B.P.P., CEO at Rutgers University Behavioral Health Care, and Harsh Trivedi, M.D., M.B.A., president and CEO of Sheppard Pratt Health System, are among the presenters.

The webinar will highlight types of services, key messages to share with team leaders, unique challenges for people with serious mental illness, how to handle group therapy, and more. It will include a live chat session for audience members to submit questions during the webinar. A recording will be available after the event.

The hourlong webinar next week will begin at 2 p.m. ET. Click here to register.

Mental Health Liaison Group Urges Policymakers to Broaden Telehealth Services

NABH joined other members of the Mental Health Liaison Group (MHLG) in urging House and Senate leaders to temporarily lift telebehavioral health restrictions during the Covid-19 pandemic.

“Given the orders from local, city, state, and national leaders for communities to shelter in place, the Centers for Medicare and Medicaid Services have broadened access to telehealth services and established payment parity under a temporary and emergency basis under the 1135 waiver authority and Coronavirus Preparedness and Response Supplemental Appropriations Act,” the MHLG wrote in its March 25 letter to Senate Majority Leader Mitch McConnell (R-Ky.) and House Speaker Nancy Pelosi (D-Calif.) “We applaud this decision to expand telehealth coverage for Medicare beneficiaries and strongly urge states to follow suit,” it continued. “We request states to temporarily lift restrictions on telebehavioral health at all levels of care by telephone or video for individuals regardless of insurance plan and ensure payment parity until the conclusion of this national emergency.”

Kaiser Family Foundation Releases Medicaid Emergency Authority Tracker

The Kaiser Family Foundation this week released a Medicaid Emergency Authority Tracker that aggregates information on approved Medicaid emergency authorities to address the Covid-19 pandemic.

The page noted that it currently includes details about section 1135 waivers and 1915 (c) waiver appendix K strategies and will later add other emergency authorities.

NABH has posted the tracker on the Covid-19 resources page.

Fact of the Week

As a result of the Covid-19 pandemic, states may request blanket exceptions for all stable patients in an opioid treatment program to receive 28 days of take-home doses of the patient’s medication for opioid use disorder.

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