Alerts

Friday, the U.S. Department of Health and Human Services (HHS), announced that it is extending the application deadline for Medicaid and CHIP Provider Relief Fund distribution from today July 20, 2020 to August 3, 2020.

In June, HHS announced plans to distribute approximately $15 billion to eligible providers that participate in state Medicaid and CHIP programs who had not yet received a payment from earlier distributions from the Provider Relief Fund.

This HHS fact sheet explains the application process.

In addition, HHS is holding focus groups tomorrow and Wednesday to identify opportunities to increase application volumes in the current Medicaid/CHIP distribution. The focus group discussion will center on three topics-

1. Awareness of the PRF program and Medicaid/CHIP distribution
2. Understanding of program components, such as eligibility
3. Technical challenges faced during the application process

These sessions will be held on Tuesday, July 21^st from 6:30 – 7:30 pm ET and Wednesday, July 22^nd from 3:00 – 4:00 pm ET.

To confirm your participation, please send an email to preston.white@mckinsey.com with your name, email, title, organization and state, and note which session you would like to attend.

If you have any questions, please reach out to our Director of Policy and Regulatory Affairs, Kirsten Beronio.

HHS announced that as of Wednesday, July 15, the Centers for Disease Control and Prevention (CDC) National Healthcare Safety Network (NHSN) Covid-19 module will no longer be an option for hospitals to fulfill the agency’s request for daily data reporting on bed capacity, utilization, personal protective equipment (PPE), and in-house laboratory testing data.

Instead, HHS is asking hospitals to use one of these four options to report that information:

• If your state has assumed reporting responsibility, submit all data to your state each day and your state will submit on your behalf. Your state can provide you with a certification if they are authorized to submit on your behalf.
• Submit data to TeleTracking™. All instructions about the data submission are on that site and the new and updated fields will be ready as of July 15.
• Authorize your health information technology (IT) vendor or other third party to share information directly with HHS.
• Publish to the hospital or facility’s website in a standardized format, such as schema.org.

For additional details about these options, please see page 9 in HHS’s updated guidance. This information is also posted to NABH’s Covid-19 resources page.

The Substance Abuse and Mental Health Services Administration (SAMHSA) on Monday issued a final rule to update the Confidentiality of Substance Use Disorder Patient Records known as 42 CFR part 2 (or “part 2”) regulations, further aligning the regulations with other healthcare delivery rules.

Key changes include:

• Part 2 programs may share information verbally with a non-part 2 provider without subjecting the non-part 2 record to the requirements of part 2, as long as the non-part 2 provider segregates specific substance use disorder (SUD) records.
• Patients may consent to disclosures without naming a specific individual to receive this information; the update provides instructions for disclosures to exchanges and research institutions and provides guidance on disclosures related to care coordination and case management.
• Non-part 2 providers are not required to redact information in their medical records and may redisclose information if the patient has signed a written consent, or if the disclosure is otherwise permitted under the regulations.
• Written consents expressly allow sharing information with 18 types of payment and healthcare operations, including for care coordination and case management.
• Non-opioid treatment providers have access to central registries if they have a treatment relationship to the patient.
• Opioid treatment programs have new permissions to disclose information to prescription drug monitoring programs.
• During medical emergencies, information may be shared among part 2 programs or other SUD treatment providers during state or federally declared natural and major disasters.
• Disclosures for conducting scientific research may be made to non-Health Insurance Portability and Accountability Act (HIPAA) covered entities and those who are not subject to the Common Rule.
• Permits federal, state, and local agencies to conduct audits and evaluations.
• Extends to 12 months the period of placement of undercover agents or informants, which may be further authorized by a new court order.

These changes do not include provisions that recently became law in the Coronavirus Aid, Relief and Economic Security Act (CARES Act). CARES Act provisions are effective March 27, 2021.

This rule is expected to be published in the Federal Register this Wednesday, July 15, and will become effective within 30 days of its publication.

For questions about this rule, please contact Sarah Wattenberg, NABH’s director of quality and addiction services, at sarah@nabh.org.

HHS said Tuesday it expects to distribute about $15 billion through the department’s Health Resources and Services Administration (HRSA) to eligible providers who participate in state Medicaid and CHIP programs and have not received a payment from the Provider Relief Fund General Distribution.

HRSA will also distribute about $10 billion from the Provider Relief Fund to the nation’s safety-net hospitals, which is expected to happen this week.

HHS said it will launch an enhanced Provider Relief Fund Payment Portal on Wednesday that is intended to allow eligible Medicaid and CHIP providers to report their annual patient revenue, which will be used as a factor for HHS to determine their Provider Relief Fund payment.

According to an announcement, the payment to each provider will be at least 2% of reported gross revenue from patient care. HHS said it will determine the final amount that each provider receives after data is submitted, including information about the number of Medicaid patients providers serve.

To be eligible for this funding, healthcare providers must not have received payments from the $50 billion Provider Relief Fund General Distribution and either have directly billed their state Medicaid/CHIP programs or Medicaid managed care plans for healthcare-related services between January 1, 2018, to May 31, 2020.

On Monday, HHS contacted all hospitals, asking them to update information on their COVID-19 positive-inpatient admissions for the period January 1, 2020, through June 10, 2020. This information will be used to determine a second round of funding to hospitals in COVID-19 hotspots to ensure they are equitably supported in the battle against this pandemic. To determine their eligibility for funding under this $10 billion distribution, hospitals must submit their information by June 15, 2020 at 9:00 PM ET.

HHS said close to 1 million healthcare providers may be eligible for these patients. Click here for more information about eligibility and the application process.

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 will be published in the Federal Register on Tuesday, April 14.

According to the proposed rule, CMS will adopt the Office of Management and Budget (OMB) 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 announced on Friday it is distributing $30 billion immediately to healthcare providers fighting the deadly Covid-19 pandemic. The funding is the first portion of the $100 billion allotted to hospitals and other providers as part of the Coronavirus Preparedness and Response Supplemental Appropriations (CARES) Act that President Trump signed on March 27.

The funding will arrive via direct deposit to eligible providers starting on Friday, April 10. HHS’ announcement said the money is in the form of payments, not loans, so the money will not need to be repaid.

Eligible healthcare providers include all facilities and providers that received Medicare fee-for-service reimbursements in 2019. According to HHS, payments to practices that are part of larger medical groups will be sent to the group’s central billing office. Click here to learn how HHS will determine the payments and what eligible providers need to do.

To receive funding, providers must agree not to seek to collect out-of-pocket payments from a Covid-19 patient that are greater than what the patient would have otherwise been required to pay if an in-network provider had provided care, HHS said.

HHS has created a public website that shows all Covid-19 grant and cooperative agreement awards, which features a U.S. map detailing the amounts awarded by states, graphics highlighting the numbers of awards, amounts awarded by agency, and more.

The White House on Monday released a $4.8 trillion budget for 2021 that would modify Medicaid’s Institutions for Mental Diseases (IMD) exclusion to provide states with flexibility to provide inpatient mental health services to beneficiaries with serious mental illness (SMI).

The budget requests $94.5 billion for HHS, a 10-percent decrease from the 2020 enacted level. Although Congress is likely to reject President Trump’s proposal, the budget is significant for outlining the president’s top policy priorities as he seeks re-election in November. Notably for NABH, those priorities address mental health and addiction treatment services.

These provisions include changes to the IMD exclusion, which under current law states Medicaid cannot pay for certain inpatient stays at IMDs. The president’s budget would provide more than $5 billion in new federal funding to states to ensure the full continuum of care exists to provide help to people with SMI. These changes—which appear in summary tables at the end of the budget proposal—would exempt Qualified Residential Treatment Programs (QRTPs) from the IMD exclusion.

The budget also includes $225 million for Certified Community Behavioral Health Clinics (CCBHC) expansion grants, and would extend, through 2021, the CCBHC Medicaid demonstration programs to improve community mental health services for the eight states participating currently in the demonstration. In addition, the White House has proposed $25 million to expand primary healthcare services to address homelessness. These provisions, together with the changes to the IMD exclusion, are “part of a comprehensive strategy that includes improvements to community-based treatment,” the budget proposal noted.

Meanwhile, the president’s 2021 budget would continue 2020 funding to expand medication assisted treatment (MAT) from a small pilot program to half of all eligible Bureau of Prisons (BOP) facilities and provide an additional $37 million to complete MAT expansion to all eligible BOP facilities.

NABH will continue to analyze the Trump administration’s budget proposal and keep NABH apprised of any additional details regarding the IMD exclusion, MAT funding, and other topics related to the association’s policy priorities.

The Office of National Drug Control Policy (ONDCP) has issued its 2020 National Drug Control Strategy (Strategy) and accompanying National Treatment Plan (NTP) that includes action items for federal agencies and external stakeholders to increase access to care and close the addiction treatment gap.

The Strategy is presented using the domains of prevention, treatment and recovery, and supply-side strategies for reducing the availability and consumption of illicit drugs. These domains are established as ‘pillars’ that undergird the federal initiatives of expanding the early intervention, treatment and recovery infrastructure; improving the delivery system; and improving quality.

Specifically, the NTP calls for treatment expansion and improved quality by:

• Developing protocols for medically managed withdrawal including MAT to prevent relapse and promote stabilization;
• Increasing emergency department use of addiction medicine specialty services;
• Exploring the inclusion of stimulant disorder treatment in opioid treatment programs;
• Increasing access to all medication and psychosocial services, promoting syringe exchange, interim methadone, mobile methadone vans, and peer outreach. One objective of the federal Performance and Reporting System is to make sure 100% of all specialty providers offer MAT by 2020;
• Adopting model state specialty SUD treatment licensing laws;
• Developing mobile and online platforms with updated information on treatment slot availability with online appointment capacity;
• Encouraging public and private payers to cover comprehensive services and improve reimbursement rates where out-of-network rates are higher;
• Urging providers to subsidize and provide treatment scholarships; and
• Exploring the idea of developing national consensus standards for addiction treatment to consolidate treatment quality standards.

If you have questions about the Strategy or NTP, please contact Sarah Wattenberg, NABH’s
director of quality and addiction services.

The age-adjusted rate of U.S. drug overdose deaths in 2018 was 4.6% lower than the rate in 2017, the Centers for Disease Control and Prevention reported Thursday.

New data from the National Vital Statistics System also show there were 67,367 drug overdose deaths in the United States in 2018, 4.1% fewer than the 70,237 deaths reported in 2017.

Despite the decline in overall drug overdose deaths, there was a 10% increase in the rate of drug overdose deaths involving synthetic opioids other than methadone, such as fentanyl, in 2018 compared with 2017.

Furthermore, the age-adjusted rate of overdose deaths involving cocaine more than tripled from 2012 through 2018, while the rate of deaths involving certain psychostimulants, such as methamphetamine, increased nearly five-fold.

The CDC also reported that decreases in life expectancy between 2014 and 2017 were driven mostly by deaths due to unintentional injuries, suicide, and Alzheimer’s disease.

Improvements in life expectancy between 2017 and 2018, meanwhile, were driven by decreases in  mortality from cancer, unintentional injuries, and chronic lower respiratory diseases. The positive contributions to the change in life expectancy were offset, in part, by the rising number of deaths by suicide, chronic liver disease, and cirrhosis.

Unintentional injuries and suicide remain in the top ten leading cause of death in the United States.