Legislative Action
Netsmart continues to be a strong advocate for selected federal legislation on behalf of our clients and providers across the country. We are passionate about being a voice on Capitol Hill, and we strive to channel our partners’ needs when advocating for change. Here are several current areas of focus we’ve been involved in.
S. 824/ H.R. 1767: Excellence in Mental Health and Addiction Treatment Expansion Act
Summary
This legislation would extend the Certified Community Behavioral Health Clinic (CCBHC) pilot program in its original eight states (Minnesota, Missouri, Nevada, New Jersey, New York, Oklahoma, Oregon and Pennsylvania) for two years and expand the program to several additional states, which are still to be determined. CCBHCs are a proven vehicle for expanded access to intensive community-based services for individuals with untreated severe mental illness or addiction, and Netsmart provides a complete range of solutions that equip providers as CCBHCs.
Status
Before its August recess, Congress passed a bill extending the CCBHC program for all eight participating states through September 13, 2019. Advocacy efforts are now focused on including S. 824/H.R. 1767 in more comprehensive Medicaid legislation to be considered this fall. Netsmart participated in a special National Council for Behavioral Health CCBHC Hill Day to advocate for the extension/expansion, and we will continue to work with key stakeholders in that effort.
CMMI Financing Demonstrations
Summary
The Center for Medicare and Medicaid Innovation (CMMI) is in the process of structuring pilot programs tied to provisions of the SUPPORT for Patients and Communities Act (the large opioid treatment bill passed by Congress last fall). Section 6001 of the SUPPORT Act authorizes the testing of incentive payments for behavioral health and substance use treatment providers for adoption and use of certified EHR technology to improve the quality and coordination of care through the electronic documentation and exchange of health information.
Status
CMMI is formulating details and funding amounts for the various financing demonstration programs. Netsmart is advocating for inclusion and funding for behavioral health and substance use treatment providers under the CMMI Medicare Opioid Treatment bundled payment program and Medicaid provider infrastructure demonstration.
H.R. 2062: Overdose Prevention and Patient Safety Act / S. 1012: Protecting Jessica Grubb’s Legacy Act
These identical bipartisan bills would align 42 CFR Part 2 substance use treatment privacy regulations with HIPAA solely for the purposes of treatment, payment and health care operations (TPO). Also increase penalties for information breaches and strengthens patient protections around criminal proceedings. The decades-old 42 CFR Part 2 regulations prevent Netsmart clients and other providers from providing fully-informed diagnosis and treatment for patients with a substance use disorder (SUD). This is especially challenging in integrated care models like HIEs and Health Homes where every member of a patient’s treatment team needs to understand their full medical/SUD history. It also poses a serious safety risk to persons with SUD via potential drug interactions and unintended prescribing errors due to lack of complete patient information for prescribers.
Status
Advocacy focus is on including S. 1012 as amendment to S. 1896, the Lower Health Care Costs Act (S. 1895), expected to be up for a vote sometime in September.
In addition, the Substance Abuse and Mental Health Services Administration (SAMHSA) will issue a Notice of Proposed Rulemaking (NPRM), “Coordinating Care and Information Sharing in the Treatment of Substance Use Disorders” this summer. Netsmart provided a legal opinion to SAMHSA outlining their ability to go farther in making modifications to Part 2 for treatment and operations. Netsmart representatives also met with SAMHSA and the Dept. of Health and Human Services leadership to provide input on this issue.
FCC Connected Care Telehealth Pilot Program
Summary
This $100 million pilot program proposes an 85% discount on connectivity for broadband-enabled telehealth services that connect patients directly to their doctors to treat a wide range of health conditions. These services aim to facilitate the effective treatment of chronic conditions outside of the doctor’s office at significant savings for patients and health care providers.
The FCC Notice of Proposed Rulemaking seeks comment on testing the new program. Several Netsmart human services client communities appear to meet the proposed eligibility requirements, including community mental health centers and local health departments.
Status
Netsmart will provide comments in response to the NPRM about the importance of funding under-resourced providers that serve persons with chronic, co-occurring health conditions.