Your voice in Washington

Behavioral Health Information Technology Coordination Act

S. 2688 Lead Sponsors: Sen Markwayne Mullin (R-OK) and Sen. Catherine Cortez Masto (D-NV)

H.R. 5116 Lead Sponsors: Rep. Doris Matsui (D-CA-07), Rep. Ron Estes (R-KS-04), Rep. Sharice Davids (D-KS-03) and Rep. Bill Johnson (R-OH-06)

This proposed legislation authorizes grants totaling $100 million ($20 million per year over 5 years to behavioral health providers) to purchase software and support services needed to provide behavioral health care services. The grant program will be administered by the Office of the National Coordinator for Health Information Technology (ONC). The agency would have up to 18 months after passage of the bill to issue a Notice of Funding Opportunity (NOFO).

With a significant focus on integrated care, program requirements specify that behavioral health care providers receiving a grant shall use the grant funds to:

• Demonstrate the capacity to exchange patient clinical data with primary care physicians, medical specialty providers and acute care hospitals, psychiatric hospitals, and hospital emergency departments
• Promote, where feasible, the implementation and improvement of bidirectional integrated services, including evidence-informed screening, assessment, diagnosis, prevention, treatment, recovery, and coordinated discharge planning services for mental health and substance use disorders, and co-occurring physical health conditions and chronic diseases

More Information
Summary of the legislation
Bill text

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Preserving Access to Home Health Act of 2023

S. 2137 Lead Sponsors: Sen. Debbie Stabenow (D-MI) and Sen. Susan Collins (R-ME)

H.R. 5159 Lead Sponsors: Rep. Terri Sewell (D-AL-07) and Adrian Smith (R-NE-03)

The Centers for Medicare and Medicaid Services (CMS) is proposing to apply an additional 5.653% permanent cut to the Medicare home health benefit in its CY 24 Home Health Prospective Payment System (HH PPS) Rate Update proposed rule, which already reflects a nearly -4% reduction put in place for CY 2023.

These additional cuts would have significant, long-term repercussions for home health patients and home health providers. It is estimated that more than half of Medicare-certified home health agencies will be operating with negative margins as a result of these reductions.

Netsmart joins the National Association for Home Care & Hospice (NAHC), the Partnership for Quality Home Healthcare (PQHH), LeadingAge, and other organizations in supporting the Preserving Access to Home Health Act of 2023. This legislation will help ensure stability in payments to home health agencies by:

• Addressing cuts made to home health by CMS during the implementation of Medicare’s Patient Driven Groupings Model (PDGM)
• Repealing the requirement that CMS make determinations related to the impact of behavior changes on estimated aggregate expenditures
• Eliminating the authority of CMS to adjust home health payments based on such determinations under PDGM
• Instructing the Medicare Payment Advisory Commission (MedPAC) to review and report on aggregate trends under Medicare Advantage, Medicaid, and other payers and consider the impact of all payers on access to care for Medicare home health beneficiaries
• Adding requirements for Medicare home health cost reports to include data on visit utilization and total payments by program

More Information
CALL TO ACTION: Add your voice to advocacy opposing rate reductions
Bill Text
CMS Fact Sheet on Proposed Rule
NAHC/PQHH Fact Sheet

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Nationwide CCBHC Expansion in Bipartisan Safer Communities Act

S. 2938

Certified Community Behavioral Health Clinics (CCBHCs) coordinate and manage care across the spectrum of health services for positive outcomes. Netsmart is a technology partner to CCBHCs nationwide, and a strong advocate for sustained funding for CCBHC expansion alongside the National Council for Mental Wellbeing and other key associations.

This landmark bill, signed into law in June 2022, includes $8.5 billion for extension and expansion of the successful CCBHC Medicaid state financing demonstration program:

• Adds 10 new states to the demonstration program beginning in July 2024 and 10 additional states every two years
• Provides planning grants to help new states develop proposals to participate in the CCBHC demonstration program
• Extends enhanced match for the original 8 demo states through Sept. 2025
• Provides Kentucky and Michigan (the 2 newest demo states) funding for 6 additional years beyond their launch dates

More Information
National Council for Mental Wellbeing 2022 CCBHC Impact Report
Netsmart comment filing: SAMHSA CCBHC Certification Criteria
Speak with a Netsmart CCBHC Specialist

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42 CFR Part 2 Reform

• Netsmart played a key role in passage of the Protecting Jessica Grubb’s Legacy Act (the Legacy Act) as part of the CARES Act in 2020
• The Legacy Act made significant amendments to the decades-old 42 CFR Part 2 substance use disorder (SUD) privacy statute to align it more fully with HIPAA for the purposes of treatment, payment and healthcare operations (TPO)
• This closer alignment with HIPAA enables appropriate access to a patient’s SUD treatment records, with patient consent, for only healthcare TPO to help ensure accurate diagnosis, effective treatment, and enable coordinated, “whole-person” care in an integrated healthcare ecosystem
• The law also strengthens protections against the use of SUD records in civil, criminal, administrative, or legislative proceedings, and retains strong penalties for information breaches
• The Legacy Act will be actuated upon issuance of a SAMHSA Final Rule, expected in late 2023
• Netsmart filed comments to the SAMHSA Notice of Proposed Rulemaking (NPRM) to help assure that the Final Rule closely aligns with the CARES Act statutory language
• Other commenters included the Partnership to Amend 42 CFR Part 2, a consortium of behavioral healthcare providers, patients, patient advocate organizations, clinicians, hospitals, payers and others, including technology providers (Netsmart is a founding member)

More Information
Netsmart Summary: The Legacy Act
Netsmart comment filing: SAMHSA Part 2 NPRM
Partnership to Amend 42 CFR Part 2 comment filing: SAMHSA Part 2 NPRM

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Local 988 Response Act of 2023

• Authorizes funding through a variety of sources to help states, counties and community providers facilitate 988 response and a related continuum of services
• Supports the full continuum of local crisis response efforts including call centers, mobile crisis teams and crisis centers, all of which would connect persons in crisis with trained first responders and mental health providers

More Information
News Release – Cong. Tony Cárdenas (D-CA-29), Lead Sponsor

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Medicaid Inmate Exclusion Policy (MIEP)

The National Association of Counties reports that nearly 11 million arrested and detained individuals pass through more than 3,000 local jails each year, with an average stay of 25 days. NACo data also show that approximately 44% of jail inmates have a diagnosed mental illness, and almost 2/3 have co-occurring substance use disorders.

Counties are required by federal law to provided adequate healthcare for inmates, including the NACo-reported six of ten that are incarcerated and not yet adjudicated. However, Section 1905(a)(A) of the Social Security Act prohibits Medicaid matching funds from being used to pay for inmate medical care, even if they are eligible or enrolled. This Medicaid Inmate Exclusion Policy (MIEP) results in discontinuity of care for persons after release because of the time it take to reenroll and for benefits to be restored after re-entry into the community. The significant cost of inmate medical care is the single largest line item in some counties’ budgets.

Netsmart is the technology partner to more than 250 county behavioral health, public health and other human services departments and authorities. We join NACo and the National Association of County Behavioral Health and Developmental Disability Directors (NACBHDD) in supporting legislation to allow reimbursement of jail healthcare costs for Medicaid-eligible individuals.

More Information
NACo Policy Brief: Improving Health Services for Justice-Involved Individuals