Can the Behavioral Health Sector Fulfill its Role?

by admin on June 16, 2010

VP of Policy

Charles Ingoglia, MSW
Vice President of Public Policy
National Council for Community Behavioral Healthcare

The healthcare reform process has resulted in many significant victories for the behavioral healthcare sector.

Indeed, our long-desired goal has been achieved: Behavioral healthcare is seen by policy makers as fundamental to overall health and wellness.

We find evidence of this achievement throughout the healthcare reform law–mental health and substance use services must be provided by all plans that participate in the new exchanges, and these benefits must be offered at parity. Healthcare home and Accountable Care Organization pilots must address substance use and mental health disorders. Additionally, the law includes a number of provisions specific to mental health and substance use, including authorization for new grants to colocate services as well as new workforce development grants.
Even with all the progress we have made, many areas of policy and payment need to be improved for the behavioral health sector to fulfill its intended role in a reformed healthcare system. The National Council is committed to advancing the following issues:
  • Extension of the temporary Federal Medicaid Percentage increase
  • Federal policy and payment equity for behavioral health organizations
  • Health information technology funding fix
  • Medicare parity implementation

Extension of the temporary Federal Medicaid Percentage increase. As part of the American Recovery and Reinvestment Act, Congress provided a temporary increase to the Federal Medicaid Percentage to help cash-strapped states meet their Medicaid obligations. As of this writing, Congress is expected to vote this week on a 6-month extension of this important provision, extending federal assistance until June 2010. This action is critical, and given the combination of state revenue projections and Medicaid growth, Congress may need to provide additional relief to states beyond June 2010.

Federal policy and payment equity for behavioral health organizations. In recognition of the healthcare access and use challenges confronting communities that are low income or have high rates of illness and few medical providers, Congress has enacted a number of policy and payment preferences for “safety net” providers, including enhanced reimbursement under Medicaid, federal funding to provide care to uninsured people, loan guarantees, and access to federally subsidized malpractice insurance. Unfortunately, the safety net does not offer equity. To correct this situation, the National Council, working with other national organizations, is advancing the notion of Federally Qualified Behavioral Health Centers. This effort includes establishing national treatment and reporting standards for organizations that choose to obtain this designation as well as a proposed reimbursement model that more accurately reflects the costs of providing services.

Health information technology funding fix. For healthcare reform to be successful, all medical providers need to share information to better coordinate care, reduce inefficiencies, and improve client outcomes. Behavioral healthcare providers need access to federal funding for the meaningful use of health information technology. The National Council has been working with Rep. Patrick Kennedy (D-RI) and others for the introduction of HR 5040, the Health Information Technology Extension for Behavioral Health Services Act of 2010, which would extend Medicare and Medicaid facility payments to community mental health and addiction organizations as well as private and public psychiatric hospitals.

Medicare parity implementation. In June 2008, Congress enacted payment parity in Medicare’s Part B benefit, which will provide copayment equity for mental health and addiction services. Although this is an important step, much more needs to be done in Medicare for there to be true parity. First, the types of outpatient mental health interventions paid for by Medicare need to be extended to include, for example, case management, psychiatric rehabilitation, and other intensive community-based interventions. Medicare also must recognize mental health counselors and marriage and family therapists as independent practitioners.

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