When we returned from this past holiday season, which now seems very long ago, we were quite pleasantly surprised to learn that Senator Lamar Alexander, the Chair of the U.S. Senate Health, Education, Labor, and Pensions Committee (HELP), would like to develop and pass a long-awaited mental health bill this year. This week, we were even more delighted when Representative Gene Green of Texas, the Ranking Member of the Health Subcommittee of the U.S. House Energy and Commerce Committee, and five of his colleagues, introduced the Comprehensive Behavioral Health Reform and Recovery Act of 2016. Considered together, these two developments could not be more consequential for us.
The Comprehensive Behavioral Health Reform and Recovery Act of 2016
First, I would like to provide a brief overview of the bill Representative Green just introduced.
This bill consists of several major components:
Strengthening and investing in SAMHSA programs. The proposed legislation would create a new Assistant Secretary for Mental Health and Substance Use Disorders, but significantly also assign that role to the Administrator of SAMHSA. It would call for a full review of SAMHSA to determine what programs, staffing, and funding will be needed to meet America’s current needs for behavioral health services, and it would authorize a much-needed Center for Behavioral Health Quality and Statistics. It also would create and reauthorize a broad range of grant and technical assistance programs to promote innovation and adoption of evidence-based practices throughout the field. For the states, it would create an acute care bed registry and require a biannual report on state mental health and substance use services.
Interagency serious mental illness coordinating committee. The bill would implement a much-needed interagency serious mental illness coordinating committee that would monitor research and practice developments and make recommendations to the Assistant Secretary. Funding would be authorized to support this function.
HIPAA clarifications. The proposal would require the Health and Human Services (HHS) Secretary to issue a regulation consistent with the 2014 HHS Office of Civil Rights guidance on HIPAA privacy protections, and to provide training and technical assistance on its implementation. Significantly, it also would require the Secretary to issue a regulation modernizing 42 CFR Part 2, which provides special privacy protections for substance use care. Finally, it would authorize pilot grants to improve communication between consumers, family members, and providers.
Improving Medicaid and Medicare mental health services. The resolution would permit same-day billing for behavioral health and primary care services under Medicaid, as well as extend and expand the federally qualified behavioral health clinic and the Medicaid emergency psychiatric demonstration projects. Very importantly, it also would modify IMD exclusions under managed care arrangements for both Medicaid and CHIP so that additional funds would be available for care.