Behavioral Health

As part of the Biden-Harris Administration’s ongoing commitment to increasing health data exchange and investing in interoperability, CMS issued a proposed rule that would improve patient and provider access to health information and streamline processes related to prior authorization for medical items and services. CMS proposes to modernize the health care system by requiring certain payers to implement an electronic prior authorization process, shorten the time frames for certain payers to respond to prior authorization requests, and establish policies to make the prior authorization process more efficient and transparent.

The AHRQ Academy has released a new guide on health equity and behavioral health integration designed to help practices reduce health disparities and advance health equity by promoting belonging, dignity and justice for providers and patients from marginalized groups. The AHRQ Academy aims to support the integration of behavioral health into primary and ambulatory care settings with a focus on providing care for patients using substances, particularly opioids, and for those with mental health conditions. This guide provides tools and resources for addressing economic and social inequities, bias, discrimination and racism.

MACPAC has released its June 2022 Report to Congress on Medicaid and CHIP. The report recommends measures that Congress can take to better monitor access to care for Medicaid beneficiaries, improve the oversight and transparency of managed care directed payments, increase access to vaccines for adults enrolled in Medicaid, encourage the uptake of health information technology in behavioral health, and better integrate care for Medicaid and Medicare dual-eligibles. The commission also offers policy levers that states and the federal government can use to promote equity in Medicaid.

The National Center for Complementary and Integrative Health (NCCIH) at the National Institutes of Health (NIH) is has released a request for information to assist in defining a set of key determinants of health that addresses all the elements of the whole person health model, including factors that can influence health either positively or negatively, and that encompass the full continuum of biological, behavioral, social, and environmental domains.

The University of Kansas School of Nursing is seeking nursing homes to participate in an NIH-funded research study testing a new online version of the evidence-based Changing Talk (CHAT) communication training program. CHAT educates staff about reducing elderspeak (infantilizing communication) and results in reduced behavioral symptoms and need for psychotropic medication for residents with dementia. The new online version (Changing Talk: Online Training (CHATO)) consists of 3, one-hour interactive online modules that provide flexible and accessible access for staff.

The Department of Health and Human Services (HHS), through the Centers for Medicare & Medicaid Services, is working with states to promote access to Medicaid services for people with mental health and substance use disorder (SUD) crises. Authorized under President Biden’s American Rescue Plan (ARP), states have a new option for supporting community-based mobile crisis intervention services for individuals with Medicaid. This option will help states integrate these services into their Medicaid programs, a critical component in establishing a sustainable and public health-focused support network.

This brief draws from interviews with states operating new and long-standing MLTSS programs to identify six major trends in the refinement of MLTSS and underlying LTSS delivery systems nationally. The states examined in this brief are strengthening their Medicaid MLTSS programs to serve more LTSS beneficiaries and facilitate the development of integrated care programs that reduce service fragmentation for Medicare-Medicaid enrollees, particularly through Medicare Advantage D-SNPs

This report examines how health plans can partner to promote successful integration of care for enrollees with behavioral health conditions. As part of this report, CHCS interviewed leaders of organizations that are partnering to integrate care.. The report analyzes findings from Colorado, Oregon, Arizona, And Arkansas and highlights key elements that contribute to successful partnerships between physical and behavioral health organizations.

This case study examines the benefits of coordinating care for dually eligible members with serious mental illness. It looks specifically at how one Pennsylvania plan used a robust care coordination and member engagement model to successfully reduce urgent and unplanned inpatient admissions; and optimize health outcomes, quality of life, and self-management skills for individuals with serious mental illness.

"This document provides guidance to CCBHCs on how to use the Certified Community Behavioral Health Clinic (CCBHC) cost report for the two Certified Clinic Prospective Payment System (CCPPS) rate methodologies—CC PPS-1 and CC PPS-2. The cost report may be used to determine the clinic-specific PPS rate and to annually report demonstration costs. These payment rates were provided through the Demonstration Program to Improve Community Mental Health Services."