Jul 25, 2018 | Behavioral, Substance Abuse
The Affordable Care Act designated mental health and substance use services as essential health benefits in Marketplace plans and also extended parity requirements to the individual and small-group markets. This brief highlights a recent Health Affairs study that analyzed the extent to which the law improved coverage for these services. Read more here.
Jun 21, 2018 | Drugs, Medicaid, Medicaid Managed Care, Substance Abuse
In its June 2018 Report to Congress, the Medicaid and CHIP Payment and Access Commission made recommendations to change a Medicaid rebate loophole preventing states from paying the lowest price for certain drugs, and to clarify privacy requirements for people with substance use disorder that may inhibit care coordination. The report also addressed the growth of managed long-term services and supports and state coverage of substance use disorder services. Click to read more.
Jun 20, 2018 | Autism, Behavioral
The prevalence of autism spectrum disorder (ASD) has increased over the years, from about 1 in 150 children in 2000 to 1 in 59 in 2014, according to the CDC. While a broader ASD definition and improved diagnosis may explain some of this increase, experts note that a true increase in prevalence cannot be ruled out. Over the past decade, more and more states have required Medicaid and commercial plans to cover applied behavioral analysis (ABA), the leading type of autism service. We expect coverage rates to grow as states continue to expand services, such as New Jersey’s recently proposed...
May 22, 2018 | Inpatient Psych
CMS recently released proposed updates to the Inpatient Psychiatric Facilities (IPF) Prospective Payment System (PPS). The proposed rule would update the IPF Quality Reporting Program and prospective payment rates for discharges occurring during FY2019. Click to read more.
Mar 21, 2018 | Behavioral, Hospitals, IDD, Medicaid
In March, the Medicaid and CHIP Payment and Access Commission (MACPAC) continued its conversation on the substance use disorder treatment continuum of care and IMD exclusion. The commission also discussed tailoring managed long-term services and supports (MLTSS) programs for individuals with intellectual and developmental disabilities (IDD), along with the role of Medicaid base and supplemental payments to hospitals. Click to read more.
Mar 8, 2018 | Drugs, Substance Abuse
Attorney General Jeff Sessions recently announced the Department of Justice’s new Prescription Interdiction and Litigation (PIL) Task Force. The task force will coordinate all available criminal and civil law enforcement tools to fight the opioid crisis, with a focus on manufacturers and distributers. The Justice Department will file a statement of interest in a multidistrict lawsuit against several opioid manufacturers and distributers for the substantial costs the federal government has suffered from opioid addiction. The creation of this new task force reflects the national commitment to...
