Advocacy Alert: August 2023 Advocacy Update for NBHAP Members

August 15, 2023

Greetings, NBHAP Members!

On behalf of Slingshot Solutions, thank you for your membership in NBHAP and your commitment to advocacy that will shape the future of behavioral health. As your advocate in Washington, D.C., it is my responsibility to keep you informed when it comes to policy developments, and to represent your interests before the federal government. We do this by working with Congress, the White House and executive agencies, and other interest groups and coalitions.

Andrew Kessler
Principal
Slingshot Solutions LLC

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The Mental Health & Addiction Parity Equity Act passed in 2008 and was the culmination of efforts that lasted for over a decade. Now, a decade and a half since its passage, advocates are still busy working to assure it is enforced by the federal government. Last month, the Biden administration announced it would seek to strengthen the law through a series of new proposed rules.

First, the new rules would require health plans to make changes when they are providing inadequate access to mental health care. Health plans will need to evaluate the outcomes of their coverage rules to make sure people have equivalent access between their mental health and medical benefits. This includes evaluating the health plan’s actual provider network, how much it pays out-of-network providers, and how often prior authorization is required and the rate at which prior authorization requests are denied. These analyses will show plans where they are failing to meet their requirements under the law and will require plans to improve access to mental health care – by including more mental health professionals in their networks or reducing red tape to get care – to be in compliance with the law.

The administration wants plans to make clear what they can and cannot do. The proposed rule will provide specific examples that make clear that health plans cannot use more restrictive prior authorization, other medical management techniques, or narrower networks that make it harder for people to access mental health and substance use disorder benefits than their medical benefits. Under the proposed rule, health plans must use similar factors in setting out-of-network payment rates for mental health and substance use disorder providers as they do for medical providers.

Finally, the law as it exists does not require non-federal governmental health plans, like those offered to state and local government employees, to comply with its requirements. The proposed rule would remedy this, and codify Congressional changes made to MHPAEA by requiring more than 200 additional health plans to comply with MHPAEA, providing critical protections to 90,000 consumers.

Meanwhile, on Capitol Hill, we continue the appropriations process. The United States Senate released its proposal for funding the government in FY 2024, and while the numbers for SUD treatment and recovery-based programs were not stellar, they were still far superior to those we saw in the House of Representatives. Small increases were also included for the State Opioid Response Grant, and the Substance Use Prevention, Treatment & Recovery Block Grant. Unfortunately, the Senate and House are extremely far apart on their funding numbers, not just for SAMHSA but for the entire Department of Health and Human Services, which also oversees such important agencies as the National Institutes of Health, and the Centers for Disease Control. We will continue to keep you informed of all developments as they occur.

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Questions? Concerns?

As always, we want your input. What topics would you like to see us cover in future Advocacy Alerts? If you are a representative of a state association and have something for us to consider for an Advocacy Alert, let us know! Please contact us with any questions or concerns you have about our advocacy efforts.