D.C. Update – July 13th, 2015

News from NASADAD

  • NASADAD attends AAAS briefing on substance use disorders and incarceration

Around the Agencies

  • Veterans Health Administration releases videos on the safe administration of naloxone
  • CMS releases new infographic outlining five key steps for health care providers transitioning to ICD-10
  • CDC releases new date showing increased heroin usage rates over the past 10 years
  • New AHRQ report states that nearly one in three hospital stays in 2012 involved at least one mental or substance use disorder diagnosis
  • Proposed CMS regulations for Medicare managed care seeks to alter the IMD exclusion

In the News

  • Former Ohio Department of Alcohol and Drug Addiction Services Director Luceille Fleming passes away at age 91
  • Alliance for Health releases new toolkit on telemedicine
  • President Obama nominates Andy Slavitt for CMS administrator

Upcoming Events

  • SAMHSA announces webinar discussing 42 CFR Part 2, the federal regulation governing drug and alcohol use treatment and prevention record confidentiality

News from NASADAD

NASADAD attends AAAS briefing on substance use disorders and incarceration
Brian Denten, Public Policy Intern, attended the briefing hosted by the American Association for the Advancement of Science (AAAS). Two prominent researchers concentrating on the science of substance use disorders spoke at the briefing, noting the high success rates of medication-assisted treatment (MAT) in treating individuals with substance use disorders. Both speakers spoke at length on the effect that substance use disorders have on the brain, suggesting that a combination of MAT and cognitive therapy is the best combination for successful treatment. Methadone, buprenorphine, and Vivitrol were all discussed as potential medication options for individuals struggling with opioid use disorders. The speakers recommended that the criminal justice system increase its effort to create substance use disorder treatment programs for individuals while they are incarcerated to prevent relapse among individuals exiting prison.

Speakers:

  • Charles O’Brien, PhD; Vice-Chair of Pyschiatry at University of Pennsylvania and Director of the Prestigious Center for Studies in Addiction
  • Joshua Lee, PhD; Assistant Professor in Medicine and Psychiatry at New York University Langone Medical Center
  • Remarks: Representative Chaka Fattah (D-PA)

Around the Agencies

Veterans Health Administration releases videos on the safe administration of naloxone
The Department of Veterans Affairs, (VA) Veterans Health Administration released a new series of videos on the safe administration of naloxone. The series is available on YouTube, and describes the signs and symptoms of an opioid overdose and the proper method for administrating intranasal and intramuscular naloxone. A separate video displays how naloxone auto-injectors can also be used to reverse opioid-overdoses.

CMS releases new infographic outlining five key steps for health care providers transitioning to ICD-10
The Centers for Medicare & Medicaid Services (CMS) released a new infographic describing the procedure for health care providers transitioning to the ICD-10 diagnosis codes taking effect on October 1st. The infographic describes five key steps to facilitate a smooth transition process that include staff training, the updating of processes, and the testing of systems. All health care providers covered by the Health Insurance Portability Accountability Act (HIPAA) are required to transition to ICD-10.

CDC releases new data showing increased heroin usage rates over the past ten years
The Centers for Disease Control and Prevention (CDC) released a new edition of the monthly Vital Signs publication this week. This month’s edition concentrates on changing trends and risk factors surrounding heroin use in the United States, finding that in the past ten years “heroin use has more than doubled among people who abused or were dependent on prescription opioid painkillers.” The issue further describes how groups with historically low rates of heroin use – including women, privately insured individuals, and high-income populations – have seen increased rates of heroin use in recent years. The groups at highest risk for heroin use disorders include “non-Hispanic whites, men, 18-to-25 year olds, persons with annual household incomes less than $20,000, people living in urban areas, Medicaid recipients, and the uninsured.” Heroin-related overdose deaths have almost quadrupled in the United States from 2002 to 2013, underlining the importance of determining a comprehensive approach to the heroin epidemic.

New AHRQ report states that nearly one in three hospital stays in 2012 involved at least one mental or substance use disorder diagnosis
A new Agency for Healthcare Research and Quality (AHRQ) report has found that nearly one in three hospital stays in 2012 involved at least one mental health or substance use disorder diagnosis – accounting for 8.6 million patients and 32.3 percent of inpatient stays. About 1.8 million inpatient stays were primarily for mental health or substance use disorders, with mood disorders being the most common mental health diagnosis and alcohol-related disorders being the most common substance use disorder diagnosis. Mental health and substance use disorder inpatient stays were on average longer (6.6 days for mental health and substance use disorders versus 4.8 days for other conditions), yet had lower average costs ($6,300  for mental health and substance use disorders versus $12,600 for other conditions).

Proposed CMS regulations for Medicare managed care seeks to alter the IMD exclusion
The Centers for Medicare and Medicaid Services (CMS) have proposed new rules that would alter the institutions of mental disease (IMD) exclusion. The proposed rules would update the managed care regulations for Medicaid and the Children’s Health Insurance Program (CHIP) to alter the prohibition on using federal Medicaid funding for adult mental health and substance use disorder treatment in institutions of mental disease (residential treatment facilities with more than 16 beds). Under the proposed rules, Medicaid managed care plans would be able to provide funding for adult IMD treatment for up to 15 days. In addition to providing funding for some IMD treatment, the proposed rules would require States to create quality ratings for all Medicaid and Children’s Health Insurance Program (CHIP) managed care plans to ensure plans meet federal standards. NASADAD is working with the Coalition for Whole Health to develop a sign-on letter in support of the proposed rules, along with the suggestion to remove the language limiting IMD stays to only 15 days. Comments are due on July 27, 2015, after which CMS will review the comments received, make changes, and respond with final regulations.

In the News

Former Ohio Department of Alcohol and Drug Addiction Services Director Luceille Fleming passes away at age 91
The former Director of Ohio’s Department of Alcohol and Drug Addiction Services, Luceille Fleming, recently passed away at age 91 following decades of service. Luceille led both Pennsylvania’s and Ohio’s substance use disorder agencies, working under six Governors in two separate States over the course of her career. Her forthright, charismatic leadership helped provide second chances for thousands of men and women. Ohio greatly expanded substance use disorder programs for women and juveniles and established new support groups in prisons – in addition to securing millions of dollars in federal grants for Ohio’s substance use disorder systems during her time as Director. Luceille retired from the Ohio Department of Alcohol and Addiction Services in 2003, receiving numerous State and national awards for her work including the esteemed National Governor’s Distinguished Service Award and induction into the Ohio Women’s Hall of Fame. Ms. Fleming was very active in NASADAD, serving on the NASADAD Board of Directors, including as Board Chair, and participating on the Public Policy Committee, Child Welfare Committee, and much more. Her family suggests donations in her memory be made to the Fleming House in Lisbon, Ohio, or the House of Hope and First Village in Columbus.

Alliance for Health releases new toolkit on telemedicine
Alliance for Health released a new toolkit focusing on the background and future of telemedicine this past week. The toolkit provides an overview of the policy implications and uses of telemedicine, as well as a variety of news articles examining telemedicine in greater detail. Alliance for Health notes that the field of telemedicine has greatly expanded in recent years as more rural and areas take advantage of telemedicine’s lower costs and easier accessibility. The toolkit was produced with support from the Robert Wood Johnson Foundation.

President Obama nominates Andy Slavitt for CMS administrator
President Obama nominated Andy Slavitt for the position of Centers for Medicare and Medicaid Services (CMS) administrator. Slavitt has worked as acting administrator of CMS since March 2015, previously working as an executive at Optum from 2012 to 2014. The former CMS administrator Marilyn Tavenner stepped down from the agency in February following nine years of service. Slavitt will continue to guide CMS through the implementation of the Affordable Care Act, including the issuance of rules on how insurers, pharmaceutical companies, and hospitals should operate under the legislation.

Upcoming Events

SAMHSA announces webinar discussing 42 CFR Part 2, the federal regulation governing drug and alcohol use treatment and prevention record confidentiality
The Substance Abuse and Mental Health Services Administration has announced a new webinar discussing 42 CFR Part 2 to be held on Tuesday, July 21 from 1-2 PM EST. The webinar aims to address and debunk common myths surrounding 42 CFR Part 2 – the federal regulation governing drug and alcohol use treatment and prevention record confidentiality. Several experts will speak on the application of 42 CFR Part 2 and the how adopting electronic health records and health information exchanges affects compliance.

Featured presenters include:

  • Kate Tripping, JD; Public Health Advisor, SAMHSA
  • Deborah Reid, JD; Senior Health Policy Attorney, Legal Action Center
  • Katie O’Neill, JD; Consultant, Legal Action Center

 

Should you have any questions, or require additional information, please do not hesitate to contact Robert Morrison, Executive Director, (202) 293-0090 or Colleen Haller, Public Policy Associate, at (202) 293-0090.