SAMHSA Community Forums Scheduled In Cleveland and Columbus

The Northern Ohio Recovery Association (NORA, Inc.) is hosting an in-person SAMHSA Community Forum on March 14 from 2:00-5:00 p.m. at NORA's Main Office located at 1400 E. 55th St. in Cleveland. SAMHSA recognizes that the federal grant process could be daunting without guidance. In particular, organizations may find it more challenging in underserved communities to secure a federal grant. Dr. Kurt John, Chief Financial Officer and Office of Financial Resources Director at SAMHSA, along with two grant technical experts, will be in attendance to provide insight about SAMHSA's funding opportunities, grant application process, and resources available to help grantees administer their award. For more information and to register, please email Susan Cloud at [email protected]. A similar meeting is being planned for Columbus in April. Registration for the April meeting will be shared separately.

Americans See Opioids, Fentanyl As Top Threat, Mental Health Not Far Behind

Americans see poor mental health as one of the biggest threats to public health. This is especially true for young adults, who were twice as likely to identify it as the most pressing public health issue today.

Even more pressing for Americans are opioids and fentanyl, which topped the list of most significant threats to public health in the Axios-Ipsos American Health Index.

The poll also found that nine out of 10 Americans support health insurers covering mental health care on par with physical health care.

The Axios-Ipsos poll also found that while Americans are comfortable with some AI applications in health care, they remain wary of machine learning’s place in the doctor’s office.

Artificial intelligence (AI) is becoming increasingly commonplace in the behavioral health industry, generating attention and millions in funding.

Pennsylvania Courts to Pay $100,000 to Settle DOJ Lawsuit Alleging Opioid Discrimination

Pennsylvania courts will pay $100,000 to settle a federal lawsuit alleging that people with opioid use disorder under court supervision were prevented from taking prescribed medicine, the U.S. Department of Justice announced Thursday.

Experts say the lawsuit represents a nationwide issue where people with substance use disorders seeking jail alternative programs such as drug court, probation or parole are restricted from using federally approved addiction treatments that contain opioids.

Sally Friedman, senior vice president of legal advocacy at the Legal Action Center, said the lawsuit in Pennsylvania was the first of its kind, noting she has seen similar issues arise in courts across Ohio, South Carolina, Louisiana, New York, Florida and other states.

“All too often, people taking medication to treat their OUD are subjected to discrimination based on unfounded stigma associated with these medications,” said Jacqueline C. Romero, U.S. attorney for the Eastern District of Pennsylvania. “It is a violation of the ADA to deny someone access to programs and services simply because they are taking medication their doctors have prescribed to get and keep their OUD in remission.”

Medicaid Coordination of Benefits with New Medicare Behavioral Health Coverage

Beginning January 1, the Medicare program began covering services provided to Medicare beneficiaries by marriage and family therapists (MFT) and mental health counselors (MHC), and Intensive Outpatient Program (IOP) services authorized under Sections 4121 and 4124 of the Consolidated Appropriations Act of 2023. These provisions are implemented as part of two recently published final rules:

• CY 2024 Medicare Physician Fee Schedule Final Rule.
• CY 2024 Medicare Hospital Outpatient Prospective Payment System and Ambulatory Surgical Center Payment System Final Rule (CMS 1786-FC).

As of January 1, Medicare became the primary payer for Medicare-covered services furnished by MFTs and MHCs to individuals who are eligible for both Medicare and Medicaid. Additionally, Medicare became the primary payer for IOP services furnished to individuals eligible for Medicare and Medicaid by hospital outpatient departments, Medicare community mental health centers (CMHC), opioid treatment programs, rural health clinics (RHC), and federally qualified health centers (FQHC).

CMS recently provided guidance to states regarding coordination of benefits between Medicare and Medicaid and third-party liability under the Medicaid program. In accordance with this guidance, to allow providers time to complete the Medicare enrollment process:

• Ohio Department of Medicaid and MyCare Ohio plans will continue to pay claims for services to Medicaid enrollees with dual Medicare and Medicaid eligibility for impacted providers and services for claims submitted through June 30, 2024.
• Once practitioners are enrolled with Medicare, claims must be submitted to Medicare prior to seeking cost-sharing reimbursement from Medicaid, starting on the effective date of the provider’s enrollment with Medicare.

For any payments made by Medicaid (before or after June 30, 2024), including payments made by Medicaid managed care entities, if Medicare is later found to be the liable payor because the provider’s Medicare enrollment was active and the service was Medicare-covered, the Medicaid payment will be recouped as required by CMS.

To ensure secondary payments by Medicaid can be made, eligible practitioners that provide services to individuals who are eligible for Medicare and Medicaid should also be enrolled with Medicare. Eligible practitioners can apply to become Medicare providers through the Provider Enrollment Chain and Ownership System (PECOS) at Provider Enrollment Chain, and Ownership System (PECOS). The PECOS website offers tutorials regarding enrollment in Medicare.

Information on CMS’ coverage of these new Medicare providers is found below:

https://www.medicaid.gov/sites/default/files/2023-12/cib12142023.pdf

https://www.cms.gov/files/document/marriage-and-family-therapists-and-mental-health-counselors-faq-09052023.pdf