SUD Crisis

Congress should make mobile crisis services mandatory under Medicaid. At a minimum, these services should be made a permanent state option available to states eligible for enhanced federal Medicaid match funding.[1]

The Centers for Medicare and Medicaid Services (CMS), Food and Drug Administration (FDA), and the United States Preventive Services Task Force (USPSTF) should implement a fast-track review process for any new evidence-based technology supporting substance use disorder (SUD) prevention and treatments.[1]

The Centers for Medicare and Medicaid Services (CMS) should fix its currently flawed implementation of Essential Health Benefits (EHB) for mental health and substance use disorders (MH/SUD), which results in large coverage gaps for key services and allows many state benchmark plans to be in blatant violation of the Mental Health Parity and Addiction Equity Act’s (MHPAEA) requirements.[1]

The U.S. Department of Health and Human Services (HHS) must finalize strong regulations to align privacy protections for substance use disorder (SUD) patient recommendations with protections under the Health Insurance Portability and Accountability Act (HIPAA). Congress previously passed legislation to address problems caused by a provision of federal law – 42 CFR Part 2 – that has inhibited the integration of SUD care with mental health and physical health care.[1]

Congress should require the Centers for Medicare and Medicaid Services (CMS) to establish a single global payment under the Physician Fee Schedule for mobile crisis response team services for Medicare beneficiaries experiencing a mental health or substance use disorder (MH/SUD) crisis. A bipartisan group of Senate Finance Committee members has supported this important step.[1]

The Department of Health and Human Services (HHS) should issue guidance to hospitals on their obligations under the Emergency Medical Treatment & Labor Act (EMTALA) to stabilize and treat individuals with a substance use disorder (SUD), and Congress should provide financial resources to incentivize hospitals to hire appropriate staff for their emergency departments[1]