Download National Policy—Parity, Healthcare Reform and Beyond

National Policy Update—Parity,
Healthcare Reform and Beyond
Legal Action Center
July 11, 2010
Tremendous Opportunity for Expansion of
Coverage for Addiction Treatment
• The Paul Wellstone and Pete Domenici Mental Health
Parity and Addiction Equity Act (MHPAEA)
– Represents greater understanding of addiction as treatable
chronic health condition
– Now in effect
– Statute and regulations to guide implementation
• The Patient Protection and Affordable Care Act (PPACA)
– Identification of substance use prevention and addiction
treatment as health care
– Expansion of coverage of treatment in both private and public
insurance
– Inclusion of addiction services and the addiction service
workforce in broader initiatives to strengthen health care
Implementing Parity: Work
Nationally and in the States
• Focus on Parity in Washington:
– Additional guidance from federal regulators?
• Scope of services
• Work with Centers for Medicare and Medicare
Services (CMS) re: Medicaid managed care plans
• Continued legal challenges
• Engaging our Congressional champions
• Monitoring compliance and encouraging strong
federal activity and response
Implementing Parity: Work
Nationally and in the States (cont’d)
• Focus at the State Level:
– Continued work with state policy-makers
• Intersection with state laws
– Additional challenges to the law
• Fighting violations of both the letter and spirit of the
law
– Tremendous need for education to ensure
compliance
Implementing Healthcare Reform
– Key areas of focus:
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Services in minimum benefit package
Changes to Medicaid and Medicare
Intersection with parity
Work with primary care
Models of care
Prevention
Recovery support services
Workforce and other service delivery issues
Health information technology
Implementing Healthcare Reform:
Work in Washington
– Enormous scope of the regulatory process—moving forward
quickly!
– Focus at SAMHSA and ONDCP:
• Educating HHS (CMS, HRSA) and other key agencies about our
world
• SAMHSA’s leadership on healthcare reform: working internally and
with stakeholders to first determine what people need—then who
should purchase which services
• Defining the essential benefit package
• Areas needing additional analysis/clarity: prevention, recovery
supports, adult residential treatment and adolescent services
• Discussions about improving coordination of addiction, mental
health and primary health care—integration?
• Conversations about potential changes to purposes of existing
funding streams in light of healthcare reform
• Timing
• Dollars to align with priorities in current funding environment?
Focus of Our Advocacy in the
Implementation Process
• Implementing the parity and healthcare reform laws:
– Ensuring that addiction experts are at the table—nationally and at the
state level
– Developing specific recommendations and advocating for their
inclusion—cohesion of the field
– Continuing to serve as a resource to decision-makers
– Engaging our Congressional champions in the regulatory process—
continued outreach and education
– Anticipating arguments against full inclusion and gathering/bolstering
what we need
– Protecting the healthcare safety net—the SAPT Block Grant and other
key programs
– Sustaining support for strategies/interventions/services not covered by
the new law
– Continuing to fight for stronger protections for people in need of care
and supports