Behavioral Health

About Behavioral Health

An estimated 7.5 million people in California experience a mental health disorder in any given year, but only one-third of adults who experience mental illness are getting treatment. The caregivers at hospitals know the obstacles people with behavioral health conditions face and the challenges in getting them the treatment they need. While hospitals embrace the essential role they play in addressing this crisis, more needs to be done. Solutions like payment reform, resource allocation, more outpatient and community-based services, a bolstered behavioral health workforce, and a statewide set of standardized core services will help Californians with behavioral health conditions access the care they deserve.

Labor Department Provides Resources on Mental Health Parity Laws

The U.S. Department of Labor has released a series of documents designed to help stakeholders understand the Mental Health Parity and Addiction Equity Act (MHPAEA) of 2008, the 21st Century Cures Act, the SUPPORT for Patient and Communities Act, and the Employee Retirement Income Security Act. The documents, which provide examples and illustrations of how the laws work, include FAQs about mental health and substance use disorder parity implementation and the 21st Century Cures Act, and an MHPAEA disclosure template and enforcement fact sheet.

Mental Health Resources Available for Families of First Responders

The Substances Abuse and Mental Health Services Administration (SAMHSA) has released a series of fact sheets for the families of first responders, intended to help them understand and cope with the potential mental health issues that emergency personnel may face, and to help children understand their parents’ role at work.

TriWest to Administer California’s VA Community Care Network

The Department of Veterans Affairs (VA) has awarded TriWest Healthcare Alliance (TriWest) a contract to administer the VA’s Community Care Network (CCN) in California. TriWest will establish and maintain a network of community care providers in the state, as outlined in the Veterans Community Care Program final rule.

CMS Issues FFY 2020 Inpatient Psychiatric Facility PPS Final Rule

The Centers for Medicare & Medicaid Services (CMS) released its final rule for the federal fiscal year (FFY) 2020 inpatient psychiatric facility (IPF) prospective payment system (PPS).

CMS finalized a 2.9% market basket update, offset by reductions including a productivity adjustment of 0.4% and an Affordable Care Act-mandated 0.75% reduction, resulting in a payment increase of approximately 1.75%. After accounting for a $10 million decrease as a result of an update to the outlier threshold, CMS estimates overall payments will increase by $65 million compared to FFY 2019. CMS also finalized its proposals to revise and rebase the market basket to reflect a 2016 base year rather than a 2012 base year, and remove the one-year lag in wage index data used under the IPF PPS. As a result, CMS will apply the FFY 2020 pre-floor, pre-reclassified inpatient prospective payment system wage index data. 

For the IPF Quality Reporting Program, CMS finalized the adoption of one new measure — Medication Continuation Following Inpatient Psychiatric Discharge (National Quality Forum #3205) — beginning with the FFY 2021 payment determination and subsequent years.

The proposed rule is effective Oct. 1. Additional information is available in a CMS fact sheet.