By Andrew Siddons, CQ Roll Call
March 16, 2016 -- A sweeping bill to improve the nation's mental health care system and address opioid addiction, as well as four other bills to combat drug abuse, were approved with a voice vote by the Senate Committee on Health, Education, Labor and Pensions (HELP) on Wednesday.
As the mental health bill heads to the Senate floor, likely in early April, HELP Chairman Lamar Alexander, R-Tenn., hoped House lawmakers would follow the example of the Senate bill’s sponsors, Bill Cassidy, R-La., and Christopher S. Murphy, D-Conn., who introduced an earlier version of the bill last summer.
"They worked with their colleagues here and they’ve come up with a bipartisan approach that’s a consensus. That might help the House come to a conclusion," Alexander told reporters.
Speaking at a fast-moving markup, Democratic ranking member Patty Murray of Washington, also a cosponsor of the bill, said the issues it addresses are personal for lawmakers.
"We’ve all heard from too many families about the struggle to find quality, effective health care for a loved one in need," Murray said. "And we’ve heard too many times from mothers and fathers who fought often for years to help a child break an addiction to opioids."
The Mental Health Reform Act of 2016 (S 2680) would provide block grants to strengthen state-provided mental health care. It also would define the leadership roles of Substance Abuse and Mental Health Services Administration (SAMHSA) officials, establish new residency programs to help meet increased demand for mental health providers, and make it easier for patients to access providers. Rules governing patient privacy information also would be clarified.
Although the bill moved through the committee without any objection, some senators addressed several issues they hope to see included as amendments when the bill comes to the floor.
Both Democrats and Republicans were concerned about Medicaid’s prohibition against reimbursements to hospitals and facilities larger than 16 beds for mental health and substance abuse treatment.
"It is stunning to me that in this day and age we still do not treat mental illness in the same way that we treat physical illness from the perspective of federal reimbursement policy," said Sen. Susan Collins, R-Maine.
Alexander, who also cosponsored the bill, told reporters after the markup that there is bipartisan support to address the reimbursement exclusion, and the issue would be addressed on the Senate floor after the Senate Finance Committee, which oversees Medicare and Medicaid, is consulted.
Murphy said an earlier Congressional Budget Office estimate that including those mental health facilities would cost up to $60 billion should be revisited, and that money could be found to pay for the issue.
"There’s certainly money to be saved within our health care accounts that could be dedicated toward this kind of necessary expansion," he said.
Other areas will likely be revisited when the bill heads to the Senate floor. Cassidy will push for an amendment that would put SAMHSA’s chief medical officer in charge of the agency’s office of policy planning and innovation, effectively giving that person more resources and more clout in developing and evaluating evidence-based practices.
Sen. Sheldon Whitehouse, D-R.I., has an amendment that would offer behavioral health providers grants to provide incentives to use electronic health records, a provision similar to Medicare’s Meaningful Use program, which uses financial bonuses and penalties to motivate hospitals and physicians to adopt electronic records.
Both of those amendments were offered and withdrawn at Wednesday’s markup.
Before the committee approved all five bills en bloc by a voice vote, members approved four amendments to the primary measure. The amendments would:
- Strengthen parity laws, which require insurance companies to offer mental health coverage that is equal to coverage for physical healthcare.
- Clarify federal regulations to allow patients to request that opioid prescriptions are only partially filled, limiting leftover pills that often find their way into the hands of drug abusers.
