In January 2024, the Centers for Medicare and Medicaid Services (CMS) announced a new innovation care delivery model that seeks to bridge the gap between behavioral and physical health. The Innovation in Behavioral Health (IBH) Model aims to improve the quality of care and behavioral and physical health outcomes for adults with moderate to severe mental health conditions and substance use disorders (SUDs). The IBH Model will service beneficiaries who are enrolled in Medicare and Medicaid, including those who are dual eligible.[1] These populations experience higher than average rates of mental health conditions or SUDs, or both, highlighting the importance of a model that integrates behavioral and physical healthcare as well as addressing health-related social needs (HRSN).[2]
Continue Reading CMS Notice of Funding Opportunity for the Innovation in Behavioral Health Model Open Until September 9, 2024
ONC’s Trusted Exchange Framework and Common Agreement (TEFCA) Announces First Cohort of Participants
On January 19, 2022, the U.S. Department of Health and Human Services (HHS) Office of the National Coordinator for Health Information Technology (ONC) published the Trusted Exchange Framework and Common Agreement (TEFCA) for health information exchange. The Trusted Exchange Framework established a set of non-binding, foundational principles for trust policies and practices to help facilitate
ONC’s Trusted Exchange Framework and Common Agreement (TEFCA) Announces First Cohort of Participants
On January 19, 2022, the U.S. Department of Health and Human Services (HHS) Office of the National Coordinator for Health Information Technology (ONC) published the Trusted Exchange Framework and Common Agreement (TEFCA) for health information exchange. The Trusted Exchange Framework established a set of non-binding, foundational principles for trust policies and practices to help facilitate
Health Sector Efforts to Address Health Equity and Affordability in 2023
As we move into 2023, the impact of the pandemic on marginalized groups continue. The COVID 19-pandemic has exacerbated longstanding racial and ethnic disparities in health care. In terms of national healthcare spending, healthcare inequities make up about $230 billion in annual spending; and that amount could potentially reach $1 trillion by the year 2040 if inequities persist or worsen. In 2021, the Centers for Medicare & Medicaid Services (CMS) announced a new strategic vision to guide the Centers’ model testing and priorities toward a vision of achieving equitable outcomes through high-quality, affordable, person-centered care. But it is important to also highlight what other federal agencies, states, and health plans are doing to address health inequity especially as our healthcare system, as a whole, is moving towards value-based care initiatives.
Continue Reading Health Sector Efforts to Address Health Equity and Affordability in 2023Medicaid Redetermination & Unwinding Updates
Initiated in response to the COVID-19 pandemic, the Families First Coronavirus Response Act (FFCRA) requires Medicaid programs to keep beneficiaries continuously enrolled through the end of the public health emergency (PHE). The PHE is expected to end on May 11, 2023. Despite FFCRA’s initial timeline, the Consolidated Appropriations Act, 2023 (CAA 2023) established the end of the continuous enrollment provision to be March 31, 2023, in effort to reduce the enhanced federal Medicaid matching funds through December 2023. Accordingly, as of April 1, 2023, states can resume Medicaid disenrollment. The unwinding of the Medicaid continuous enrollment provision has raised concerns about the number of people who will lose coverage.
Continue Reading Medicaid Redetermination & Unwinding UpdatesHHS Proposed Changes Would Align Part 2 Regulations on Substance Use Disorder Records with HIPAA
In late November, HHS proposed long-awaited changes to regulations at 42 C.F.R. Part 2 (“Part 2”) governing the confidentiality of substance use disorder (“SUD”) records as required under the Coronavirus Aid, Relief, and Economic Security (“CARES”) Act. Generally, HHS is attempting to align Part 2 requirements with the HIPAA (“Health Insurance Portability and Accountability Act”) Privacy Rule. The most significant changes are those to the rules governing consent for entities subject to Part 2’s restrictions to use, disclose, and redisclose Part 2 records with respect to treatment, payment, and health care operations (“TPO”) activities.
Continue Reading HHS Proposed Changes Would Align Part 2 Regulations on Substance Use Disorder Records with HIPAA