HHS Names Top 3 Regulatory Priorities for Behavioral Health in 2022

The U.S. Department of Health and Human Services (HHS), the nation’s top health care regulator, will tackle three major initiatives within the behavioral health space in 2022 as the Biden administration enters its second year.

The agency holds up increasing access, promoting equity, tackling the COVID-19 pandemic and enhancing the priorities of children and families as key rhetorical points at the heart of the many specific objectives for 2022. Behavioral health is key to those objectives, according to a regulatory priorities document published by HHS.

“The COVID-19 pandemic has made clear that too many Americans have unmet behavioral health needs, which have seen an alarming rise during the pandemic due to illness, grief, job loss, food insecurity, and isolation,” the document states.

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Specific to behavioral health, HHS hopes to initiate three new regulations through the administrative rulemaking process in 2022:

  • make permanent a rule that allows for opioid-use disorder treatment providers to give extended take-home doses of methadone
  • allow for buprenorphine to be administered via telehealth
  • clarify existing law on reimbursement parity between behavioral health providers and physical health providers

Back in March 2020, HHS allowed opioid treatment providers to dispense 28 days’ worth of take-home methadone doses — an opioid used to help treat opioid addiction — for stable patients and up to 14 days’ worth of medication for less stable patients. These allowances were a social distancing protocol in the early days of the pandemic. Normally, methadone is administered under the supervision of a physician.

“There are very few reports of diversion or overdose, and the provision of extended take-home doses facilitates patient engagement in activities, such as employment, that support recovery,” the Substance Use and Mental Health Services Administration (SAMHSA), the part of HHS that specifically oversees addiction treatment regulation, said in its explanation for the rule. “Moreover, those with limited access to transportation benefit from extended take-home doses since they are not required to attend the [opioid treatment provider] almost each day of the week to receive methadone.”

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Buprenorphine, also an opioid, is also used in medication-assisted treatment when treating opioid use disorder. SAMHSA hopes to make permanent changes that were developed after the onset of the COVID-19 pandemic. The use of telehealth, which has exploded since the pandemic picked up, is vital to ensuring access to this form of treatment, SAMHSA said.

In one indication of this trend, Behavioral Health Business reported in December that New York City-based Ophelia Health Inc. landed $50 million in a Series B funding round to continue its development as a new virtual medication-assisted treatment provider.

The proposed reimbursement parity rule would enforce laws enacted by the Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA) and later modified by the Consolidated Appropriations Act of 2021. This is a key and frequent complaint of the behavioral health industry — that health plans do not meet the federal requirements forbidding less favorable benefits for behavioral health compared to other medical benefits. The Centers for Medicare & Medicaid Services (CMS), the part of HHS that regulates the titular health plans, has previously said that it is prioritizing reimbursement parity for behavioral health.

“This rule would clarify group health plans and health insurance issuers’ obligations under the MHPAEA and promote compliance with MHPAEA, among other improvements,” the HHS document states, without going into detail.

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