Biden Administration Releases ‘Historic’ Final Rule on Behavioral Health-Physical Health Parity

The Biden administration has released its final rule updating mental health parity compliance for group and individual health plans. The final rule updates how federal agencies oversee whether health plans treat behavioral health benefits differently than physical health benefits. In short, it requires and spells out how health plans are to analyze nonquantitative treatment limitations (NQTL) for both types of benefit and requires plans to remedy and disparity. The rules apply to group health plans with new plan years starting after Jan. 1, 2025, with other, more technical aspects of the rule going into effect a year later. The new final rule applies to individual health plans starting on Jan. 1, 2026. NQTLs are non-numerical limits of benefits and include things such as prior authorization and other medical management techniques. Behavioral health executives and advocates have long argued that they and their patients are mistreated by health plans. They often point to practices that make it harder to get and stay in treatment. On top of that, providers often maintain that they are underpaid by health plans when providing services that are equivalent to physical health services.

OhioMHAS Virtual Data Forum - October 16

The Ohio Department of Mental Health and Addiction Services (OhioMHAS) is pleased to announce our next Data Forum on October 16, 2024, from 3:00 p.m. to 4:30 p.m. The purpose of the Data Forums is to:

• highlight new data resources, share information about current and upcoming data projects;
• facilitate opportunities for peer-to-peer learning;
• demonstrate how data can be used in the daily practice of ADAMH Boards and Behavioral Health providers; and
• discuss local needs related to data and data infrastructure.

The Data Forum series will convene on a quarterly basis to provide a venue for sharing timely and useful best practices, examples, and resources for ADAMH Boards and behavioral health providers that may be implementing or updating their own data systems and data analytic capabilities.

Intended Audience

This resource is intended for any stakeholders who are interested in learning about data and data resources, including ADAMH Board and Behavioral Health provider leadership and staff who work with, manage, and communicate data at all levels.

OCTOBER 2024 DATA FORUM AGENDA

1. Overview – OhioMHAS Data Strategy, Ken Simmons, OhioMHAS  
2. Review – Ohio Youth Surveys, Jon Kraus (Ohio Department of Health) & Lara M Belliston (OhioMHAS)
3. Update – Ohio Substance Abuse Monitoring (OSAM) Network, Tom Sherba, OhioMHAS

Contact [email protected] if you have any questions.

Click Here to Register

The Ohio Council Welcomes New Member Provider, Ever Well Community Health

Ever Well Community Health in Ravenna, OH - Erica Spencer, CEO, can be reached at [email protected] or by phone at (234) 973-9841. 

Ever Well Community Health is a for-profit organization providing individual/family counseling, case management, RN, and medication management services in Northeast Ohio.

Click here to learn more about Ever Well Community Health!

A ‘Miracle Molecule’ Could Cut Fentanyl Deaths in Half — Or Lead More Into Addiction

America’s sky-high rate of fatal fentanyl overdoses could be halved if users were treated with another opioid, Biden administration officials and a bipartisan group of senators believe.

They and others who support expanded access to methadone argue that allowing addiction specialists to prescribe it outside of the clinics (OTPs) now permitted to dispense it would save tens of thousands of lives.

But the proposal faces opposition from the health care providers with the most intimate knowledge of methadone treatment: methadone clinic directors. They tell POLITICO that allowing prescribing outside of clinics is risky without their strict safeguards.

Methadone is an addictive opioid that’s deadly if abused. “The idea that a physician in private practice without support staff … that they’re going to be able to treat a complex medical problem like the use of fentanyl, is just not substantiated,” said Mark Parrino, president of the American Association for the Treatment of Opioid Dependence, which represents methadone clinics. The disagreement over how to proceed comes as fatal overdoses climbed more than 50 percent during the pandemic before declining slightly in the year ending in March to 103,451. And while proponents of making methadone easier to get say that toll is ample reason to rethink treatment rules that are now decades old, the clinics fear it’s a bad idea that could make the overdose problem worse. Thus far, they’re winning the debate in the only forum that matters: Congress.