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DGR Telephone:
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CMS Finalizes CMHC Reimbursement for Partial Hospitalization Services
CMS has released a Final Rule on Community Mental Health Centers. CMHCs will be paid using a threshold separate from hospitals. CMS reasoned given the difference in partial hospitalization charges between hospitals, which are more costly, and CMHCs, which are less costly, it is inappropriate to make outlier payments to CMHCs using the outlier percentage and target amount and threshold established for hospitals. CMS has created four payment rates, including two for CMHCs and two for hospital-based partial hospitalization programs. CMHCs and hospital based providers will be reimbursed differently for the partial hospitalization services they provide. CMS believes the separate reimbursement amounts reflect the unique cost structures of CMHCs and hospital-based partial hospitalization programs. For CY 2012, CMS will calculate the CMHC partial hospitalization program APC per diem rates for Level I and Level II services using only CMHC data.
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APA Responds to FDA Draft Blueprint for Prescriber Education
The Food and Drug Administration (FDA) is soliciting comments in response to its draft document titled "Blueprint for Prescriber Education for the Long-Acting/Extended-Release Opioid Class-Wide REMS." The draft Blueprint contains core messages intended for use by continuing education providers to develop educational materials to train prescribers of long-acting and extended-release opioids under the required risk evaluation and mitigation strategy (REMS) for these products. In comments submitted to the FDA, the APA recommended that the FDA work with organizations representing primary care physicians, like the AAFP and ACP, to advocate with the Residency Review Committee of the ACGME to ensure adequate training in pain management for primary care. The APA joined the FDA in acknowledging the public health crisis that has been spurred by opioid misuse and abuse. |
Senate Aging and Homeland Security/Government Affairs Committees Focus on Psychotropic Medications
This week, the Senate Special Committee on Aging and the Senate Committee on Homeland Security and Government Affairs held separate hearings that focused on the alleged overuse of psychotropic medications in nursing homes and foster care systems respectively. DGR staff attended both hearings.
Chaired by Senator Herb Kohl (D-WI), the Aging Committee explored a May, 2011, audit issued by the Department of Health and Human Services (HHS) Office of Inspector General. Culling Medicare data, the audit found that in the first half of 2007, 14% of nursing home residents were prescribed an atypical antipsychotic, and that 88% of these prescriptions were written to treat dementia. In 2008, the Food and Drug Administration issued a black-box warning on the use of atypical and conventional antipsychotics to treat dementia, citing an increased risk of death. Staff from the Centers of Medicare and Medicaid testified to several steps it is undertaking to improve the care of patients with dementia in nursing homes, the chief of which is encouraging greater use of appropriate non-pharmacological treatments.
Chaired by Senator Tom Carper (D-DE), the Homeland Security and Government Affairs Subcommittee on Federal Financial Management, Government Information, Federal Services, and International Security explored an upcoming Government Accountability Office (GAO) report that found children in foster care systems receive psychotropic medications at a much higher rate than children who are not. The report used Medicaid data from five states: Florida, Massachusetts, Michigan, Oregon, and Texas. The GAO recommended that HHS issue permanent guidelines to state Medicaid and child welfare agencies regarding best practices for prescribing psychotropic medications and monitoring prescriptions. APA supports this recommendation as well as greater investments that would reduce the shortage of child and adolescent psychiatrists.
APA will be releasing two statements for the hearings' permanent records early next week. Stay tuned!
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| Advocates Brief Congress on Societal and Workplace Impact of Untreated AD/HD
This week, APA CEO and Medical Director James Scully, M.D., in his capacity as Chairman of the American Psychiatric Foundation, participated in a Capitol Hill briefing on the economic impact of ADHD. Dr. Scully was joined by representatives from Children and Adults with AD/HD (CHADD), the American Academy of Child and Adolescent Psychiatry (AACAP), and TIME.com columnist Judith Warner. The event was sponsored by Congressman Tim Murphy (R-PA), who co-chairs the House Mental Health Caucus.
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