The U.S. Senate Committee for Health, Education, Labor and Pensions (HELP) advanced a bipartisan mental health bill to the full Senate on March 16, but currently, a pilot program providing financial incentives for behavioral health providers to obtain electronic health records (EHRs) is not part of the legislation.
Sen. Sheldon Whitehouse (D-R.I.) is the author of the pilot, which builds on the Improving Health Information Technology Act (S. 2511) that the HELP Committee recently approved with a strong bipartisan vote. According to a recent letter from the Behavioral Health IT (BHIT) Coalition pushing for the inclusion of this program, “The BHIT Coalition believes that the meaningful use program needs major legislative reforms encompassing improved interoperability, better EHR usability, and enhanced transparency including the star rating system authorized in S. 2511. At the same time, meaningful use reform efforts cannot be completed without providing HIT incentive payments to frontline acute care behavioral health providers.”
The Whitehouse bill proposes a $250,000,000 budget through 2022 but doesn’t offer any suggestions on how that money will be provided. Currently, behavioral health provider organizations can qualify for meaningful use incentive funds only through the current definition of eligible professionals, which includes physicians and some nurse practitioners that are affiliated with their facilities. The typical behavioral health organization has a limited number of these professionals compared to psychologists and licensed social workers.
Earlier this month, the Center for Medicare & Medicaid Services (CMS) announced that it will permit states to request the 90 percent enhanced matching funds from CMS to help more Medicaid providers, such as long-term care, behavioral health providers and substance abuse treatment centers, connect to a health information exchange
According to a report in Politico, “The Mental Health Reform Act does add grants for telemedicine child psychiatry through the Substance Abuse and Mental Health Services Administration (SAMHSA). It requires separate reports from the U.S. Department of Health and Human Services (HHS) and the Government Accountability Office (GAO) on the barriers that 42 CFR Part 2 (confidentiality of alcohol and drug abuse patient records) presents to the sharing of substance abuse treatment records.” The report continued, “The HELP Committee's mental health bill is practically silent on that section of federal law, which requires a patient to sign off on each provider who can see his or her substance abuse treatment records. But a proposed SAMHSA rule from last month provides patients a blanket authorization for providers as long as they first sign a consent form explicit about the information they are disclosing.”
However, according to a statement released by Kansas-based behavioral health vendor Netsmart, “The intent of the proposed rule is to protect patient privacy, while updating and simplifying the consent process for the sharing of SUD [substance abuse disorders] medical records in new integrated care settings like health information exchanges (HIEs), accountable care organizations (ACOs) and Medicaid health homes. However, many of the proposed rule’s provisions are not viable today, but may be in the future when technology and standards are developed uniformly across all electronic health record and HIE vendors.”