The Biden administration laid out a road map (PDF) for increasing pay parity and access to mental health care as efforts in Congress stall out.
The Department of Health and Human Services (HHS) released the road map Friday that laid out strategies for integrating mental health and substance abuse care into larger systems. A key pillar of the road map is to make it easier for people to get care, including making reforms to behavioral health financing arrangements in government programs such as Medicaid.
“Low affordability of care related to insurance and other financing limitations remains one of the most commonly identified challenges to accessing behavioral health care in the U.S.,” the road map said.
HHS laid out several programs and tailored efforts to engage high-risk populations into integrated behavioral health care.
For example, the Centers for Medicare & Medicaid Services (CMS) will authorize “Medicaid coverage and reimbursement of inter-professional consultations and, as a longer-term strategy, test payment models that leverage behavioral health integration to support the delivery of whole-person care,” the road map said.
CMS also recently proposed in the Physician Fee Schedule rule to amend regulatory requirements for licensed mental health counselors and therapists.
Currently, such practitioners can only get payment if they perform services under the “direct supervision” of the billing physician or another practitioner. The proposed rule would enable reimbursement for general supervision, instead of the direct approach, with the aim of increasing access to mental health.
The agency has also proposed to incentivize integration of psychologists and social workers into primary care settings. CMS aims to establish billing codes that account for monthly care integration.
The road map comes as a key Senate panel has proposed reforms to address the lack of pay parity between behavioral and physical health.
The Senate Finance Committee announced an effort earlier this year to improve mental health access, which has increased in need considering the COVID-19 pandemic.
Chairman Sen. Ron Wyden, D-Oregon, has said that even though the Affordable Care Act mandated such parity, some insurers are still not reimbursing providers at the same level for mental health.
However, the panel has not yet released text on the parity reform. Congress returned this week but is working on legislation to fund the federal government this month as well as reauthorize the user fee program for the Food and Drug Administration.
Wyden’s office did not return a request for comment on the status of the mental health reform package.