July 15, 2019
Federal Opioid Epidemic Behavioral Health Funding Lapses 

Funding for a $1 billion Medicaid pilot program providing mental health and addiction services to hundreds of thousands of people in eight states, including New Jersey, expired on Sunday, when the U.S. Senate failed to advance a bill that had passed the House of Representatives in June. Pending action on this matter, clinics will remain open. They will, however, not receive the higher federal Medicaid matching rate.
H.R. 3253, the ‘Empowering Beneficiaries, Ensuring Access, and Strengthening Accountability Act of 2019’ would:

  • make appropriations through FY2024 for, and otherwise revises, the Money Follows the Person Rebalancing Demonstration Program;
  • allow state Medicaid fraud control units to review complaints regarding patients who are in non-institutional or other settings;
  • temporarily extend the applicability of Medicaid eligibility criteria that protect against spousal impoverishment for recipients of home and community-based services;
  • temporarily extend the Medicaid demonstration program for certified community behavioral health clinics;
  • repeal the requirement, under the Medicaid Drug Rebate Program, that drug manufacturers include the prices of certain authorized generic drugs when determining the average manufacturer price (AMP) of brand name drugs (also known as a "blended AMP"), and excludes manufacturers from the definition of "wholesalers" for purposes of rebate calculations; and
  • increase funding available to the Medicaid Improvement Fund beginning in FY2021.

The 2017 pilot program increased Medicaid funding to about 80 “certified community behavioral health centers” in eight states. Those centers use the funding to integrate mental health and addiction treatment into primary care. The program represents an innovative response to the opioid crisis in those states, and advocates say progress will be undermined if it doesn't continue.

Funding for these centers was initially slated to run out in March in two states, Oregon and Oklahoma, and in June for the remaining states: Minnesota, Missouri, Nevada, New Jersey, New York and Pennsylvania. Congress has already extended the program twice in the last few months, and Senate sponsors are hoping their colleagues will pass a short-term extension (through September 30) this week. We believe that extension would provide funding retroactive to this past Sunday’s sunset.
Contact: Jon Moran, Senior Legislative Analyst, jmoran@njlm.org, 609-695-3481 x121.

222 West State Street, Trenton, NJ 08608 Phone: 609-695-3481 Web: www.njlm.org

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