In late June, 340 organizations signed a   letter urging Congressional leaders to make telehealth flexibilities created during the COVID-19 pandemic permanent. Those signing this multi-stakeholder letter include national and regional organizations representing a full range of health care stakeholders and all 50 states, the District of Columbia, and Puerto Rico.

Congress quickly waived statutory barriers to allow for expanded access to telehealth at the beginning of the COVID-19 pandemic, providing federal agencies with the flexibility to allow healthcare providers to deliver care virtually. If Congress does not act before the COVID-19 public health emergency expires, current flexibilities will immediately disappear.

Therefore, 340 stakeholders have sent a powerful message to Congress outlining the immediate actions necessary to ensure CMS has the authority to continue to make telehealth services available once the national health emergency is rescinded. Read more here.

CHE Behavioral Health Services , a Brooklyn company that has traditionally provided mental health services to patients in nursing homes, had been working on a telehealth solution for about two years when the pandemic hit.

It had deployed the service in rural settings, where telehealth was already being reimbursed by Medicare, but hadn't rolled it out in New York City. That has all changed in the past three months, and the company now is doing about 15,000 behavioral health televisits a month.

The company, which was founded in 1995, gradually expanded its offering to include nursing home workers, then their families and finally any person seeking behavioral health services. CHE, which has financial backing from private equity, employs about 700 licensed psychologists, psychiatrists, psychiatric nurse practitioners and other mental health professionals. Read more here.

The COVID-19 pandemic has taken a devastating toll on Americans across the country, whether in lives lost or economic impacts, and it has particularly affected our fellow citizens who have the most vulnerabilities, including the elderly and communities of color.  We've been forced to adjust and adapt our daily lives in innumerable ways, while significant public health resources have had to be redirected to help us meet and beat this unprecedented pandemic.

But even as we've battled COVID-19, federal, state, and private sector initiatives didn't stop addressing other critical issues, including another one of the most pressing public health crises facing our country:  opioid misuse and overdose.  As the largest healthcare payer in the U.S., the Centers for Medicare & Medicaid Services (CMS) is actively using coverage and payment levers to advance evidence-based responses to the opioid epidemic.  To frame our strategy, we've created a three-part  Roadmap to fight the epidemic:  preventing opioid misuse; expanding access to opioid use disorder (OUD) treatment; and using data to better target our efforts.

We recently announced a proposed rule for Medicaid (CMS-2482-P) that builds on current policies to help ensure that opioid prescribing is appropriate, medically necessary, and avoids adverse medical events. Read more here.

The COVID-19 pandemic and resulting economic downturn are taking a toll on mental health for many Americans, with large shares of the public saying that related worry and stress is having a negative effect on their mental health.

A  new KFF analysis and series of state fact sheets examine mental health and substance use disorder needs in the states and capacity to meet residents' needs prior to the pandemic, which is expected to place additional strains on the system. Average weekly data for June 2020 found that 36.5% of adults in the U.S. report symptoms of anxiety or depressive disorder, up from 11.0% in 2019. Louisiana (42.9%), Florida (41.5%) and Oregon (41.3%) have the highest shares reporting such symptoms, while Wisconsin (27.2%), Minnesota (30.5%) and Nebraska (30.6%) have the lowest.

The analysis highlights the wide range of needs and resources across states. Read more here.

Additional article of interest:  Fatal overdoses climbed to record high in 2019, reversing historic progress

The Centers for Medicare and Medicaid Services (CMS) made big news once again. On June 17, CMS issued a proposed rule to grant state Medicaid programs and other payers flexibility to enter value-based payment (VBP) arrangements with drug manufacturers. The rule's definition of VBP is an arrangement intended to align payments to therapeutic or clinical value in a population, such as evidence-based measures. The cost should be linked to existing evidence of the effectiveness and/or outcomes-based measures. Or payment should be linked to the drug's actual performance in a consumer or a population-such as reduction in medical expenses.

A significant change is that the proposed rule allows medication manufacturers to report multiple "Best Prices" for a medication. The current Federal reporting requirements for medication prices are byzantine in my view and an impediment to rational pricing. In short, under the current Federal reporting requirements, manufacturers must report to CMS their drug's "Best Price"-the lowest net price a manufacturer offers for the medication in the U.S. after factoring in all rebates and discounts. Manufacturers then pay Medicaid programs a rebate equal to 23.1% of a drug's "Average Manufacturer Price" if that amount of rebate results in a net price lower than or equal to the Best Price. This is intended to assure that the post-rebate price to Medicaid programs is no more than the Best Price available on the commercial market. Read more here.