Psychiatrists Can Now Apply for COVID-19 Provider Relief Funding

The Department of Health and Human Services (HHS) has announced $20 billion in new funding for an expanded group of behavioral health providers, including psychiatrists, in the third round of distributions from the CARES Act Provider Relief Fund. HHS is encouraging providers to apply as soon as possible for the funds.

Providers who have previously received a payment under phase 1 or phase 2 of the General Distribution are eligible to apply for a payment even if they have previously received a disbursement of 2% of annual revenue from patient care. Providers who have not previously received a General Distribution payment, such as psychiatrists whether or not they take insurance, may also apply for funds.

“Our behavioral health providers have shouldered the burden of responding and confronting this expanded challenge [of mental health needs] triggered by the pandemic,” stated an HHS press release announcing the Phase 3 General Distribution. “When traditional face-to-face counseling was restricted and new telehealth flexibilities were put in place in response to the pandemic, many behavioral health providers invested in and adopted telehealth technologies to continue providing patient care.”

According to the release, HHS has already issued over $100 billion in relief funding to providers through in prior distributions. The Phase 3 General Distribution will include funds for providers who previously received, rejected, or accepted a General Distribution Provider Relief Fund payment; as well as those who were previously ineligible, such as psychiatrists, whether or not they bill insurance, and providers who began practicing in 2020.

Funding for the Phase 3 General Distribution was made possible through the bipartisan Coronavirus Aid, Relief, and Economic Security (CARES) Act and the Paycheck Protection Program and Health Care Enhancement Act, which allocated $175 billion in relief funds to hospitals and other health care providers. Providers have until November 6 to apply for Phase 3 General Distribution funding.

Information about the Provider Relief Fund and how to apply is available on the APA website, which also includes a link to an Application and Attestation Portal for physicians who want to apply for funds.

HHS Extends Deadline for Provider Relief Fund Applications; Learn More at Webinar This Afternoon

The Department of Health and Human Services (HHS) has extended the deadline for health care professionals to apply for the second phase of distribution of COVID-19 Provider Relief Funds to Friday, August 28. Additionally, HHS is allowing certain health care professionals who missed the deadline for the first-phase distribution in June to apply for the new distribution.

The Provider Relief Fund was created by Congress under the Coronavirus Aid, Relief, and Economic Security (CARES) Act passed in March. Eligible health care professionals—including those who bill Medicare, Medicaid, Medicaid managed care, or the Children’s Health Insurance Program—can receive up to 2% of their patient revenue. Relief fund payments do not need to be repaid to the U.S. government, assuming recipients comply with the terms and conditions.

The initial deadline for the second-phase distribution was June 20. In a statement on July 31, HHS Secretary Alex Azar extended the deadline to August 28, while also allowing certain health care professionals who missed the first distribution to use the August 28 deadline to apply for the second distribution. Those who missed the first distribution but are unsure of their eligibility for the second are encouraged to apply.

The agency has posted a six-step guide to applying for the fund, which provides information on determining eligibility, validating one’s tax ID number, applying for funding, receiving a payment, attesting to payment, and reporting on use of funds. HHS is holding a webinar on the relief fund today, August 13, at 3 p.m. ET. The webinar will be recorded and archived on the HHS website.

“HHS’s administration of the Provider Relief Fund has been focused on distributing funding in a way that is fast, fair, and transparent,” Azar said in the July 31 statement. “Extending the deadline for Medicaid providers and giving certain Medicare providers another shot at funding is another example of our work with providers to ensure as many as possible receive the support they need.”

---

Contribute to Strengthening APA’s Leadership
Nominate yourself or a colleague

As chair of APA’s Nominating Committee, Immediate Past President Bruce Schwartz, M.D., is seeking to diversify the elected leadership of APA and invites all members to consider running for one of the open Board of Trustee offices in APA’s 2021 election: president-elect; secretary; early-career psychiatrist trustee-at-large; minority/underrepresented representative trustee; Area 1, 4, and 7 trustees; and resident-fellow member trustee-elect. You may nominate yourself or a colleague—the important point is that you get involved! The deadline is Tuesday, September 1.

Access Nomination Requirements and Form

Rules on Confidentiality of SUD Treatment Records Updated to Enhance Coordination of Care

The Substance Abuse and Mental Health Services Administration (SAMHSA) announced yesterday that it has revised regulations governing the disclosure of information about a patient’s history of substance use disorders (SUDs). The changes are intended to help advance coordination of treatment of patients under the care of multiple health care professionals.

The regulations that were revised fall under 42 CFR Part 2 and govern confidentiality of SUD treatment records.

The 42 CFR Part 2 regulations were designed to protect patient records created by federally assisted programs (“Part 2 programs”) for the treatment of SUD. With the revisions announced by SAMHSA yesterday, treatment records created by non-Part 2 health care professionals evaluating or caring for patients with SUD are explicitly not covered by Part 2, thereby allowing coordination of SUD care by non-Part 2 health care professionals.

Additionally, declared national emergencies (such as the COVID-19 pandemic) that disrupt treatment facilities and services are considered under the revised guidelines to be a “bona fide medical emergency” for the purposes of disclosing SUD records without patient consent.

HHS Assistant Secretary for Mental Health and Substance Use Elinore F. McCance-Katz, M.D., Ph.D., said the adoption of this rule means Americans will be better able to receive integrated and coordinated care in the treatment of their substance use disorders. “We are grateful to the individuals and organizations that contributed their input to the rule-making process,” she said. “This is great news for our nation’s families and communities.”

These regulations will be further revised next year to better align Part 2 with HIPAA per passage of the Coronavirus Aid, Relief, and Economic Security Act (CARES Act, HR 748) passed by Congress and signed into law by President Donald Trump on March 27.

(Image: iStock/FilippoBacci)

---

Contribute to Determining the Future of APA
Nominate yourself or a colleague

As chair of APA’s Nominating Committee, Immediate Past President Bruce Schwartz, M.D., is seeking to diversify the elected leadership of APA and invites all members to consider running for one of the open Board of Trustee offices in APA’s 2021 election: president-elect; secretary; early-career psychiatrist trustee-at-large; minority/underrepresented representative trustee; Area 1, 4, and 7 trustees; and resident-fellow member trustee-elect. You may nominate yourself or a colleague—the important point is that you get involved! The deadline is Tuesday, September 1.

Access Nomination Requirements and Form

(Image: iStock/IIIerlok_Xolms)

HHS, CMS to Host Sessions on Applying for Provider Relief, Information on COVID-19

1. Help on Applying for Provider Relief

The Department of Health and Human Services (HHS) earlier this month launched the Enhanced Provider Relief Fund Payment Portal to distribute $15 billion in CARES Act Provider Relief Fund payments to eligible Medicaid and Children’s Health Insurance Program (CHIP) physicians and organizations. The new portal was developed for providers who did not receive payments under the previous general distribution.

Among the providers who may be eligible for this funding include opioid treatment and behavioral health providers, assisted living facilities, and other home and community-based service providers, according to an HHS press release. “To be eligible for this funding, health care providers must not have received payments from the $50 billion Provider Relief Fund General Distribution and either have directly billed their state Medicaid/CHIP programs or Medicaid managed care plans for healthcare-related services between January 1, 2018, to May 31, 2020.”

HHS will host two webcasts this week for physicians and other health care professionals who are interested in learning more about the application process to acquire these funds (registration is required):

• Tuesday, June 23, at 2 p.m. ET
• Thursday, June 25, at 2 p.m. ET

“At this time, this portal will serve as the point of entry for providers who have received Medicaid and CHIP payments in 2017, 2018, 2019, or 2020 and who have not already received any payments from the $50 billion Provider Relief Fund General Distribution,” the agency wrote in FAQs. The site is open to all providers who want to apply for a Provider Relief Fund payment, regardless of network affiliation or payer contract, the agency noted.

(Image: iStock/jacoblund)

---

2. Next COVID-19 Stakeholder Engagement Call:
Tuesday, June 23, 5 p.m.-6 p.m. ET

The Centers for Medicare and Medicaid Services hosts stakeholder engagement sessions to share information related to the agency’s response to COVID-19. These sessions are open to members of the health care community and are intended to provide updates, share best practices among peers, and offer an opportunity to ask questions of CMS and subject matter experts. Conference lines are limited so you are invited to join via audio webcast on your computer or smartphone web browser.

Toll-Free Attendee Dial In: 833-614-0820

Access Passcode: 5775248

Audio Webcast link

All call recordings and transcripts are posted on the CMS podcast page.

---

Now in Psychiatric News

Psychiatric News continues to report news and information relevant to psychiatrists about the COVID-19 pandemic. We will highlight these articles for you as they become available online:

Reinventing Networking During Era of Social Distancing

Don’t miss out! Learn when Psychiatric News posts new articles by signing up here.

Policy Changes in Response to Pandemic Have Transformed MH Care

The journals of APA Publishing are receiving numerous submissions on aspects of the COVID-19 pandemic. To get information about findings to the field faster, Psychiatric News is posting summaries of these submissions soon after journal submissions are accepted.

Responding to the COVID-19 pandemic has required rapid and far-reaching changes in health care delivery, including changes in services for patients with mental and substance use disorders. These changes were enabled by a surge of policies made at the local, state, and federal levels, policies that the authors of an article in press in Psychiatric Services say should be evaluated for use in a post-pandemic world.

“Seldom in recent history have so many policies evolved so quickly as in this period of COVID-19 crisis response. These circumstances raise a critically important question: What evidence for new policies and approaches have been born from the COVID-19 crisis that should—or should not—be sustained in the future?” wrote Matthew L. Goldman, M.D., M.S., of the University of California, San Francisco, and colleagues. “As we continue to move through the unique challenges presented by this global pandemic, we can and should be opportunistic when it serves the public interest and the well-being of people with mental illness.”

The authors highlighted pandemic-related changes in mental health policy in several areas: legislation, regulation, financing, accountability, and workforce development.

Legislation. The Families First Coronavirus Response Act provides paid sick leave for people affected by COVID-19. The Coronavirus Aid, Relief, and Economic Security (CARES) Act is a $2 trillion stimulus package that includes appropriations for the Substance Abuse and Mental Health Services Administration, the Department of Health and Human Services, the Federal Communications Commission, and others to use to create programs or disseminate to various stakeholders affected by the pandemic.

Regulation. The majority of the regulations issued in response to the pandemic aim to reduce requirements for face-to-face contact between patients and health care professionals. These regulations include an exception regarding the maximum take-home methadone doses for patients with opioid use disorder enrolled in an Opioid Treatment Program and an easing of Medicare telehealth rules.

Financing. The Centers for Medicare and Medicaid Services (CMS) has made several changes that help professionals and organizations that provide mental health services remain afloat. These changes include reimbursements for telehealth services that are equivalent to that of in-person appointments and a blanket waiver that allows more flexibility in Medicare and Medicaid reimbursements, reduces prior authorizations, and affords easier transfer of patients between facilities.

Accountability. CMS has delayed quality reporting requirements for programs such as the Merit-based Incentive Payment System. While accountability mechanisms are essential, the pandemic crisis justifies the relaxation of burdensome reporting requirements.

Workforce Development. Several measures address issues concerning credentialing, licensure, scope of practice, training and technical assistance, and incentives such as loan repayment programs. For example, many states have temporarily waived state licensing and renewal requirements, CMS has temporarily exempted requirements for physician supervision of nurse practitioners and physician assistants, and the Drug Enforcement Agency waived the requirement to register in new states to prescribe controlled substances.

“[These] major areas of mental health policy … encompass a large range of stakeholders, each of whom [has] unique perspectives and incentives,” the authors wrote. “Engaging a diverse coalition of partners can help ensure the success of a policy regardless of the lever involved.”

(Image: iStock/monkeybusinessimages)

---

Now in Psychiatric News

Psychiatric News continues to report on what the COVID-19 pandemic means for psychiatrists and the patients they serve. We will highlight these articles for you as they become available online:

Telehealth to Flatten the Curve: A Plea From Psychiatry Trainees

Don’t miss out! Learn when a new issue of Psychiatric News is available by signing up here.

Funding for Telehealth Available Under FCC’s COVID-19 Program

The COVID Telehealth Program, administered by the Federal Communications Commission (FCC), is offering funding to community mental health centers, teaching hospitals, medical schools, and other eligible nonprofit health systems seeking to adopt and integrate telehealth technology into their practices.

The $200 million program, funded by the Coronavirus Aid, Relief, and Economic Security (CARES) Act, is designed to help eligible practices, hospitals, and other organizations provide and maintain telemedicine/telepsychiatry services so they can continue to provide care during the COVID-19 pandemic, while many states are still enforcing stay-at-home orders. Details about the program are posted in an FAQ on the FCC website.

Funding is limited to nonprofit and public eligible health care centers and systems that fall within the following eight categories:

• Postsecondary educational institutions offering health care instruction such as teaching hospitals and medical schools
• Community health centers or health centers providing health care to migrants
• Local health departments or agencies
• Community mental health centers
• Not-for-profit hospitals
• Rural health clinics
• Skilled nursing facilities
• Consortia of health care centers consisting of one or more entities falling into the first seven categories

Eligible entities may use the money to offset costs associated with a range of services, outlined in the FAQ, that are essential to telehealth. Eligible beneficiaries can submit applications for funding here; applications are being accepted on a rolling basis, with no current deadline.

Potential beneficiaries can determine whether they are eligible by filing an FCC Form 460 through My Portal on the webpage of the Universal Service Administration Co., an independent nonprofit designated by the FCC to administer FCC programs. Potential beneficiaries can submit applications for funding while their eligibility determinations are pending.

APA members with questions about recent telepsychiatry policy changes should contact the Practice Management Help Line at practicemanagement@psych.org.

(Image: iStock/izusek)

---

Now in Psychiatric News

Psychiatric News continues to report on what the COVID-19 pandemic means for psychiatrists and the patients they serve. We will highlight these articles for you as they become available online:

Patients With SMI in the Age of COVID-19: What Psychiatrists Need to Know

Risk Management Amid a Global Pandemic

APA Calls for Emergency Funding as COVID-19 Overwhelms Behavioral Health System

The behavioral health system is “collapsing,” despite an increase in anxiety, fear, grief, and substance use related to the global COVID-19 pandemic, according to a statement signed by APA and 11 other organizations and sent to Congressional leadership yesterday as Congress prepares to approve another round of COVID-related federal funding.

The funding under consideration is primarily focused on shoring up existing programs—especially the Small Business Administration (SBA) Paycheck Protection Program, which ran out of money last week. Congressional Democrats are hoping to add funding for hospitals, state governments, and a nationwide testing program for COVID-19. The bill is expected to be approved by Congress this week.

APA and the other groups are hoping to alert Congress to the dire need for funding for mental and substance use treatment programs. “Before the pandemic broke out, there was bipartisan consensus that addressing mental health, substance use, and suicide were urgent national priorities. Congress took preliminary steps to increase funding for mental health and addiction services, but these investments may soon be lost because of the financial strain COVID-19 has taken on our mental health and addiction system,” the coalition stated.

Citing a survey conducted by the National Council for Behavioral Health, the coalition noted that many behavioral health organizations “don’t have the funds they need to ride out this crisis.” The survey of 880 behavioral health organizations across the country revealed that 62% believe they can survive financially for only three months or less under current conditions. “Organizations have cancelled, rescheduled, or turned away 31% of patients, and 92% have reduced their operations,” they wrote.

The statement noted that the CARES Act included funding to health care professionals, with a priority on paying hospitals through Medicare. However, community behavioral health organizations rely primarily on Medicaid and have largely been left out of critical emergency funding. “We urge Congress to dedicate significant resources specifically to supporting community behavioral health programs during the crisis,” the coalition stated. The coalition also called for $1 billion each to the SAMHSA Community Mental Health Services block grant and the Substance Abuse Prevention and Treatment block grant programs.

“Our nation’s behavioral health system is crumbling because of COVID-19 at a time when we should be strengthening it to help those in need when the pandemic ends,” said APA President Bruce Schwartz, M.D.

APA CEO and Medical Director Saul Levin, M.D., M.P.A., agreed. “It is hoped that Congress and the Trump administration will support what is expected to be an increased need for services for those with mental and substance use disorders as well as the general population in the wake of COVID-19.”

---

APA Members Invited to Join AHA Webinar to Focus on Lessons Learned Regarding Behavioral Health Services During COVID-19 Pandemic

Wednesday, April 22, 2-3 p.m. ET

Senior leaders from Baltimore’s Sheppard Pratt Health System, including President and CEO and AHA Trustee Harsh Trivedi, M.D., will discuss how they re-engineered care processes, developed new care protocols for agitated patients, and created a virtual emergency department assessment to decrease the number of psychiatric patients in the ED during the COVID-19 surge. Sheppard Pratt also will discuss its efforts to support staff and build resilience during the crisis. Register for the webinar here.

APA Praises Mental Health Provisions in COVID-19 Stimulus Aid Package

APA today praised Congress for approving a $2 trillion stimulus aid package to provide fiscal relief for Americans and businesses in the face of the COVID-19 pandemic. The legislation, known as the Coronavirus Aid, Relief, and Economic Security Act (CARES Act), includes many provisions supported by APA that will enable psychiatrists and mental health care professionals to better respond to the pandemic. President Donald Trump signed the legislation on March 27..

“You can’t have a healthy economy without healthy people—and that includes mental health,” said APA President Bruce Schwartz, M.D. “This stimulus bill will strengthen our ability to help the millions of Americans with existing mental illnesses or substance use disorders, and more with emerging mental health issues as the pandemic unfolds. This is a promising development in the nation’s efforts to fight the impact of COVID-19.”

Among the provisions of the CARES Act that APA supports are $425 million for Substance Abuse and Mental Health Services Administration programs (including $250 for Certified Community Behavioral Health Clinics and $50 million for suicide prevention programs) and $4 billion for community health centers. The bill further loosens restrictions governing telehealth services by repealing the Medicare requirement that allows only health care professionals to see a patient remotely if they have previously seen that patient within the past three years. The legislation also aligns 42 CFR Part II with the Health Insurance Portability and Accountability Act (HIPAA) to allow sharing of substance use disorder records between health care professionals. Additionally, the legislation suspends the 2% Medicare sequester cut through December 2020.

“As we respond to one of the largest public health threats facing our country in decades, funding for behavioral health initiatives and expanding telemedicine is critical,” said APA CEO and Medical Director Saul Levin, M.D., M.P.A. “We strongly believe that federal and state government will need to continue to support physicians, who will be working long hours and in many cases risking their own health, as we continue to address this pandemic.”

---

APA’s COVID-19 Resource Center Keeps You Updated

APA’s COVID-19 Resource Center brings together a number of useful resources from APA and other authoritative sources to help you deal with the COVID-19 crisis.