House subcommittee advances mental health overhaul, other reforms

Bipartisan legislation addressing issues with the country’s mental health system was approved in an 18-12 vote by subcommittee and will be before the full House Energy and Commerce Committee as a next step. The legislation, H.R. 2646, the Helping Families in Mental Health Crisis Act (the Act), is centered on “refocusing programs, reforming grants, and removing barriers to care,” according to the subcommittee. In the same markup session, the subcommittee also advanced six other health-related pieces of legislation to full committee, including those focused on reforming certain aspects of the Patient Protection and Affordable Care Act’s (ACA) (P.L. 111-148) food labeling requirements, Medicaid, and controlled substances.

Mental health reform

This comprehensive reform of the mental health system proposes to:

  • establish an Assistant Secretary for Mental Health and Substance Use Treatment within HHS to replace the Administrator of the Substance Abuse and Mental Health Services Administration (SAMHSA);
  • establish a committee to assist the new Assistant Secretary;
  • establish a National Mental Health Policy Laboratory;
  • reform the Health Insurance Portability and Accountability Act (HIPAA) (L. 104-191) and allow licensed medical professionals to share certain diagnoses and instructions related to mental health patients with the patients’ caregivers;
  • increase brain research funding at the National Institute of Mental Health;
  • provide for eligibility of electronic health records among behavioral health specialists under the Health Information Technology for Economic and Clinical Health (HITECH) Act (L. 111-5);
  • reform SAMHSA “with restrictions on lobbying by systems that accept federal funds to protect and advocate the rights of individuals with mental illness;” and
  • require the Government Accountability Office to conduct research on discriminatory actions against those with mental illness and substance abuse issues.

The legislation also would require that the new Assistant Secretary be a licensed psychiatrist or clinical psychologist. A number of reforms to the Medicare and Medicaid systems are also included in the Act, according to the subcommittee’s summary.

Menu labeling

The Common Sense Nutrition Disclosure Act, H.R. 2017, which was also advanced by the subcommittee, proposes to amend the provisions of the ACA that require calorie and nutrition information to be provided to customers in certain food retail establishments. Specifically, the bill would help alleviate the burden of this requirement on businesses and account for diverse business models when implementing these requirements.

Controlled substances

Another piece of legislation passed on to the full committee by the subcommittee was the Synthetic Drug Control Act of 2015, H.R. 3537. This bill was proposed to help stop the sale of synthetic drugs by identifying them as Schedule I under the Controlled Substances Act (CSA) (21 U.S.C. § 812). The American Hospital Association has voiced its support of this proposal, noting that many new synthetic substances “have entered the market, leading to devastating health consequences and increased mortality, particularly among the nation’s youth.”

The subcommittee also considered and advanced the Medical Controlled Substances Transportation Act, H.R. 3014, which would provide for a means of agreement and approval by the Drug Enforcement Administration (DEA) for physicians to transport and administer controlled substances outside of their practice areas and in disaster areas.

Medicaid reform

Three Medicaid-related pieces of legislation were considered and moved forward by the subcommittee. The Medicaid Directory of Caregivers Act, H.R. 3821, would establish a directory of physicians that have treated Medicaid beneficiaries in the last 12 months in states that operate Medicaid programs with fee-for-service and primary care case management programs. The Ensuring Medicaid Providers Are Removed from Medicaid and CHIP Act, H.R. 3716, would attempt to reduce the prevalence of providers that are registered in states’ Medicaid or Children’s Health Insurance Programs (CHIP) who have been excluded or removed from other states’ programs. H.R. 2446, would amend the Social Security Act to require use of electronic visit verifications for personal care services provided to Medicaid beneficiaries.