On July 25, the Centers for Medicare & Medicaid Services (CMS) released the Medicaid and CHIP Mental Health (MH) and Substance Use Disorder (SUD) Action Plan Overview and Guide, which outlines the agency’s strategies for improving treatment and support for enrollees with these conditions. Areas of focus include improving coverage and integration to increase access to prevention and treatment services, encouraging engagement in care through increased availability of home and community-based services and coverage of non-traditional services and settings, and improving quality of care for MH conditions and SUDs. The areas target issues that impact American Indians and Alaska Natives such as improving coverage of mental health and substance abuse disorder screening and therapies and promoting parity by supporting connection to health care coverage.
The Action Plan is CMS and CHIP’s latest step in addressing MH and SUD. In March 2016, CMS finalized a rule targeting MH and SUD parity. The goal of the rule was to benefit the over 23 million people enrolled in Medicaid managed care organizations (MCOs), Medicaid alternative benefit plans (ABPs), and CHIP. It required plans to disclose information on MH and SUD benefits upon request- including the criteria for determinations of medical necessity- and required states to disclose the reason for any denial of reimbursement or payment for services with respect to MH and SUD benefits.
NCUIH advocates on behalf of urban Indian organizations (UIOs) and urban American Indians and Alaska Natives to raise awareness of the impacts of MH conditions and SUDs in American Indian and Alaska Native communities. NCUIH outlined the disproportionately high rates of MH conditions and SUDs among American Indians and Alaska Natives in its 2023 Policy Priorities. To address this, NCUIH continues to urge Congress to appropriate $80 million for Behavior Health and Substance Abuse Disorder Resources for American Indians and Alaska Natives, which was authorized in the Fiscal Year 2023 omnibus. NCUIH also advocates for expanding access to traditional healing services at UIOs. NCUIH also recommends Congress remove funding restrictions in grants to allow for traditional healing services at UIOs, that HHS review its existing policies concerning use of federal funding, and that federal agencies engage with UIOs directly to support expansion of traditional healing services.
NCUIH will continue to advocate on behalf of UIOs and American Indians and Alaska Natives to receive culturally based care to address their MH conditions and SUDs.