Regulatory Updates: June

Department of Education

Rule/Title: 6A-1.094121 Mental and Emotional Health Education

Purpose and Effect: To establish minimum hours of required instruction related to mental and emotional health education for grades 6-12 students and to establish procedures for school districts to document the instruction.

The preliminary text of the proposed rule development is not currently available.

Department of Children and Families

Rule/Title: 65D30.014 Methadone and Methadone Maintenance
We have heard the agency is very close to final adoption of the rules relating to methadone. Stay tuned…..

Low Income Pool for Central Receiving Systems Update

OBHA Staff

Good News! The final milestone to implement the Low Income Pool (LIP) for Behavioral Health providers was reached on April 17 when AHCA received approval from federal CMS on the Revised Funding Methodology Document (RFMD) that includes Behavioral Health providers (central receiving systems) in Florida’s LIP.   AHCA has already initiated the invoicing process and providers are expected to receive payment before June 30.  We are excited to have the opportunity to demonstrate the positive impact this will have on the system of care statewide.

This lengthy process began over three years ago with the hiring and collaboration of Health Management Consultants (HMA) on revenue maximization language. At the conclusion of the 2018 session (March) LIP proviso was agreed upon and accepted by the legislature, written into the GAA, and signed by the Governor. AHCA had to submit the 1115 Waiver Amendment and obtain CMS approval. Then One BH staff worked to get a state budget amendment passed by the Joint Legislative Budget Commission after the CMS approval.  Finally AHCA received the RFMD approval by CMS to implement the behavioral health LIP payments in April.

CMS Updates on Efforts to Address Opioid Epidemic

The Medicare Administrative Contractors (MACs) under the Centers for Medicare and Medicaid Services (CMS) recently mailed letters to all Medicare fee-for-service providers to outline federal agency efforts to reduce opioid misuse by Medicare enrollees, including:

  • Providing guidance on co-prescribing Naloxone
  • Implementing new Medicare Part D opioid policies
  • Promoting a range of safe and effective pain treatments

Also released by CMS in February was an expanded version of the Opioid Prescribing Mapping Tool, which includes current data to effectively address the opioid epidemic across the country. The goal is to better inform local prevention and treatment efforts, particularly in rural communities hard hit by the opioid crisis.

New to this tool is data on opioid prescribing through Medicaid, along with the capability to make geographic comparisons of Medicare Part D opioid prescribing rates over time for urban and rural communities.

The full text of the press release can be found here: CMS Press Release (issued February 22).

DCF Clarification on Serving Individuals from Out of State in Outpatient Detox

On March 13, the Department of Children and Families (DCF) issued a policy clarification regarding Outpatient Detox and Day or Night with Community Housing services. In the clarification memo, DCF reported that some outpatient detox providers are serving individuals from out of state who do not have family support, as required in Section 65D-30.006(3), FAC. Additionally, DCF has become aware of instances where individuals are receiving treatment services (assistance with medications) while living in day or night treatment with community housing program, in violation of 65D-30.008(1), FAC.

In response to these violations, DCF is requiring all outpatient detox providers to eliminate the practice of admitting individuals from out of state who do not have local family support to monitor their compliance. Additionally, day or night community housing providers may not accept individuals who are receiving detox services. (link to memo)

Update: DCF Issuance of New Methadone Licenses

In the February 2019 newsletter, we reported the Department of Children and Families (DCF) had received 123 applications for methadone medication-assisted treatment licenses by the February 4 deadline, under the emergency suspension of the requirement for a determination of need.

On March 13, DCF informed the 123 applicants that pursuant to a settlement agreement reached with plaintiffs in a lawsuit challenging the legality of the emergency suspension, the Department would NOT be issuing any new licenses. Application fees will be refunded to organizations that submitted applications before the deadline. DCF will be publishing revisions to the current rule for methadone licenses (65D-30.014) soon – in advance of a public hearing on the proposed changes to the rule currently scheduled for April 5, 2019.

The staff of One Behavioral Health Association will be monitoring any updates on the proposed rule and will attend the DCF public hearing on your behalf.  (link to letter)