Washington, D.C. Report

Periodically, NOFAS will report on legislative and policy news related to FASD.

Wednesday, December 1, 2010

• Among the leading FASD advocates in the U.S. Senate, Alaska Republican Lisa Murkowski appears to have won reelection as a write-in candidate. Certification of the result has been held up pending a review of approximately 8,000 ballots. Unofficially, Murkowski has a lead of over 11,000 votes.

• In the U.S. House of Representatives Alaska Republican Don Young and New Jersey Democrat Frank Pallone (D-NJ) will serve as co-chairs of the Congressional Caucus on Fetal Alcohol Spectrum Disorders in the new Congress.

• No action is expected to be taken before the close of the current congressional session on the Advancing FASD Research, Prevention, and Services Act (S.3154) introduced by Murkowski and Tim Johnson (D-SD). The bill reauthorizes FASD-related programs within the Department of Health and Human Services and establishes FASD programs in the Departments of Education and Justice. If the bill is not passed this month, FASD legislation must be reintroduced in the new Congress.

• The Indian Health Care Improvement Reauthorization and Extension Act (S.1790) was enacted into law as part of the Patient Protection and Affordable Care Act (H.R.3590), the major health care reform bill signed by President Obama in March. The Indian health care bill includes a comprehensive FASD section authorizing the Indian Health Service, Tribes and Tribal organizations to establish programs that, in part, provide:

• community and in-school training, education, and prevention programs relating to fetal alcohol spectrum disorders;

• behavioral health treatment to high-risk Indian women and high-risk women pregnant with an Indian’s child;

• appropriate psychological services, educational and vocational support, counseling, advocacy, and information to fetal alcohol spectrum disorders-affected Indians and their families or caretakers;

• counseling and support programs in schools for fetal alcohol spectrum disorders-affected Indian children;

• prevention and intervention models which incorporate practitioners of traditional health care practices, cultural values, and community involvement;

• culturally sensitive assessment and diagnostic tools including dysmorphology clinics and multidisciplinary fetal alcohol spectrum disorders clinics for use in Indian communities and urban Centers;

• training on fetal alcohol spectrum disorders to professionals providing services to Indians, including medical and allied health practitioners, social service providers, educators, and law enforcement, court officials and corrections personnel in the juvenile and criminal justice systems;

• early childhood intervention projects from birth on to mitigate the effects of fetal alcohol spectrum disorders among Indians;

• Community-based support services for Indians and women pregnant with Indian children; and

• Community-based housing for adult Indians with fetal alcohol spectrum disorders.

• The Birth Defects Prevention, Risk Reduction, and Awareness Act of 2010  (S.3479 and H.R. 5462), introduced by Senators Kay Hagan (D-NC), Bob Casey (D-PA) and Mary Landrieu D-LA, and Representative Rosa DeLauro (D-CT), has passed the House and awaits action in the Senate. The bill would establish and implement a birth defects prevention and public awareness program, which includes:

• a nationwide media campaign to increase awareness among health care providers and at-risk populations about pregnancy and breastfeeding information services;

• campaigns to increase awareness about, pregnancy and breastfeeding information services; and

• surveillance of or research on maternal exposures that may influence the risk of adverse pregnancy outcomes and maternal exposures that may influence health risks to a breastfed infant

• This year, the Centers for Medicare & Medicaid Services issued regulations for the implementation of the Mental Health Parity and Addiction Equity Act.

  • The law preserves the provisions in the Mental Health Parity Act of 1996 stating that a group health plan may not impose annual or lifetime dollar limits on mental health benefits that are less favorable than any such limits imposed on medical surgical benefits, and extends the parity requirements to substance use disorder benefits. Standards for medical necessity determinations and reasons for any denial of benefits relating to mental health/substance use disorders (MH/SUD) must now be disclosed upon request.

  Limitations of the new regulations:

  • the requirements only apply to large group health plans and their health insurance issuers that had ALREADY included mental health and substance use disorder benefits in their benefit packages as of October 2009;
  • large group health plans and their health insurance issuers are NOT required to include MH/SUD benefits in their benefits package;
  • small employers who have between 2 and 50 employees are EXEMPT from the requirements;
  • large group health plan sponsors able to demonstrate that compliance with the new regulations increases their claims by at least two percent in the first year (one percent in subsequent years) may request EXEMPTION;
  • A nonfederal governmental employer that provides self-funded group health plan coverage to its employees (coverage that is not provided through an insurer) may elect to EXEMPT its plan (opt-out) from the requirements.