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Advocacy Update: December 2023

The last few months have seen significant movement across a broad array of issues.

APA-Led Activities

APA Resources about 2024 Medicare and Telehealth Policy

APA has released several resources for APA members about Medicare coverage and telehealth policy in 2024. This includes a recorded 30-minute webinar on the topic: 2024 Medicare Physician Fee Schedule & Telehealth Policy Updates and Telepsychiatry Blog post: Telepsychiatry Policy in the 2024 Medicare Physician Fee Schedule.

APA Policy and Practice Insights Series

APA’s Policy and Practice Insight Series keeps interested members informed on policy changes, recent breakthroughs, and impactful insights. Our last session, “Eating Disorders: Early Diagnosis for Better Prognosis — Decision Support and Other Tools” on Dec. 14, 2023, provided psychiatrists and other health professionals tools to recognize and treat eating disorders. Attendees were also able to engage with APA Practice Guidelines staff and ask questions about these tools to support early diagnosis and better prognosis of eating disorders. To view this session and previous webinars, click here.

Executive Branch Activities

APA Along with Partners Met with OMB Regarding Banning Menthol Cigarettes

On December 4, APA, along with partner medical societies, met with the Office of Information and Regulatory Affairs within the Office of Management and Budget, the Food and Drug Administration (FDA), and Health and Human Services to discuss support for the FDA’s menthol cigarette ban and flavored cigar ban. APA shared data on the impact of menthol cigarettes on youth and adolescents, as well as data on nicotine use and the increased risk for current and future addiction of other drugs. APA is requesting swift action to finalize the rules to ban menthol cigarettes and flavored cigarettes.

Congressional Activities

APA Supports Provisions in Senate Finance Package

On November 7, APA sent a letter to the Chair and Ranking Member of the Senate Finance Committee to express support for provisions included in the markup of the Better Mental Health Care, Lower-Cost Drugs, and Extenders Act. In the letter, we endorsed several provisions of the bill, including Section 104, “Medicare Incentives for Behavioral Health Integration with Primary Care.” Section 104 of the bill includes APA priority legislation, H.R. 5819/S.1378, the Connecting Our Medical Providers with Links to Expand Tailored and Effective (COMPLETE) Care Act. The COMPLETE Care Act is a bicameral, bipartisan bill that would temporarily enhance Medicare reimbursement for behavioral health integration services like the Collaborative Care Model (CoCM). The package was favorably passed out of committee and is awaiting consideration by the full Senate.

APA Joins MHLG Telehealth Workgroup in Letter to Senate Finance

On November 14, APA joined the Mental Health Liaison Group Telehealth Workgroup in a written statement for the record to the Chair and Ranking Member of the Senate Finance Health Subcommittee to urge the Committee to pass a provision that would permanently remove the telemental health in-person requirement as passed within Section 123 of the Consolidated Appropriations Act of 2021. This statement was sent to correspond with the Finance Committee’s hearing that day entitled, “Ensuring Medicare Beneficiary Access: A Path to Telehealth Permanency.”

AMA Letter to Avert Medicare Payment Cuts

On November 16, APA joined a letter to the House and Senate leadership urging them to pass legislation to stop another impending round of Medicare payment cuts. Without intervention from Congress, physicians are facing a 3.37 percent payment reduction on January 1, 2024. In the letter, we express that many physicians could be forced to reduce available health care services, cut office hours, or even forgo treating Medicare patients altogether if payment cuts are not addressed.

APA Attends White Ribbon Day on Capitol Hill

APA member Uju Berry, MD, MPH, was invited to speak at this year’s White Ribbon Day event in Congress. APA joined other partner organizations in recognizing survivors of domestic violence and pledging to support victims and survivors of violence, gender-based discrimination, harassment, and assault. The event opened with remarks from the Honorable Tanya J. Bradsher, Deputy Secretary of Veterans Affairs, reaffirming the VA’s efforts in addressing domestic and gender-based violence. Dr. Berry, a member of APA’s Committee on Women’s Mental Health, shared her experience in treating patients who have experienced such violence and reminding attendees that the leading cause of death in pregnant women is homicide. Representatives Debbie Dingell (MI-06) and Lucy McBath (GA-07) spoke about their personal experiences and legislative efforts around the cause. The event closed with everyone taking the White Ribbon VA pledge to never commit, excuse or stay silent about sexual harassment, sexual assault, or domestic violence against others.

Tanya Bradsher and Uju Berry
The Honorable Tanya Bradsher (L), Deputy Secretary of Veterans Affairs, and Uju Berry (R), M.D., M.P.H., member of APA’s Committee on Women’s Mental Health

State Activities

APA Submits Testimony in Opposition to DC B25-545

District of Columbia: On December 7, APA submitted written testimony of Dr. Saul Levin to the DC Council’s Committee on Health urging them to oppose DC B25-545 which would change the composition of the Board of Medicine to authorize non-physicians to oversee and regulate physicians. The Board of Medicine is currently composed of ten physicians and four members of the public. DC B25-545 would reduce the number of physicians to six and add two physician assistants, one chiropractor, one podiatrist, and one acupuncturist. These non-physicians would have authority to regulate physician licensure and practice in the District of Columbia. Not all health professions have the same guidelines for practice, and it is illogical to have non-physicians determining licensure requirements for physicians.

In addition, several non-physician occupations (chiropractors and podiatrists) will move under the Board’s purview. The language of DC B25-545 makes sweeping changes to patient safety requirements currently in law and would authorize non-physicians such as nurse practitioners and pharmacists to practice without physician supervision. Patient safety must be paramount when considering the change of any law, and by making broad changes to DC B25-545 patients are put at risk.

Partnership Advocacy

Aetna Reverses Policy After Letter Urging Continued Telehealth Services

On November 2, APA joined a letter to Aetna Inc. to express our concern with the insurer’s announcement to terminate several services to treat mental health and substance use disorders via telemedicine and telehealth, including intensive outpatient and partial hospitalization program services. These services had been offered by Aetna since the onset of the pandemic and termination of this coverage would have been effective December 1 this year. However, after receiving the above letter, Aetna announced that it would expand its telehealth policy rather than terminate it.

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