February 4, 2020

February 2020: Advocacy Update

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

APA Updates Resources for Electronic Prescribing

In light of rapidly changing state laws, as well as changes to national pharmacy chain policies, APA has updated its electronic prescribing website. The updated website offers new resources on selecting an electronic prescribing solution, determining whether your state is affected by these changes, and selecting an electronic prescribing tool. This page can be used in conjunction with APA’s Electronic Health Record (EHR) FAQs for those providers who wish to adopt a full EHR suite solution into their practice.

APA Continues to Educate Employers on MHPAEA Compliance

APA continues to educate decision-makers about the protections afforded by the Mental Health Parity and Addiction Equities Act (MHPAEA). Most recently, alongside the APA Foundation’s Center for Workplace Mental Health, APA created an infographic explaining the business case for health plans being MHPAEA compliant. This infographic is aimed at large employers.

APA Supports Coverage and Appropriate Payment for Esketamine

In response to a request from the Centers for Medicare and Medicaid Services (CMS), APA has offered feedback on an interim proposal on coverage and payment for Esketamine. APA supports coverage for the medication, which was recently approved by the FDA. APA’s comments encouraged CMS to revise their proposed payment structure to better reflect how the medication will be administered and patients monitored in an outpatient setting. The feedback advocates for unbundling of services and for an increase in reimbursement, in an effort to ensure that the work and time involved are appropriately valued.

APA Supports NIMH Strategic Plan for Research

APA submitted comments on the National Institute of Mental Health (NIMH) Draft Strategic Plan for Research, expressing support for its continued emphasis on the need to close the gap between research and clinical practice with a strong focus on understanding development and disease trajectories to identify forms of early intervention. APA recommended they elaborate on: 1) their plan on the role of NIMH to promote information sharing, such as between registries and EHRs, their workforce development and young investigators efforts, and 2) training to develop a workforce able to work with big and complex data sets using novel computational approaches.

APA Provides Feedback to CMS on APRN and PA Supervision

APA expressed our concerns to CMS regarding the elimination of Medicare supervision and licensure requirements that are more stringent than other applicable federal or state laws, potentially resulting in the reduction of supervision requirements for Advanced Practice Registered Nurses (APRNs) and Physician Assistants (PAs). Instead, we requested a study about the impact of such a change, recommended an approach that incentivizes a team-based approach, improves access to care for all patients, improves quality of care by standardizing training for APRNs and PAs nationally, and addresses inequities in reimbursement for supervision of psychiatric trainees. APA also signed on to an AMA letter.

APA Supports Legislation to Make Behavioral Health Treatment More Affordable

APA worked with Rep. Lauren Underwood (D-IL) on legislation to make behavioral health visits more affordable. H.R. 5575, The Primary and Behavioral Health Care Access Act, would require private insurance plans to cover three annual behavioral health visits without charging a copayment, coinsurance, or deductible-related fee. APA worked with Rep. Underwood to ensure that psychiatrists would not receive lower reimbursement for treatment covered by the bill and that insurers wouldn’t implement other cost-cutting barriers to care for patients who receive treatment under this bill. APA joined five other physician organizations in announcing its support of H.R. 5575.

Congressional Champions Help Expand Access to Telepsychiatry

Congressional support for expanding access to telepsychiatry is increasing. Rep. Gus Bilirakis (R-FL) introduced H.R. 5473, the EASE Behavioral Health Services Act, and Rep. Doris Matsui (D-CA) introduced H.R. 5201, the Telemental Health Expansion Act of 2019. Both of these bills would increase access to telepsychiatry for Medicare beneficiaries by allowing them to participate in telepsychiatry from their own homes and eliminating certain geographic limitations on “originating sites.”

State Legislative Season Begins. Here’s What to Look Out For

State health care policies play a fundamental role in guaranteeing patients receive the highest quality of mental health care. Several state legislative sessions began in January and APA is working with the district branches and state associations to monitor bill introductions that could impact the practice of psychiatry. So far this year, legislators in Florida, Indiana, Kansas, Missouri, New Hampshire, Ohio, and Oklahoma have introduced APA’s model Mental Health Parity legislation. Arizona, Maryland, Virginia, and West Virginia are also working on legislation to improve mental health parity; while district branches in Idaho, Kansas, and Louisiana are working with regulators to improve mental health parity compliance. Additionally, APA and district branches in Hawaii, Florida, and Nebraska are working together to protect patient safety, opposing legislation that would allow psychologists to prescribe medication..

Questions? Contact APA's Department of Government Relations at advocacy@psych.org.

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