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Advocacy Update: February 2023

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

Executive Branch Activities

Coalition Webinar: Bias and Diagnostic Anchoring of the Behavioral Health/SUD Patient and How That Impacts Care

Join APA and the Coalition on Psychiatric Emergencies on March 15 from 12:00-1:00 pm Central for a webinar on Bias and Diagnostic Anchoring of the Behavioral Health/SUD Patient and How that Impacts Care. Lisa A. Wolf, PhD, RN, CEN, FAEN, FAAN will:

  • Describe ED behavioral health trends, morbidity and mortality
  • Identify opioid use disorder as a co-existing problem
  • Discuss cognitive errors that impede the assessment and care of the BH/SUD patient
  • Identify ways to mitigate the effect of bias in the assessment and care of this patient population

Click here for the event page and here to register.

APA Responds to Notice of Proposed Rulemaking on Confidentiality of Substance Use Disorder (SUD) Patient Records

APA has responded to a Notice of Proposed Rulemaking issued by HHS, an update to 42 CFR Part 2 made as a result of the Coronavirus Aid, Relief, and Economic Security (CARES) Act requirements to more closely align Part 2’s data protections with HIPAA’s data protections. The proposed rule includes “greater integration of SUD treatment information with other PHI … [to] improve communication and care coordination between providers and with other elements of the health care system.” While integrated data can support care coordination and reduce administrative burden, access to Part 2 data can also increase risks of stigma and criminalization. In its response, APA urged HHS to work with federal, clinical, and technology partners to better balance patient protection and care coordination priorities in the final rule, accounting for practical constraints in achieving the proposed rule’s objective.

APA Responds to CMS Request for Information on Essential Health Benefits

The Centers for Medicare and Medicaid Services (CMS) put out a request for information on Essential Health Benefits (EHB) established by the Affordable Care Act. In response, APA addressed barriers of access to EHB mental health and substance use disorder treatment, noting administrative barriers, workforce issues, plans with disparate coverage, and a lack of mental health parity. The comments highlighted telehealth utilization and the Collaborative Care Model as a way to address coverage gaps. We also discussed the importance of culturally informed and linguistically appropriate care, working towards eliminating co-pays, and requiring plans to effectively track data to monitor existing disparities, as ways to advance health equity and nondiscrimination efforts. APA also signed onto a coalition letter, urging CMS to consider that children require services and care specifically suited to their unique developmental needs, when addressing coverage of EHB.

APA Applauds Addition of Mental Health Facilities and Substance Use Disorder Treatment Centers to ECPs for 2024

APA supported CMS proposals to assist consumers seeking to access mental health and substance abuse disorder (SUD) treatment to expand network adequacy by adding two distinct essential community provider categories for mental health facilities and SUD treatment centers and implementing standards for appointment wait times. APA also supported CMS’ proposal of a special enrollment period of up to 90 days for individuals who are expected to lose Medicaid or Children’s Health Insurance Program coverage and permitting coverage to begin on the first day of the month during which the old coverage ends.

Congressional Activities

APA Applauds Omnibus Health Provisions and Urges Medicare Payment Reform

On January 11, APA joined the Group of 6 in a letter of support for the health care provisions included in the year-end omnibus package. In the letter, the group thanked Congress for including provisions to protect patients’ access to care by extending Medicare telehealth flexibilities and extending postpartum Medicaid coverage for a full year. Congress also included a 6.5 percent cut in Medicare payments that were originally slated to take effect this year. While the omnibus mitigated a large percentage of these cuts, physicians are still facing a 2 percent reduction in the 2023 Medicare conversion factor. The annual threat of Medicare payment cuts via the Medicare Physician Fee Schedule (MPFS) underscores the critical need for Congress to invest in a more sustainable Medicare physician payment system. Additionally, on January 23, APA joined the House of Medicine in a letter to welcome Members of Congress to the 118th Congress. The letter expresses that Medicare payment reform will be one of the coalition’s top priorities this year. We urge the 118th Congress to address outdated Medicare physician payments so patients can access the high-quality care they deserve, and so physicians have the resources and flexibility they need.

APA Supports CONNECT for Health Act

On January 30, APA joined a letter to Sen. Brian Schatz (D-HI) and Rep. Mike Thompson (D-CA) in support of the reintroduction of the Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act in the 118th Congress. The letter urges that the reintroduction of this bill include a provision that would eliminate the in-person requirement for telemental health. This requirement was a prerequisite for coverage of telehealth services that was passed in the Consolidated Appropriations Act of 2021. We support in-person care when it is clinically appropriate or desired by the individual receiving services. However, the current in-person requirement is applied to all patients with mental health conditions regardless of whether such a visit is required. We hope that language is included in the bill to remove this requirement this Congress.

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