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Advocacy Update: June 2024

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

APA-Led Activities

APA Leads Hill Briefing on Telehealth

APA, in partnership with the American Psychological Association, the Association of Behavioral Health and Wellness, and the American Foundation for Suicide Prevention, held a briefing for Congressional staffers on the importance of telehealth access. APA members Shabana Khan, MD, and Jimmy Potash, MD, MPH participated in the briefing and spoke to the impact telehealth has had on their patients and mental healthcare as a whole. A requirement that Medicare patients have an in-person visit within the last six months before they can access telemental health care goes into effect at the end of this year if Congress does not act. The multi-stakeholder panel urged Congress to pass the bipartisan Telemental Health Care Access Act (HR.3432/S.3651), which would permanently remove this 6-month in-person requirement under Medicare. Congresswoman Dorris Matsui (D-CA) sponsored the hill briefing for APA.

APA Leads Hill Briefing on Telehealth

Advocacy Update Webinar

Join the Division of Advocacy, Policy, and Practice Advancement on July 30 from 12:00 - 12:45 p.m. ET to hear the latest updates on APA’s federal, state, and regulatory advocacy. Learn what is happening in Washington, D.C. and the states and how you can fuel our advocacy efforts to create impactful change for our profession and patients. Click here to register.

Frank J. Menolascino Award Nominations Open

Nominations are open for the Frank J. Menolascino Award. The award recognizes an American Psychiatric Association member who has made significant contributions to psychiatric services for persons with intellectual developmental disorders/developmental disabilities through direct clinical services and/or dissemination of knowledge in this field through teaching or research. The Frank J. Menolascino Award carries an honorarium of $500 and a plaque to be given at an educational session presented by the winner at the 2025 APA Annual Meeting. Nominations are due July 10, 2024.

Psychiatric Services Achievement Awards Submissions Open

Submissions for the Psychiatric Services Achievement Awards are open. The Psychiatric Services Achievement Awards recognize outstanding programs that deliver services to people with mental illness or disabilities that have overcome obstacles and that can serve as models for other programs. There are three award tiers: Gold, Silver, and Bronze. The deadline for submission is July 19, 2024.

Executive Branch Activities

APA Submits Considerations to ONC’s Strategic Plan

APA provided valuable input to shape the future of healthcare technology and sent a letter to the Office of National Coordinator (ONC) providing input on their strategic plan for 2024-2030. This letter provides comments on where ONC should focus their efforts. APA urged ONC to protect data privacy standards; include telehealth and audio-only care to become an essential strategy to improve health equity; and consider smaller and rural behavioral health organizations who may face resource limitations in adopting and maintaining health IT solutions.

APA Provides Comment to FDA’s Psychopharmacologic Drugs Advisory Committee

APA provided comprehensive feedback to the US Food and Drug Administrations Psychopharmacologic Drugs Advisory Committee request for comments regarding Midomafetamine Capsules (MDMA). APA’s comments highlight its position to support research and therapeutic discovery into psychedelic agents provided they are conducted with the same scientific integrity and regulatory standards applied to other emerging therapies in medicine. The comments further discuss the need to sound research design, expectancy effects, and therapy as part of the treatment. At the June 4th hearing, APA’s Chair of the Council on Research, Dr. Jonathan Alpert, provided verbal testimony highlighting comments in the written letter. APA will continue to advocate to prioritize patient safety and public health, ensuring that any new treatment for PTSD does not inadvertently lead to adverse consequences for individuals.

APA Responds to CMS Proposed Rules on Hospital Services

APA commented on CMS’s proposed rule for Inpatient Psychiatric Facilities supporting recommendations for enhanced payments for ECT, however we also raising concerns about the implementation of a Patient Assessment Index as well as the adoption of a 30-day emergency department visit quality measure which could be overly punitive while failing to have an impact on improving the quality of care. A second proposed rule on the Inpatient Prospective Payment System focused largely on changes to the condition classification system (MS=DRG) that is part of the payment formula for inpatient care. APA supported the proposed classification change that will increase payments to hospitals when providing care for patients experiencing homelessness. APA also urged CMS to reverse their proposed decision and apply a similar increase for patients with Delirium, and supported CMS's proposal to create a Patient Safety Structural Measure for use in the inpatient setting.

APA Hosts Parity Enforcement Authorities

APA hosted representatives of the Employee Benefits Security Administration of the Department of Labor, (EBSA/DOL) the agency tasked with enforcing the Mental Health Parity and Addiction Equity Act at the APA’s annual meeting. Enforcement personnel met with over 270 APA members to hear about psychiatrists’ experience with navigating the barriers to care as they treat their patients. These meetings were the result of years long APA advocacy to the agency that barriers to MH/SUD continue and urging them to enforce parity laws and regulations. APA encourages members to contact the EBSA/DOL at 866-444-3272 with concerns and questions about barriers to care and to make the EBSA/DOL phone number available to their patients using this poster.

Congressional Activities

APA Participates in MFP Hill Briefing

APA’s immediate past Trustee-at-Large, Michele Reid, M.D, spoke at a congressional briefing and joining other health organizations highlighted 50 years of success of the Minority Fellowship program (MFP). The MFP is designed to train a diverse health care workforce to reduce health disparities and improve outcomes for racial and ethnic populations. Dr. Reid, representing the APA, presented along with the American Psychological Association, American Nurses Association, and National Board for Certified Counselors and urged Congress to continue the current level of funding for the MFP. Congresswoman Nanette Barragán (D-CA) sponsored and participated in the briefing.

APA Participates in MFP Hill Briefing

APA Endorses HR 3412, the 'Mental Health Act'

APA endorsed new legislation, the U.S. Senate Commission on Mental Health Act (S. 4312), introduced by Sens. John Fetterman (PA) and Tina Smith (MN). The legislation seeks to create a new independent commission charged with investigating barriers to mental health care delivery, crafting an annual report that reviews ongoing research, provides a comprehensive needs assessment, and makes policy recommendations to improve access. The commission would be composed of six sitting Senators (3 Democrats and 3 Republicans), along with two experts “with demonstrated academic and professional background in MH care.” In the first year following establishment, the Commission would specifically be tasked with considering mental health parity requirements, reimbursement rates for mental health services, workforce challenges.

APA Pushes for Increased Funding of Mental Health Programs

APA supported increased appropriations for behavioral health priorities in the fiscal year 2025 (FY25) federal budget through multiple coalition letters to Congress. APA joined with maternal mental health organizations to urge appropriators to increase funding for the Maternal Mental Health Hotline and perinatal psychiatry access programs. APA also joined a letter urging Congress to fund the Children’s Hospitals Graduate Medical Education (CHGME) program on par with other GME programs, as it represents one of the most important federal investments supporting the pediatric psychiatric workforce and access to care for the nation’s children. More than 40% of child psychiatrists currently train at CHGME hospitals.

APA Endorses HR 6664, the 'Innovation in Pediatric Drugs Act'

APA joined a letter supporting the Innovation in Pediatric Drugs Act (H.R. 6664). The bill would help speed therapies to the children and adolescents by making needed changes to the pediatric drug laws by increasing the number of rare disease drugs studied in children, ensuring that mandated Pediatric Research Equity Act studies are completed, and give the NIH Best Pharmaceuticals for Children Act program its first funding increase in 22 years.

State Advocacy Activities

APA Partners with DB/SAs to Advocate for Patient Safety Protections in Prescribing

During the winter/ spring 2024 session, APA DBs in Arizona, Florida, Hawaii, New York, Oklahoma, and Washington State fought and defeated legislation to license prescribing psychologists. The Illinois DB kept psychologists prescribing scope expansion legislation from moving forward.

New Mexico enacted expanded scope of practice for prescribing psychologists. The Louisiana DB lobbied against legislation to allow medical psychologists to enter into a collaborative agreement with an APRN or physician assistant, which are required to have a collaborative agreement with a medical doctor. The bill is currently before the Governor for his consideration. Due to political considerations, the Utah DB negotiated for stronger patient protections in psychologists prescribing legislation that became law.

APA staff collaborates closely with DB/SAs throughout the country in advocating for patient safety. For more information, please contact [email protected].

Oklahoma Approves Behavioral Health Workforce Legislation

The Oklahoma Governor signed into law legislation to provide for behavioral health workforce development and greater access to behavioral health professionals. The pilot program's purpose includes psychiatric residencies, internships, and post-doctoral training programs.

Michigan Enacts APA Model Mental Health Parity Legislation Into Law

Gov. Whitmer signed APA model mental health parity legislation into law. Insurers will be required to cover mental health and substance use disorder treatment at the same level as physical health services. MH and SUD benefits in any classification cannot be subject to any financial requirements, quantitative or non-quantitative treatment limits are more restrictive than those for medical/ surgical benefits in the same classification. Visit APA model state parity legislation or email [email protected] for more information.

Michigan Enacts APA Model Mental Health Parity Legislation Into Law

Illinois Governor Pritzker is expected to sign legislation into law that will increase access to care for those undergoing mental health or substance use disorder (SUD) treatment. It bans the use of step therapy requirements in prescription drug plans and for SUD treatment. It also requires insurers to use “generally accepted standards of care” when deciding whether to cover certain treatments or services. Insurers will be prohibited from requiring prior authorization before covering in-patient psychiatric care. It protects those who receive inpatient care from being billed for care if their insurer does not find it medically necessary. It also provides for transparency in the prior authorization process.

Governor Pritzker is also expected to sign legislation into law that will restrict the ability of Medicaid to require prior authorization for the use of psychotropic medications to treat serious mental illnesses in adults.

State Legislation to Allow Therapeutic Use of Psilocybin Fails To Move Forward

During the regular California legislative session, the California State Association of Psychiatrists (CSAP) and California district branches contributed to the successful effort to defeat a bill that would have licensed psychedelic therapeutic use. The bill was in part defeated due to an estimated large fiscal impact. CSAP voiced their strong opposition citing patient safety concerns in conjunction with the California Medical Society.

In Illinois, similar legislation to allow therapeutic use of psilocybin was kept in committee due to the Illinois DB’s strong opposition over patient safety concerns.

APA does not support states authorizing the use, manufacture, or sale of psilocybin prior to FDA approval of psilocybin for safe treatment of patients. The APA continues to assist DB/SAs in voicing patient safety concerns in response to related legislative proposals. For more information, contact [email protected]

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