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Advocacy Update: October 2023

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

APA-Led Activities

APA Responds to Congressional RFIs

On September 22, APA submitted a response to Senate HELP Committee Ranking Member Bill Cassidy’s (R-LA) request for information on the ethics, regulation, and future of artificial intelligence in health care. Sen. Cassidy released an additional RFI on health data protection strategies and APA submitted a response that includes how to improve health outcomes through data and technology while still protecting patient privacy. In addition to these HELP RFIs, we responded to House Ways and Means Chair Jason Smith’s (R-MO) RFI regarding rural health care and how to address our nation’s ongoing health care workforce shortages.

APA Collaborating with AMA to Update Medicare Physician Payment

The American Medical Association (AMA) Physician Practice Information (PPI) Survey is underway, and APA urges all selected psychiatrists to actively engage in this effort. The intent of the survey is to collect updated and accurate data on practice costs which are a key element of physician payment. Mathematica is coordinating this effort. Your practice may receive an email (from [email protected]) and an USPS priority mail packet from Mathematica that contains a link to the survey as well as supporting information. In addition, in the coming weeks or months, your practice, or Mathematica, may ask you to complete a brief survey on the number of weekly hours spent on direct patient care. We urge you to complete this two-minute survey. Help us help you to update Medicare physician payment!

Executive Branch Activities

APA Responds to DEA’s Public Listening Sessions on Telemedicine Prescribing

On September 12 and 13, the Drug Enforcement Administration (DEA) conducted public listening sessions to receive additional input concerning the practice of telemedicine with regards to controlled substances and potential safeguards that could effectively prevent and detect diversion of controlled substances prescribed via telemedicine. Dr. Shabana Khan, Chair of APA’s Telepsychiatry Committee, was invited to speak on behalf of APA. Dr. Khan’s comments focused on balancing common-sense safeguards for DEA enforcement of legitimate controlled substances prescribed via telemedicine without decreasing access to lifesaving treatments. The listening sessions follow after the DEA received over 38,000 public comments in response to the proposed rules - Telemedicine Prescribing of Controlled Substances When the Practitioners and the Patient Have not Had a Prior In-Person Medical Evaluation and Expansion of Induction of Buprenorphine via Telemedicine Encounter. In response to the large number of public comments and comments during the listening sessions, on October 6, the DEA in coordination with HHS announced the extension of COVID-19 telemedicine flexibilities for prescription of controlled medications through December 31, 2024.

Congressional Activities

APA Supports Proposed Mental Health Parity Rule

APA submitted comments supporting the Administration’s proposed rule implementing requirements that Congress enacted in the Consolidated Appropriations Act, 2021, that plan/issuers conduct and document comparative analyses of their benefit designs as part of their compliance with the Mental Health Parity and Addiction Equity Act and that these analyses be provided upon request to federal and state regulatory bodies. APA also submitted comments in response to a Technical Release, released with the proposed rule, regarding, among other things, relevant data points that plans/issuers should be required to collect and analyze as part of their MHPAEA compliance. Input to the Technical Release is anticipated to inform future rulemaking.

APA Supports Military Treatment Facilities in FY2024 NDAA

On September 8, APA joined the Military Health System coalition in a letter of support for increased staffing levels in Military Treatment Facilities (MTFs) and military medical end strength in the Fiscal Year (FY) 2024 National Defense Authorization Act (NDAA). Last year, a five-year pause in reductions to military billets was enacted. However, the letter expresses that some branches, particularly the Navy and the Air Force, have already proceeded with a substantial reduction in military medical end strength that has affected staffing levels at MTFs and the remaining clinicians’ ability to provide quality health care. The letter details several legislative asks for FY2024 that would support maintaining sufficient military medical end strength.

MHLG Supports Introduction of House COMPLETE Care Act

On September 19, the Mental Health Liaison Group (MHLG) sent a letter of support to Sens. Cortez-Masto (D-NV) and John Cornyn (R-LA) in support of S. 1378, the Connecting Our Medical Providers with Links to Expand Tailored and Effective (COMPLETE) Care Act. This bill would temporarily increase the Medicare for integrated care code for three years to incentivize the integration of behavioral health care in primary care settings. In addition to the Senate bill, a bipartisan companion bill was introduced in the House on September 26. The press release for the House bill can be found here.

Group of Six Writes Workforce Op-Ed

On September 25, APA President Petros Levounis, M.D., M.A., joined Group of Six leadership in an article urging Congress to act on healthcare workforce development. The letter urges lawmakers to take action on the current physician shortage and to push for legislation supporting GME slots, student debt relief, the National Health Service Corps, the Conrad State 30 program, and culturally competent care.

APA Supports Mental Health Infrastructure Improvement Act

On September 28, APA CEO and Medical Director Saul Levin, M.D., M.P.A., provided a quote in support of H.R. 5804, the Mental Health Infrastructure Improvement Act, which was introduced by Reps. Derek Kilmer (D-WA) and Don Bacon (R-NE). This bill would increase access to mental health and substance use disorder (SUD) care in rural and underserved areas, as well as address the emergency department boarding crisis by establishing a loan program to fund the construction or renovation of mental health or SUD treatment facilities that provide inpatient care, partial hospitalization, intensive outpatient care, and/or crisis stabilization. The press release with Dr. Levin’s quote can be found here.

APA Supports the TEAMS Act

On September 28, APA CEO and Medical Director Saul Levin, M.D. M.P.A., provided a quote in support of S. 2966, the Targeting Emotional and Mental Stability (TEAMS) Act, which was introduced by Sens. John Boozman (R-AR) and Cory Booker (D-NJ). This bill would call for school-based initiatives supporting the mental health needs of college athletes to be eligible for the Garrett Lee Smith Campus Suicide Prevention Grant Program. The TEAMS Act would allow this funding to be used for school-based mental health programs such as mental health care services, peer-to-peer counseling, 24/7 crisis lines, training for students and staff on how to responds to students exhibiting signs of mental distress, and campus-wide measures to address the stigma associated with seeking care. The press release can be read here.

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