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Advocacy Update: April 2021

April 12, 2021

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

APA-Led Activities

2021 Virtual Federal Advocacy Conference

Registration is now open for APA’s 2021 Federal Advocacy Conference and all APA members are invited to participate in this unique opportunity to play a critical role in shaping health care policy during the 117th Congress.

Before holding virtual meetings with federal legislators and staff, attendees will spend Saturday, June 5th, learning everything they need to know to advocate for psychiatry and insights on the inner workings of Congress and the legislative process. On June 10th, attendees will put their training to use in virtual meetings with their members of Congress and their staff and promote APA’s legislative agenda. Learn more & Register ».

APA Developing Quality Measures to Advance Measurement-Based Care by Mental Health and Substance Use Clinicians

APA is developing a suite of measures aimed at promoting and advancing measurement-based care (MBC). The set includes a measure assessing adherence to MBC processes, outcome measures based on patient-reported assessments of function and recovery, and measures assessing suicide safety planning processes and outcomes. The measures were recently posted for public comment, and submitted comments were reviewed by the project’s Technical Expert Panel and Consumer & Family Panel. More information can be found here.

Help APA Advocate for an Increase in Residency Positions

Match Day 2021 just happened and 99.8% of all psychiatric residency positions were filled! This shows that there is a huge demand to join the psychiatric profession; however, the threat of a healthcare workforce shortage still loams. It is estimated that by 2033 the United States will face an estimated shortfall of 54,100 to 139,000 primary care and specialty physicians.

APA and 69 other healthcare organizations endorsed the Resident Physician Shortage Reduction Act, which was recently introduced by Senators Robert Menendez (D-NJ), John Boozman (R-AR), and Charles Schumer (D-NY). This bipartisan legislation would ultimately create 14,000 new federally funded residency positions by raising the number of Medicare-supported GME positions by 2,000 each year for seven years. Some of these will be distributed to rural hospitals or hospitals in health professional shortage areas. While others will go to hospitals in states with new medical schools or to hospitals that are already training over their caps.

You can help the APA advocate for this critical legislation by using APA’s Action Center to write a letter to your members of Congress.

Improving SUD Education and Training for Physicians

In January, the U.S. Department of Health and Human Services announced it will publish Practice Guidelines for the Administration of Buprenorphine for Treating Opioid Use Disorder, to expand access to medication-assisted treatment (MAT) by exempting physicians from certain certification requirements needed to prescribe buprenorphine for opioid use disorder (OUD) treatment. However, the Practice Guideline was never published and implemented as HHS decided it did not have legal authority. The APA has stayed neutral on the repeal of the waiver but reached out to the Biden Administration to urge that regardless of what happens with the DATA waiver there needs to be a focus on addressing the additional barriers to treating SUD, most notably the educational needs of clinicians and stigma surrounding substance use disorders. APA’s Councils developed a Resource Document on Education and Training for Substance Use Disorders to highlight the need.

Executive Branch Activities

ONC Provides Updated FAQs on Interoperability and Information Blocking

The Office of the National Coordinator for Health Information Technology (ONC) has updated its Frequently Asked Questions (FAQs) around the Interoperability and Information Blocking Final Rule. The two new FAQs address questions around requests for sharing patient information. The Rule’s first “applicability date” for its Information Blocking provision and its eight Exceptions is April 5, 2021. More information about the Rule can be found on APA’s summary page. Further, APA has partnered with the College of Health Information Management Executives (CHIME) and other provider groups to create the Information Blocking Resource Center, a site aggregating numerous organizations’ resources on the ONC Final Rule.

CMS Issues Technical Correction for Esketamine Codes

CMS issued a technical correction to the payments for HCPCS codes, G2082, and G2083 which are billed for the administration and observation of esketamine, restoring payments to an amount slightly higher than what was originally proposed for 2021. CMS’s rationale for the change was that the reduction in payment put in place for 2021 had been done without the opportunity for public comment. APA raised concerns in a joint letter with other stakeholders including patient advocacy groups regarding the reduction in payments and the potential negative impact on patients. This change is retroactive to January 1, 2021 however CMS Medicare Contractors will not automatically reprocess payments; clinicians will need to resubmit their claims for the positive adjustment.

HHS Delayed Comment Period for HIPAA Proposed Changes

The U.S. Department of Health and Human Services announced a 45-day extension of the public comment period for the Notice of Proposed Rulemaking (NPRM) to modify the Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule. OCR first released the NPRM to the public on the HHS website on December 10, 2020, and it was published in the Federal Register on January 21, 2021. The 45-day extension moves the current deadline for the public to submit comments from March 22, 2021, to May 6, 2021. The notice of extension of the comment period is available here. The APA is working with its members to develop comments on the changes.

Biden-Harris Release Statement on Drug Policy Priorities

On April 1, the Biden-Harris Administration released a Statement of Drug Policy Priorities to layout the urgent, first-year steps that must be taken to address the nation’s overdose and addiction epidemic. The plan includes an investment of nearly $4 billion in behavioral health services. The plan includes:

  • Expanding access to evidence-based treatment
  • Advancing racial equity issues in our approach to drug policy
  • Advancing racial equity issues in our approach to drug policy
  • Enhancing evidence-based harm reduction efforts
  • Supporting evidence-based prevention efforts to reduce youth substance use
  • Reducing the supply of illicit substances
  • Advancing recovery-ready workplaces and expanding the addiction workforce
  • Expanding access to recovery support services

Congressional Activities

Mental Health is Not a Crime Congressional Briefing

On April 2 APA joined other mental health advocacy organizations in hosting a briefing for members of Congress and their staff on the role the new suicide hotline and crisis services will play in the transformation the way the country addresses individuals in a mental health crisis. Dr. Matthew Goldman, a member of the Council on Advocacy and Government Relations, joined five other panelists to discuss the transformation of crisis services across the nation and highlight new programs under the Mental Health Block Grant that address crisis care.

Frontline Physicians Recommend Priorities for the Biden Administration

APA and five other frontline physician associations joined together to welcome the new Biden Administration and make several recommendations to improve the health care system. The organizations, which represent over 590,000 physicians, encouraged the Administration to:

  • Implement a science-based and public health approach to end the pandemic
  • Expand and protect access to care by building upon the Affordable Care Act
  • Strengthen Medicaid by removing barriers to care
  • Improve health care for women and ending interference in the patient-physician relationship
  • Address physician workforce issues
  • Reduce administrative burdens in health care

Mental Health Community Support New Telehealth Legislation

The Mental Health Liaison Group, a coalition of national mental health organizations that APA participates in, recently applauded Senators Tina Smith (D-MN) and Lisa Murkowski (R-AK) for introducing the Tele-Mental Health Improvement Act. This bipartisan legislation, which APA helped to draft during the last Congress, would require insurers to cover mental health and substance use disorder telehealth services during the COVID-19 pandemic.

APA Endorses Legislation to Create a Mental Health Dashboard

APA applauded Senators Deb Fischer (R-NE) and Tina Smith (D-MN) for reintroducing the Achieving Thorough Transparency & Accessibility for Information Navigation (ATTAIN) on Mental Health Act on March 10th. This bipartisan legislation would create a user-friendly online dashboard to make it easier to identify and apply for mental health grants. APA, the National Alliance on Mental Illness and the National Association of Social Workers endorsed the legislation.

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