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Advocacy Update: July 2019

July 23, 2019

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

APA Members Participate in Local Advocacy

During the month of August, members of Congress will return to their home districts to reconnect with their constituents. This year, APA’s Congressional Advocacy Network (CAN) members will schedule meetings with their lawmakers to promote mental health parity and Part 2 reform as priorities in the fall. APA will provide our advocates with background materials and one-on-one support. Additionally, we will host a webinar on August 1 at 8PM to review the issues and answer your questions.

Join PsychPRO and Help Bolster the Availability of Meaningful Quality Measures in Federal Programs

APA is developing quality measures and needs your expertise to ensure these measures meet the needs of psychiatrists treating those with mental and/or substance use disorders. By volunteering to be part of a learning collaborative through PsychPRO (APA’s registry), APA members can lend their voices to this important initiative. To learn more about the initiative and incentives for participation, please visit the APA Measure Development Initiative webpage.

APA’s Mental Health Parity Bill Included in Bipartisan Legislation

S. 1895, the Lower Health Care Costs Act, was voted out of the Senate HELP Committee on June 26th. This legislation includes APA’s Mental Health Compliance Act, which would require insurers to show their work and demonstrate their compliance with federal parity requirements. APA thanked the Committee for its work to lower the costs of untreated mental health and substance use disorders by including this language in their legislation. The bill could be considered soon by the full Senate.

APA Calls on Administration to Provide Humane Treatment for Individuals Seeking Asylum

On July 9th, APA released a statement calling on the Trump administration to provide humane care for individuals seeking asylum at the border. The statement also urges the Administration to follow the Flores Settlement Agreement and hold detention centers accountable to the maximum safety requirements to mitigate the traumatic impact of long-term detainment and minimize the number of days that families spend in detention.

Increasing Payer Reimbursement for Collaborative Care Services

APA’s efforts to expand the number of state Medicaid programs and commercial payers who participate in the Collaborative Care Model (CoCM) has reached another milestone. Currently, eight state Medicaid programs and over 20 commercial payers (including many Blue Cross plans), are now reimbursing primary care physicians for the CoCM. As with any medical service, coverage varies by individual insurance plans, so it is important that practices verify coverage on a payer-by-payer basis.

APA Calls on FDA to Provide Regulatory Oversight of Cannabis Products

The Farm Bill, signed on December 20, 2018, removed hemp from the controlled substances list. Since then, the market of cannabis-derived products has grown quickly with little regulation over safety, manufacturing, labeling, and marketing. The bill maintained FDA’s oversight authority and the agency solicited public comments to learn how to structure its role. APA’s comments reiterated that we do not endorse cannabis as medicine and that there is no current evidence that it can treat psychiatric disorders. Additionally, we urge FDA to create a regulatory framework for the current market, dedicate funding to researching the medical potential of cannabis, and provide strict enforcement of product marketing to children and other vulnerable patients.

APA Endorses Three Bills to Address the Opioid Epidemic

APA voiced its support for three different pieces of legislation intended to address the opioid epidemic. Specifically:

  • The Opioid Workforce Act (H.R. 3414) which would create an additional 1,000 graduate medical education positions over five years in hospitals that have, or are in the process of establishing, accredited residency programs in addiction medicine, addiction psychiatry, or pain medicine.
  • The CREATE Opportunities Act (S. 1983/H.R. 3496) which seeks to stem the rates of overdose deaths amongst recently incarcerated individuals.
  • The Comprehensive Addiction Resources Emergency (CARE) Act (S. 1365/H.R. 2569) which would provide additional funding to areas hardest hit by the addiction epidemic.

APA Supports Bill to Heighten Transparency in Drug Pricing

APA joined its partners in the Alliance for Transparent and Affordable Prescriptions in voicing support for S. 1227, the Prescription Pricing for the People Act. This legislation would direct the Federal Trade Commission to study the effects of mergers and consolidation on the pharmaceutical supply chain and then make recommendations to Congress on ways to protect patients by improving competition and promoting transparency. S. 1227’s sponsor, Senator Charles Grassley (R-IA), thanked the Alliance for their support when the bill advanced to the Senate floor.

APA Supports Bill Requiring Step Therapy Override

APA supports legislation introduced by fellow physicians Rep. Raul Ruiz, MD (D-CA) and Rep. Brad Wenstrup, MD (R-OH) that would protect patients from unnecessary step therapy insurance policies. H.R. 2279, the Safe Step Act, would require insurance plans to develop clear, publicly accessible procedures for patients and providers to request exemptions to step therapy protocols. Plans would also be required to approve these requests within three days (or 24 hours when the patient’s life is in danger).

Missouri Passes Legislation Addressing Wide Range of Mental Health Care Needs

In the final days before the end of its 2019 legislative session, the Missouri legislature passed health care legislation (SB 514) that addresses a wide range of mental health care needs. APA and the Missouri District Branch worked very closely together on this successful legislation. Among its many provisions, this legislation:

  • Adds psychiatrists to the state’s Health Professional Student Loan Repayment Program
  • Requires coverage of medication-assisted treatment (MAT) for substance use disorders
  • Suspends Medicaid coverage while individuals are incarcerated so that they can have immediate access to health care upon their release
  • Establishes a Task Force on Substance Abuse Prevention and Treatment, which will examine current and future substance abuse in Missouri and suggest legislative solutions

Wisconsin Protects Patients from Step Therapy

On July 9th, Governor Tony Evers signed legislation that would protect patients from certain step-therapy policies. Under this new law, insurers that implement step therapy protocols will have to base them on clinical review criteria and grant exceptions for patients who meet certain criteria.

Connecticut Signs APA’s Model Parity Legislation into Law

Connecticut Governor Ned Lamont publicly thanked APA for its efforts as he signed our model parity legislation into law- making Connecticut the seventh state to enact parity legislation this year.

In anticipation of next year’s legislative session, APA’s State Government Relations team is holding topical conference calls on APA’s model parity legislation with District Branch/State Association leadership so that they can discuss the issue and ask questions of State Government Relations staff. APA intends to include all states on these calls over the next few months.

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