June 24, 2019

June 2019: Advocacy Update

APA’s Legislation Introduced to Boost Mental Health Parity Compliance

APA-backed legislation to address continued concerns regarding mental health parity was introduced in the U.S. Senate and House of Representatives in June. The Mental Health Parity Compliance Act (S. 1737 / H.R. 3165) would enhance the transparency and accountability of insurers’ coverage of mental health and substance use benefits to ensure compliance with existing laws.

Additionally, the Senate HELP Committee responded favorably to APA’s request that it include the Mental Health Parity Compliance Act in legislation the committee is drafting to address the high cost of health care. This progress represents yet another successful outcome from APA’s Federal Advocacy Conference and will complement APA’s state efforts that have resulted in 7 states passing parity legislation so far.

APA Responds to the Commission on Civil Rights Investigation of the Treatment on Immigrants at Detention Centers

Last summer, the Commission on Civil Rights voted to reopen its investigation of the conditions of immigrant detention, following the Administration’s decision to separate undocumented children from their parents at the border. APA responded to the Commission’s request for public feedback and focused on the trauma prolonged detention could cause, the need for strong oversight of detention centers, and how to best address the mental health needs of immigrants fleeing violence. APA also offered to be a resource to the Commission as it examines the issue and formulates recommendations.

APA and Coalition Partners Call on the Administration to Uphold Nondiscrimination Patient Protections

At the end of May, HHS issued a proposed rule that would weaken nondiscrimination protections for patients, including those who are transgender, those with limited English proficiency, those with disabilities, and those who are seeking access to reproductive health care. Along with the Group of Six Coalition, APA urged the Administration to consider the proposed rule’s medically unnecessary restrictions in light of the negative impact they will have on patient access to care. Additionally, APA and 30 other health provider organizations wrote to HHS Secretary Alex Azar opposing the rule and highlighting the rule’s particular implications for transgender patients, who have been vulnerable to discrimination.

APA Responds to ONC Proposed Rule

In February 2019, The Office of the National Coordinator for Health Information Technology (ONC) released a proposed rule, 21st Century Cures Act: Interoperability, Information Blocking, and the ONC Health It Certification Program. The proposed rule would implement certain provisions of the 21st Century Cures Act, including conditions and maintenance of certification requirements for health IT developers under the ONC Health IT Certification Program, and reasonable and necessary activities that do not constitute information blocking. The goal is to promote interoperability across the entire healthcare landscape. In response, APA submitted comments on June 3, highlighting areas of support and concern. While APA is supportive of efforts to improve physicians’ access to the patients’ complete record via interoperability and less information blocking on the part of uncooperative vendors, the APA is concerned that the Rule might lead to information overload and place undue burden on physicians to separate useful from extraneous information. APA is also concerned that the new definition of “Electronic Health Information,” (EHI) is so expansive that many patients and providers may not fully understand what patient data falls under this vast umbrella. Because the rule is so broad, the APA has requested more time for the implementation of provisions within the forthcoming final rule, as well as for an interim final rule to be published in advance of a final rule, to give stakeholders one last change to weigh-in. It is unclear when the ONC will release an interim or final rule.

APA Participates in America’s Frontline Physicians Leadership Advocacy Day

APA President, Dr. Bruce Schwartz, joined leaders from five other frontline physician organizations on Capitol Hill to discuss issues impacting their patients. Dr. Schwartz and his colleagues spoke to key members of Congress about:

  • The patient safety risks posed by 42 CFR Part 2 and asked for improved coordinated care
  • The impact of high drug prices on their patients
  • Patients who have been affected by gun violence and asked for an increase in funding for public health research
  • Issues regarding vaccine adherence and the need to combat misinformation about vaccine safety
  • Support for protecting patients against surprise bills

Model Collaborative Care Legislation Passes in Illinois

APA continues to fight for access to care for our patients by promoting its collaborative care model (CoCM) legislation. APA worked closely with the Illinois Psychiatric Society to help pass such legislation that will require both Medicaid and commercial insurers to reimburse for services billed under collaborative care codes. Once the legislation is signed, Illinois will be the first state to enact APA’s model collaborative care legislation. APA is already working with several district branches interested in passing this legislation in their state. You can find CoCM legislation APA drafted for your state here.

Model Legislation to Advance Mental Health Parity

APA’s model legislation promoting mental health parity and coverage of SUD services continues to successfully make its way through many state legislatures. Recently, Connecticut, Minnesota, and Missouri joined Colorado, New Jersey, and Wyoming on a list of states that have passed versions of the parity legislation this year. Delaware, the District of Columbia, Illinois and Tennessee enacted parity legislation prior to this year’s legislative session.

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