New legislation would allow psychologists to provide Medicare services to patients free of unnecessary physician supervision.

On Dec. 16, 2015, Rep. Kristi Noem, R-S.D., and Rep. Jan Schakowsky, D-Ill., introduced the Medicare Mental Health Access Act (H.R. 4277) in the U.S. House of Representatives. This bipartisan legislation would allow psychologists to provide Medicare services to patients free of unnecessary physician supervision in all treatment centers by amending the Medicare definition of physician to include psychologists.

Reps. Noem and Schakowsky are members of the influential House Ways & Means Committee and House Energy & Commerce Committee, respectively, which have jurisdiction over health care legislation. The APA Practice Organization is currently working to solidify sponsors to introduce a companion bill in the U.S. Senate.

We need psychologists’ help to encourage Congress to pass this legislation. Your personal stories and experiences demonstrating how the current physician oversight requirement affects your work and patient services are valuable in educating members of Congress on the need to support this legislation. Send us your stories so we can share them with your congressmen.

Psychologists can also help by using social media to thank Reps. Noem and Schakowsky for introducing this important legislation. 

Sample tweets:

  • Thank you @RepKristiNoem and @JanSchakowsky for sponsoring #HR4277 to increase #MentalHealthAccess for #Medicare patients.
  • @ [insert representative’s twitter handle] please cosponsor #HR4277 to increase #MentalHealthAccess for #Medicare patients 

It’s easy to find twitter handles for your representatives. Also be sure to retweet thank you cards for Rep. Noem and Rep. Schakowsky posted by the APA Practice Organization from our Twitter account @APAPractice. 

Why psychologists must be included in the Medicare's definition of physician

Psychologists are a major provider of mental and behavioral health services to Medicare beneficiaries, but are unable to provide their full range of services due to Medicare's outdated physician oversight requirements. Psychologists provide more than 70 percent of hospital inpatient, partial hospital and residential mental health care; nearly 50 percent of hospital outpatient mental health care; and nearly all psychological and neuropsychological testing.

By adding psychologists to Medicare’s “physician” definition, H.R. 4277 would allow psychologists to practice independently in all Medicare treatment settings consistent with state licensure. The Medicare physician definition already includes other nonallopathic or osteopathic physician disciplines such as chiropractors, optometrists, dentists and podiatrists.

Unlike other health insurance payers, Medicare currently requires physician supervision of psychologists' services in many treatment settings, which means that when no physician is available, psychologists cannot treat beneficiaries. Medicare requires supervision of psychologists' services provided in hospital outpatient departments, partial hospitalization programs, comprehensive outpatient rehabilitation facilities, rural health clinics and federally qualified health centers. Supervision of psychologists' services may be done by physicians who do not have significant training in psychological treatment.

Psychologists are licensed to practice without supervision in all states and the District of Columbia. Psychologists are also able to practice independently, without physician supervision, in all private sector health plans, Medicare Advantage plans, the Veterans Health Administration and TRICARE. 

“Allowing psychologists to practice independently in all Medicare settings will make it easier for beneficiaries to access the care they need,” says APA Executive Director for Professional Practice Katherine C. Nordal, PhD. “APAPO is committed to making sure psychologists who are Medicare providers are able to practice independently without inefficient physician supervision.”