Make Psychologists Eligible for HITECH Act Incentives

Congress should make psychologists eligible for existing HITECH Act incentive payments by passing behavioral health information legislation: The Behavioral Health Information Technology Act of 2013 (S. 1517/H.R. 2957), sponsored by Senator Sheldon Whitehouse (D-RI) and Representatives Tim Murphy (R-PA) and Ron Barber (D-AZ); The Behavioral Health Information Coordination Act of 2013 (S. 1685), sponsored by Senator Rob Portman (R-OH).

The legislation would amend the Health Information Technology for Economic and Clinical Health ("HITECH") Act of 2009 to support mental and behavioral health by enabling clinical psychologists, to qualify for Medicare and Medicaid incentive payments for integrating electronic health records into their practices. It would also extend this eligibility to nationally accredited community mental health centers, psychiatric hospitals, clinical social workers and outpatient mental health treatment facilities and substance use facilities.

Providing incentives will increase the likelihood that Medicare and Medicaid patients will receive effective, high-quality care from psychologists. The inclusion of psychologists and other mental health providers will also generate savings for Medicare and Medicaid. Recognizing these providers as "meaningful users" under the law will promote integration of mental health into primary care settings, reduce adverse drug to drug interactions, reduce duplicative tests, and provide necessary information to the emergency department at hospitals to triage patients more effectively.

Background: The HITECH Act significantly expanded the U.S. government's efforts to establish a national electronic health records (EHR) system. Such a system enables authorized health care professionals and hospitals to, among other things, access centralized information such as lab test results and medication lists to provide safer and more efficient patient care. The Act includes significant protections for mental health record confidentiality.

The Act authorizes the Centers for Medicare & Medicaid Services to provide a reimbursement incentive for physician and hospital providers who are successful in becoming "meaningful users" of (EHR). These incentive payments began in January 2011, and will gradually phase down by 2016. Starting in 2015, providers are expected to be actively utilizing EHRs in compliance with the meaningful use definition or they will be subject to financial penalties under Medicare. For mental health providers the bills move this timeline out to 2019.

Unfortunately, the HITECH Act excluded psychologists and most other non-physician providers from receiving Medicare and Medicaid incentive payments. The Act defines eligible professionals as medical doctors, doctors of osteopathic, dentists, dental surgeons, podiatrists, optometrists and chiropractors. Though incentives are offered in the early years, failure to meet the meaningful use requirements within four years will result in penalties against eligible professionals. The Final Rule for the Act went into effect July 28, 2010. 

APA Practice Organization
Revised: January 2014