November Capitol Hill wrap-up

Congress makes headway on reimbursement, the sustainable growth rate payment formula and other issues important to psychologists

by Government Relations Staff

November 23, 2009 — This month has been a busy one on Capitol Hill, with the House and Senate making headway on issues of importance to professional psychology.

5 percent psychotherapy payment restoration
On November 7, the House of Representatives passed its health care reform bill and on November 18, the Senate unveiled its bill. Both include the 5 percent psychotherapy payment restoration.

Back in June 2008 with passage of the Medicare Improvements for Patients and Providers Act of 2008, the American Psychological Association Practice Organization (APAPO) won an 18-month restoration of Centers for Medicare and Medicaid Services (CMS) reimbursement payments that partially offset cuts imposed in 2007. But the law provided the increased payments only through December 31, 2009. The new House and Senate bills referred to in this article increase payments by 5 percent until 2012 and 2011, respectively. Psychology was the only provider group to win an adjustment in Medicare fees.

The Senate voted Saturday, November 21 to consider and vote on the pending health care reform bill likely late in December. Once the Senate passes its version of the bill, it will convene a conference committee with the House to work out the differences between the two bills. Congressional leaders now hope to have a final bill passed and to President Obama by the end of January.

Sustainable Growth Rate (SGR) payment formula
The Medicare "sustainable growth rate" or SGR payment formula ties Medicare provider payments to factors related to the national economy. In recent years, the formula has operated automatically to cut most provider payments.

On November 19, the House passed the Medicare Physician Payment Reform Act (H.R. 3961). The bill permanently replaces the Medicare Sustainable Growth Rate formula, thereby blocking a 21.2 percent cut in Part B scheduled for January 1, 2010. The bill will be referred to the Senate, where it is more controversial, for debate and a vote. The passage of legislation in the House is a direct result of lobbying and grassroots advocacy of psychologists along with the AMA and numerous other provider groups.

Mentally Ill Offender Treatment and Crime Reduction Act
On November 5, the U.S. Senate approved the Fiscal Year 2010 Criminal, Justice, State Appropriations bill (H.R. 2847). The legislation provides $10 million for the Mentally Ill Offender Treatment and Crime Reduction Act (MIOTCRA). The American Psychological Association Practice Organization (APAPO) has advocated for MIOTCRA since 2004; the program passed that year.

MIOTCRA authorizes federal grant money to help states and local communities fund collaborative efforts between the criminal justice, mental health and juvenile justice systems aimed at reducing the criminalization of people with mental disorders.

These efforts include:

  • mental health courts, which link non-violent mentally ill offenders with support services, treatment, employment and housing

  • jail diversion, alternative prosecution, and sentencing programs

  • treatment for incarcerated individuals with mental disorders

  • community reentry services

  • cross-training of criminal justice, juvenile justice and mental health personnel.

For more on MIOTCRA, see the October 23, 2008 PracticeUpdate article, "Mental Health Grant Offers Alternative to Incarceration."

The Fiscal Year 2010 Criminal, Justice, State Appropriations bill (H.R. 2847) also provides $64 million for prisoner reentry, including $50 million for Second Chance Act programs, which are designed to reduce recidivism among the formerly incarcerated, and $14 million for reentry initiatives in the federal Bureau of Prisons.

The House version of the bill passed in June and provides $12 million for MIOTCRA and $114 million for prisoner reentry, including $100 million for Second Chance Act programs. The House and Senate will now convene a conference committee to work out the differences between the two versions of the bill. The APAPO, a member of the MIOTCRA working group, continues its advocacy to ensure funding for this important program.

Red Flags Rule
The Federal Trade Commission's (FTC) Red Flags Rule requires entities covered by the rule to implement a written identity theft prevention program designed to detect the warning signs — or "red flags" — of identity theft in their daily operations.

On October 21, the House passed a bill that would exempt the psychological practices with 20 employees or fewer, as well as certain practices with low risk of identity theft from the rule. The bill, H.R. 3763, passed with 400 votes and no objections, and now moves to the Senate.

While psychology is covered by the legislation's general provision, the Government Relations staff for APAPO is working with congressional staff to ensure that psychology is specifically included in the list of exempted professions.

Learn more about the Red Flags Rule