APA Practice working for you

A wrap-up of Practice Directorate activities and achievements from August 2010 to March 2011 highlights our recent work on behalf of professional psychology

By Communications Staff

March 17, 2011—The Practice Directorate engages in a broad range of activities on behalf of practicing psychologists in diverse settings and consumers of psychological services. The directorate’s primary activities involve advancing and protecting professional psychology and supporting adequate and appropriate consumer access to psychological services. 

APA Executive Director for Professional Practice Katherine C. Nordal, PhD, provides staff leadership for the work of the APA Practice Directorate as well as the APA Practice Organization (APAPO), a companion organization to APA. The APAPO is housed in the Practice Directorate.

Following are brief highlights of selected APA Practice Directorate and APA Practice Organization activities and significant developments from August 2010 to March 2011.

Successfully advocating for introduction of new federal legislation to include psychologists in the Medicare definition of “physician”

In September 2010, we gained the introduction of federal legislation that would include psychologists in the Medicare definition of “physician.” But Congress adjourned before the legislation could be voted on.

This legislative initiative to ensure that practitioners can provide psychological services to Medicare beneficiaries free of inappropriate physician supervision requirements that hinder access to services moved forward with the new Congress in late February and early March 2011 when Senators Olympia Snowe (R-ME) and Jeff Bingaman (D-NM), who sit on the Finance Committee, sponsored S.483 and Congresswoman Janice Schakowsky (D-IL), who serves on the Energy & Commerce Committee, introduced HR. 831.

On March 15, 2011, the final day of the 28th State Leadership Conference, psychology leaders from across the country will descend on Capitol Hill to press the case for inclusion in the “physician” definition, among other advocacy initiatives that support professional psychology. 

Seeking appropriate Medicare reimbursement for psychological services

Seeking appropriate Medicare reimbursement levels for psychological services remains a top priority for the APAPO and continues to guide our advocacy work. Throughout 2010, the APA Practice Organization’s PracticeUpdate e-newsletter devoted articles to keeping members apprised of our advocacy activities, deadlines related to Medicare payment and opportunities for grassroots involvement.

The Centers for Medicare and Medicaid Services (CMS) continued taking actions that have a disproportionate adverse impact on payment for psychological services. Despite persistent advocacy by our Government Relations staff and grassroots psychologists, the Practice Directorate was unable to prevent CMS from releasing a final rule on the 2011 Medicare fee schedule with a significant negative impact on mental health services reimbursement. When Medicare payment changes took effect on January 1, 2011, reimbursement for psychological services was reduced 6 percent on average.

Nonetheless, our advocacy helped prevent Medicare payment cuts that would have been much deeper. With strong support from grassroots psychologists, APAPO successfully lobbied Congress to block the projected 25 percent Sustainable Growth Rate (SGR) cut and extend through 2011 the five percent payment restoration for Medicare psychotherapy services.

The APA Practice Organization will continue our advocacy efforts to reverse Medicare payment cuts that disproportionately affect reimbursement for psychological services.

Providing guidance to members regarding implementation of the federal mental health parity law

The Practice Directorate provided guidance to members regarding implementation of the federal mental health parity law. Numerous resources related to the Wellstone-Domenici Mental Health Parity & Addiction Equity Act are available in the Mental Health Parity section of our Practice Central website.

Influencing the stakeholders and policymakers involved with mental health services delivery

In late September, Dr. Nordal was an invited expert to the stakeholder, provider and consumer meeting of the National Business Group on Health (NBGH), which represents more than 300 major employee groups. Dr. Nordal gave input to NBGH about the recommended child and adolescent mental health plan benefit structures for their members’ insurance plans.

Also in September, Dr. Nordal sent a comment letter to the Department of Health and Human Services regarding the tobacco cessation preventative items and services included in the United States Preventative Task Force recommendations.  APAPO recommended that there be more specific minimum tobacco cessation plan benefits coverage, that plan enrollees have access to both counseling and medication for tobacco cessation, and that cost-sharing for services by out-of-network providers be permitted only if the plan has licensed behavioral health care providers available in-network.

In November, our Legislative & Regulatory Affairs staff submitted comments on the National Committee for Quality Assurance (NCQA) Accountable Care Organizations (ACO) Criteria to recommend increased integration of mental and behavioral health services in ACOs, consistent with APA's priorities for health care reform. 

Pursuing advocacy and educational activities to influence the implementation of the Health Information Technology for Economic and Clinical Health (HITECH) Act

The Practice Organization gained bipartisan support for House and Senate legislation that would extend eligibility for electronic health record incentive payments to mental, behavioral and substance use health professionals. As federal rules to implement the HITECH Act take effect, APAPO is advocating for full inclusion of psychologists under the law’s incentive programs.

As a result of our advocacy, the Health Information Technology for Economic and Clinical Health (HITECH) Act mandated a study to determine whether psychological testing data should be afforded the same level of privacy protection as psychotherapy notes in electronic health records. Staff participated in an advisory panel for this study during 2010.

Promoting the appropriate use of psychological testing in disability evaluations

As a result of Practice Directorate advocacy, the Social Security Administration rescinded a guideline that discouraged the use of psychological testing in disability evaluation cases involving memory impairment.

Succeeding in narrowing the application of the “Red Flags” rule to protect professional psychologists

On December 18, 2010, President Obama signed the Red Flags Clarification Act of 2010, following successful advocacy by the American Psychological Association (APA) and the APA Practice Organization to narrow the application of the federal Red Flags Rule so it generally does not apply to practicing psychologists. The Red Flags Rule requires “creditors” to develop plans to detect and prevent identity theft.

Expanding public education about psychology and the value of psychological services

The APA’s annual Stress in America survey, which promotes the value of psychologists in treating health problems, was released in November 2010 and generated more than 1,000 stories in hundreds of media outlets with the potential to reach an audience exceeding 340 million. The publicity value of the broadcast coverage alone is estimated at nearly $2 million.

Also among its successful public education campaign activities, the APA Practice Directorate engaged psychologists to participate in YMCA’s Healthy Kids Day for families and children, which attracted more than 700,000 participants. Further, in 2010, psychologists in 23 states and provinces worked with their local YMCAs to offer workshops on APA Mind/Body Health campaign topics including stress, heart disease, depression and obesity.

In addition, we participated in a radio media tour on holiday stress highlighting the psychological issues U.S. troops, veterans and their families might experience during the holiday season. APA teamed with Give an Hour, which provides pro bono psychological services to those in the military and their family members, and reached an audience estimated at 4.1 million. 

Offering education and outreach in the wake of shootings in Arizona through the Disaster Response Network (DRN)

The APA Disaster Response Network responded to the tragic January shootings in Arizona by participating in a congressional webinar and offering disaster mental health support to persons affected by the tragedy.

Several months prior, the Disaster Response Network (DRN) program was invited to the Department of Health and Human Services (HHS) National Biodefense Science Board’s Disaster Mental Health Subcommittee September meeting. This select 12-member subcommittee comprises six APA members; the lead staff person is also an APA member. The subcommittee called upon the government to set policy, structure and authority for the integration of disaster mental and behavioral health at all levels of preparedness, response and recovery.

Disaster mental health recommendations: Report of the Disaster Mental Health Subcommittee of the National Biodefense Science Board

Expanding and enhancing member communications for 2011

Practice Central, our online home for members, has more in store for  members in 2011. Among the enhancements already implemented or coming soon:  more frequent issues of APA Practice Organization member publications, including the PracticeUpdate e-newsletter and Good Practice magazine as of January 2011; new tools and resources to help practitioners manage and build their practice, including an online calculator that shows how changes in the services practitioners provide or payments they receive would affect their practice’s financial bottom line; and more online learning, including multimedia programs on reimbursement, telehealth and workplace stress management.

Affirming the value of psychologists in the marketplace

Senior staff continues to educate groups involved in employee benefits and workplace health promotion about the value of psychologists practicing in applied settings and raised psychology’s visibility in the marketplace through presentations to large employers, government agencies and employee assistance professionals. 

For example, in October 2010 Assistant Executive Director for Marketing and Business Development David W. Ballard, PsyD, MBA, delivered the opening keynote address — “Thriving in the New Workplace: The Critical Role of EAPs” — for the Employee Assistance Professionals Association (EAPA) Annual World EAP Conference in Tampa, Fla.