APAPO legislative advocacy priorities for 2014
With 2014 being the second year of a two-year congressional legislative cycle, the APA Practice Organization’s (APAPO) legislative advances from 2013 are still in play. Our 2014 legislative advocacy agenda builds on the work accomplished last year. Here’s a look at the key legislative issues the APAPO will address in 2014.
Because private reimbursement rates follow Medicare’s lead, Medicare payment is a crucial avenue for safeguarding reimbursement for psychological services.
The release of the Medicare final fee schedule for 2014 marked the first time since 2007 that the payment pool allocated for Medicare psychological services was increased.
In 2014, we hope to build on that success by addressing three areas of Medicare payment:
- Medicare payment formula: Medicare pays for all services based on a formula that values services relative to each other. Under the current Medicare payment formula, psychologists are being penalized by a system that increasingly favors services involving higher costs for equipment and supplies. APA Practice Organization (APAPO) Government Relations lobbyists are working with key members and committees of Congress on a legislative remedy to the flawed payment formula. We are collaborating with House and Senate committees with jurisdiction over Medicare payment to explore ways the formula could be modified to ensure more appropriate reimbursement for psychologists.
- Sustainable growth rate formula: The Sustainable Growth Rate (SGR) was enacted as part of the Balanced Budget Act of 1997 to limit growth in Medicare provider payments and contain program costs. However, the formula is not working and Congress has intervened 16 times to avert staggering provider cuts, most recently with a three month extension of current physician payment rates, as enacted in the Bipartisan Budget Act of 2014, to avert a 24 percent cut on Jan 1. APAPO is advocating for Congress to replace the SGR with a payment system that enhances quality and coordination of care coordination, while treating physician and non-physician providers equally to ensure fair and adequate reimbursement.
- Sequestration: The Budget Control Act of 2011, known as sequestration, requires about $1 trillion in automatic, across-the-board spending cuts, including an annual 2 percent reduction in all Medicare provider payments. The Bipartisan Budget Act of 2014 extended that annual 2 percent reduction an additional two years through 2026. A 24 percent cut over 12 years is untenable; we are urging Congress to eliminate these payment reductions and find a more targeted approach to addressing Medicare spending.
Physician definition in Medicare
Unnecessary physician supervision requirements in the Medicare program hamper psychologists from providing their full range of services to Medicare patients within state licensure. APAPO continues to urge Congress to pass the Sen. Sherrod Brown (S. 1064) and Rep. Jan Schakowsky (H.R. 794) bills to include psychologists in the Medicare "physician" definition.
Behavioral health information technology incentive payments
Psychology has now gained three bills, two in the Senate and one in the House of Representatives, that further our goal of including clinical psychologists in the Medicare and Medicaid incentive payments established by the Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009.
The Behavioral Health Information Technology Coordination Act (S. 1685), sponsored by Sen. Rob Portman, R-Ohio; the Behavioral Health Information Technology Act (S. 1517), sponsored by Sen. Sheldon Whitehouse, D-R.I.; and The Behavioral Health Information Technology Act (H.R. 2957), cosponsored by Rep. Tim Murphy, R-Pa., and Rep. Ron Barber, D-Ariz., would enable clinical psychologists to qualify for Medicare and Medicaid incentive payments for integrating electronic health records into their practices.
Member outreach to Congress is a critical component of our legislative advocacy efforts. APAPO encourages psychologists to contact your members of Congress and ask them to cosponsor legislation that is beneficial to psychology and consumers of psychological services. Please visit the Legislative Action Center whenever APAPO and our grassroots federal advocacy coordinators call on you to do so.