The Practice Organization: A year in review
Government Relations: Advocating for psychologists at the federal level
The Practice Organization Government Relations (GR) staff worked with policymakers in Washington, D.C., to enact comprehensive mental health reform legislation. In December, Congress passed the 21st Century Cures Act, which includes mental health care. The legislation strengthens federal mental health parity laws and eliminates the Medicaid same-day exclusion rule.
The Practice Organization also promoted advocacy among future psychologists by hosting its first Twitter chat between American Psychological Association of Graduate Students and Sen. Chris Murphy, D-Conn. Murphy took questions on parity and mental health reform.
Regarding Medicare, GR also submitted several comment letters to federal agencies expressing how proposed and final rules would affect practicing psychologists. The Practice Organization expressed concerns and offered suggestions for improvements on rules related to the Medicare Access CHIP Reauthorization Act of 2015 (MACRA) and the 2017 Physician Fee Schedule.
Legal and Regulatory Affairs: Advocating for psychologists with insurance companies
On all of the state-specific activities described below, the Legal and Regulatory Affairs Office (LRA) collaborated with the psychological association in that state, unless otherwise specified.
Neuropsychological testing exclusion by Cigna
LRA worked with the Inter Organizational Practice Committee (IOPC), a collaboration of several national neuropsychology groups1 and APA Practice Organization, to challenge Cigna’s national neuropsychological (NP) coverage policy that denies NP testing for patients with certain diagnoses, including psychiatric disorders and autism.
Working with IOPC and the New York State Association of Neuropsychology, LRA drafted a complaint to the New York attorney general. The Practice Organization argued that this blanket denial was a hidden exclusion, because consumers could not easily determine that NP testing was not covered. LRA also alleged violations of New York’s autism coverage law and New York and federal parity laws.
Rate differential between 90834 and 90837
LRA learned that several insurers were reimbursing psychotherapy CPT© codes 90837 and 90834 at the same rate, or at a very small differential while paying appropriate differentials for graduated codes on the medical/surgical side.
LRA had previously secured Aetna’s agreement to pay a significant differential. Regence BlueCross BlueShield (BCBS) created a differential between the codes after the Practice Organization helped the Washington State Psychological Association file a complaint with the state insurance Commissioner. In Utah, however, Regence’s very small differential led to complaints to the state insurance commissioner. Regence BCBS in Utah responded by lowering the rate for 90834, prompting LRA to raise concerns about retaliation.
Letters to psychologists on billing code 90837
Anthem and Highmark BCBS sent letters to psychologists who were identified as using the 90837 code more frequently than their peers. The companies informed the psychologists that their code usage would be monitored, making the psychologists feel threatened. LRA attorneys convinced these companies to clarify that their intent was educational in nature and not an attempt to keep psychologists from using the code.
National parity advocacy
In addition to working with state and federal officials, the Practice Organization is aligning with other stakeholder groups interested in parity compliance and enforcement. The Practice Organization provided comments (PDF, 433KB) to the White House Parity Task Force which the Task Force addressed in its final report.
State Advocacy: Addressing the concerns of psychologists at the state level
The Advisory Committee on Colleague Assistance developed a map showing which states, provinces and territories have colleague assistance programs (CAP) and what level of services are offered. The levels of services range from having limited CAP services offered by the state, provincial and territorial psychological associations (SPTA) or licensure board to a formal full CAP housed under a separate organization. This map will be made available for the first time to SPTA leaders attending the 2017 Practice Leadership Conference.
This year the communications department unveiled a new look for PracticeUpdate. Along with the new design, communications launched new columns “State Beat” and “Legal Corner,” and a new series for early career psychologists.
The communications department also helped provide essential information on complex topics like Medicare and reimbursement. APA and Practice Organization members were treated to a reimbursement coding webinar with President-elect Antonio Puente, PhD, as the speaker. Communications also published a new toolkit for psychologists with information on Medicare and how to use it.
1 Those organizations are: the American Academy of Clinical Neuropsychology (AACN), the American Board of Clinical Neuropsychology (ABCN), Div. 40 of APA, the National Academy of Neuropsychology (NAN) and the American Board of Professional Neuropsychology (ABN).