New Senate legislation would include psychology in HITECH incentive payments

The bill would add psychology and other mental health providers to those entities already eligible under a 2009 law

by Government Relations Staff

March 31, 2011—The Senate introduced legislation on March 10, 2011, sponsored by Sen. Sheldon Whitehouse (D-RI), to allow mental health practitioners and facilities to seek reimbursement for purchasing electronic health record-keeping systems (EHRs). The Health Information Technology for Economic and Clinical Health (HITECH) Act, enacted by Congress in 2009 as part of the American Recovery and Reinvestment Act, excludes psychologists and most other non-physician providers from receiving Medicare and Medicaid incentive payments and grant funds to adopt EHRs.

Providers who participate in the Medicare and Medicaid program stand to receive between $43,000 and $64,000 for individuals and up to $11 million for hospitals in incentives over four to six years. The reimbursement incentive payments began in January 2011, and will gradually phase down by 2016. Starting in 2015, providers receiving incentive payments who cannot demonstrate “meaningful use” of an EHR will see their Medicare reimbursement reduced each year.  

In order to be considered a meaningful user, the eligible professional or hospital will need to meet the following three requirements:

First, they must have purchased and be using “certified EHR technology” in a meaningful manner. A meaningful manner, according to the Department of Health and Human Service, means that Medicaid providers must have at least a 39 percent Medicaid caseload. Second, the system must be “interoperable” with other EHR systems, meaning that the EHR technology is capable of providing an electronic exchange of health information to improve the quality of health care in accordance with the standards and criteria adopted under the Act. And finally, one’s EHR technology must provide data on “quality measures” and clinical quality measures.

History of the Legislation

Due to the hard work of psychology in coalition with other mental health and substance abuse providers and treatment facilities, long-time mental health advocate and former Congressman Patrick Kennedy (D-RI) and Rep. Tim Murphy (R-PA), a psychologist in the House, and Senators Sheldon Whitehouse and Olympia Snowe in the Senate introduced legislation in the last Congress to include psychology and other mental health providers and institutions in the payments. Although the legislation had bipartisan support in both chambers with 84 cosponsors in the House and 12 cosponsors in the Senate, the clock ran out on the 111th Congress before it became law.

Going Forward

As federal rules to implement the HITECH Act take effect, the APA Practice Organization (APAPO) continues to push for the full inclusion of psychologists under the Act’s incentive programs. APAPO is working in coalition with other mental health and substance abuse providers and treatment facilities to stress the importance of including mental health in HITECH incentive payments.

At the 2011 State Leadership Conference, psychology leaders had more than 300 meetings with their Members of Congress and staffs to advocate for the issue and others. The meetings helped gain interest from many Congressional offices; we now have several potential lead sponsors and a number of potential co-sponsors for the HITECH incentives payment legislation.

APAPO considers it a priority to gain re-introduction of the legislation in the House and move it through to final passage in both chambers.

“The inclusion of psychologists in the EHR incentive payments is an issue of parity, and recognizes our contribution to whole health and prevention in the primary care setting,” said Marilyn Richmond, JD, assistant executive director of government relations for the APAPO.