APAPO and APA submit joint letter to Senate Finance Committee

Letter addresses mental health care in the U.S.

By Government Relations staff

On Sept. 26, the APA Practice Organization (APAPO) and APA submitted a detailed letter to the Senate Finance Committee addressing issues concerning Medicare and Medicaid, including reimbursement and patient access to care. The letter was in response to an Aug. 1 open request from Senate Finance Committee Chairman Max Baucus, D-Mont., and Ranking Member Orrin G. Hatch, R-Utah, to the mental health community asking for input on how to improve mental health care in those programs.

The request from senators Baucus and Hatch recognized disturbing mental health care statistics in the U.S., and asked for input on several questions to gather information and help inform committee direction:

  1. What administrative and legislative barriers prevent Medicare recipients from obtaining the mental and behavioral health care they need? And how can Medicare be cost-effectively reformed to improve access to and quality of care for people with mental and behavioral health needs?
  2. What administrative and legislative barriers prevent Medicaid recipients from obtaining the mental and behavioral health care they need? And how can Medicaid be cost-effectively reformed to improve access to and quality of care for people with mental and behavioral health needs?
  3. What are the key policies that have led to improved outcomes for beneficiaries in programs that have tried integrated care models?

APAPO and the APA Education and Public Interest directorates wrote a letter reflecting psychology's key legislative advocacy priorities related to Medicare and Medicaid.

The letter details reforms that APA and APAPO believe will reduce the unmet mental and behavioral health needs of Americans, improve quality of care and better control rising costs:

  • Adjust Medicare payment formula to halt plummeting payment for psychologists.
  • Include clinical psychologists in the Medicare "physician" definition (1861(r) of the Social Security Act) by enacting S. 1064/H.R. 794.
  • Make psychologists eligible for HITECH Act incentive payments for the adoption of electronic health records (EHRs) by enacting S.1517/H.R 2957.
  • Repeal the flawed Sustainable Growth Rate Formula (SGR) and replace it with fair and adequate payment reforms.
  • Provide clinical psychologists eligibility for Medicare evaluation and management (E&M) services reimbursement.
  • Make the provision of psychological services mandatory under the Medicaid program in order to promote patient choice of provider and allow access to the full range of psychological services.
  • Require Medicare/Medicaid reimbursement for doctoral psychology interns, residents and post-doctoral trainees.
  • Promote effective community-based services for people with serious mental and addiction disorders by enacting S. 264/H.R. 1263.
  • Promote home- and community-based alternatives for children with serious mental health conditions in Medicaid, and make the cost-effective demonstration program permanent.
  • Ensure Medicaid managed care plans are providing integrated care for dual eligible beneficiaries.
  • Include mental health and substance use services in the financing of long-term services and supports.
  • Medicare and Medicaid integrated care models should be fully inclusive and involve multiprofessional care.

This is not the first time APAPO has addressed the Senate Finance Committee during this Congress on issues of importance. APAPO has submitted letters on Medicare payment, the Sustainable Growth Rate (SGR) formula and Behavioral Health Information Technology incentive payments. The Senate Finance Committee has jurisdiction over health programs under the Social Security Act, including Medicare, Medicaid and the Children's Health Insurance Program (CHIP).

"This letter is a roadmap of APAPO's legislative advocacy priorities," says APA Executive Director for Professional Practice Katherine C. Nordal, PhD. "We're working toward cost-effective reforms of Medicare and Medicaid that will ensure fair and adequate payment for psychologists, improve access to mental and behavioral health services and better meet the health care needs of beneficiaries across their lifespan."