APAPO’s legislative road map for 2015
The 114th Congress convened earlier this month with Republican majorities in both the House and the Senate. The gridlock that beset the last session of Congress may persist on Capitol Hill; despite their majorities, Republicans generally lack the votes to override a presidential veto. Additionally, the 2016 presidential election is likely to distract attention from legislating.
Nevertheless, Congress will be under pressure to act on multiple fronts with respect to health care policy, most immediately the need to pass Medicare legislation before April 1. Congress needs to act by that date to avoid a more than 20 percent payment rate cut under the Sustainable Growth Rate (SGR) formula.
The APA Practice Organization (APAPO) will be working to stop these cuts and renewing our push for initiatives affecting psychologists’ participation in Medicare. Much of our work this year will be devoted to reintroducing bills. Each session of Congress begins with a clean slate, as no legislation is carried over from the previous Congress.
Following is a brief summary of APAPO’s legislative advocacy aims for 2015. Further, we are working to repeal the SGR and end the 2 percent cuts in Medicare rates currently in effect due to federal budget sequestration.
Including psychologists in Medicare’s physician definition
The Medicare Mental Health Access Act will be reintroduced in the new Congress with new bill numbers. By adding psychologists to Medicare’s “physician” definition, this legislation would allow psychologists to practice independently in all Medicare treatment settings consistent with state licensure. The Medicare physician definition already includes other non-physician disciplines: chiropractors, optometrists, dentists and podiatrists. In many cases, psychologists must have potential Medicare clients wait for physician sign-off before providing treatment, which disrupts the provision of effective, timely care. Psychologists have begun to share stories with us showing the need for the legislation and APAPO encourages more to join this effort.
If you have a personal story of how physician certification requirements are causing treatment delays or other disruptions in your work with Medicare beneficiaries, please share it with APAPO staff by sending a short email.
APAPO is working with current bill sponsors and other congressional leaders to ready the legislation’s introduction early in the 114th Congress, and to secure additional bipartisan support. Congressional committees with jurisdiction over Medicare include the Senate Finance Committee, the House Ways & Means Committee, and the House Energy & Commerce Committee.
Make psychologists eligible for incentive payments for the use of electronic health records
APAPO is working toward the reintroduction of the Behavioral Health Information Technology (BHIT) Act in the 114th Congress. This bill would allow psychologists and other mental health professionals to receive Medicare incentive payments for the use of electronic health records (EHRs).
APAPO is collaborating with the BHIT Coalition to achieve this legislative goal.
Increase psychologists’ Medicare payment rates under the physician fee schedule
Psychologists’ Medicare reimbursement rates have dropped 18 percent since 2006 — a 36 percent reduction when accounting for inflation. APAPO contracted with a leading health policy consulting group to determine the mechanisms within Medicare’s payment formula that have been contributing to the steady declines, and to figure out how to reverse them.
In late 2014, APAPO staff met with Sean Cavanaugh, deputy administrator of the Centers for Medicare and Medicaid Services (CMS), regarding this issue, and sent a letter to CMS describing possible solutions. APAPO will be discussing the problem and legislative solutions with members of Congress later this year.
Mental health system reform and funding for serious mental illness
Last year APAPO worked closely with APA’s Public Interest, Science and Education Directorates on comprehensive mental health reform legislation, introduced by Rep. Tim Murphy, R-Pa., at the end of 2013, called the “Helping Families in Mental Health Crisis Act” (HR 3717). APAPO and APA offered broad support for the bill’s intent of reforming the mental health delivery system for people with a serious mental illness, and we promoted consideration of the bill and refinement of some of its provisions. The legislation garnered more than 100 co-sponsors from both political parties, but fell short of gaining the support necessary for its consideration on the House floor. Rep. Murphy is expected to reintroduce a version of this legislation in 2015, and APAPO looks forward to working with him and our other colleagues in support of this legislation.