State Beat: A new monthly column reporting the news, issues and advocacy efforts impacting practitioners in states around the country

Advocacy successes in Massachusetts; narrowing the definition of psychology practice in Texas; board vacancies in Maine.

By Hannah Calkins

This is the inaugural edition of State Beat, a monthly column reporting news, issues and advocacy efforts impacting practitioners in specific state, provincial and territorial psychological associations (SPTAs). 

Some months, like this one, we will provide a round-up of key developments in a few places. Other months, you can expect us to go in-depth on an issue particular to a single state.

The information in this column was collected from a recent survey of the executive directors of SPTAs. If you would like to report something in your state for possible inclusion in State Beat, please contact the executive director of your SPTA.


MPA advocacy results in policy changes with BCBSMA, state mandate for EHR systems

Brian Doherty and Michael Goldberg, PhD, of the Massachusetts Psychological Association (MPA) reported that MPA’s advocacy, with assistance from the APA Practice Organization’s legal and regulatory affairs team, has resulted in three separate policy changes recently.

Two of these successes were with Blue Cross Blue Shield of Massachusetts (BCBSMA), says Doherty, who is the executive director of MPA. In April, BCBSMA announced they would expand their telehealth coverage to include more of the psychotherapy codes they currently reimburse on an in-person basis. More recently, in September, BCBSMA agreed to change its policies on CPT 90837 (“psychotherapy for 53 minutes or more”), announcing that in 2017 they would expand the billable list of evidence-based treatments for this code and discontinue the requirement for preauthorization.

In both of these instances, the MPA and staff from the Practice Organization used scientific research and data to make their case for changing the policies, says Goldberg, who is now MPA’s associate director of professional affairs.

MPA’s third success was with the state. Doherty said that the Massachusetts Executive Office of Health and Human Services (EOHHS) has decided to extend the deadline for providers to develop electronic health records systems (EHRs), a mandate which was originally scheduled to go into effect on Jan. 1, 2017. The mandate also required providers to connect to Mass HIway, a statewide health information exchange, by this date.

According to a Sept. 21, 2016, MPA news update authored by Goldberg, the EOHHS changed the deadline to “later than January 2018” as a result of his advocacy on behalf of MPA. As a member of the Behavioral Health EHR Task Force advising EOHHS, Goldberg “advocated strongly for an understanding of the unique problems this mandate would cause for behavioral health providers and the significant costs associated with it.”

Providers will also be given at least one year’s advance notice of the new deadline, he wrote.

In addition to extending the deadline, Goldberg says that the EOHHS will develop regulations clarifying what “connection” to Mass HIway entails. MPA will continue to monitor developments regarding the revised mandate.


TPA narrows definition of psychology practice as board faces Sunset Review

In January 2017, the Texas State Board of Examiners of Psychologists is up for its review by the state legislature’s Sunset Advisory Commission, which assesses state boards and agencies every 12 years. This would not be particularly newsworthy were it not for a recent ruling that compelled the Board to narrow its definition of psychology practice, says David White, the executive director of the Texas Psychological Association (TPA). (This June article from the Texas Tribune provides background on the ruling and the lawsuit precipitating it.)

TPA, the Board of Examiners of Psychologists and other state agencies are working on the redefinition ahead of the next legislative session. In addition to narrowing the definition to satisfy the ruling, White says that TPA, in collaboration with the Practice Organization’s legal and regulatory affairs staff, is taking this opportunity to work to include psychologists’ diagnostic capabilities in the definition. “There’s nothing in the current definition that says psychologists diagnose, but we know that they’re doing that every single day,” White says.


Critical number of vacancies on the Board of Examiners of Psychologists

A psychologist who applied to serve on the Board of Examiners of Psychologists has been approved by the governor, reports Sheila M. Comerford, the executive director of the Maine Psychological Association (MePA). This approval will fill one of five vacancies on a board with nine seats total.

The vacancies, which Comerford says have increased steadily over the past two to three years, would be significant under any circumstances. But the situation in Maine is especially problematic because the state legislature recently changed the rules of governance for state boards, allowing a quorum to be constituted by a majority of those present during a vote.

“This means that decisions of great importance to practicing psychologists and examiners can be made by very few people,” Comerford explains. If one or more board members are absent during a vote, “very few” could mean just two or three.

In response, MePA has been urging qualified individuals to apply to serve on the board, including the psychologist who was just approved.

Four vacant seats remain. “Two seats are for psychologists or psychologist examiners, and two are public seats,” Comerford says.