The 2015 legislative advocacy agenda includes many of the key issues of 2014. As we move into the 114th Congress, here is a look at the legislative priorities for Practice and for Education.
Medicare payment rates for psychologists' services have declined steadily over the past several years; the payment rate for the most commonly provided service, a 45-minute therapy session, has fallen by more than a third over the past 14 years. This drop in payment rates makes it difficult for psychologists to continue treating Medicare patients, limits beneficiary access to care and negatively impacts private sector policies.
Physician Definition in Medicare
Unlike other health insurance payers, Medicare requires physician supervision of psychologists' services in many treatment settings, which means that when no physician is available, psychologists cannot be reimbursed for the services they provide to beneficiaries. These unnecessary supervision requirements hamper psychologists' ability to offer the full range of services they are authorized to provide under state licensure laws. The APA Practice Organization (APAPO) is advocating for Congress to take up and pass legislation to include psychologists in the Medicare definition of "physician," which would eliminate the outdated and inappropriate physician oversight requirements.
Behavioral health information technology use incentive payments
The Medicare and Medicaid programs have provided millions of dollars in incentive payments over the past few years to assist general medical providers to adopt and use electronic health records (EHRs). Psychologists and other behavioral health providers, however, are not eligible for this help.
Congress can correct this exclusion by supporting and passing legislation to enable psychologists and other key behavioral health providers to qualify for much-needed EHR incentives to enhance quality of care. Bills introduced in the 113th Congress by Sen. Sheldon Whitehouse (S. 1517) and Sen. Rob Portman (S. 1685), and by Rep. Tim Murphy and Rep. Ron Barber (H.R. 2957) would enable clinical psychologists to qualify for Medicare and Medicaid incentive payments for integrating EHRs into their practices.
The education advocacy agenda includes developing strategies to increase federal investments in psychology education and training, and to promote the overall application of psychology to education and training. The current legislative priorities include:
The Graduate Psychology Education Program
Established in 2002 within the Health Resources and Services Administration’s (HRSA) Bureau of Health Professions, the Graduate Psychology Education (GPE) program provides grants to accredited psychology doctoral, internship and postdoctoral training programs to expand access to mental and behavioral health services for vulnerable and underserved populations in rural and urban communities. An exemplary “two-for-one” federal activity, the program supports the interprofessional training of psychology graduate students while also providing supervised mental and behavioral health services to underserved populations, such as older adults, children, those suffering from chronic illness, veterans, victims of abuse, unemployed persons and victims of natural disasters. GPE funds may be used to cover costs for student and intern stipends, curriculum development, model demonstration programs, faculty supervision and technical assistance. The GPE program is the nation’s only federal program dedicated solely to the education and training of doctoral psychologists.
In Fiscal Year 2014, Congress approved more than $7 million within the mental and behavioral health program at HRSA, $6.9 million of which HRSA plans to use to support GPE grants. Congress also appropriated $35 million for the Behavioral Health Workforce Education and Training program, which is a joint initiative between HRSA and the Substance Abuse and Mental Health Services Administration (SAMHSA) to support the clinical training for behavioral health professionals, including doctoral psychology interns, which is also included in our 2014 education advocacy agenda.
The Garrett Lee Smith Memorial Act Reauthorization of 2013
Signed into law on Oct. 21, 2004, the Garrett Lee Smith Memorial Act (GLSMA) was named in memory of Sen. Gordon H. Smith's son, Garrett, who died by suicide on Sept. 8, 2003. The bill was authored by a bipartisan bicameral group of members of Congress intent on curbing the rate of youth suicide in the United States.
The House and Senate bills would reauthorize and maintain the GLSMA Youth Suicide Early Intervention and Prevention Strategies Program for States and Tribes, the Mental Health and Substance Use Disorders Services and Outreach on Campus Program, and the Suicide Prevention Technical Assistance Center. Both pieces of legislation would make changes to the Campus Suicide Prevention program that will allow for flexibility in the uses of funds to better meet the diverse, documented and growing needs of students.
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*APA employees and division members, and members and employees of state and regional psychological associations