The Consolidated Appropriations Act of 2023 (HR 2617) passed at the end of 2022. This federal funding legislation includes many American Psychiatric Association initiatives and priorities impacting psychiatry and mental health care, lobbied for by the APA advocacy team of staff and members.

See below for the list of legislative priorities included in the legislation, next to APA Advocacy activities in support thereof.

Consolidated Appropriations Act of 2023 (HR 2617)

Summary of APA Priorities

• Workforce Equity Investments: Makes crucial investments in our behavioral health care workforce that APA championed: adds 100 new graduate medical education (GME) slots specifically for psychiatry or psychiatry subspecialties. View recent APA workforce equity advocacy efforts (.pdf).
• Collaborative Care Model: Includes APA’s legislation that authorizes grants and technical assistance to primary care practices to implement the evidence-based Collaborative Care Model into their practices for early intervention and prevention of mental health and substance use disorders (SUD). View recent APA Collaborative Care advocacy efforts (.pdf).
• Telehealth: Extends the current public health emergency Medicare telehealth flexibilities and delays the implementation of the in-person requirement for telehealth services (.pdf) for mental health until Dec. 31, 2024. View recent APA advocacy efforts on telehealth (.pdf).
• Health Equity: Provides increased authorization and funding for Substance Abuse and Mental Health Services Administration’s (SAMHSA) Minority Fellowship Program and programs to improve maternal health. View recent APA health equity advocacy (.pdf).
• Parity Compliance: Eliminates the parity opt-out for non-federal governmental health plans and authorizes funding for state insurance departments to enforce and ensure compliance with the mental health parity law. View recent APA advocacy efforts on parity compliance(.pdf).
• Crisis Services: Provides more than $500 million in new funding to support the 988 Suicide and Crisis Lifeline and doubles funding for programs aimed at diverting mental health and SUD crisis response from law enforcement to mobile crisis teams. View recent APA crisis services advocacy efforts (.pdf).
• Physician Wellness: Adds new exceptions to the Stark Law to allow for hospitals to provide evidence-based programs for physicians to improve their mental health and increase resiliency, and to prevent suicide among physicians.
• Puerto Rico and Territory Medicaid Funding: Extends Puerto Rico’s higher federal Medicaid match of 76% through FY 2027, and permanently extends a federal Medicaid match of 83% for American Samoa, the Commonwealth of the Northern Mariana Islands, Guam and the U.S. Virgin Islands.
• Conrad 30 Waiver Program: Extends through Sept. 30, 2023, the Conrad 30/J-1 visa waiver program, allowing J-1 foreign medical graduates to apply for a waiver of the two-year foreign residence requirement upon completion of the J-1 exchange visitor program.
• Health and SUD Programs - Substance Abuse and Mental Health Services Administration (SAMHSA): $7.5 billion ($790 million billion increase), including a $2.8 billion increase for mental health. Highlights include:
  • Community Mental Health Services Block Grant – $1.01 billion (an increase of $150 million) to enable states to implement evidence-based mental health promotion, prevention, and treatment practices for early intervention with individuals with serious mental illness (SMI) and children with serious emotional disturbances.
  • Practice Improvement and Training – Nearly $8 million in support of SAMHSA’s Practice Improvement and Training Programs.
• Workforce - Health Resources Services Administration (HRSA): $7.5 billion (an increase of $1.6 billion). Including:
  • STAR Loan Repayment Program – $40 million (an increase of $24 million) in funding for loan repayment to individuals working in either a full-time SUD treatment job that involves direct patient care in a county/municipality where the average drug overdose death rate exceeds the most current national average or a Mental Health Professional Shortage Area.
  • MH/SUD Workforce Training Program - $34.7 million (an increase of $3 million) in grant funding for institutions to support training for medical residents and fellows in psychiatry and addiction medicine who are willing to provide SUD treatment in underserved areas.
• Research - National Institutes of Health (NIH): $47.5 billion ($2.5 billion increase). Including more than $4.4 billion in funding for the federal research entities the National Institute on Alcohol Abuse and Alcoholism, the National Institute of Mental Health and the National Institute on Drug Abuse. $25 million in funding to support gun violence research split between the NIH and Centers for Disease Control and Prevention.
• Veterans Mental Healthcare: $13.9 billion for Veterans mental healthcare ($744 million increase), including $498 million for suicide prevention outreach. In addition, the bill includes a record $916 million for medical and prosthetic research.
• REMS Reform: Instructs the Secretary to open a single docket for comments (at least 90 days) of factors that should be considered when there is a request to change vendors of drugs subject to risk evaluation and mitigation strategies (REMS), including patient access and prescribing and administration of drugs by providers.
• Psychotherapy Payments: Establishes new codes for payment of psychotherapy for crisis services that are furnished at applicable sites of service and provides education and outreach for physicians to participate in the furnishing of this service.
• Intensive Outpatient Services: Requires Medicare to cover intensive outpatient services provided in community mental health centers, federally qualified health centers, and rural health centers.

More to be done – you can get involved

While we celebrate these important wins, there is more to do to improve mental health policy and physician reimbursement. For example, Congress chose to restore only 2.5% of a 4.5% Medicare payment cut for all physicians beginning Jan. 1. This runs counter to the need to improve access to care for patients and APA is urging Congress to revisit this along with other medical specialty societies.

We look forward to continuing to advance our agenda on Capitol Hill and alongside your District Branches at the state level in the coming year. To learn more about how APA is working for you, visit our Advocacy page.

Here’s how you can get involved:

1. Visit our Advocacy Action Center  
   We make it easy for you to take action & contact your legislators.
2. Sign up for Advocacy Alerts and Updates  
   Timely news and requests for action to help us make a difference for psychiatry.
3. Support APAPAC  
   APAPAC is the political arm of APA—it amplifies our voice on Capitol Hill and helps us get mental health champions elected to the U.S. Congress.
4. Join the APA Congressional Advocacy Network  
   CAN is APA's political grassroots network—our advocates connect with members of Congress to ensure that legislation is informed by constituent psychiatrists.