The last few months have seen significant movement across a broad array of issues.
APA-Led Activities
Members Gather in DC for the 2024 State Advocacy Conference
159 APA members, including fellows, traveled to Washington, DC to participate in the State Advocacy Conference, which focused on critical issues impacting the field of psychiatry. Sessions delved into topics such as scope of practice, the emerging role of psilocybin, and mental health parity, offering valuable insights into current advocacy challenges and opportunities. Attendees engaged in interactive discussions with panelists who shared advocacy strategies that have proven successful—or not—across various states. The conference also featured guest speakers like Jeff Dufour, Editor-in-Chief of National Journal, who provided an election forecasting overview, and Holly Amaya, who emphasized the power of storytelling in advocacy efforts, as well as Assistant Secretary Gomez from the Department of Labor talking about how APA members can ensure enforcement of the of the mental health parity law. This conference aimed to equip members with the tools and knowledge to enhance their advocacy initiatives back home.
Empowering Psychiatry’s Voice
Contributing to APAPAC is an important way APA members can invest in the outcomes of the upcoming election. Contributions from APA members to APAPAC ensure that psychiatry has the resources needed to support congressional mental health champions and build relationships with candidates and elected officials to grow new champions. The combined contributions of APA members allow APAPAC to make substantial investments in races. It is critical that APAPAC has enough funds to help impact races this year and ensure psychiatry’s mental health champions are reelected.
View APA’s election resources and make your contribution to APAPAC today!
Executive Branch Activities
APA Applauds the Final Parity Rule
On September 9, 2024 the Departments of Labor, Treasury and Health and Human Services released final rules to strengthen parity between mental health and substance use disorders benefits and medical/surgical benefits. The final rule is a big win for the behavioral health community because it will finally close loopholes in MHPAEA that insurance companies routinely use to deny care for mental health conditions and substance use disorder. The rule clarifies and strengthens requirements related to the analysis of NQTLs, an area where parity violations continue to persist. The rule will also ensure parity protections to people who have health coverage from state and local governments.
APA Advocates for Two-Year Extension of DEA Teleprescribing of Controlled Substances Flexibilities
APA has called on the Biden administration to work with the Drug Enforcement Administration (DEA) to extend the COVID-19 telemedicine flexibilities for the prescription of controlled medications for two years through December 31, 2026. The current flexibilities are slated to end on December 31, 2024. Without a finalized rule or an extension prior to that date, the current regulatory framework under the Ryan Haight Act will continue to apply, abruptly ending care for many across the country. In our letter dated September 6, we share the challenges that many face across the country accessing mental health and substance use services in-person, and how the flexibilities have benefited those seeking care.
APA Submitted Comments on Medicare’s Proposed Rule on the 2025 Medicare Physician Fee Schedule and Quality Payment Program
APA submitted comments supporting a number of proposals related to telehealth and safety planning interventions that would go into effect January 2025, if approved. We also urged CMS to delay coverage for digital mental health devices until there was sufficient evidence showing a positive impact on outcomes. APA did not support the sunsetting of traditional MIPS (by 2029) in favor of MIPS Value Pathways (MVPs) as MVPs do not have enough meaningful cost or quality measures at this time.
APA Encouraged CMS to Allow ECT to be Provided in the Ambulatory Surgery Center Setting in Comments on the Hospital Outpatient Prospective Payment System and ASC proposed rule
APA commented on CMS’s proposed rule focused on ensuring access to all psychiatric services through coverage and payment. We encouraged CMS to reverse their decision and allow coverage of ECT in the Ambulatory Service Center (ASC) setting as a mechanism to increase access to this evidence-based service. We also encouraged CMS to recognize the resource costs incurred when providing accelerated TMS. APA supported CMS’s increased focus on equity, as reflected in their proposal to add health measures of health equity and social determinants of health (SDOH) in the hospital outpatient and rural emergency quality reporting programs. We also urged them to take that one step farther and commit resources to measure how many patients who are screened positive for SDOH actually get connected to community resources.
APA Meeting With FDA and SAMHSA to Address Stimulant Shortage
The Chair of the Childrens, Adolescents, and their Families, represented APA in a meeting with the FDA Commissioner, Dr. Robert Califf and Assistant Secretary at SAMHSA, Dr. Miriam Delphin-Rittmon on Friday September 6th. Along with a few other partner organizations, we spoke to the agency staff about the stimulant shortages, the impacts on members and their patients, as well as diagnosing and treatment of ADHD. This meeting comes on the heels of the September 5 DEA announcement (.pdf) to adjust the aggregate production quota for Lisdexamfetamine and d-Amphetamine for conversion. APA was also able to share the latest pulse survey information with the FDA and SAMHSA. APAs survey has been open for about 4 weeks starting the last week of August. 316 members, representing 39 states, DC and Puerto Rico, responded with 99% saying they are continuing to face challenges with the stimulant shortage.
APA Participation at the SAMHSA Harm Reduction Summit
APA was invited to participate in a three-day SAMHSA Harm Reduction Summit focusing on the continued implementation and adoption of the Harm Reduction Framework (.pdf). APA provided comments in August of 2023 to the development of the framework, supporting the increased investment into harm reduction programs, sites, and services. APA passed our Position Statement on Harm Reduction (.pdf) in 2023 and just recently finalized a Resource Document on Harm Reduction.
Congressional Activities
APA Supports Fetal Alcohol Spectrum Disorders Legislation
APA supported bipartisan legislation to reauthorize and expand a comprehensive FASD awareness, prevention, identification, intervention, and services delivery program at HHS. H.R. 3946/S. 1800, the Fetal Alcohol Spectrum Disorders Respect Act, also establishes FASD Centers for Excellence to build local, Tribal, State, and national capacities to prevent and identify the occurrence of FASD. This bill addresses gaps in FASD diagnostic and clinical resources, including a shortage of psychiatrists, to help individuals and families impacted by FASD. View the full letter of support here (.pdf).
APA Backs Bill to Increase Behavioral Health Care Access
APA supported H.R. 9133/S. 4835, the Primary and Behavioral Health Care Access Act, which requires private health insurance plans to cover three primary and three behavioral health care visits per plan year without cost-sharing requirements. The bill takes an important step in lessening financial barriers to behavioral health care and allows patients to seek treatment early-on for improved outcomes. View the full letter of support here (.pdf).
APA Endorses H.R. 6664/S.4905, the "Innovation in Pediatric Drugs Act"
APA joined a letter in support of the Innovation in Pediatric Drugs Act (H.R. 6664/S.4905). The bill would help speed therapies to children and adolescents by making needed changes to pediatric drug laws including increasing the number of rare disease drugs studied in children, ensuring that mandated Pediatric Research Equity Act studies are completed, and giving the NIH Best Pharmaceuticals for Children Act program its first funding increase in 22 years. View the full letter of support here (.pdf).
APA Acts on Medicare Physician Payments
APA joined a letter in support of H.R. 2474, the Strengthening Medicare for Patients and Providers Act, and S. 4935, the Physician Fee Stabilization Act. H.R. 2474 seeks to address this issue by providing an annual inflationary physician payment update in Medicare tied to the Medicare Economic Index (MEI). S. 4935 would provide a much-needed increase to the budget neutrality threshold, raising the trigger amount from $20 million, where it has been since 1992, to $53 million. Click here for more information, and to urge your member of Congress to support H.R. 2474.