APA’s Government, Policy, and Advocacy Update

In its massive year-end appropriations and COVID relief funding package, Congress passed the Strengthening Behavioral Health Parity Act (HR 7539), for which APA has been advocating for two years. It gives the U.S. Department of Labor (DOL) new powers to regulate and audit health plans to determine if they are in compliance with the 2008 Mental Health Parity and Addiction Equity Act (MHPAEA). President Donald Trump signed the legislation on December 27.

The legislation applies to federally regulated ERISA plans as well as state-regulated insurance plans. Among its provisions, the legislation requires plans to perform comparative analyses of their mental health/substance use and medical/surgical benefits and send those analyses to the DOL or a state insurance commissioner in response to complaints or violations. It also requires that Congress receive an annual report identifying plans that are out of compliance with MHPAEA.

Congress’s year-end funding package and COVID relief legislation contains several provisions that support mental health programs and initiatives in addition to the new parity law, including: $6 billion for the Substance Abuse and Mental Health Services Administration and $35 million for crisis care and coordination within the Mental Heath Block Grant, as well as increases in funding for several federal agencies that conduct mental health and substance use research.

In early December, APA CEO and Medical Director Saul Levin, M.D., M.P.A., sent a letter to President-elect Joe Biden and Vice President-elect Kamala Harris, congratulating them on their win and urging them to prioritize responding to the country’s increased demand for psychiatric services. The letter outlined several recommendations for Biden’s first 100 days in office, including improving access to treatment and investing in the mental health system.

As many states begin their legislative sessions this month, APA is working closely with district branches across the country to protect patient safety and introduce APA’s model legislation.

Late last year, APA and its partner organizations finalized model legislation to enforce the holding of the Wit v. UBH decision. The Jim Ramstad Model State Parity Legislation would ensure health plans cover medically necessary care that aligns with practice guidelines and treatment criteria developed specifically by associations like APA. It is similar to legislation that was signed into law in California last year.

APA is also working with states to introduce the Psychiatric Collaborative Care model legislation, which would require private insurers to reimburse collaborative care billing codes, and the telehealth model legislation, which would ensure fair reimbursement for psychiatrists who provide telehealth, as well as audio-only service delivery. Half the states have expressed interest in the telehealth model legislation already. APA members interested in learning more can contact APA’s director of state government relations, Erin Berry Philp. ■