APA’s Government, Policy, and Advocacy Update (May 2022)

In late March, the Ninth U.S. Circuit Court of Appeals reversed a district court’s February 2019 decision in the Wit v. United Behavioral Health case.

The decision set a precedent for health plans that are regulated by the federal mental health parity law. It established that mental and substance use disorders are chronic conditions that should be treated as such by insurers ("Court Rules Against UBH in Precedent-Setting Case"). The court found that United Behavioral Health (UBH) had violated its fiduciary duty to beneficiaries seeking mental health care by making coverage decisions according to its own guidelines rather than generally accepted standards of care.

“We are extremely disappointed in the Ninth Circuit’s ruling, particularly as the nation faces a mental health and substance use disorder crisis in the aftermath of COVID-19,” APA said in a statement. “As access to mental health and substance use services is a priority for the Biden administration, we urge Congress, as well as states across the nation, to pass legislation adopting the principles of the Wit district court decision to ensure fair and equitable treatment of patients with mental health and/or substance use disorders and hold insurance companies accountable.”

American Psychiatric Association Statement on Ninth Circuit Court’s Decision in Wit v. United Behavioral Health.

 

A new collaboration including APA and 14 leading mental health professional organizations, advocacy groups, and funders is working to raise awareness and increase support among state and municipal officials as they prepare for the launch of the 988 crisis hotline. The CEO Alliance for Mental Health will “advance a unified vision for qualitative transformation of mental health and substance use care in the U.S.,” according to an APA news release.

The alliance has started a social media campaign to direct policymakers and advocates to its roadmap for mental health crisis response. The roadmap “offers leadership at every level of government an evidence-based toolkit for designing and implementing a full continuum of mental health and substance use care,” the release states. The roadmap outlines the seven pillars for transforming mental and substance use disorder care, such as early identification and prevention, workforce capacity, equity and inclusion, and emergency and crisis response.

“The CEO Alliance’s 988 social media campaign aims to drive awareness among governors, mayors, city commissioners, and other civic leaders of the need for bold innovation at every touchpoint in mental health care delivery,” the release states.

Consensus Approach and Recommendations for the Creation of a Comprehensive 988 Crisis Response System.

CEO Alliance for Mental Health Launches Campaign to Drive 988 Crisis Hotline Preparedness.

 

In a statement, APA and its five partner organizations, collectively known as the Group of Six, emphasized their firm opposition to policies that unnecessarily regulate the evidence-based practice of medicine; threaten the patient-physician relationship; and inhibit the delivery of safe, timely, comprehensive care.

The Group of Six includes APA, the American Academy of Family Physicians, the American Academy of Pediatrics, the American College of Obstetricians and Gynecologists, the American College of Physicians, and the American Osteopathic Association.

The statement was issued in response to legislation passed in Idaho that bans abortions after six weeks of gestation, which is before most people know they are pregnant. The legislation also allows family members, as well as people unrelated to the pregnant person, to sue physicians or other health professionals who provide abortion services.

“This legislation, and others like it being considered across the United States, will endanger patients and clinicians by allowing private citizens to interfere in reproductive health decision-making,” the Group of Six stated. “Physicians must be able to practice medicine that is informed by their years of medical education, training, experience, and the available evidence, freely and without threat of punishment, harassment, or retribution. Our patients, not policymakers, need to be in charge of their own medical decisions.”

Physicians Oppose Legislation That Threatens Access to Reproductive Health Care.

 

The Group of Six also sent a letter to Congressional leaders asking them to swiftly appropriate additional funding for the COVID-19 response “to ensure patients can continue to access lifesaving vaccines and therapeutics [and] testing and to ensure we are prepared for future COVID-19 variants,” the letter states.

The letter is addressed to House Speaker Nancy Pelosi (D-Calif.), House Minority Leader Kevin McCarthy (R-Calif.), Senate Majority Leader Chuck Schumer (D-N.Y.), and Senate Minority Leader Mitch McConnell (R-Ky.). The letter outlines the importance of having resources available to purchase booster vaccinations, to develop variant-specific vaccines, and to increase the availability of antiviral medications, among other response activities.

“Sustained and adequate funding is essential for the federal government and public health agencies to support the country’s ongoing efforts to prevent and mitigate the harmful effects of COVID-19 on patients,” the letter continues. “Yet, without additional federal resources, these critical efforts are in jeopardy of not continuing.”

Letter to Congressional leaders asking them to swiftly appropriate additional funding for the COVID-19. ■