APA’s Government, Policy, and Advocacy Update (January 2025)
APA’s 2024 Regulatory Wins
APA had several regulatory advocacy successes on behalf of psychiatrists and their patients in 2024. The need for mental health and substance use disorder services continues to be significant, and APA has worked closely with federal agencies to ensure all people with mental illness receive the care they need.
APA’s advocacy successes in the last year included:
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Equal pay for telehealth services: Care provided via telehealth will now be paid at the same rate as in-person care using existing evaluation and management (E/M) codes for outpatient care. This was a major advocacy win in which APA played a significant role, along with other physician groups, to ensure equal pay for telehealth services.
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Extended telehealth flexibilities: The Drug Enforcement Administration and the U.S. Department of Health and Human Services issued a third extension of COVID-19 telehealth flexibilities for the prescribing of controlled substances, to be effective through December 31, 2025.
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Removed barriers to clozapine: A panel convened by the U.S. Food and Drug Administration (FDA) voted overwhelmingly against key provisions of the Clozapine Risk Evaluation and Mitigation Strategy (REMS), removing significant barriers to this highly effective medication. The REMS is designed to monitor for the rare side effect of neutropenia, a potentially deadly reduction in white blood cells that is mostly likely to occur in the early phases of clozapine treatment.
During her testimony on behalf of APA, Kathryn K. Erickson-Ridout, M.D., Ph.D., told the FDA panel that psychiatrists are capable of appropriately monitoring their patients’ hematologic status. While the REMS program is well-intentioned, it creates a barrier to clozapine.
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Closing parity loopholes: In another significant win for APA’s advocacy program, the federal government issued a new rule that strengthens enforcement of the 2008 Mental Health Parity and Addiction Equity Act (MHPAEA), requiring insurers to provide data illustrating that their beneficiaries have access to mental health services.
The new rule reinforces the original intent of the 2008 law, allowing patients to access mental health and substance use disorder benefits in parity with their medical/surgical benefits. The rule also clarifies that eating disorders and autism spectrum disorder are considered mental health conditions and protected under MHPAEA.
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Resident supervision: The Centers for Medicare & Medicaid Services (CMS) extended for another year the ability for residency training programs to supervise residents virtually when the care is being provided virtually.
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Safety planning: CMS also approved coverage for safety planning interventions and post-discharge follow-up contact for patients experiencing suicidal thoughts or behaviors.
APA played a major role in all these advocacy successes and will continue to work with the incoming administration to advance psychiatry and access to treatment. To learn how to get involved, visit APA’s Advocacy Action Center here. ■
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Information
Published In
Psychiatric News
History
Published online: 20 December 2024
Published in print: January 1, 2025 – January 31, 2025
Keywords
- Advocacy
- Legislation
- Successes
- Access
- Telehealth
- Evaluation and Management codes
- E/M codes
- Flexibilities
- COVID-19 pandemic
- Clozapine
- U.S. Food and Drug Administration
- REMS
- Parity loopholes
- 2008 Mental Health Parity and Addiction Equity Act
- MHPAEA
- Resident supervision
- Safety planning
- Centers for Medicare & Medicaid Services
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