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

Along with dozens of other health care organizations and corporations, APA wrote a letter to Sens. Charles Schumer (D-N.Y.) and Mitch McConnell (R-Ky.), urging the Senate to pass a two-year extension of the telehealth flexibilities introduced during the COVID-19 public health emergency, while still pushing to make those flexibilities permanent. The letter notes that the House passed the Advancing Telehealth Beyond COVID-19 Act (HR 4040) in July, which extends coverage of telehealth services under Medicare until at least 2024. Currently, the flexibilities are due to expire 151 days after the public health emergency ends.

“Virtual care is now a fundamental part of the U.S. health care system, and it will improve patient access to high-quality care and strengthen continuity of care well beyond the COVID-19 pandemic,” the letter states. “Telehealth is helping to address the crisis-level mental health, primary care, and other workforce shortages. Many underserved communities that historically have had limited access to care may now beam in additional support for their workforce as well as top specialists to help save lives and treat critically ill patients. Unfortunately, without statutory certainty for remote care, the hard work of building infrastructure, trust, and relationships with these communities is beginning to stall.”

Sens. Chris Murphy (D-Conn.), Tina Smith (D-Minn.), and Ben Ray Luján (D-N.M.) introduced the Parity Enforcement Act of 2022 (S 4804). The APA-supported bill would allow the Department of Labor to issue civil monetary penalties against insurers and health plans that are not in compliance with the Mental Health Parity and Addiction Equity Act of 2008.

“Giving the Department of Labor the authority to impose civil monetary penalties on health plans and insurers for violating the parity law is a critical next step for improved accountability,” APA CEO and Medical Director Saul Levin, M.D., M.P.A., said in a news release on Murphy’s website. “The Department’s report to Congress earlier this year demonstrated that despite increased transparency, plans and insurers are still falling short of full compliance. We appreciate Senator Murphy’s continued efforts to ensure true mental health parity enforcement.”

In comments to the Centers for Medicare and Medicaid Services (CMS), APA emphasized the importance of ensuring access to mental and substance use disorder treatments by supporting coverage and appropriate reimbursement for services, such as those provided via telehealth (including audio only). The comments, signed by APA CEO and Medical Director Saul Levin, M.D., M.P.A., were made in response to CMS’s proposed rule on the 2023 Medicare Physician Fee Schedule and Quality Payment Program (APA Registers Concerns About Potential Cuts to Medicare Physician Payment).

 

In late August, APA responded to the Centers for Medicare and Medicaid Services’ (CMS) proposed rule on Conditions of Participation (COP) for Rural Emergency Hospitals (REH) and Critical Access Hospital COP Updates. APA’s letter, signed by APA CEO and Medical Director Saul Levin, M.D., M.P.A., expresses APA’s support for the expansion of health care access in rural communities, while encouraging CMS to further support access to treatment for mental and substance use disorders through these hospitals.

Levin highlighted the APA report “The Psychiatric Bed Crisis in the U.S.” in the letter to urge CMS to reconsider an exemption to the 24-hour average length of stay for patients needing inpatient psychiatric care, allowing them to stay in the emergency hospitals until a bed in a facility that most meets the needs of the patient is available. “Putting an artificial average time on patient stay may affect the care the most vulnerable patients are getting, leading to potentially life-threatening decisions,” Levin stated.

APA also encouraged the coverage and reimbursement of outpatient treatment services for mental and substance use out of the REH to increase the availability of quality services in rural communities. “There is an opportunity to shore up existing outpatient services and facilitate the implementation of additional services not currently available in the community,” the letter states. ■