Legistative Advocacy

APA’s Advocacy Year in Review & Looking Ahead

Thank you for your commitment to APA advocacy!
In 2023, APA built on recent advocacy successes in Congress, across federal regulatory agencies, and within state governments to improve access to mental health care and substance-use services.

Read below for highlights from our advocacy, government relations, and regulatory work on behalf of psychiatry this past year, and for a look ahead to 2024.
In this Update:

• 2023 Advocacy Highlights
• 2023 By the Numbers
• Free Webinars on Policy & Practice
• Plans for 2024 for Federal & State Advocacy

Get Involved

2023 Advocacy Highlights
• Introduction of legislation to increase reimbursement for the Collaborative Care Model billing codes;
• Introduction of legislation to permanently remove the six-month in-person requirement for telemental health services;
• Securing U.S. House and Senate support for increased funding for the psychiatric workforce;
• Securing increased Medicare reimbursement for outpatient psychotherapy;
• Securing the continuation of Medicare reimbursement rates for outpatient telepsychiatry visits that are equivalent to in-person care;
• CMS ensuring continuation of virtual supervision for residents delivering telehealth;
• CMS allowing Medicare practitioners to report their practice address instead of their home address when delivering telehealth from home;
• CMS maintaining audio-only delivery of periodic assessments in opioid treatment programs;
• FDA reevaluation of Clozapine REMS to determine whether the REMS can be modified to minimize burden;
• Enactment of Collaborative Care Model legislation in several states;
• Advancement of state legislation to reform and remove unnecessary prior authorization restrictions; and
• Defeat of legislation allowing psychologists to prescribe medications.

2023 By the Numbers
Federal Advocacy Conference
150 Members in Attendance (largest ever)
180 Meetings on the Hill

APA PAC
$220,000 raised
1,100 APA members & staff contributors

Advocacy Action Center
524 messages to legislators sent by members
600 Congressional Advocacy Network (CAN) members

Free Member Webinars on Policy & Practice
In 2023, APA began a new webinar-based Policy and Practice Insight Series to give members an opportunity to directly engage with APA staff and other subject-matter experts on topics including: telepsychiatry advancements, digital literacy and inclusion, and collaborative care.
Recordings from past learning opportunities and a schedule of future topics is available at psychiatry.org/practicewebinars.

Looking Forward to 2024
Congressional and Regulatory Advocacy
Given the current political climate in Congress along with the upcoming presidential election, we anticipate limited opportunities for Congress to move legislation in 2024 including some of APA’s legislative priorities.

The divisiveness in Congress has resulted in a stalemate in finding agreement to fund the Federal government in 2024 and other authorization bills. The ongoing deliberations will continue into February and if an agreement is not reached, Congress will face the prospect of either a government shutdown or a continuing resolution which funds the government at current levels for 2024.
In addition, in 2024 we hope to get “clarity” in the regulatory space. Many COVID-era flexibilities are extended until the end of 2024 and many other rules should be finalized, providing stability to practice that has been in continuous change since 2020. We hope to see major updates to increase access to substance-use services both through in-person and telepsychiatry, as well as the teleprescribing of controlled substances.

Artificial or augmented intelligence (AI) will continue to dominate the health care space, leading to continued discussions in privacy and security of patient data while also offering the opportunity to enhance patient-level diagnosis and treatment. Despite these challenges, the APA Administration will continue to engage and advocate on several legislative and regulatory priorities.
State Advocacy

The APA Administration staff, in collaboration with state district branches, are geared up for a very active legislative session across the country in 2024.
We anticipate more than a dozen states to seek prescribing privileges for psychologists along with expanded scope of practice for other clinicians. APA will continue devoting resources to actively oppose these and other bills that negatively impact patients.

APA will also continue to proactively work with state district branches to advance legislation that:
• Integrates behavioral health with primary care (Collaborative Care Model);
• Reforms prior authorization restrictions on mental health and SUD services; and
• Mitigates the behavioral health workforce shortage, particularly for psychiatry.

We also anticipate a host of emerging issues in the states that APA and district branches will engage state legislature on, such as the medicalization of psilocybin, involuntary commitment, and maternal mortality.
Members are essential to APA Advocacy’s effectiveness. Get involved today at psychiatry.org/advocacy.

APA’s Advocacy, Policy, and Practice Advancement Team
• Kristin Kroeger, Chief of Advocacy, Policy and Practice Advancement
• Mikael Troubh, Government Relations Officer
• Becky Yowell, Director of Reimbursement Policy and Quality
• Brooke Trainum, Director of Practice Policy
• Ashley Mild, Managing Director, Department of Government Relations, APAPAC Director
• Agathe Farrage, Senior Manager, Federal and State Grassroots and APAPAC
• Daniel “Trip” Stanford, Deputy Director, Federal Relations
• Abby Worthen, Deputy Director Digital Health Policy
• Caryn Davidson, Deputy Director, Quality
• Jennifer Medicus, Deputy Director, Practice Guidelines
• Seung-Hee Hong, Practice Guideline Manager
• Kathy Orellana, State Senior Regional Director
• Amanda Chesley Blecha, State Senior Regional Director
• Robin Levy, State Regional Director
• Dana Doran, Associate Director, Federal Relations
• Christy Buranaamorn, Associate Director Reimbursement Policy
• Maureen Maguire, Associate Director, Payor Relations and Insurance Coverage
• Leslie Samuel, Manager, Federal Relations
• Lori Whitaker, Program Manager, Reimbursement Policy and Quality
• Naomi Watson, Government Relations Coordinator

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Get to know your state legislators. Keep yourself informed. Find your elected officials.

If you would like MAPP to advocate on behalf of an issue or if you would like to become more involved in MAPP advocacy, please send an e-mail to Dianna Poulin, Executive Director, MAPP

To Search for Bills by Number, Type or Text.

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Links to APA State Advocacy Resources

Please note this is only a select list of resources.
Please contact your District Branch Executive for more information or if you seek information about coalition building 
APA Members in Leadership Roles (APA Board, Assembly, and Components by State)District Branches & State Associations Contact Information.

Trends in State Legislatures for 2022

Quorum: Trends in State Legislatures 2022

Scope of Practice & Patient Safety

Many of the tools below are designed to be used for a variety of patient safety issues, including opposing psychologist prescribing and scope expansion legislation from nurse practitioners and physician assistants. APA staff have more talking points, letters, and testimony to assist with this kind of legislation. Please contact Erin Philp at ephilp@psych.org to discuss specific items for your state. 

APA Safe Rx Prescribing Webpage

APA Fact Sheet on Safe Prescribing

2022 National Polling on Safe Prescribing

State Specific Social Media Graphics on Safe Prescribing

State Specific Fact Sheets on Safe Prescribing

APA Position Statement on Safe Prescribing

GAO Report: Need for More Prescribing Psychologists is Not Adequately Justified

Washington State Department of Health Sunrise Review (DOH found that prescribing psychologists did not have adequate training to prescribe safely)

77 FR 69062 (Medicare does not recognize clinical psychologists to bill E/M services)

APRNs: Don’t Remove Patient Safety Requirements

Articles from Psychologists Opposed to Psychologist Prescribing Privileges:

Prescriptive authority: Psychologists’ abridged training relative to other professions’ training

Psychologists and Medications in the Era of Interprofessional Care: Collaboration Is Less Problematic and Costly Than Prescribing

988 Crisis Response

Implementing 988

Reimagine Crisis Coalition Website

State Map of 988 Legislative Activity

CMS Memo RE: Medicaid Guidance on the Scope of and Payments for Qualifying Community-Based Mobile Crisis Intervention Services

Vibrant’s data on call volume during 988’s rollout

As Launch of 988 Mental Health Crisis Number Looms, NAMI Poll Finds Broad Support for the System and Fees to Fund It, Opposition to Police Response to Mental Health Crises

988 Frequently Asked Questions | SAMHSA

Collaborative Care Model (CoCM)

APA Model CoCM Legislation for States

APA CoCM Handout for Legislators

APA Position Statement on Integrated Care

Blue Cross Blue Shield Slides in Support of CoCM

Dr. Tynes’ Testimony Before Louisiana House of Representatives (begins at 49-minute mark)

Shatterproof’s White Paper: Medicaid & Collaborative Care for Substance Use Disorder and Mental Health

AMA End the Epidemic: Collaborative care model normalizes mental health and addiction treatment in primary care

University of Washington AIMS Center: Building the Business Case for Team-Based Integrated Care 

The Effectiveness of Collaborative Care on Depression Outcomes for Racial/Ethnic Minority Populations in Primary Care: A Systematic Review

An Economic Analysis of the Implementation of Team-based Collaborative Care in Outpatient General Mental Health Clinics

Treating the Perinatal Population in the Collaborative Care Model

Mental Health Parity

APA State Model Parity Legislation

Mental Health Parity Infographic

NAIC Letter on MHPAEA Enforcement Grants (naic.org)

2022 MHPAEA Report to Congress: Realizing Parity, Reducing Stigma, and Raising Awareness: Increasing Access to Mental Health and Substance Use Disorder Coverage 

Mental Health Care: Last Week Tonight with John Oliver (to educate general public about Mental Health Parity)

Prior Authorization

APA State Model Legislation Reforming Prior Authorization

APA Prior Authorization Infographic

2021 AMA Prior Authorization Physician Survey

AMA Model Legislation on Prior Authorization Transparency

AMA Fix Prior Auth Campaign

Telehealth

APA Model Telehealth Legislation

APA Position Statement on Telemedicine in Psychiatry

APA Telehealth Handout

APA Telepsychiatry Toolkit

Center for Connected Health Policy State Policies Chart

Gun Violence Response

APA Position Statement on Firearm Access, Acts of Violence and the Relationship to Mental Illness and Mental Health Services

APA Position Statement on Homicide Prevention and Gun Control

American Academy of Pediatrics Advocacy on Extreme Risk Protection Orders (includes map of state laws)

Health Affairs Brief: Mass Shootings In The United States: Population Health Impacts And Policy Levers

Everytown For Gun Safety Gun Violence Continuum

Advocacy on Medical Licensure

Position Statement on Inquiries about Diagnosis and Treatment of Mental Disorders in Connection with Professional Credentialing and Licensing

Psychedelic and Empathogenic Agents

APA Position Statement on the Use of Psychedelic and Empathogenic Agents for Mental Health Conditions

APA Letter Opposing Oregon Ballot Initiative to Non-Medical Clinician Administration of Psilocybin


How to Contact Legislature

Maine’s legislature is composed of 186 members (151 members of the House of Representatives and 35 members of the Senate) elected every two years. Members are limited to four consecutive terms in one seat, but they may return after a break and may run for an appropriate seat in the other chamber. Maine also has a system of public campaign financing called the Maine Clean Election Act. Maine’s Governor is limited to two four-year terms. The Maine legislature meets for approximately 6 months (January to June) in the first year and for approximately 4 months (January to April) in the second year of the 2-year cycle.

All of the committees of the Maine Legislature are joint House/Senate committees generally composed of 13 members – 3 Senators with 2 from the majority party and 1 from the minority party and 10 Representatives with 6 from the majority party and 4 from the minority party. The following committees have jurisdiction over some portion of health care policy.

  • Joint Standing Committee on Health & Human Services. This Committee is the committee of oversight for the Department of Health & Human Services. It has jurisdiction over the Medicaid program (known as MaineCare), health care facility licensing (hospitals, nursing homes, ambulatory surgical centers, assisted living facilities, residential care facilities, etc.), and behavioral health and long-term care policy.
  • Joint Standing Committee on Insurance & Financial Services. This Committee is the committee of oversight for the Bureau of Insurance. It has jurisdiction over health insurance carriers and agents. It has developed Maine’s system of regulation of managed care organizations (Maine’s Patient Bill of Rights) and addressed mandated health care benefits.
  • Joint Standing Committee on Labor, Commerce, Research & Economic Development. This Committee is the committee of oversight for the Department of Professional & Financial Regulation. In addition to the Bureau of Insurance, this Department contains most of the administrative boards responsible for regulating individual health care practitioners. It also has a budgetary relationship with several “affiliated” health care boards – the Board of Licensure in Medicine (M.D.s), the Board of Osteopathic Licensure (D.O.s), and the Board of Dentistry. It has jurisdiction over the licensure and discipline of individual health care practitioners and handles scope of practice issues.
  • Joint Standing Committee on Judiciary. This committee addresses issues of medical liability, medical ethics, and medical rights. It developed all of Maine’s medical liability reform laws and has handled issues of advance directives and end-of-life care.

Stay Informed

  • Physician’s Guide to Maine Law You will find law affecting aspects of your practice. (compiled by the Maine Medical Association)
  • Maine Legislature’s Home Page You will find a wealth of information about Maine’s legislative process on this web page. You can find your legislators, research the legislative history of any bill and access Maine’s statutes online.
  • Bill Status Search You can determine the current procedural status of any bill in the current legislature at this site.
  • Joint Standing Committees You can find the membership of the joint standing committees of the current legislature at this site.
  • State Agency Rules You can find administrative rules promulgated by executive branch agencies at this site.
  • Physicians’ Day at the Legislature. Physicians’ Day at the Legislature is a bi-annual event promoted by the Maine Medical Association. Questions regarding this event can be addressed to dpoulin@mainemed.com.
  • Doctor of the Day The Maine Medical Association promotes “Doctor of the Day” at the Maine legislature You can find information about participating by visiting the MMA website. In addition to familiarizing yourself with Maine’s legislative process, your children may enjoy serving as “Honorary Pages” during your visit.
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