From the Practice Directorate
As unprecedented levels of Post-Traumatic Stress Disorder, depression and other mental health issues are reported among the nearly 1.7 million U.S. service members who have been deployed in the War on Terror and the healthcare needs of our aging veterans continue to grow, psychologists are more in demand than ever.
With 153 hospitals and 731 outpatient clinics serving approximately 7.8 million war veterans and current servicemen and women, The Veterans Health Administration operates the nation's largest health care system and is the largest single employer of psychologists in the country. On April 9, the Senate Committee on Veterans Affairs gathered at a hearing entitled, "Making the VA the Workplace of Choice for Health Care Providers" to discuss improving recruitment and retention of psychologists and other health care providers in the system.
Randy Phelps, PhD, deputy executive director and administrative director of the APA Practice Directorate, on behalf of APA, and Jennifer L. Strauss, PhD, Assistant Professor, Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, representing Friends of VA Medical Care and Health Research (FOVA), addressed the committee.
Dr. Phelps shared with the committee the myriad initiatives APA currently has underway to assist veterans. These include:
Extending services to veterans in rural areas where existing VA and Department of Defense facilities are simply beyond the reach of patients,
Forming two Presidential Task Forces on the Needs of Military Service Members and Their Families and recently adopting "Blueprint for Change: Achieving Integrated Healthcare for an Aging Population",
Providing testimony supporting increases over the Administration's FY '09 VA Medical and Prosthetic Research Account funding levels.
Click here to read Dr. Randy Phelps' complete testimony.
Click here to read Dr. Jennifer Strauss' complete testimony.
The U.S. House of Representatives passed the Paul Wellstone Mental Health and Addiction Equity Act of 2007 on March 5, bringing the country closer than ever to ensuring equal treatment for millions of Americans with mental health and substance use disorders. Both chambers of Congress have now passed full mental health parity bills for the first time in U.S. history.
Last September, the Senate unanimously passed the Mental Health Parity Act of 2007. Although there are differences in the House and Senate bills, they are similar in many important respects. Both preserve strong parity and consumer protection laws at the state level while extending federal parity protections to tens of millions more Americans.
For over a decade, the American Psychological Association (APA) has worked with members to end discriminatory health insurance coverage. Since passage of the Mental Health Parity Act of 1996, the APA has urged federal lawmakers to close loopholes in that act and finally make insurance coverage of mental health benefits truly equal to coverage of physical health benefits. The APA Practice Organization (APAPO), a companion to APA, took up the call for parity when the organization was created in 2001.
"We could not have reached this historic day without the strong and steadfast support of grassroots psychologists, health consumers and their families," said Marilyn Richmond, JD, assistant executive director of government relations for the APA Practice Organization (APAPO). "We are advocating for Members of Congress to complete negotiations on a parity bill that can pass both chambers this year."
Ms. Richmond says psychology advocates are hopeful that the momentum culminating in the recent landmark action in the House will continue. "With the intense work that has been accomplished in both chambers, Congress has an historic opportunity to pass a full mental health parity law this year."
The push for parity intensified on March 12, when psychology leaders attending the 2008 APAPO State Leadership Conference in Washington, DC, participated in approximately 300 meetings with their elected officials and staff on Capitol Hill. The advocates for professional psychology called on Members of Congress to enact a strong parity bill in 2008.
For more information on the federal parity bills and the importance of psychology's advocacy efforts, read the APAPO fact sheet, "Congress Should Enact a Mental Health Parity Bill This Year."
The Centers for Medicare and Medicaid Services (CMS) has begun to shift away from using separate regional carriers for Part A and Part B claims processing, replacing them with 15 Medicare Administrative Contractors (MACs) responsible for all Part A and Part B claims processing in contiguous geographic areas or jurisdictions.
MACs are gradually being phased into service with full implementation due to be completed in 2009. As a result, psychologists may find their claims, provider relations and local coverage policies handled by a new company.
The Medicare Modernization Act of 2003 initiated these changes, which CMS expects to streamline claims processing and reduce administrative costs.
As an example, Trailblazer was the Part B regional carrier for Maryland, Virginia, the District of Columbia and Texas. The four states had different fiscal intermediaries handling Medicare Part A claims processing. Effective March 1, Trailblazer became responsible for MAC jurisdiction 4, covering all Part A and B claims for Colorado, New Mexico, Oklahoma and Texas.
While local carriers often have different policies, MACs are required to adopt the most generous coverage policy for psychological services in all the states in the new jurisdiction. For example, if Oklahoma's coverage policy for psychological testing paid for a greater number of hours of testing and assessment than any of the other states in jurisdiction 4, then Trailblazer's local coverage determination for psychological testing will reflect Oklahoma's prior policy.
For maps of each MAC jurisdiction and information about the contractors who have been awarded jurisdictions to date, visit the CMS Web site at: www.cms.hhs.gov/MedicareContractingReform/05_PartAandPart%20BMACJurisdictions.asp#TopOfPage.
For further assistance, contact government relations staff for the APA Practice Organization via Email or (+1/202) 336-5889.