Implementing health-care reform is still a work in progress, Katherine C. Nordal, PhD, said in the opening session of the 2014 State Leadership Conference.
“It’s no news flash that the rollout of the Affordable Care
Act has been chaotic,” said Nordal, executive director for
professional practice in APA’s Practice Directorate and the
APA Practice Organization (APAPO). “But there are hopeful
signs, especially related to the goal of increasing the ranks of
Americans with health coverage.”
Sponsored by the Practice Directorate and APAPO in
Washington, D.C., March 8–11, the 31st annual conference
brought together more than 400 representatives from state,
provincial and territorial psychological associations (SPTAs);
APA divisions and governance; and the American Psychological
Association of Graduate Students, as well as early career and
diversity delegates, who are funded by APA or their SPTAs.
In addition to participating in educational briefings and
networking opportunities, participants also made almost 350
visits to members of Congress and their staffs.
While on Capitol Hill, they shared APAPO’s three legislative
priorities: halting the plummeting of Medicare payment rates
for psychologists, making psychologists eligible for Health
Information Technology for Economic and Clinical Health
(HITECH) incentives and including psychologists in Medicare’s
definition of “physician.”
At the opening session, Nordal emphasized that the changes
brought about by the Affordable Care Act will transform the
way many professional psychologists practice. In particular, the
law’s push for integrated care will spur the creation of more
collaborative, multidisciplinary practice models.
The law has also changed psychology’s advocacy strategies,
Nordal said. “The way the Affordable Care Act is unfolding
reminds us that no single advocacy strategy for psychology
can address the diverse legislative, regulatory and marketplace
environments we see from one state to another,” she said.
At the national level, Nordal said, APAPO scored a major
win this year by reversing the downward Medicare payment
trajectory for psychological services. At the regional level,
neuropsychologists have come together in a group that uses
what it calls “360-degree advocacy” to monitor and intervene
when the nation’s nine Medicare Administrative Contractors
(MACs) take action that could harm psychologists. The
neuropsychologists’ latest advocacy win, which affects
practitioners in 10 states, resulted in changes to a coverage
determination issued by the National Governmental Services
MAC. The changes include clarifying that when medically
necessary, providers may assess depression in patients entering
nursing homes and permitting providers to bill for integrating
emotional measures into neuropsychological testing.
Advocates at the state level are also seeing success. The
Alabama Psychological Association successfully fought efforts
to remove “diagnose and treat” from the psychology licensing
law, for example. The Kentucky Psychological Association
persuaded the state to include psychologists as eligible providers
in its Medicaid program. And the Minnesota Psychological
Association helped get a law passed that provides Medicaid
reimbursement for psychologists who provide consultation to
primary care providers.
At the 2014 State Leadership Conference, leaders create roadmaps
for psychological practice under the Affordable Care Act.
BY REBECCA A. CLAY