After a lengthy process and debate, the Senate finally passed its health care reform bill on December 24. The House and Senate will next meet in conference in January to begin to meld the two chambers’ versions together. Especially important for practitioners, both bills include our 5% Medicare psychotherapy restoration extension, as has each bill considered in committees of jurisdiction in both chambers. Following the implementation of across-the-board cuts resulting from the Centers for Medicare and Medicaid Services (CMS) five-year review, the APA Practice Organization (APAPO) successfully persuaded Congress in 2008 to restore payments for psychotherapy, the only codes that received relief.
Because this critical provision remains a part of the health care reform bills and has not yet been enacted into law, it is possible that January claims may be processed without the 5% payment boost. However, we continue to expect Congress to enact the restoration as part of health care reform early next year, and the Senate Finance Committee has indicated that it intends to apply the provision retroactively to all 2010 payments.
On another important reimbursement issue, the President signed legislation on December 19 postponing the scheduled 21.2% Sustainable Growth Rate (SGR) cut for two months through February 28. Congress will have to address this cut again by that deadline.
Our Government Relations team continues to work with our grassroots practitioners across the country to keep the pressure on Congress to ensure our provision is extended, and retroactively if necessary. This is a critical time for psychology. If you have not taken action already, your Senators and Representative need to hear from you TODAY that they should pass the restoration extension as soon as possible.
Action:
Click here to urge your Senators and Representative to quickly pass the psychology payment restoration extension.
Grassroots feedback is also extremely important to our advocacy efforts, so we would very much appreciate it if you would e-mail (jcook at apa dot org) or fax (202-336-5797) us any responses you receive from your Representative.
Sample Letter:
I am writing as a psychologist and constituent to share my deep concern that Congress has not yet taken action on several key Medicare priorities. While I am grateful that the Sustainable Growth Rate cut has been prevented for two months, Congress must move quickly to stop the cut from endangering Medicare patients’ access to quality mental health care and should pass a permanent solution that fairly reimburses psychologists and other providers.
Moreover, Congress must extend the 5% psychotherapy payment restoration, which was enacted as part of the Medicare Improvements for Patients and Providers Act to protect Medicare mental health services that were previously cut by CMS’s five-year review. An extension of this critical provision was passed by the House (Sec. 1309 of H.R. 3962) and is included in the Senate bill (Sec. 3107). My practice is already facing significantly lower reimbursement in 2010 due to CMS’s recent practice expense adjustments, and I simply cannot afford to provide services for less.
Please enact the MIPPA restoration extension as soon as possible and make sure it applies retroactively. This is critically important to my practice and the patients I serve. Thank you for your time and consideration.
Jeff Cook, J.D.
Director of Field & State Operations
American Psychological Association Practice Organization
750 First Street, NE Washington, DC 20002
(202) 336-5875 (Office)
(202) 336-5797 (Fax)
Republished with permission: APAPO
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