Upfront

To keep practice moving forward, psychologists need to continue the fight for proper implementation of parity for mental health and substance use disorder treatment, appropriate reimbursement for psychological services, leadership roles for psychologists in evolving systems of care under health-care reform, and prescriptive authority for appropriately trained psychologists, said panelists at an APA 2011 Annual Convention session.

Over the past 30 years, the profession has made significant strides, such as securing a place for psychological services in health-insurance reimbursement, said Sanford Portnoy, PhD, chair of APA's Committee for the Advancement of Professional Practice (CAPP). But now as the Patient Protection and Affordable Care Act gets implemented, he said, psychologists must work to ensure that they're properly compensated for their services and that they determine evidence-based treatment guidelines for practice—and not insurers.

"We ran into a situation a few years ago where the insurance companies began to develop their own treatment guidelines—for example, Blue Cross Blue Shield in Massachusetts—and slashed reimbursement rates," said Portnoy. "It was at that point that CAPP and some other groups at APA decided that we needed to take that back."

An association-wide effort to develop evidence-based clinical treatment guidelines is under way.

APA has also forestalled cuts to Medicare psychotherapy reimbursement rates and is working to ensure that psychological testing data is given the same privacy protection as psychotherapy notes in the Health Information Technology for Economic and Clinical Health Act, said Katherine C. Nordal, PhD, APA's executive director for professional practice.

But more challenges are coming, she said. "With the Deficit Reduction Act that just passed, we are headed for some rough-and-tumble times, which could include additional cuts in fees paid to all Medicare providers," she said.

Psychologists can help fight these and other legislative threats through the APA Practice Organization's Legislative Action Center.

—B. Murray Law