Advocacy Success: Mental Health Parity Rulemaking Approved by GRRC
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Mental Health Parity Rules Approved by GRRC on July 6, 2022 (Effective Date Estimated September 4, 2022)
It is with great pleasure and pride in the efforts of our organization and its leadership and collaborative partners, that I share with you news that the state regulations to promulgate the enforcement of the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA), cleared their final hurdle with a vote of approval by the Governor's Rules and Regulatory Council (GRRC) on July 6, 2022. This approval follows from and was intended under Jake's Law, the important mental health omnibus legislation signed by the Governor in March of 2022. In this final push, the Society was supported by the diligent work of the APS Lobbyist Alexis Glascock, our APA staff, and our Society leadership. All worked collaboratively with partners in the Arizona Coalition for Insurance Parity, providing a joint letter in support and testimony during the study session of GRRC held in advance of the final vote. Testimony was given by Ben and Denise Denslow of The JEM Foundation, sharing their personal story of their son, Jacob Edward Machovsky who was lost to suicide on January 11, 2016, and for whom Jake's Law is named. Testimony was also given by Tim Clement, APA Director of Legislation, who provided regulatory insight that the rulemaking was not overly burdensome and aligned with the MHPAEA and me on behalf of our Society on its importance to providing care.
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Don J. Fowls, MD
Chair, Government Affairs Committee and Past President
Arizona Psychiatric Society
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Next, we turn our work and attention to the important steps of educating our members and our community about their rights to have mental health care and benefits to be covered on par with med-surg care and benefits. Your membership and continued support are essential in these efforts.
CLICK HERE for mental health parity resources, FAQs, and other consumer information from the Arizona Department of Insurance and Financial Institutions (DIFI), including a printable brochure on mental health parity.
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2022-2023 Corporate Sponsor |
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Advocacy Update - Arizona: APS Lobbyist Final Report on 2022 Legislative Session; Mental Health Parity; Psychologists Prescribing; Physician Wellness
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Alexis Glascock, Esq.
Fennemore Craig PLC
APS Lobbyist
We celebrate with you the great news that the Governor's Regulatory Reform Council passed the Department of Insurance and Financial Institutions' ("DIFI") proposed rules to implement enforcement of mental health parity in the State pursuant to Jake's Law. As you know, Jake's Law passed in 2020. The rules will become effective 60 days after DIFI submits it to the Secretary of State's Office for publication in the Arizona Register, which has been projected by DIFI to be September 4, 2022. This is the culmination of a significant effort by Denise and Ben Denslow of the JEM Foundation, the Society's Leadership and Executive Director, Teri Harnisch, the APA, the other members of the Arizona Coalition for Insurance Parity (including Mental Health America of Arizona, the Arizona Council of Human Service Providers, MIKID, and the Arizona Chapter of the American Foundation for Suicide Prevention), Senator Kate Brophy McGee, the bipartisan unanimous support of the Legislature, the Governor, and his Policy Advisor, Cristina Corieri, to get it across the finish line. Among other important successful efforts this year, this was the most significant achievement for the Society.
Turning to the 2022 Legislative Session, there were also several important victories for the Society. As you know, the Session ended on June 25th marking one of the longest in the State's history and just a few days shy of the budget expiring on June 30th. CLICK HERE for a complete list of all bills supported by the Society that passed. In addition, provided is a Bill Chart with a list of the Society's position on all bills of interest and the final Legislative Report, which details the specifics of the bills with links to the them. Below is more information about some of the most important bills supported by the Society that passed this session along with a brief description of the work done to prevent the introduction of the potential Psychologist Prescribing bill.
Perhaps the most important win this Session was the signing of HB2429: PHYSICIANS; WELLNESS PROGRAMS; CONFIDENTIALITY. The bill was originally sponsored by Representative Amish Shah, MD, and mandates the confidentiality of physicians and nurses’ participation in employee wellness programs in hope of destigmatizing mental health services. The policy applies to and protects any members of a tax-exempt organization in the state that primarily represents health professionals and offers a wellness program. This legislation is an important partner to the efforts of the Society that were successful at the Arizona Medical Board, together with the support of the Arizona Medical Association and over twenty other physician organizations, in bringing about change to the confidential questions around physician licensure and destigmatizing mental health care and the seeking of early care by physicians through those changes, which changes were adopted and put into effect in 2022.
SB1114: COURT-ORDERED TREATMENT; CASE RECORDS; CONFIDENTIALITY was also signed into law by Governor Ducey. The bill ensures that all case records regarding a court proceeding related to court-ordered mental health evaluation and court-ordered mental health treatment statutes are not open to public access. The court is permitted to authorize the release of these case records and case information for good cause shown. It also helps increase confidentiality around mental health care in an effort to destigmatize access to mental health resources.
An important win for the house of medicine was the amendment of SB1138: GENDER TRANSITION; MINORS; PROHBITION, which was signed into law by Governor Ducey in March. The amendment added a clause that changed the purpose of the amendment to only prohibit physicians from performing irreversible sex-change surgeries on any individuals under 18 years of age, regardless of individual or parental consent. It does permit hormone replacement therapy for minors as it is not irreversible.
Two other wins for the Society were SB1392: STATE HOSPITAL; PLACEMENT; COURT-ORDERED TREATMENT and SB1651 SERIOUS MENTAL ILLNESS; ANNUAL REPORT. SB1392 states that during any period of court-ordered treatment, the medical director of the local mental health treatment agency assigned to supervise and administer the patient's treatment program is authorized to file a motion requesting the court to amend the treatment order to place the patient for treatment at the Arizona State Hospital. SB1651 requires the Arizona Health Care Cost Containment System (AHCCCS) Administration to annually report to the Joint Legislative Budget Committee and the Chairpersons of the Health and Human Services Committees of the Senate and the House of Representatives on a list of specified information relating to individuals living with serious mental illness.
Finally, SB1210: MENTALLY ILL; TRANSPORTATION; EVALUATION; TREATMENT and SB1311, HEALTH CARE WORKERS; ASSAULT; PREVENTION were supported by the Society throughout the legislative process and eventually signed by the governor. SB1210 Permits mental health facilities to authorize the transportation of mentally ill individuals without the consent of peace officers. It stipulates that reasonable grounds must be satisfied such that the patient may be transported without the assistance of peace officers. SB1311 expands workplace protection measures for healthcare workers such that the classification of assault against a healthcare worker is increased from standard to aggravated assault, requires employers to investigate instances of assault immediately after they occur as outlined in pre-existing statutes, and mandates the creation of workplace violence protection plans for healthcare institutions with 50 or more employees.
In addition, the Society worked diligently at the Capitol to prevent the introduction of the Arizona Psychological Association's proposed scope of practice bill. We met with all the members of the House and Senate Health Committees before session to point out the extreme dangers posed by allowing psychologists, even with some medical course work, to prescribe medications, including those that are controlled substances. As part of this process, we arranged a meeting with the Arizona Psychological Association along with APA legislative staff to assess the proponents' understanding of the complexities of the issues, the bill, and their organizational preparedness. We then obtained the template for their potential bill draft, which had several problematic aspects. This information was shared with the potential bill sponsor and Majority Staff highlighting the many issues with the bill’s approach to giving psychologists prescribing authority. In preparation for them possibly seeking a bill sponsor next session, we will continue to work over the interim internally and with the APA on strategy and the metrics to address the critical problems created by this potential legislation.
Overall, this was a very successful legislative session with very significant wins for the Society. It is a pleasure and an honor to represent you at the Legislature, Governor's Office, and agencies. As always, let me know if you have any questions or comments. Have a great summer.
If you would like to contribute to the work of the Government Affairs Committee on this and other important issues impacting psychiatry and your patients, please contact Morgan.
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2022-2023 Corporate Sponsor |
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Advocacy - APA: Comment on Parity Enforcement to DOL; GME Funding; PBM Practices; No Surprises Act
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APA Expresses Concerns About Lack of Parity Enforcement in Letter to DOL Secretary; Arizona Coalition Advocates for Enforcement Measures to Senator SInema
In a May 25, 2022 letter to Department of Labor (DOL) Secretary Martin Walsh, APA urged the administration to employ its new powers to investigate and sanction plans that are non-compliant with Mental Health Parity and Addiction Equity Act (MHPAEA). APA highlighted the DOL’s report to Congress (.pdf) that not a single health plan had submitted a compliant parity analysis and the Government Accountability Office’s report that consumers continue to be unable to access mental health care. Clearly, the promises of MHPAEA remain unfulfilled, and in the words of one APA member, “a cruel joke in that insurance companies treat mental health providers and our patients as if it does not exist.” APA will be meeting with the DOL regarding this letter and member complaints in the near future. APA members are encouraged to contact the Practice Management Helpline for assistance with claims issues at [email protected] and (800) 343-4671.
The Society recently joined the fellow members of the Arizona Coalition for Insurance Parity, as well as other key Arizona mental health advocacy organizations, in signing on to a letter to Senator Sinema advocating for the authority of the Department of Labor to assess fines for noncompliance under MHPAEA to ERISA Plans.
APA Advocating to Increase Federally Funded Residency Positions
Tell Your Lawmakers to Support the Resident Physician Shortage Reduction Act--
Psychiatry is facing a workforce shortage in the coming years. The Resident Physician Shortage Reduction Act would address the workforce shortage by ultimately, creating 14,000 new positions. Tell your lawmakers to support this bill!
Pharmacy Benefit Managers’ Business Practices
The Federal Trade Commission solicited comments on the business practices of pharmacy benefit managers and their impact on patients and their physicians. APA submitted comments highlighting the administrative burdens that contribute to physician burnout and reduces clinical time available for patient care and quantity requirements that pose dangers to some patients. APA also addressed changes to prescription-tiering that apply to inexpensive generics and other medications that are widely used to treat psychiatric conditions and cannot be quickly or easily changed due to the nature of these medications and result in increased costs to patients and/or disruptions to their care.
APA and Other Behavioral Health Organization Continue to Work with CMS for Clarifications of No Surprises Act Regulations
APA, the American Psychological Association, and the National Association of Social Workers met with CMS to express member concerns about the administrative burden of the good faith estimate requirements and to seek clarification of the regulations. APA anticipates ongoing meetings with CMS as the agency refines guidance and releases additional regulations and will update the membership accordingly.
Interested in Collaborative Care or Want to Learn More About It?
APA members who are participating in collaborative care or have an interest in doing so are invited to join a new online community (Collaborative Care Community) to exchange information and ideas with other psychiatrists with similar interests. To join, send a request to [email protected].
CLICK HERE to join APAPC and receive your APAPAC e-mail badge and/or to sign-up for APA Advocacv Alerts.
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Sponsor Announcement: Depression Looks Like Me Campaign Supporting LGBTQ+ Community
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Dear Arizona Psychiatric Society,
I’m excited to share that Janssen Neuroscience recently launched Depression Looks Like Me, a campaign aimed at normalizing the conversation about depression in the LGBTQ+ community and empowering people to seek the mental health care they may need.
Members of the LGBTQ+ community are disproportionately affected by depression, with research showing that LGBTQ+ adults are three times as likely to have mental health conditions as heterosexual adults and 2.5 times more likely to use mental health services than cisgender heterosexual adults.
In partnership with prominent LGBTQ+ voices and leading mental health and LGBTQ+ advocacy organizations, this campaign offers a safe space to read personal stories from members of the community with lived experiences with depression, provides culturally competent resources and highlights the different facets of depression, all in one place. The digital community we are seeking to help build will empower others to connect through shared experiences and underscore that those living with hard-to-treat depression are not alone.
To ensure the broad spectrum of the community’s needs are represented in this campaign, we are working with the National Coalition for LGBTQ Health, Mental Health America (MHA), SAGE, National Alliance on Mental Illness (NAMI), TransLatin@ Coalition and Black Emotional and Mental Health Collective (BEAM) to share and extend the reach of resources that address the diverse needs of the community.
We believe everyone deserves to be seen, heard and feel empowered to ask for help. Together, we can show others what depression truly looks like. That depression looks like you, and depression looks like me.
2022-2023 Corporate Sponsor
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At its Annual Meeting on June 18, 2022, the Society presented Representative Amish Shah, MD with a President's Leadership Award, in recognition of outstanding leadership contributions at the Arizona legislature - championing the Society’s mission by promoting the highest standards of health care, improving mental health access, and advocating for physician wellness. Representative Shah was the sponsor of HB2429, signature legislation of the Arizona Medical Association, championing physician well-being, and empowering the physician community to seek timely mental health treatment.
CLICK HERE to read more about this legislation from the Arizona Medical Association, as well as information about its Virtual Doctors’ Lounge, a peer-support program made possible by a partnership with the Arizona Health Care Cost Containment System (AHCCCS), which pairs physicians or physicians-in-training with a peer who can help alleviate stress and provide the support needed to promote well-being and life balance.
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2022-2023 Corporate Sponsor |
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