In late December, after months of negotiations, Congress passed and the president signed into law a fifth $900 billion COVID relief bill (PDF, 280KB), which provides direct support for individuals and employers through additional funds for the Paycheck Protection Program, rental assistance funding, direct payments to individuals and families, and additional unemployment insurance payments for workers displaced because of COVID-19. The legislation was part of a two-part package that included $1.4 trillion for Fiscal Year 2021 appropriations.
APA successfully advocated for several critical provisions related to Medicare, mental and behavioral health care programs, education, research, as well as increased testing and vaccine distribution. Specifically, for mental and behavioral health services, the bill provides $4.25 billion in supplemental funding, including for the Mental Health Services and Substance Abuse and Prevention Treatment Block Grants, behavioral health community clinics, suicide prevention programs, and school-based mental health services. Additionally, the legislation includes:
- $9 billion for health care providers;
- $69 billion for expanded testing, tracing, and vaccine procurement and distribution;
- $82 billion in education stabilization funding for public schools and institutions of higher education;
- $1.150 to support research and clinical trials related to the long-term effects of COVID-19 and not less than $100 million for continued support for Rapid Acceleration of Diagnostics; and
- $7 billion for broadband, which can be used for telemental health.
Teaming up with other healthcare provider organizations, APA and thousands of psychologists across the country succeeded in preventing a 10% reduction in the conversion factor used to calculate Medicare payment rates for 2021, which was announced by the Centers for Medicare and Medicaid Services (CMS) at the beginning of December. This across-the-board reduction was adopted by CMS in order to pay for increases in payments for evaluation and management (E/M) services provided by physicians. This effort and its success depended upon the more than 9,000 comments psychologists sent to CMS and the 8,700 psychologist congressional contacts through the Psychology Action Network.
The year-end package provides a 3.75% increase in the Medicare conversion factor for fee schedule payments for 2021, and postpones the implementation of one of the new E/M service codes for three years. Additionally, the package delays the 2% sequestration rate cuts that were to take effect on Jan. 1 for three months, through the end of March. This is a major victory for psychologists and other healthcare providers at a time when the COVID public health emergency is continuing to impact the United States. APA’s robust dual action advocacy strategy and strong APA member engagement led to these successes.
The bill also addresses several APA advocacy priorities related to parity and telehealth. It strengthens parity in mental health and substance use disorder benefits by requiring insurers to perform comparative analyses to help determine if plans are out of compliance. Additionally, it permanently eliminates Medicare’s telehealth originating and geographic site restrictions for the “diagnosis, evaluation or treatment” of a mental health disorder, which will take effect after the public health emergency ends.
However, the bill did fail to address several key items including extension of student loan payment suspensions and dedicated funding for remote learning. APA will continue to advocate with the new Congress and the incoming administration for further support for these and other programs needed to address the mental and behavioral health impacts of COVID-19.
For more information, contact Kenneth Polishchuk.