(207) 480-4194
tlloyd@mainephysicians.org

Legistative Advocacy

APA’s Advocacy Year in Review & Looking Ahead

Thank you for your commitment to APA advocacy!

Executive Branch Activities

APA Provides Input on Health Data, Technology and Interoperability

In the letter, APA provided comments on ASTP/ONC’s efforts to advance interoperability and improve information sharing among patients, providers, payers, and public health authorities. APA provided input on the information blocking exception proposed rules as well as advocated for technical assistance for small, psychiatric-specific health IT vendors. The letter also emphasizes the need for better integration of measurement-based care in EHRs.

APA Advocacy Encourages DEA to Extend Teleprescribing Flexibilities

On Friday October 11, the DEA filed a final rule to extend the tele prescribing flexibilities for a third time since 2020. While not finalized yet, APA is monitoring the situation and will be sharing more as it becomes available. In early September, APA advocated for an extension of the tele prescribing rules, allowing time for the DEA to propose and finalize rules that protect patients while ensuring access to quality mental health care.

Congressional Activities

APA Mobilizes Members Against Step Therapy Protocols

Step therapy, otherwise known as “fail first” therapy, is a harmful medical protocol whereby insurers require patients, sometimes even those stable on a certain medication, to try and fail medications before agreeing to cover the initial therapy prescribed by the health care provider. Not only are these protocols unnecessary and ill-advised – they are harmful to patients and limit the ability of physicians to provide quality, individualized care. APA members wrote to their members of Congress, urging them to support H.R. 2630/S.652, the Safe Step Act. This bipartisan bill requires insurance plans to provide exemptions to step therapy protocols and to implement a clear and timely process for requesting exemptions. Click here for more information, and to write your legislator.

APA Supports STAR Plus Scholarship Act

APA supported H.R. 9581, the Substance Use Disorder Treatment and Recovery (STAR) Plus Scholarship Act, which creates a new scholarship program for students pursuing a degree in the mental health, behavioral health, or substance use disorder treatment profession. “There are simply not enough clinicians to address the mental health crisis in this country,” said APA CEO and Medical Director Marketa M. Wills, M.D., M.B.A. “The APA applauds Rep. Salinas for introducing The STAR Plus Scholarship Act. This critical legislation would help alleviate the behavioral health care shortage and diversify our workforce to enhance access to much needed care.”

APA Backs Bill to Increase Veteran Telehealth Access

APA endorsed H.R. 9324, the Protecting Veteran Access to Telemedicine Services Act of 2024, introduced by Representative Steve Womack (AR-03). The bill would permanently extend the pandemic-related exemption allowing health care professionals employed by the VA to deliver, distribute, and dispense medically necessary controlled substances to veterans via telemedicine regardless of whether that health care professional has conducted an in-personal medical examination.

APA Supports Newborn Supply Kit Program for New Mothers

APA joined 46 organizations in supporting H.R. 8715, the Newborn Essentials Support Toolkit (NEST) Act, led by Reps. Julia Letlow (R-LA-05) and Dr. Kim Schrier (D-WA-08). The bill would codify the Department of Health and Human Services (HHS) pilot program to distribute newborn supply kits to new mothers and their infants. These packages will contain essential goods like diapers, wipes, maternal mental health information, and other resources, and are demonstrated to improve maternal mental health outcomes and reduce financial stress on families. View the full letter of support here.

Partnership Activities

APA and the American Psychological Association Urge Optum Behavioral Health to End Pre-Payment Audits

With members of both APAs seeing an uptick in pre-payment audits, the organizations sent a sign on letter to Optum Behavioral Health outlining our concerns that these audits are conducted without clear protocols, undermine privacy and the therapeutic relationship and negatively impact access to care and urged Optum to end them. Both APAs are continuing to work with Optum to understand more about these audits.

Get to know your state legislators. Keep yourself informed. Find your elected officials.

If you would like MAPP to advocate on behalf of an issue or if you would like to become more involved in MAPP advocacy, please send an e-mail to Tracy Lloyd, M.Ed., Executive Director, MAPP

To Search for Bills by Number, Type or Text.

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Scope of Practice & Patient Safety

Many of the tools below are designed to be used for a variety of patient safety issues, including opposing psychologist prescribing and scope expansion legislation from nurse practitioners and physician assistants. APA staff have more talking points, letters, and testimony to assist with this kind of legislation. Please contact Erin Philp at ephilp@psych.org to discuss specific items for your state. 

APA Safe Rx Prescribing Webpage

APA Fact Sheet on Safe Prescribing

2022 National Polling on Safe Prescribing

State Specific Social Media Graphics on Safe Prescribing

State Specific Fact Sheets on Safe Prescribing

APA Position Statement on Safe Prescribing

GAO Report: Need for More Prescribing Psychologists is Not Adequately Justified

Washington State Department of Health Sunrise Review (DOH found that prescribing psychologists did not have adequate training to prescribe safely)

77 FR 69062 (Medicare does not recognize clinical psychologists to bill E/M services)

APRNs: Don’t Remove Patient Safety Requirements

988 Crisis Response

Implementing 988

Reimagine Crisis Coalition Website

State Map of 988 Legislative Activity

CMS Memo RE: Medicaid Guidance on the Scope of and Payments for Qualifying Community-Based Mobile Crisis Intervention Services

Vibrant’s data on call volume during 988’s rollout

As Launch of 988 Mental Health Crisis Number Looms, NAMI Poll Finds Broad Support for the System and Fees to Fund It, Opposition to Police Response to Mental Health Crises

988 Frequently Asked Questions | SAMHSA

Collaborative Care Model (CoCM)

APA Model CoCM Legislation for States

APA CoCM Handout for Legislators

APA Position Statement on Integrated Care

Blue Cross Blue Shield Slides in Support of CoCM

Dr. Tynes’ Testimony Before Louisiana House of Representatives (begins at 49-minute mark)

Shatterproof’s White Paper: Medicaid & Collaborative Care for Substance Use Disorder and Mental Health

AMA End the Epidemic: Collaborative care model normalizes mental health and addiction treatment in primary care

University of Washington AIMS Center: Building the Business Case for Team-Based Integrated Care 

The Effectiveness of Collaborative Care on Depression Outcomes for Racial/Ethnic Minority Populations in Primary Care: A Systematic Review

An Economic Analysis of the Implementation of Team-based Collaborative Care in Outpatient General Mental Health Clinics

Treating the Perinatal Population in the Collaborative Care Model

Mental Health Parity

APA State Model Parity Legislation

Mental Health Parity Infographic

NAIC Letter on MHPAEA Enforcement Grants (naic.org)

2022 MHPAEA Report to Congress: Realizing Parity, Reducing Stigma, and Raising Awareness: Increasing Access to Mental Health and Substance Use Disorder Coverage 

Mental Health Care: Last Week Tonight with John Oliver (to educate general public about Mental Health Parity)

Prior Authorization

APA State Model Legislation Reforming Prior Authorization

APA Prior Authorization Infographic

2021 AMA Prior Authorization Physician Survey

AMA Model Legislation on Prior Authorization Transparency

AMA Fix Prior Auth Campaign

Telehealth

APA Model Telehealth Legislation

APA Position Statement on Telemedicine in Psychiatry

APA Telehealth Handout

APA Telepsychiatry Toolkit

Center for Connected Health Policy State Policies Chart

Gun Violence Response

APA Position Statement on Firearm Access, Acts of Violence and the Relationship to Mental Illness and Mental Health Services

APA Position Statement on Homicide Prevention and Gun Control

American Academy of Pediatrics Advocacy on Extreme Risk Protection Orders (includes map of state laws)

Health Affairs Brief: Mass Shootings In The United States: Population Health Impacts And Policy Levers

Everytown For Gun Safety Gun Violence Continuum

Advocacy on Medical Licensure

Position Statement on Inquiries about Diagnosis and Treatment of Mental Disorders in Connection with Professional Credentialing and Licensing

Psychedelic and Empathogenic Agents

APA Position Statement on the Use of Psychedelic and Empathogenic Agents for Mental Health Conditions

APA Letter Opposing Oregon Ballot Initiative to Non-Medical Clinician Administration of Psilocybin

VoterVoice

How to Contact Legislature

Maine’s legislature is composed of 186 members (151 members of the House of Representatives and 35 members of the Senate) elected every two years. Members are limited to four consecutive terms in one seat, but they may return after a break and may run for an appropriate seat in the other chamber. Maine also has a system of public campaign financing called the Maine Clean Election Act. Maine’s Governor is limited to two four-year terms. The Maine legislature meets for approximately 6 months (January to June) in the first year and for approximately 4 months (January to April) in the second year of the 2-year cycle.

All of the committees of the Maine Legislature are joint House/Senate committees generally composed of 13 members – 3 Senators with 2 from the majority party and 1 from the minority party and 10 Representatives with 6 from the majority party and 4 from the minority party. The following committees have jurisdiction over some portion of health care policy.

  • Joint Standing Committee on Health & Human Services. This Committee is the committee of oversight for the Department of Health & Human Services. It has jurisdiction over the Medicaid program (known as MaineCare), health care facility licensing (hospitals, nursing homes, ambulatory surgical centers, assisted living facilities, residential care facilities, etc.), and behavioral health and long-term care policy.
  • Joint Standing Committee on Insurance & Financial Services. This Committee is the committee of oversight for the Bureau of Insurance. It has jurisdiction over health insurance carriers and agents. It has developed Maine’s system of regulation of managed care organizations (Maine’s Patient Bill of Rights) and addressed mandated health care benefits.
  • Joint Standing Committee on Labor, Commerce, Research & Economic Development. This Committee is the committee of oversight for the Department of Professional & Financial Regulation. In addition to the Bureau of Insurance, this Department contains most of the administrative boards responsible for regulating individual health care practitioners. It also has a budgetary relationship with several “affiliated” health care boards – the Board of Licensure in Medicine (M.D.s), the Board of Osteopathic Licensure (D.O.s), and the Board of Dentistry. It has jurisdiction over the licensure and discipline of individual health care practitioners and handles scope of practice issues.
  • Joint Standing Committee on Judiciary. This committee addresses issues of medical liability, medical ethics, and medical rights. It developed all of Maine’s medical liability reform laws and has handled issues of advance directives and end-of-life care.

Stay Informed

  • Physician’s Guide to Maine Law You will find law affecting aspects of your practice. (compiled by the Maine Medical Association)
  • Maine Legislature’s Home Page You will find a wealth of information about Maine’s legislative process on this web page. You can find your legislators, research the legislative history of any bill and access Maine’s statutes online.
  • Bill Status Search You can determine the current procedural status of any bill in the current legislature at this site.
  • Joint Standing Committees You can find the membership of the joint standing committees of the current legislature at this site.
  • State Agency Rules You can find administrative rules promulgated by executive branch agencies at this site.
  • Physicians’ Day at the Legislature. Physicians’ Day at the Legislature is a bi-annual event promoted by the Maine Medical Association. Questions regarding this event can be addressed to dpoulin@mainemed.com.
  • Doctor of the Day The Maine Medical Association promotes “Doctor of the Day” at the Maine legislature You can find information about participating by visiting the MMA website. In addition to familiarizing yourself with Maine’s legislative process, your children may enjoy serving as “Honorary Pages” during your visit.
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