APA’s Government, Policy, and Advocacy Update (July 2024)

Illinois Passes Legislation to Boost Patient Access to MH Care, Cut M.D.’s Prior Authorization Burdens

As of press time, Illinois Gov. J.B. Pritzker (D) was expected to sign into law legislation to increase access to care for those undergoing mental health or substance use disorder (SUD) treatment.

Specifically, the legislation bans the use of step therapy requirements in both prescription drug plans and SUD treatment. It also requires insurers to use generally accepted standards of care when deciding whether to cover certain treatments or services.

Insurers will also be prohibited from requiring prior authorization before covering inpatient psychiatric care and must provide greater transparency in the prior authorization process. The legislation protects patients who receive inpatient psychiatric treatment from being billed for it if their insurer later deems it not medically necessary.

Pritzker is also expected to sign into law legislation that will restrict Medicaid from requiring prior authorization when psychotropic medications are prescribed to treat serious mental illnesses in adults.

More information on advocating for increased access to care is available from APA’s State Government Affairs at [email protected].

Michigan Enacts APA Model Mental Health Parity Legislation

Michigan Gov. Gretchen Whitmer (D) signed mental health parity legislation based on APA’s model, requiring insurers in the state to begin covering mental health and substance use disorder treatment at the same level as other types of health care.

“The APA district branch, Michigan Psychiatric Society, spent several years working tirelessly to advocate and push the legislation over the finish line,” said Amanda Chesley Blecha, APA’s senior regional director of state government relations.

Specifically, the legislation establishes that insurers in the state may no longer impose financial requirements or treatment limits, either quantitative or nonquantitative, on mental health and substance use disorder benefits that are more restrictive than those for medical/surgical benefits.

APA model state parity legislation or email [email protected].

State Roundup on APA Partnerships to Advance Patient Safety Protections in Prescribing

In a move to advance patient safety, APA district branches fought and defeated legislation in several states (Arizona, Florida, Hawaii, New York, Oklahoma, and Washington) to license prescribing psychologists during the winter/spring 2024 legislative session.

In addition, the Illinois Psychiatric Society successfully worked to keep legislation expanding psychologists’ prescribing privileges from moving forward.

Other state prescribing law outcomes were as follows:

• The Louisiana Psychiatric Medical Association lobbied against legislation to allow medical psychologists to enter into a collaborative agreement with an advanced practice registered nurse or physician assistant, both of which are required to have a collaborative agreement with a medical doctor. As of press time, the bill was before the governor for his consideration.

• Due to political considerations, the Utah Psychiatric Association negotiated for stronger patient protections in psychologists’ prescribing legislation that became law.

• New Mexico enacted expanded scope of practice for prescribing psychologists. The state passed psychologist prescribing legislation in 2002.

APA staff collaborate closely with district branches/state associations to advocate for patient safety; email [email protected]. ■