Medicare Definition

Date: September 12, 2013

Original release date: May 31, 2013

From: Inter Organizational Practice Committee

IOPC - COORDINATING PRACTICE ADVOCACY EFFORTS FOR NEUROPSYCHOLOGISTS AND THEIR PATIENTS

Comprised of advocacy committee chairs from NAN, APA D40, AACN & ABPN

Re: Medicare Definition of Psychologists as Physicians - UPDATE.

NEW From the IOPC: We are gaining ground via our efforts in conjunction with the APAPO (you will notice a much longer list of H.R.794 and S.1064 cosponsors compared with our last outreach in May/June). We still need to work hard at this. The inclusion of psychologists in the Medicare definition of physician will go a long way toward solving many of the access and payment issues that we face today.

NEW From APAPO: In the House, additional support can be useful to secure any other republican or democrat cosponsors. In the Senate, we need additional targeted assistance with: Sen. Mike Enzi (R-WY)

Sen. David Vitter (R-LA)

Sen. Rob Portman (R-OH)

The APAPO requests anyone with connections with any of these Senators, including constituents, to contact Ashton Randle (arandle@apa.org) in the APAPO Practice Government Relations office who will guide you in how you can be most effective. It is very important that this bill have bipartisan sponsorship.

The rest of the information in this attachment remains the same (aside from cosponsor lists).

Fellow Neuropsychologists:

Situation: Efforts are underway once again to include psychologists in the Medicare definition of physician. You may not know that psychologists are the only remaining doctoral level medical specialty not included in the Medicare physician definition, which includes medical doctors, chiropractors, dentists, and optometrists. Including psychologists will open significant advocacy doors for neuropsychologists and their patients. Your support can make a difference.

History: On 2/15/13, Rep. Jan Schakowsky (D-IL) introduced H.R.794 , and on 5/23/13 Sen. Sherrod Brown (D-OH) introduced the companion S.1064 - “To amend title XVIII of the Social Security Act to provide for treatment of clinical psychologists as physicians for purposes of furnishing clinical psychologist services under the Medicare Program.” In the House, it has 21 co-sponsors (see list below), and is assigned to Subcommittee on Health (see list of members below) of the Energy & Commerce Committee (http://beta.congress.gov/bill/113th-congress/house-bill/794/text). In the Senate, it is assigned to the Senate Committee on Finance, and no co-sponsors as of yet (http://beta.congress.gov/bill/113th-congress/senate-bill/1064/text). There will likely be additional co-sponsors of the bills, but we do not know who they will be.

Action: We encourage Ohio neuropsychologists to contact Sen. Brown’s office to express gratitude and support of his introduction of S.1064, and to encourage him to continue to push the bill forward. Illinois neuropsychologists are encouraged to contact Rep. Schakowsky’s office to express gratitude and support for what she has done and to encourage her to continue to push the bill forward. Neuropsychologists from other states are encouraged to thank co-sponsors from their state, and to contact their other U.S. Senators and Representatives in support of including psychologists in the Medicare definition of physician (especially if they are members of the Health subcommittee of the House Energy & Commerce Committee). EVERYTHING THAT YOU WILL NEED TO DO THIS IS IN THIS MESSAGE (and has been updated).

Strategy: We need to impress on Senators and Representatives that including psychologists in the Medicare physician definition will remove barriers to patient access to quality mental health care for Medicare recipients, including neuropsychological care, in a cost efficient manner (compared with medical doctors), while simultaneously educating them about the patients that we serve (using very basic language, e.g., in the typical elderly Medicare population such as depression, dementing conditions including Alzheimer’s disease, other degenerative diseases such as Parkinson’s, caregiver support; and younger SSDI Medicare recipients such as those suffering severe traumatic brain injury, developmental neurological conditions such as mental retardation and cerebral palsy, severe pervasive developmental delays such as Autism (these are some of the political attention grabbers at present). Remind Congress that psychologists are the only doctoral trained non-physician providers who have still not been included in the definition. (NOTE: We know that including psychologists in the physician definition will help us as well, especially in our organizational advocacy efforts for neuropsychology, but we need to impress on Senators and representatives that the primary benefit is to our patients who are also their CONSTITUENTS – please avoid the temptation to complain about professional unfairness).

Action: Please contact your Senators and Representative via e-mail, mail, fax, telephone, or in-person. If writing, be somewhat brief (sample letters are at the end of this message, but please modify them so that our politicians don’t get the impression of a form letter). If calling or meeting in person, you should bring a brief letter with you, and then provide more information in person. Remember, contact with an aid is the same (and sometimes better) than direct contact with the member of Congress (they are the eyes and ears, and organizers for very busy Congresspersons). Treat the aid with the same degree of respect that you would the member of Congress. In addition to the above, also impress on your member of Congress that you are their CONSTITUENT. This will carry weight with them.

Also, reference the legislation by title or by an abbreviation thereof as opposed to referencing it by number alone which will make it easier for those at the receiving end to recall it. Title: “To amend title XVIII of the Social Security Act to provide for treatment of clinical psychologists as physicians for purposes of furnishing clinical psychologist services under the Medicare Program.” We suggest: “Psychologists as physicians under the Medicare Program” as a working title.

Contact Information:

Sen. Sherrod Brown’s contact information can be found at: http://www.brown.senate.gov/

Hon. Sherrod Brown

U.S. Senator

713 Hart Senate Office Bldg.

Washington, DC 20510

Phone: (202) 224-2315

Fax: (202) 228-6321

Rep. Jan Schakowsky’s contact information can be found at: http://schakowsky.house.gov/

Hon. Jan Schakowsky

U.S. Representative

Rayburn HOB

Washington, DC 20515

Phone: (202) 225-2111

Fax: (202) 226-6890

Additional mailing addresses and phone numbers are at the bottom of their web pages (to local offices in their home states). E-mail is sent to them via their web sites above.

Other Members of the U.S. Senate: http://www.senate.gov/

Click on Senators (upper left) to find lists and urls to your senators.

Other members of the U.S. House of representatives: http://www.house.gov/representatives/

Click on Representatives (upper left) to find lists and urls to your representative.

Uncertain of who your senators and representatives are? Each state has two senators who represent the entire state, so you can Google, for example, “Ohio U.S. Senators,” and go from there. You will have only one representative, who can be found by entering your zip code at http://www.house.gov/representatives/find/.

House: Co-sponsors (and date of sponsorship) of HR 794:

Rep Andrews, Robert E. [NJ-1] - 6/3/2013
Rep Barber, Ron [AZ-2] - 5/9/2013
Rep Bishop, Rob [UT-1] - 8/2/2013
Rep Cartwright, Matt [PA-17] - 9/10/2013
Rep Castor, Kathy [FL-14] - 6/14/2013
Rep Christensen, Donna M. [VI] - 2/15/2013
Rep Chu, Judy [CA-27] - 2/15/2013
Rep Cohen, Steve [TN-9] - 6/3/2013
Rep Connolly, Gerald E. [VA-11] - 2/26/2013
Rep Cooper, Jim [TN-5] - 7/8/2013
Rep DeFazio, Peter A. [OR-4] - 2/15/2013
Rep Ellison, Keith [MN-5] - 2/15/2013
Rep Enyart, William L. [IL-12] - 7/8/2013
Rep Grayson, Alan [FL-9] - 4/25/2013
Rep Griffin, Tim [AR-2] - 9/10/2013
Rep Hanna, Richard L. [NY-22] - 6/14/2013
Rep Hastings, Alcee L. [FL-20] - 4/10/2013
Rep Honda, Michael M. [CA-17] - 2/15/2013
Rep Jones, Walter B., Jr. [NC-3] - 9/10/2013
Rep Kirkpatrick, Ann [AZ-1] - 3/13/2013
Rep Langevin, James R. [RI-2] - 5/9/2013
Rep Lee, Barbara [CA-13] - 6/3/2013
Rep Lofgren, Zoe [CA-19] - 7/31/2013
Rep Lowenthal, Alan S. [CA-47] - 3/12/2013
Rep McCollum, Betty [MN-4] - 4/10/2013
Rep McGovern, James P. [MA-2] - 6/4/2013
Rep Moore, Gwen [WI-4] - 2/15/2013
Rep Napolitano, Grace F. [CA-32] - 6/4/2013
Rep Payne, Donald M., Jr. [NJ-10] - 3/20/2013
Rep Peters, Scott H. [CA-52] - 7/30/2013
Rep Peterson, Collin C. [MN-7] - 9/10/2013
Rep Pierluisi, Pedro R. [PR] - 2/15/2013
Rep Pocan, Mark [WI-2] - 7/30/2013
Rep Quigley, Mike [IL-5] - 3/6/2013
Rep Rush, Bobby L. [IL-1] - 3/12/2013
Rep Ryan, Tim [OH-13] - 3/15/2013
Rep Schwartz, Allyson Y. [PA-13] - 5/15/2013
Rep Tonko, Paul [NY-20] - 6/3/2013
Rep Wilson, Frederica S. [FL-24] - 5/9/2013
Rep Wittman, Robert J. [VA-1] - 3/5/2013
Rep Yarmuth, John A. [KY-3] - 5/22/2013
Rep Young, Don [AK] - 7/8/2013

House: Members of the House Energy & Commerce Health subcommittee reviewing HR 794:

Republicans

Chairman: Joe Pitts (PA)
Vice Chairman: Michael C. Burgess, M.D. (TX)
Ed Whitfield (KY)
John Shimkus (IL)
Mike Rogers (MI)
Tim Murphy (PA)
Marsha Blackburn (TN)
Phil Gingrey (GA)
Cathy McMorris Rodgers (WA)
Leonard Lance (NJ)
Bill Cassidy (LA)
Brett Guthrie (KY)
Morgan Griffith (VA)
Gus Bilirakis (FL)
Renee Ellmers (NC)
Joe Barton (TX)
Fred Upton (MI)

Democrats

Ranking Member: Frank Pallone, Jr. (NJ)
John D. Dingell (MI)
Eliot L. Engel (NY)
Lois Capps (CA)
Jan Schakowsky (IL)
Jim Matheson (UT)
Gene Green (TX)
G.K. Butterfield (NC)
John Barrow (GA)
Donna M. Christensen (VI)
Kathy Castor (FL)
John Sarbanes (MD)
Henry A. Waxman (CA)

Senate: Co-sponsors of S.1064:

Sen Heinrich, Martin [NM] - 7/24/2013
Sen Hirono, Mazie K. [HI] - 9/9/2013
Sen King, Angus S. Jr. [ME] - 7/11/2013
Sen Schumer, Charles E. [NY] - 8/1/2013

Senate: Members of the Subcommittee on Health Care of Senate Committee on Finance for S.1064:

Chairman
John D. Rockefeller IV, WV

Ranking Member
Pat Roberts, KS

Democrats
Debbie Stabenow, MI
Maria Cantwell, WA
Bill Nelson, FL
Robert Menendez, NJ
Thomas R. Carper, DE
Benjamin L. Cardin, MD
Robert P. Casey, Jr., PA

Republicans
Orrin G. Hatch, UT
Chuck Grassley, IA
Michael B. Enzi, WY
John Cornyn, TX
Richard Burr, NC
Patrick J. Toomey, PA

Sample letters/language:

For constituents of Rep. Schakowsky and Sen. Brown (highlighted sections will need to be modified).

Date

Hon. Sherrod Brown (AND CO-SPONSORS IN THE SENATE)

U.S. Senator

713 Hart Senate Office Bldg.

Washington, DC 20510

Fax: (202) 228-6321

Hon. Jan Schakowsky (AND CO-SPONSORS IN THE HOUSE)

U.S. Representative

Rayburn HOB

Washington, DC 20515

Fax: (202) 226-6890

Re: H.R.794/S.1064 “To amend title XVIII of the Social Security Act to provide for treatment of clinical psychologists as physicians for purposes of furnishing clinical psychologist services under the Medicare Program”, as introduced.

Dear Rep. Schakowsky OR Sen. Brown:

I am writing as a constituent and a neuropsychologist to thank you for introducing H.R.794/S.1064, a bill “To amend title XVIII of the Social Security Act to provide for treatment of clinical psychologists as physicians for purposes of furnishing clinical psychologist services under the Medicare Program.” I believe that this bill will benefit your constituents who are Medicare recipients.

As you know, including clinical psychologists in the Medicare physician definition will remove barriers to patient access to quality mental health care for Medicare recipients, including neuropsychological care, in a cost efficient manner compared to other options. Neuropsychologists are clinical psychologists with specialized knowledge of brain-behavior relationships who provide evaluation and treatment services to traditional elderly Medicare recipients such as those suffering severe depression, progressive dementing conditions (e.g., Alzheimer’s, vascular), and other degenerative diseases (e.g., Parkinson’s, Huntington’s), as well as support to their caregivers and loved ones. We also provide services to younger SSDI Medicare recipients such as those suffering the effects of severe traumatic brain injury, developmental neurological conditions such as mental retardation and cerebral palsy, and severe pervasive developmental delays such as Autism. These, and other, patient groups and their caregivers deserve unfettered access to the care that clinical psychologists provide in an effort to help them remain in the community as long as possible, both for their quality of life as well as for economic reasons (which concerns me as a tax payer).

As you know, including clinical psychologists in the definition of physician under the Medicare Program is not a novel idea. In fact clinical psychologists are the only doctoral level independently licensed clinical healthcare provider group not yet included in the Medicare physician definition. Dentists, podiatrists, optometrists and chiropractors are already included, along with medical doctors. Adding clinical psychologists to the Medicare definition of physician will not change how clinical psychologists are licensed to practice, but it will allow your Medicare recipient constituents more complete access to necessary services.

Again, thank you on behalf of your Medicare recipient constituents for acting to reduce barriers to service introducing H.R. 794/S.1064. Please let me know if there is any way in which I can support your efforts to see the adoption of this bill.

Thank you for your time, and take care.

Respectfully,

Other Representatives or Senators:

Date

Hon. Other sen/rep

Address/fax

Dear sen/rep:

As a constituent and a psychologist who specializes in clinical neuropsychology, I am writing to encourage you to support H.R.794/S.1064 in the House/Senate, a bill to “To amend title XVIII of the Social Security Act to provide for treatment of clinical psychologists as physicians for purposes of furnishing clinical psychologist services under the Medicare Program” as introduced. I believe that this bill will benefit your constituents who are Medicare recipients.

Including clinical psychologists in the Medicare physician definition will remove barriers to patient access to quality mental health care for Medicare recipients, including neuropsychological care, in a cost efficient manner compared to other options. Neuropsychologists are clinical psychologists with specialized knowledge of brain-behavior relationships who provide evaluation and treatment services to traditional elderly Medicare recipients such as those suffering severe depression, progressive dementing conditions (e.g., Alzheimer’s, vascular), and other degenerative diseases (e.g., Parkinson’s, Huntington’s), as well as support to their caregivers and loved ones. We also provide services to younger SSDI Medicare recipients such as those suffering the effects of severe traumatic brain injury, developmental neurological conditions such as mental retardation and cerebral palsy, and severe pervasive developmental delays such as Autism. These, and other, patient groups and their caregivers deserve unfettered access to the care that clinical psychologists provide in an effort to help them remain in the community as long as possible, both for their quality of life as well as for economic reasons (which concerns me as a tax payer).

Including clinical psychologists in the definition of physician under the Medicare Program is not a novel idea. In fact clinical psychologists are the only doctoral level independently licensed clinical healthcare provider group not yet included in the Medicare physician definition. Dentists, podiatrists, optometrists and chiropractors are already included, along with medical doctors. Adding clinical psychologists to the Medicare definition of physician will not change how clinical psychologists are licensed to practice, but it will allow your Medicare recipient constituents more complete access to necessary services.

Again, please help us to reduce barriers to service for your Medicare recipient constituents by supporting legislation to designate clinical psychologists as physicians under the Medicare Program.

I know that you are very busy, but I will plan to follow this letter with a call to your office. Hopefully, I can express my encouragement for this legislation to one of your aides.

Thank you for your time, and take care. I appreciate your work for our country and for the State of ????.

Respectfully,