MPA retains a professional lobbying firm to represent the interests of consumers and providers in the Commonwealth. We track bills and regulations to be sure that interests of the citizens are represented appropriately. 

 

MPA’s Legislative Agenda is created by MPA’s Director of Professional Affairs in conjunction with MPA’s Advocacy Committee. The final agenda is then approved by MPA’s Board of Directors. In determining which issues should take priority, we consider the scope and the depth of how that issue impacts both psychologists and members of the public, potential unintended consequences of passage of that bill, the viability of that bill being successful, and the sustainability of the resulting law over time.

 

Advocacy Opportunity:  If you are interested in helping us support certain bills or issues and you are an MPA member, please consider joining our Advocacy Committee by contacting the chair: Dr. Diana Westerberg

 

MPA’s advocacy focuses on issues at the state level, but we have made statements about federal issues such as mental health parity , funding for research on gun violence , the Medicare Mental Health Access Act , and travel bans for specific groups of people. MPA’s responses to federal advocacy issues are managed by our Federal Advocacy Coordinator, Dr. Beth Jerskey.  For additional information on federal advocacy issues, the American Psychological Association has a Guide to Federal Advocacy, an Advocacy Grassroots Network, a Science Advocacy Toolkit, and a general Advocacy Page with links to the different APA Initiatives. 

 

You can also find your state legislators and register to vote or update your information online.  There is also this easy guide to how a bill becomes law in Massachusetts

 

2019 – 2020 Legislative Session

MPA’s Legislative Agenda for the 2019 – 2020 Session

Top 3 Priorities for this Legislative Session

Anti-claw back legislation (Sen. Cindy Friedman; Rep. James O’Day): S.589 and H.1078 set a limit of 12 months on the ability of a health care plan to retract payments made in good faith (also referred to as claw backs). Success! This bill was enacted through the Budget and signed into law by Gov. Charlie Baker, effective starting July 1, 2019. Read our member update for more information.

Increasing access to telehealth services (Sen. Jason Lewis; Rep. Kate Hogan): S.612 and H.1002 require health plans to cover the same medical, behavioral health, and substance abuse services via telehealth as they do for in-person sessions, and at the same rate as in-person sessions. The committee is still reviewing the bill.

Eliminating “ghost networks” (Rep. Christine Barber): H.913 calls for a task force to be created to develop guidelines and standardization across health plans for areas such as specialties, provider information change requests, maintenance of an accurate and up-to-date list of providers in network to make it easier for consumers to find providers, better monitor network adequacy, and eliminate “ghost networks” (read our written testimony) . Success! This bill was enacted through the Children’s Health and Wellness bill and signed into law by Gov. Baker on November 26, 2019.MPA’s Director of Professional Affairs, Dr. Jennifer Warkentin, was appointed to the Provider Directory Task Force charged with recommending new/amended regulations. The task force has completed it’s work and we are now waiting for a final report to be released by the Division of Insurance.

Other Legislation of Interest:

Expanding access to mental health care (Senate Committee on Ways and Means): S.2546 seeks to improve access to mental health care by addressing issues related to mental health parity, workforce needs, and insurance reforms. MPA’s Director of Professional Affairs, Dr. Jennifer Warkentin, participated in the creation of the bill, and was invited to the press conference (see our member alert). The bill was unanimously passed by the Senate on February 20, 2020, and has been sent to the House for review.

Improving quality and access to health care (Gov. Charlie Baker): H.4134 is Gov. Baker’s VALUE bill that aims to boost spending in primary care and behavioral health, penalize excessive drug price increases, and limit surprise emergency billing.The legislature is still reviewing it, but it’s more likely that sections will be taken from it and used in other bills, as opposed the bill going through in it’s entirety.

Ban on conversion practices for minors (Sen. Mark Montigny; Rep. Kay Kahn): S.70 and H.140 ban licensed mental health providers from using conversion therapy to forcibly change the gender identity or sexual orientation of a minor, while protecting healthy exploration of these issues in therapy. Success! This bill was enacted by the House and the Senate on April 4, and signed into law by Gov. Charlie Baker on April 8, 2019.

Allowing clinicians to determine medical necessity (Rep. Natalie Higgins): H. 1723 allows licensed clinicians, in consultation with their patient, to determine medical necessity instead of each health plan creating their own medical necessity criteria.A hearing was held on July 26, but the committee is still reviewing the bill.

Protecting the therapist-client relationship when health plans change (Sen. Joanne Comerford; Reps. Ruth Balser and Tricia Farley-Bouvier): S.555 and H.907 require continued coverage of mental health services with an “out-of-network” provider with whom the patient already has an ongoing treatment relationship if the provider accepts the in-network payment rate and comply with the insurer’s reasonable administrative requirements. A hearing was held on June 6 (read our written testimony ), but the Committee on Financial Services is still reviewing the bill.

Removing unnecessary barriers to psychological care in some health care settings (Sen. Cynthia Creem; Rep. Ruth Balser): S.1225 and H.1844 would allow nurses in hospitals, skilled nursing centers, and similar health care settings to follow written orders of a psychologist within their scope of practice (ex. initiating 15-minute safety checks).Currently, they have to wait for a physician to order any such service, which can take hours or days.A hearing was held on November 18 (read our written testimony ), but the Joint Committee on Public health is still reviewing the bill.

Removing regulation preventing MassHealth patients from full access to psychological services (Rep. Ruth Balser): H.1697 allows MassHealth clients in non-managed care programs to receive treatment services from a psychologist in independent practice. Also allows for appropriate supervision of clinical providers to further increase access. A hearing was held on June 19, 2019 (read our written testimony), but the Joint Committee on Mental Health, Substance Use and Recovery is still reviewing the bill.

Ensuring health plans are meeting current mental health parity requirements (Sen. Cindy Friedman; Rep. Ruth Balser): S. 588 and H. 910 target the barriers that result in decreased access to mental health and substance use treatment services, which are not present in medical services. These include overly restrictive medical necessity criteria, arbitrary utilization reviews, and historically low reimbursement rates. A hearing was held on June 6, 2019 (read our written testimony ), but the Joint Committee on Financial Services is still reviewing the bill.

Parity in disability insurance between medical and psychiatric diagnoses (Rep. Natalie Higgins): H. 1723 requires disability insurers pay out wage replacements for behavioral health issues at the same rate as they do for medical issues.

2017-2018 Legislative Session

 

MPA’s Legislative Agenda for the 2017-2018 Session

 

Top 3 Priorities for this Legislative Session

Anti-claw back legislation (Sen. Michael Rodrigues; Rep. James O’Day): S.582 and H.2193 would set a limit of 6 months on the ability  of a health care plan to retroactively retract payments made in good faith (also referred to as claw backs).See our Legislative Update for more information .This bill was included as an amendment in both the Senate (S.2471 ) and the House (H.4605) Health Care bills, but no compromise could be found to pass a final health care bill, so it was not successful. At that point it was too late to advocate for the original bills in the formal session. This will again be our first priority for the next legislative session.

Telehealth parity: There were a number of telehealth bills introduced this session. Telehealth amendments were included in both the Senate ( S.2471) and the House (H.4605 ) Health Care bills, but no compromise could be found to pass a final health care bill, so it was not successful. At that point it was too late to advocate for the original bills in the formal session. This issue will continue to be a top priority for MPA in the 2019-2020 legislative session.

Increased access to telemedicine for behavioral health/substance use services (Sen. Jennifer Flanagan): S.1095 would require health plans to cover the same behavioral health and substance abuse services via telehealth as they do for in-person sessions, and at the same rate as in-person sessions. See our Legislative Update for more information.

Expanded coverage among non-profit health plans (Sen. Jennifer Flanagan; Rep. Ruth Balser): S.527 and H.2156 would expand the recent changes to laws that state that coverage of telehealth must be consistent with coverage of in-person services to non-profit health plans (ex. Blue Cross Blue Shield of MA).Currently, it only applies to for-profit health plans. See our Legislative Update for more information.

Continuity of coverage (Sen. Barbara L’Italien; Rep. Ruth Balser): S.552 and H.484 would require continued coverage of mental health services with an “out-of-network” provider with whom the patient already has an ongoing treatment relationship, if the provider accepts the in-network payment rate and complies with the insurer’s reasonable administrative requirements (see our written testimony for more information). This bill did not progress beyond the first committee that reviewed it. We will likely submit this bill again for the next legislative session, but it will not be a top priority.

Other Supported Legislation:

Protecting access to confidential healthcare (Sen. Kate Hogan; Rep. Karen Spilka): S.591 and H.2960 would allow consumers who are not the primary beneficiary of a health plan to be able to have explanation of benefits (EOBs), reimbursement checks, and similar communication sent to a different address than the primary beneficiary. Success! This bill was signed into law by Gov. Charlie Baker on March 30, 2018.

Ban on conversion practices for minors (Sen. Mark Montigny; Rep. Kay Kahn): S.62 and H.1190 would ban licensed mental health providers from the practice of conversion therapy to change the gender identity or sexual orientation of minors (see our Legislative Update for more information).The House approved it but time ran out in the formal session before the Senate could vote..

Providing equal access to evaluations for children with disabilities (Sen. Barabara L’Italien; Rep. James O’Day): S.58 and H.2866 would require state-set rates for educational evaluations to reflect actual market rates and to be adjusted regularly and fairly (see our Legislative Update for more information). Success! The legislation did not pass but our regulatory efforts were successful.MPA participated in the review of these regulations by EOHHS, and the final rules include the changes recommended in the legislation.

Eliminating “ghost networks” (Sen. Jennifer Flanagan; Rep. Christine Barber): H.2947 and S.528 would require health plans to keep accurate and current provider directories and make transparent their process and criteria for creating their provider network (see our Legislative Update for more information). This bill was included as an amendment in both the Senate (S.2471) and the House (H.4605 ) Health Care bills, but no compromise could be found to pass a final health care bill, so it was not successful.

Allowing clinicians to determine medical necessity (Sen. Jennifer Flanagan; Rep. Kay Kahn): H.1070 and S.1093 would require health plans to allow clinicians make the determination of whether a service is medically necessary for a patient, instead of health plans drafting their own criteria and definitions for each service (see our Legislative Update for more information).A version of this bill was included as an amendment in both the Senate ( S.2471) and the House (H.4605 ) Health Care bills, but no compromise could be found to pass a final health care bill, so it was not successful.

Removing unnecessary barriers to psychological care in some health care settings (Sen. Cynthia Creem; Rep. Ruth Balser): S.1179 and H.2430 would add psychologists to the list of providers whose written instructions nurses may follow in hospitals and other skilled nursing facilities, such as adding or removing frequently safety checks and offering mental health services (see our written testimony for more details). The bill was progressing through the legislature but time ran out in the formal session before it could be voted on.

Removing regulation preventing MassHealth patients from full access to psychological services (Rep. Ruth Balser): H.1060 would allow MassHealth to reimburse psychologists in independent practice for psychotherapy services and appropriate supervision of clinical providers (see our Legislative Update ).This bill did not progress beyond the first committee that reviewed it.

Improving regulation of health plans through increased transparency (Rep. Ruth Balser): H.487 would allow state agencies to monitor health plan denial of service for behavioral health services and size of the provider network, and track number of patients who are unable to schedule an appointment with a behavioral health provider. This bill did not progress beyond the first committee that reviewed it.

 

2015-2016 Legislative Session

 

Anti-clawback legislation (Rep. James O’Day): H.925 would set a limit of 6 months on the ability of a health care plan to retroactively retract payments made in good faith (also referred to as clawbacks). MPA’s Director of Professional Affairs, Dr. Michael Goldberg, testified on behalf of MPA, and MPA also sent a follow-up letter to the Chairs of the Joint Financial Services Committee further outlining the reasoning for the creation of the bill.It did not progress beyond that committee.

Continuity of coverage (Rep. Ruth Balser): H.785 would protect mental health patients from harm caused by interrupted treatment that is the result of behavioral health plans effectively terminating contracts with providers.One of MPA’s Board of Directors, Dr. Andrea Piatt, testified in support of the bill, but it did not progress beyond the first committee that reviewed it.

Increased access to telemedicine for behavioral health/substance use services (Rep. John Scibak): H.267 would improve access to telemedicine services by allowing certain clinicians to be credentialed and allowing for coverage of such services by all payers and the Medicaid program.It progressed to the Committee on House Steering, Policy and Scheduling but no further action was taken on it at that point.

Expanded coverage of telemedicine behavioral health services (Rep. Elizabeth Malia): H.1810 would mandate coverage for telemedicine behavioral health services in circumstances when office visits are not practical. The bill was reported favorably by the first committee that reviewed it, and MPA sent a letter in support of this bill to the co-chairs of the Joint Committee on Health Care Financing; however, it did not progress any further.

Removing unnecessary barriers to psychological care in some health care settings (Rep. Ruth Balser): H.1884 would add psychologists to the list of providers whose written instructions nurses may follow in hospitals and other skilled nursing facilities, such as adding or removing frequently safety checks and offering mental health services.MPA past Presidents Alan Gruber and Dennis Girard, and MPA Executive Director Brian Doherty testified in support of the bill.It progressed to the Committee on Health Care Financing, which sent the bill for further study and no further action was taken.

Providing equal access to evaluations for children with disabilities (Sen. Barbara L’Italen; Rep. Tom Sannicando):This bill would require the secretary of health and human services to review the rates for independent evaluations and adjust the rates as necessary to make them more competitive.Current rates are low and many evaluators will not perform these evaluations, which creates limited access for children of low- and middle-income parents.MPA’s Director of Professional Affairs, Dr. Michael Goldberg, testified in support of the bill, and it was referred to the committee on House Ways and Means, but did not progress beyond that point.

Changing oversight of psychoanalysis (Rep. Jay Kaufman): H.212 would create a separate board of registration through Allied Mental Health and Human Services for providers of psychoanalysis (currently such providers are licensed by the Board of Registration for Psychologists).MPA’s Director of Professional Affairs, Dr. Michael Goldberg, testified in opposition of this bill, and it did not progress beyond the first committee that reviewed it.

 

2013-2014 Legislative Session

 

MPA drafted bills:

Enhancing mental health treatment (Rep. Ruth Balser): H.1002 would expedite the implementation of the transparency provisions of Chapter 224 from 10/01/2015 to 08/01/2014. The bill was given a favorable report and the Joint Committee on Health Care Finance redrafted the bill (now H. 3704 ) and recommended its passage. Success! On June 19, 2014, both the House of Representatives and the Senate enacted the bill, and Governor Deval Patrick signed it into law on July 2, 2014.

Removing unnecessary barriers to psychological care in some health care settings (Rep. Ruth Balser): H.1891 would amend the Nurse Practice Act to authorize nurses to follow written orders issued by psychologists. The MPA presented testimony in support of the bill at a public hearing held by the Joint Committee on Public Health but it did not progress beyond that point.

Promoting efficient access to mental health services (Rep. Ruth Balser): H.1783 was drafted by Dr. Michael Goldberg to ensure more fairness in dealings between health plans and behavioral health providers. It was given a favorable report by the Joint Committee on Mental Health and Substance Abuse, and by the Joint Committee on Health Care Financing but it did not progress beyond that point.

Other legislation of interest:

Expanding training settings for psychologists (Sen. Cynthia Creem; Rep. Ruth Balser): S.904 and H.1893 were filed by the Massachusetts School of Professional Psychology, and would authorize the use of school settings for psychologist training.The bill was given a favorable report by the Joint Committee on Mental Health and Substance Abuse and was redrafted by the Joint Committee on Health Care Financing as H. 3731 but it did not progress beyond the Committee on Senate Ethics and Rules.

Continuity of coverage (Rep. Ruth Balser): H.835 is an initiative of the Mental Health Legal Advisers Committee and would require health plans to continually cover mental health care as they cover pregnancy and cancer care.It was referred to the Joint Committee on Financial Services but did not progress beyond that point.

Gun control legislation: There are nearly 30 bills pending before the Legislature to amend the Commonwealth’s gun control laws. Many of these bills include provisions that impact the level of scrutiny that will apply to persons with mental illness. At this time, the legislator assigned by House Speaker DeLeo to manage this issue has said that a bill is not imminent.

Health plan transparency: MPA signed on to a letter sent to the Honorable Stephen Brewer, Chair of the Senate Committee on Ways and Means, to advocate for increased transparency on topics such as utilization reviews.

 

2011-2012 Legislative Session

 

Chapter 224 of the Acts of 2012 (also known as the Health Payment Reform Law)

Summary of the law

This comprehensive reform law includes numerous provisions advanced by and advocated for by the MPA and its members. Most importantly, it includes a provision requiring health plans to make public their utilization review criteria and medical necessity criteria and protocols. This provision is not effective until October of 2015. However, Rep. Ruth Balser has filed a bill this session at the request of the MPA to remedy this problem.

Chapter 224 also created a Behavioral Health Task Force and gave the MPA a seat on the Task Force. This group was charged with studying the impact of payment reform on behavioral health service delivery. The Task Force has issued a report and recommendations to the newly created Health Policy Commission.

Chapter 224 required the Division of Insurance and MassHealth to issue parity regulations. The MPA worked closely with Health Law Advocates and other stakeholders to influence the content of the regulations.

Other provisions important to the MPA included in Chapter 224 include:

Requiring the Health Care Workforce Center, for the first time, to include mental health professionals in all aspects of the Center’s work. It makes mental health professionals eligible for the current health care workforce loan repayment.

Mandating that the e-Health Institute develop grant and no interest loan programs to fund electronic health records, with priority given to those providers not eligible for federal funding (i.e., mental health professionals).

Directing Accountable Care Organizations to integrate and provide mental health services.

Licensure of behavior analysts (Rep. Ruth Balser): H.1002 would establish a public credentialing and licensing scheme for behavior analysts at the Board of Allied Mental Health and Human Service Professionals within the Division of Professional Licensure.  The bill was ultimately redrafted as S. 2379.  Success!  The House of Representatives and the Senate enacted the bill on December 27, 2012 and Governor Deval Patrick signed it into law on January 3, 2013.

Amending psychology training (Rep. Ruth Balser): H.1003 would change the sequencing of psychology training to ensure that at least one year of clinical training is completed prior to receipt of a doctoral degree.  Success!  The House of Representative and the Senate enacted the bill on December 20, 2012 and Governor Deval Patrick signed it into law on December 28, 2012.