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Legislative Update
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AMHCA Agenda Awaits Budget Super Committee’s Report

11/01/11
By James K. Finley
Director of Public Policy

Congress remains at political and ideological loggerheads, so movement on most legislation has slowed to a crawl while nearly everyone on Capitol Hill awaits the report of bipartisan deficit reduction “super committee” later this month. Bills requiring spending at any level are particularly difficult to move as the super committee deliberates on cuts. Legislation on AMHCA’s priority list covering Medicare, DOD, and Veterans Affairs is stymied while the super committee does its work. Following are recent developments on our advocacy concerns.

Congress remains at political and ideological loggerheads, so movement on most legislation has slowed to a crawl while nearly everyone on Capitol Hill awaits the report of bipartisan deficit reduction “super committee” later this month. Bills requiring spending at any level are particularly difficult to move as the super committee deliberates on cuts. Legislation on AMHCA’s priority list covering Medicare, DOD, and Veterans Affairs is stymied while the super committee does its work. Following are recent developments on our advocacy concerns.

 
Medicare Legislation

AMHCA’s Medicare provider status legislation has been introduced in the Senate as S 604 by Senators Ronald Lee “Ron” Wyden (D–Ore) and John Barrasso (R–Wyo.), and in the House as HR 2954 by Rep. Barbara Lee (D–Calif.). The House bill introduced in late September is very large, offering a number of provisions to expand access to care for underserved communities. 

Because the budget super committee is considering Medicare spending reductions, it is highly uncertain how Congress will advance Medicare amendments this year. Nevertheless, AMHCA and its coalition partners are making many visits on our legislation, hoping to build momentum for inclusion in larger Medicare legislation, once leaders set a direction for consideration later this month. 

 
TRICARE

Past-due TRICARE rules to implement clinical mental health counselor (CMHC) independent provider status are still under review within the Administration. Draft rules have been forwarded through administrative channels, but still await final clearance. AMHCA will notify members as soon as they are published.
 

VA/OPM

AMHCA is urging the Department of Veterans Affairs (VA) to step up hiring of clinical mental health counselors (CMHC). Unfortunately, reports from AMHCA members and VA indicate that virtually no new positions have been made available. AMHCA will meet again this month with VA staff to press our hiring concerns. 

AMHCA recently received a seat on the VA’s Office of Mental Health Services Stakeholder Advisory Committee. Participation in the quarterly meetings presents an important opportunity to press AMHCA concerns to VA mental health leaders about their services and staffing. AMHCA will also meet later this month with the Office of Personnel Management (OPM) concerning the need to issue job standards defining CMHCs as a discrete professional group, an administrative procedure that will aid VA hiring. 

Separate job standards were promised in September 2010, but OPM declined earlier this year to issue the standards. AMHCA’s Public Policy Committee has made it a top priority to reverse OPM’s decision.

 
Impact of Healthcare Reform on Practice

Accountable Care Organizations (ACOs) are a major component of both Democratic and Republican plans to reform the nation’s broken healthcare system. Several weeks ago, the Obama Administration released new ACO rules that generally pleased hospital and provider groups eager to establish themselves in the emerging market. 

Kaiser Health News, a respected health policy think tank in Washington, D.C., has analyzed the Administration’s new ACO rules. The easy-to-follow paper describes how the healthcare industry may move to create ACOs, while everyone remains uncertain about how the model will actually perform. AMHCA members who are interested in how health reform and ACOs may realign their practice environment are encouraged to view the article. 

On an ominous note, the paper makes clear the urgency that clinical mental health counselors must gain Medicare provider status to ensure their participation in the emerging healthcare delivery system. 

Click here to view the report, “KHN’s FAQ on ACOs: Accountable Care Organizations, Explained.”

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