Discussion on PSYPACT proposal continues

On June 8, the Massachusetts Psychological Association held an Advocacy Committee meeting to discuss the Psychology Interjurisdictional Compact (PSYPACT), which has been proposed by the Association of State and Provincial Psychology Boards.

The compact calls for a regulatory framework under which licensed psychologists in states that agree to join will be allowed to practice across state lines through HIPAA-compliant video conferencing.

Additionally, these psychologists would be given a “Passport” that grants the right to practice in-person in another state for up to 30 days per calendar year.

James Leffert, Ed.D., chair of the MPA Advocacy Committee, reported that Eric Harris, Ed.D., J.D., MPA attorney, delivered a presentation at the June meeting during which he offered background and explanation of the compact.

The Massachusetts Licensing Board takes a conservative approach to teletherapy, stipulating that psychologists who use this method in their practices must be licensed in the Commonwealth and in the other states, according to Harris.

He explained further that the federal government seeks “to promote teletherapy as a way to help meet unmet needs in areas not well served.”

He added that if the psychology profession doesn’t create a legal framework for teletherapy, the Department of Health and Human Services would likely impose structure, guidelines and HIPAA compliant mechanisms. He said that the psychological community should take the lead in establishing rules.

If the Massachusetts Psychology Licensing Board and MPA agree to join the compact, Harris explained that they would have to lobby the state legislature to pass a bill and the governor would need to sign it.

“Since we are in the middle of the current legislative cycle, we can’t file a new bill for a year and a half,” he said.

In addition to legal and ethical questions, the committee discussed reimbursement for teletherapy.

Harris observed that from an economic survival standpoint, private practice psychologists might have to develop new areas of activity if they expect to remain in business. He added that the Affordable Care Act and shift to integrated models of service delivery and bundled payments would likely negatively impact sole practitioners.

However, psychologists with a specialty area could benefit by “offering their services electronically to clients across a wider geographic area,” Harris said.

The Massachusetts legislature has introduced HB 1810, which would mandate coverage for telehealth services in Massachusetts by Massachusetts licensed providers, according to Michael Goldberg, Ph.D., MPA director of professional affairs.

“Also, the state mandated behavioral health task force, which I serve on, will be issuing its final report to the legislature in July and they will be recommending that the legislature take action to remove payment and licensure barriers to providing tele-behavioral health services,” he said.

“That group has been meeting since January and has completed its work. The final report is being drafted and should be delivered to the legislature in July.”

Leffert reported that on July 20, UBH/Optum announced an initiative to expand coverage to include “telemental health.” Qualified providers will be able to bill Optum for teletherapy services using the add-on GT billing codes and will be paid at the same rate as for face-to-face sessions, he said.

The committee noted that if Massachusetts joins the compact, psychologists in other states, including for-profit companies, would be allowed to offer teletherapy services to Massachusetts’ residents. Harris countered that most competition will come from “master’s level providers, out of state and in-state, not from out-of-state psychologists, and that the compact would be irrelevant to that form of competition.”

PSYPACT will not take effect until at least seven states accept it. At that time, representatives appointed by the participating state licensing boards will finalize details, noted Leffert.