From where I sit, we’re in the lull between storms.

In March, just as I was returning from APA’s Practice Leadership Conference in Washington DC, the nation was about to enter into a new world (to many of us) of telepsychology.  Psychologists, physicians, patients, insurers, legislators all scrambled to figure out how to provide quality psychological healthcare, in ways we had never imagined.  As DPA, my weeks were a blur of getting information to all of you about the changing landscape of telepsychology, using technology safely & effectively, and getting paid for our work.  As a Medicare provider, I held my breath for the Centers for Medicare & Medicaid Services (CMS) to approve necessary but sweeping changes to how Medicare had traditionally viewed telehealth.  Like many of you, I was doing this while also guiding my teen through isolation, distance learning, and the election.  Thankfully, teens (even 9^th graders) are relatively self-sufficient in many areas of technology, so once we got some of the bugs worked out, I could go to my corner home office and get to work, knowing my child was engaging (somewhat) in distance learning, although also keeping a parent’s eye on their fragile mental health.

Once we got through that storm, we had to navigate the waves of insurers making changes in their coding policies for telehealth, threatening end of telehealth services long before we were ready to open up, and getting temporary licensure in other states to continue to provide services to clients who might no longer be in state.  Many psychologists were also navigating what to do with their offices, waiting for guidance about how to perform testing and evaluation in ways that were safe and effective for psychologist and patients alike, or making decisions about returning to the office.  Students and early career psychologists were also navigating changes in licensing regulations, taking the EPPP safely, getting enough hours, and worrying about how practica and internships would survive this new reality.

Amidst telehealth, telepsychology, and COVID-19, our nation and especially our state found itself on the front lines of debates about racism and policing and a tumultuous and divisive election season.

The next wave was helping patients and psychologists alike make the transition from short-term crisis to long-haul management of this new reality, with no idea how long this long-haul would last.  In my practice, I work often with medical patients navigating chronic illness with significant impact on their previous way of life with no assurances of what the future holds.  That seems like a perfect analogy for our current situation.

Coming up next, I’ve been working with DPAs across the country and APA staff to ensure that psychologists continue to practice at the top of our licenses and get reimbursed fairly for the work we are doing.  I have worked with the OPA Legislative Committee and lobbyists to prepare for the upcoming Legislative session and likely budget cuts. 

I have begun a dialog with the Medical Director for Behavioral Health at Providence Health Plan, which is bringing their behavioral health services back to an in-house panel (they previously contracted with Optum/United Behavioral Health).  He has provided me with a contact at the health plan for providers who need assistance to continue seeing patients into the transition, and we also discussed “pain points” such as underpayment for 90837, and denials of payment for medical/psychologically overlapping conditions.

 OPA has transitioned to a new website design that will allow us to update the website frequently. I hope to find volunteers to help me build the Professional Affairs section of the website to be a dynamic resource of information.  If you’re not already on the OPA Listserv, please consider joining.  I do provide researched updates there, labeled with the subject PROF AFFAIRS so you can quickly find my posts. My goal is to provide well-researched and vetted information to help you practice ethically and in compliance with relevant laws, regulations, and guidelines, and advocate for you getting paid for your work.

Let’s keep in touch – I need to hear from you.