2023 Health Policy Agenda

The American Association of Psychiatric Pharmacists (AAPP) is a professional association representing nearly 3,000 psychiatric and neurologic pharmacists. AAPP’s membership consists of specialized pharmacists, many being Board Certified Psychiatric Pharmacists (BCPP), who treat patients living with psychiatric, substance use, and neurologic disorders.

Psychiatric pharmacists are on the frontlines providing direct patient care, optimizing medication outcomes, and supporting fellow health care colleagues in primary care and mental health. Sufficient reimbursement continues to stand in the way of many practices and institutions seeking to include a psychiatric pharmacist on the care team. In order to expand the use of psychiatric pharmacists, federal payment polices must be changed to allow psychiatric pharmacists to directly bill for their comprehensive medication management services.

Patients with psychiatric and substance use disorders (SUD) are currently confronted with a health care system that lacks mental health and substance use providers and is unable to meet their unique needs. Additionally, research shows that the COVID-19 pandemic greatly exacerbated existing behavioral health issues leading to substantial increases in anxiety, depression, and SUD. Patients deserve high-quality, evidence-based, measurement-driven, comprehensive care that psychiatric pharmacists can provide as an integral member of interprofessional teams.

To increase patient access to psychiatric pharmacist services, AAPP’s federal policy priorities for 2023 are as follows:

AAPP will play an active role in legislative and regulatory advocacy to:

1. Increase understanding and awareness by policymakers, health care professional organizations, and patient advocacy organizations on the role of psychiatric pharmacists on the health care team and the value added to the team and patient outcomes.
2. Increase access to medication management services for mental health and substance use disorders by:
   1. Advocating for Medicare coverage of comprehensive medication management services and recognition of psychiatric pharmacists as providers.
   2. Increasing payment for psychiatric pharmacists’ services.
   3. Expanding the mental health and substance use disorder treatment workforce through use of psychiatric pharmacists.
   4. Increasing adoption of innovative care and payment models that integrate mental health, including SUD, into primary care services.

AAPP will actively work with key partners to advance legislative and regulatory policies to:

1. Maintain access to psychiatric and substance use services provided through telehealth, including removing initial in-person visit requirements.
2. Increase access and remove barriers to medically necessary mental health and substance use treatment medications such as long-acting injectable antipsychotics, naloxone, and medication for the treatment of alcohol and opioid use disorders including:
   1. Removing barriers to access to medication-based opioid use disorder treatment (MOUD) such as:
      1. Expansion of methadone treatment beyond the Opioid Treatment Program (OTP) setting, including take-home doses for stable patients and pick-up doses at pharmacies.
      2. Removal of barriers in access to tele-prescribed controlled substances while maintaining appropriate safeguards 
   2. Enforcement of the Mental Health Parity and Addiction Equity Act of 2008
3. Increase CMS funding for psychiatric pharmacy residency training including pharmacy residency (PGY1) and psychiatric pharmacy residency (PGY2) training.
4. Maintain the 340B Drug Pricing Program (340B) as essential in providing low-income patients access to medically necessary medications as well as psychiatric pharmacists’ services and residency training.
5. Reduce stigma, prevent suicide, and dispel mental health myths and misperceptions for patients living with mental health disorders, including substance use disorders.