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PSYPACT
Telehealth and Insurance
Change in Requirements for PSYPACT Participation
PSYPACT FAQ
Application Process
Thank you for your support
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PSYPACT

PSYPACT is a compact enacted into law by participating states that allows the practice of psychological services via tele-communications technologies within compact states by licensed psychologists. PSYPACT authorizes both telepsychology and temporary in-person, face-to-face practice of psychology across state lines in PSYPACT states. PSYPACT allows states to maintain the authority to regulate telepsychology and temporary in-person, face-to-face practice. MPA actively pursued PSYPACT in Maryland during the 2021 Maryland Legislative Session and won!

How PSYPACT works

PSYPACT Summary 

Why is PSYPACT important? 

PSYPACT Fact Sheet: Reducing Regulatory Barriers. Increasing Access to Mental Health Care

Interstate Compacts to Support License Portability


Telehealth and Insurance

A question we frequently receive from MPA members is how insurance will treat telehealth services. The following is courtesy of our Director of Professional Affairs Paul Berman.

Maryland law requires that every traditional insurance (and only 50% of people actually have traditional insurance) plan in Maryland have a benefit for telehealth to be paid at the same rate as in-person services. The problem is, that only about half of Maryland’s citizens (and in the US) have traditional insurance. The others have what is known as a health plan whose benefits are actually paid by the employer – these are known as self-insured plans. Self-insured plans are not regulated by the states. So, they decide whether they maintain telehealth benefits or not. Traditional insurance cards and self-insured health benefit cards look the same. The only way you can tell is by calling and finding out. Or, you can guess that if the employer operates in more than one state, then most likely the health benefit is not state-regulated.

Bottom line:
Some self-insured companies are pulling back on telehealth coverage. APA and MPA, and others, are advocating for legislation already introduced in Washington DC which would require the self-insured plans to maintain telehealth coverage. But there is no way to know if this will pass.

The bottom, bottom-line:
No one knows. But you can be sure that anyone with traditional insurance will maintain telehealth coverage.

 


Change in Requirements for PSYPACT Participation


As a result of good advocacy work, The PSYPACT Commission recently changed the criteria for the E.Passport. This is a significant change since the E.Passport is required for participation in PSYPACT.  The change specifically involves individuals who received their doctorate prior to January 1, 1985.
 
Old language required graduation from an APA accredited program or a program jointly designated by the National Register and ASPPB
(essentially programs that were on their way to accreditation). Unfortunately, a number of our more experienced and more senior psychologists graduated in the 1980s at a time when some programs were not yet APA accredited. The proposed changed was to allow psychologists to have graduated from a regionally accredited program prior to some specific date.
 
The PSYPACT Commission did change the criteria  for psychologists who graduated with a doctoral degree from a regionally accredited program prior to January 1, 1985. The PSYPACT Commission deemed that an individual who graduated from a regionally accredited program prior to January 1, 1985 and has been continuously licensed is deemed to have met the E.Passport educational requirements.
 
The change was effective immediately.  The specific language change is immediately below:

 
“6. Do I have to have graduated from an APA/CPA accredited or Joint Designated program?*


Yes. 
Eligibility requirements state that the degree program must have
been accredited by the American Psychological Association/ Canadian Psychological Association or designated by the ASPPB National Register Joint Designation Project (https://www.asppb.net/page/JointDesignation) at the time your degree was conferred in order to be eligible.
Please note: Applicants who have been continuously licensed (active or inactive) to practice psychology at the independent level in one or more ASPPB member jurisdictions since January 1, 1985, based on a doctoral degree in psychology from a regionally accredited institution, are deemed to have met the educational requirements for the E. Passport and/or Interjurisdictional Practice Certificate (IPC).” 
 
*(see: https://www.asppb.net/page/telepsychology)


PSYPACT FAQs

MPA members have been asking questions about the implementation of PSYPACT. Below are answers to frequently asked questions.

What credentials are required to participate in PSYPACT?

This is a several step-process which is completed on the PSYPACT website at: https://psypact.site-ym.com/page/telepsychology. A psychologist must first apply for and obtain an E. Passport from the Association of State and Provincial Psychology Boards (ASSPB). Psychologists then apply to the PSYPACT Commission for an Authority to Practice Interjurisdictional Telepsychology (APIT) to practice telepsychology across state lines in PAYPACT states and/or apply to the PSYPACT Commission for a Temporary Authorization to Practice (TAP) which allows the psychologist to practice in-person up to 30 days in each PSYPACT state.

 

What is a PSYPACT/Compact State?

A PSYPACT/Compact State is a state, territory, or the District of Columbia that has enacted PSYPACT legislation and participates in this interjurisdictional psychology compact.

What is a Home State?

The Home State is the PSYPACT state in which the psychologist is licensed to practice.  For telehealth, it is also the state in which the psychologist is physically located (and is licensed to practice).

What is a Receiving State?

The Receiving state is the PSYPACT state where the client is physically located during telehealth visits.

What is a Distant State?

The Distant State is the PSYPACT state in which the psychologist is physically located when delivering temporary in-person, face-to-face services under the Temporary Authorization to Practice (TAP).

Can a psychologist deliver telehealth services from any location?

A psychologist must initiate the telehealth contact in the psychologist’s Home State. A psychologist licensed in multiple PSYPACT states can change their Home State designation as necessary depending on where they are located at the time of the teletherapy session.

In which state does the visit take place?

The psychological service takes place at the physical location of the psychologist.

 

Which state’s laws and regulations apply?

Scope of Practice. The psychologist is able to provide services under the authority of their home state license.

A psychologist practices under the scope of practice of the State Psychology Regulatory Authority of the Receiving State (for telepsychology) or the Distant State (for temporary in-person, face-to-face services). However, the psychologist’s scope of practice cannot exceed the scope of practice in the Home State. For example, if the Receiving State includes prescription privileges, and the Home State does not, the psychologist cannot prescribe in the Receiving State.

Laws which protect the health and safety of the patient/client and citizens of the state. The compact subjects the psychologist to laws of the Distant or Receiving State with regard to laws that protect the health and safety of the state’s citizens. This includes, for example, laws governing duty to warn, applicable state child abuse reporting requirements, elder abuse, record-keeping rules, and  informed consent, among other laws.

 

Which state initiates proceedings if there is a Board complaint against the psychologist?

The Home State, Receiving State, or Distant state can initiate Board proceedings against the psychologist. If the Home State or Receiving State issue an adverse action against the psychologist, then the authority to practice under PSYPACT is suspended. The Home State has the power to impose an adverse action against a psychologist’s license.

 

Which state has the authority to issue a subpoena to the psychologist?

A subpoena issued by a Compact State’s Psychology Regulatory Authority is enforceable in other Compact States.

 

How long do I have to retain records under PSYPACT? Different states impose different requirements for retaining records, and some have no requirements. APA’s Record Keeping Guidelines indicate that psychologists may consider maintaining full records for seven years after the last date or services or for three years after a minor patient reaches majority, whichever comes later. Given the varying state laws on this issue, it is safest to follow APA’s Record Keeping Guidelines.

 

Can I notify others that I am authorized under PSYPACT?

Under listed Certifications, the authorization holder may include the Authority to Practice Interjurisdictional Telepsychology (APIT) and/or Temporary Authorization to Practice (TAP) and indicate that it is granted by the PSYPACT Commission.  They can include the date issued and APIT or TAP number. They must not indicate that this authorization implies an advance skill, license, or education level.

 

Which state regulates the psychologist’s practice?

The PSYPACT commission obtained a legal opinion stating that the psychologist is subject to the Distant State or the Receiving State’s laws applicable to a psychologist licensed in that state that protect the health and safety of that state’s citizens. In addition, the psychologist is always subject to their licensing state(s) laws, rules, and regulations. The Receiving State or Distant State can refer a complaint to the Home State.

 

What Code of Maryland Regulations (COMAR) should I be aware of when practicing telehealth through PSYPACT?

All Maryland regulations relevant to the practice of psychology are applicable. In addition, Maryland has specific telehealth regulations found in COMAR 10.36.10, including the following:

  1. A psychologist practicing telepsychology shall establish safety protocols for emergencies or crises including local telephone numbers at the client’s location for: (a) Police, fire, and emergency mental health and medical services; (b) The local hospital emergency room; and (c) An emergency contact.
  2. Informed consent for telepsychology shall include: (a) Requirements for privacy such that only the psychologist and the client shall participate in, or be present during, a telepsychology session, unless otherwise agreed to by the psychologist and the client; (b) Actions to be taken if the technology used for the telepsychology session is disconnected or any other technological issues arise; (c) The emergency safety protocols required by §E(3) and (4) of this Regulation; and (d) Disclosure of the privacy and security risks of telepsychology and potential risks of disruption of telepsychology session.

 


PSYPACT Application Process

Link to the PSYPACT E. Passport (telehealth) application

Link to temporary in-person practice through PSYPACT

Link to PSYPACT application/practice FAQs

Missed our June 28 PSYPACT webinar with Paul Berman and PSYPACT Executive Director Janet Orwig? Here's the link to the video

From Paul Berman

Janet Orwig, Executive Director of PSYPACT, provided me with some additional information she asked me to post on our listserve regarding the PSYPACT application process. These issues were discussed during the June workshop, but she asked that I post the following to clarify some answers provided during the workshop.

  1. PSYPACT applications require that the graduate school transcript be sent directly by the university to PSYPACT by mail or email.
    1. Email address: [email protected]
    2. USPS snail mail address: P. O. Box 849 Tyrone, GA 30290 is the mailing address.

 

  1. The Educational Section for the application requests more information than is necessary (the other sections are required for other applications at ASPPB, but not required for the E.Passport or IPC). The following only need to be completed in this section:
    1. Institution Name
    2. City
    3. State/Province
    4. Department
    5. Program of Study
    6. Degree
    7. Date Degree Conferred

 

  1. Also, please note: the Verification of the Program section located at the bottom of the Education Section does not need to be completed (any necessary verifications will be done by PSYPACT).

Thank you for your support and celebrating PSYPACT with MPA

Thank you to everyone who attended our PSYPACT celebration on Sunday, August 22. While the weather prevented an outdoor event, we were able to maintain a socially distant celebration as we raised a glass to our members and colleagues who made this victory possible. Thanks to your support, we raised over $5,000 for MPA PAC which played a large role in bringing PSYPACT to Maryland by supporting our legislative champions in Annapolis. Congratulations MPA!

 

MPA Legislative Update

5/21/21 - MARYLAND HAS BEEN ACCEPTED INTO PSYPACT!  WE ARE ALL OF THE WAY THERE!

Those interested in joining PSYPAC begin applying to the program. Anyone who completed the application  to PSYPACT and was denied because Maryland were not a PSYPACT state at the time of your application: be patient. PSYPACT will be reversing those denials without you having to do anything, they are in process now.  If you are qualified, you will be approved.

If anyone has already applied and been accepted in to PSYPACT through another state, i.e., Virginia, Pennsylvania, Delaware, etc. you don't need to reapply to assign Maryland as your home state.  You go to the PSYPACT portal, which you should be familiar with and change your home state to Maryland and you can practice out of Maryland into another PSYPACT state.  If you then go back to say Virginia the next day, you reverse the process.  In other words once you are approved by PSYPACT you can change your home state as needed via their internet portal.  Please note that this means you have to be licensed in each state you identify as a home state.  For folks already PSYPACT approved, you can start practicing from Maryland under PSYPACT today. .well maybe tomorrow after you change your home state. .

Here is a link to the PSYPACT website that will help get you started on the application process as it provides answers to the most commonly ask questions:    https://psypact.site-ym.com/page/appfaq

Lastly keep your eyes and ears open, MPA will be putting more information out as we receive it and holding workshops, if there is an interest to provide you our members with the ability to take advantage of this opportunity.  We are on our way into the 21st Century.  "To infinity and Beyond."

5/18/21: Governor Hogan signs HB 970 into law. PSYPACT is heading to Maryland! A big thanks to MPA member Dr. Cheryl Rubenstein for helping to secure the picture of the bill signing.

 

To everyone who wrote an email, responded to our action alerts, called their legislator, testified on behalf of PSYPACT...

THANK YOU!!!!!

4/6/21: SB 500 has cleared the Senate with the same Emergency Legislative designation as HB 970. The bill is headed to Governor Hogan for his signature.

4/1/21: HB 970 has cleared the Senate and is on its way to Governor Hogan for his signature.

3/18/21: HB 970 passed out of the House of Delegates! Now, it will go to the Senate for review and vote.

3/16/21: SB 500 passes out of the State Senate. Now, it will go the House of Delegates for review and vote.

3/11/21: PSYPACT passed out of the Health and Government Operations subcommittee today UNANIMOUSLY!!!!!!!!!!  It was also amended to be Emergency Legislation, which means as soon as it is signed into law it goes into effect. Most laws take effect October 1 of the year in which they are passed.

3/5/21: The Senate Education, Health and Environment Committee favorably reported SB 500 out of committee by a unanimous 10-0 vote! The bill is expected to receive a vote on the Senate Floor next week. Please ask your Senator to support SB 500 through our Action Alert.

2/25/21: House Health and Government Operations Committee Hearing on HB 970

2/16/21: Senate Education, Health and Environment Committee Hearing on SB 500

2/5/21: PSYPACT has been introduced in the Maryland State House. The bill number is HB 970 (PSYPACT).

1/21/21: The PSYPACT bill has been introduced in the Maryland State Senate. The bill number is SB 500 (PSYPACT

 

Legislators to contact

The legislators below serve on the jurisdictional committees in the Maryland General Assembly that will take up PSYPACT when the bill is officially introduced. MPA is asking members to contact these legislators and encourage them to support PSYPACT. With your help, we can get PSYPACT approved in Maryland!

Take action on PSYPACT - MPA's Action Alert on PSYPACT. Click the link to send a message to your legislator(s) asking them to support SB 500 and HB 970.

How to find your legislator in the Maryland General Assembly (link)  - Under Find My Representative, Click "Look up". Then write your address and zip code and click "Find". This will pull a list of your local representatives.

Sample letter to your legislator (link) - This is a sample letter on PSYPACT you can use in communicating with your legislator.

Legislator Contact Form (link) - Once you contact your legislator(s), use this form to provide any feedback to MPA.