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PsiAN petition

NAAP would like to alert you to action initiated by our partner professional organization, PsiAN. PsiAn’s letter below outlines some of the challenges that may confront mental health practitioners if the “No Surprises Act” is enforced. Please read the letter, sign the petition, and reach out to your legislators!


LEGISLATIVE ACTION: Call or email your legislators about the NSA and the privatization of Medicare!!

Dear all,

If you’ve already done what’s in the subject line, you can stop reading.  If not, please stick it out with this long email and ACT!

Your legislators need to know where you stand about the NSA’s application to mental health professionals, and about the privatization of Medicare through Direct Contracting.

The No Surprises Act

Many legislators who voted for the Act have been surprised (the joke is getting old around here) that the Act is including mental health professionals in private practice, because the act is intended to protect patients who don’t have an opportunity to choose a provider–virtually never the case in mental health treatment. The involvement of legislators is crucial to gaining an exemption, both to influence the CMS to write rules that match what they intended the bill to address, and to amend it legislatively, should that be necessary.

Our strategy is to focus on the clinical costs of the Act more than the administrative burden. Both are real and significant, but the former is the core problem and can’t be discarded as just a complaint about more work. Moreover, legislators are very aware that we are in the midst of a mental health pandemic, and aspects of a law that further complicate accessibility to treatment are truly a bad idea.

You can find contact information for your legislators here:  When you email, leave a message, or speak to someone in the office, we suggest that you let them know

  • That you are a constituent, and your professional status if you are a provider
  • That the Act requires you to provide self-pay (OON and uninsured) patients a Good Faith Estimate which can negatively affect their treatment.  Here are the points we make in our letter:
    • The Good Faith Estimate (GFE) created by the NSA requires cost, treatment plans, and length of treatment information that is very similar to the Informed Consent we already provide to our clients in accordance with our various professional Codes of Ethics and state licensure laws. The diagnosis and length of treatment cannot be estimated until the therapist has an understanding of the patient, which can take several sessions. It is an ethical violation for mental health clinicians to diagnose and treat without a complete evaluation. • Patients who receive a mental health diagnosis often have anxiety about being labeled. When and how a diagnosis is addressed during treatment can make a significant difference in how successfully a client accepts help. Many clients see a private practice psychotherapist because they prefer not to have a formal diagnosis, a factor that mental health clinicians take into account. • Many patients, as well, are concerned about the lack of confidentiality that will result if insurers are allowed access to the information in the GFE. A major reason patients choose an out-of-network provider is to have as much privacy as possible.
  • Therefore, you are asking your legislator to support an exemption of all mental health professionalsto protect clinical care and your ability to practice both lawfully and ethically.
  • And send them our letter, written jointly with CSWA and supported by eight other organizations who together represent the interests of nearly 300,000 licensed practitioners. It is attached here.

Direct Contracting of Medicare

Physicians for a National Health Program ( has mounted a vitally important campaign to stop Medicare Direct Contracting.  Here is their summary of the problem:

During the final days of the Trump Administration, officials at the Center for Medicare and Medicaid Innovation (CMMI) launched a dangerous and insidious pilot program known as Medicare Direct Contracting.

Left unchecked, this program would allow profit-hungry Direct Contracting Entities (DCEs) to manage the care of up to 30 million Traditional Medicare beneficiaries. These entities, which have received a huge influx of money from private equity, have every incentive to frustrate patients and deny medically necessary care.

Unless we stop DCEs, these entities could spell the end of Medicare as a public, nonprofit, social insurance program.

PsiAN strongly supports PNHP’s effort.  Medicare has been one of the few insurers who have covered long-term, intensive psychotherapy, and we can be certain that will change when profit-motivated entities are running the show.  Moreover, there is extensive data that Medicare Advantage programs, which promised to cost less than traditional Medicare, in fact have cost considerably more.

Action: sign the PNHP petition

  • ask your legislators to demand that HHS stop this destructive program.

Again, you can find contact information for your legislators here:


Janice Muir, PhD
for PsiAN the Executive Board