Providing relief for APA members struggling with managed care problems was the goal of several action papers from Area 3 approved by the APA Assembly last month in Washington D.C.

Psychiatrists need more clout in negotiating contracts with managed care, and APA can help in establishing collective bargaining rights, recommended the Area 3 authors. Other steps include becoming a resource on collective bargaining information, legislative advocacy by the Joint Commission on Government Relations (JCGR), and working with coalitions in the next Congress to remove legal hurdles to bargaining rights.

Eliminating "termination without cause" clauses in psychiatrists' managed care contracts would remove a potential barrier to psychiatrists' full disclosure to patients, stated another action paper. APA should mount a vigorous campaign to ensure that psychiatrists have "due process" protections regarding termination and includes the following elements:

• The JCGR's advocating for such protection in managed care legislation;

• APA's seeking the voluntary compliance of managed care companies with this request;

• APA's affiliated liability insurance company warning insured members about such clauses and their consequences;

• Psychiatric News publicly discussing this issue and identifying managed care companies that provide such protection;

• APA's AMA Section Council on Psychiatry working within AMA to gain the support of a broad coalition of medical groups on this issue;

• APA's working with advocacy groups to convey the importance of such protection for professionals and with other mental health provider groups on this issue; and

• APA's legal counsel defining elements of a "due process" procedure to ensure justice for members threatened with termination by managed care networks.

In related actions, the Assembly approved a recommendation that APA develop principles to monitor and report on managed Medicaid plans under state contract. APA should also urge the district branches to become involved with state monitoring activities and disseminate managed care quality information to the public, said the action paper.

The Assembly voted to have APA devise a position on the use of restricted formularies by managed care companies, and if necessary, to develop guidelines on this issue to recommend to managed care companies.

"We felt the appropriate way to address capitation was through quality of care standards rather than advocating for specific financial amounts."

The Assembly proposals will now go to the Board of Trustees for further discussion.

(Psychiatric News, December 6, 1996)