VACP and its regional academies such as NVACP were born fighting for clinical psychology, and they continue to be strong and effective advocates for us. We know that our vigilance is the guardian of victory and complacency its enemy. Our effectiveness has impressed Russ Newman, PhD, JD, former Executive Director for Professional Practice of the American Psychological Association (APA). That is why he calls us “the Special Forces of APA.”

The Historic Battles for Our Professional Independence

VACP was born fighting for clinical psychology and helped shape the course of our profession not only in Virginia but nationally.

In 1975, VACP and its regional branches were created and quickly launched the First Battle for Professional Independence, an arduous campaign against the medical establishment. We persisted in lobbying Virginia state legislators, making our argument that we should not be under the control of physicians. And we prevailed. Virginia passed a statute affirming our professional autonomy.

After a few years, we mobilized again for the Second Battle for Professional Independence because our livelihoods and clinical practices were still stifled by remnants of physician control. Virginia Blue Cross and Blue Shield (BC/BS) denied reimbursement for our psychotherapy services unless billed through a physician. In effect, we were being told that the appropriateness and competency of our clinical work had to be supervised by MDs.

So, the fledgling VACP waged the Second Battle for Professional Independence by its fateful decision, along with several determined VACP members to sue BC/BS and the state Neuropsychiatric Society. The struggle was protracted, hard fought and expensive but we pushed it all the way to the Virginia Supreme Court. Again, we prevailed. The favorable ruling was a strong one: The court declared that BC/BS violated the federal Sherman Antitrust Act; they were in “restraint of trade” and breached freedom of practice laws. The victory quickly had national repercussions, convincing insurance companies to remove procedural and reimbursement obstacles to the services of clinical psychologists.

We are proud that VACP and NVACP along with a handful of courageous members advanced the legal and economic foundation for the “independent practice of clinical psychology” in the United States. We were bestowed the respect we earned from our education, training, dedication, professionalism and competencies. The Battles for Professional Independence removed us from under the thumb as well as out of the shadow of medicine. Increasingly, society regards clinical psychologists as a first and best choice for treatment and as offering expert, interesting and useful perspectives on diverse facets of human behavior. This remarkable political, economic and cultural achievement was made possible by VACP, NVACP and courageous dedicated members who understand the necessity to support and become involved in advocacy.

 VACP and its regional academies help you make a living and protect your livelihood through effective legislative advocacy.

We were formed to establish the independent practice of clinical psychology in Virginia. And we succeeded! Here are some other examples of our effectiveness in the state General Assembly:

• We were instrumental and continual to be so in defining, protecting and expanding the scope of the practice of clinical psychology.
• Aside from psychiatrists, clinical psychologists are the only other professionals allowed to treat moderate and severe disorders.
• We expanded our scope of practice through the statutory recognition of our competence and right, not just evaluate but, to diagnose -- formerly the exclusive province of physicians!
• Similarly, the law now supports our expertise in forensic cases such as determining competency to stand trial, in sanity in criminal cases and pre-sentencing evaluations of sex offenders.
• Clinical psychologists are specifically included in the “any willing provider” statute that mandates insurance companies to permit qualified providers to join their networks.
• HMO, “point of service” and “out of network” insurance plans must include clinical psychologists.
• We promoted a state version of mental health parity, requiring copay and deductibles for mental health services, including those rendered by a clinical psychologist, to be on par with those for physical illness.
• We prevented insurance/manage-care companies from insisting that clinical psychologists have to agree to participate in all of their carriers or in all of their plans.
• We were allowed to continue providing sex offender treatment services without having to obtain additional certification.
• We achieve legislation that requires insurance companies to pay interest on “clean claims” not paid within 30 days.
• We successfully advocated for increased reimbursement for court-ordered forensic services.

VACP and its regional academies help you make a living and protect your livelihood through effective advocacy with insurance, managed-care companies, Tricare, Medicare and Medicaid.

Shortly after VACP and its regional academies were formed, we sued Virginia Blue Cross/Blue Shield and won, paving the way nationally for the legal and economic autonomy of our profession from physician control. Want some more examples of what we continue to do for you?

• In 2006, we challenged the MAMSI health plan’s requirement that clinical psychologists could only be reimbursed for psychotherapy if a psychiatrist authorized it. We prevailed and they eliminated this noxious impediment.
• Magellan Behavioral Health wanted to implement an authorization procedure that encroached on patient confidentiality and burdened the therapist. We argued our case with its executives, and we prevailed. They simplified the process.
• Previously, we arranged an agreement with Magellan Behavioral Health to pay claims more quickly and to resolve disputed claims, resulting in tens of thousands of recouped dollars.
• We assisted clinical psychologists to obtain increased reimbursement from Tricare for psychological and neuropsychological testing. We assisted in the devising a promising change strategy to have Tricare authorize intensive outpatient treatment and to reduce credentialing obstacles that limit the supply of partial, residential and inpatient treatment.
• We successfully advocated with Medicare to raise the reimbursement of clinical psychologists and to establish the reimbursement for technicians in psychological testing.
• When the Anthem insurance company wanted to have an out-of-state firm process its claims, we were concerned that this out-sourcing would hamper the resolution of claim problems. So, we initiated a campaign to persuade the State Corporation Counsel to block the move, and we prevailed. Previously, we addressed Anthem’s concerns about session limits for psychotherapy and the state’s parity law. They relaxed therapy restrictions.
• When we learned that some insurance companies did not appreciate the value of standardized psychological testing beyond the clinical interview, we embarked on educating them about the relevant scientific literature.
• We were years ahead of the American Psychological Association (APA) in sponsoring workshops to provide critical guidance to clinicians who contracted with third-party payors.

We are by no means reflexively antagonistic in our approach. Our reputation for being knowledgeable, reasonable, and professional has attracted insurance and managed-care companies to seek our guidance regarding CPT codes and treatments standards. For example, we have been invited to serve on committees to advise Sentara on treatment guidelines, to oversee clinical quality of the Tricare contract and to review the policies and procedures of Magellan Behavioral Health.

VACP and its regional academies help you make a living and protect your livelihood through effective advocacy with the Virginia Board of Psychology.

The state regulation of our profession use to be under the Board of Medicine. Now our licensure and state governance is administered by our own separate Board of Psychology. VACP continuously monitors Board proposals and provides input that has helped shape the rules, approach and environment of professional practice. Currently, we are focused on promoting licensure at the doctoral level, which is comparable to licensure for physicians and other health professionals, when a psychologist has obtained sufficient pre-doctoral supervised clinical experience. This arrangement is endorsed by APA. Currently, Virginia licensure requires at least a year of supervised post-doctoral clinical experience.