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Medicare Legislation Action Alert

July 22, 2015

New bills have been introduced in the House and Senate to extend Medicare provider status to mental health counselors and marriage and family therapists. On July 22, 2015 Senators John Barrasso (R-WY) and Debbie Stabenow (D-MI) introduced the “Seniors Mental Health Access Improvement Act” (S. 1830) and on June 12, 2015 Representatives Chris Gibson (R-NY) and Mike Thompson (D-CA) introduced the House version as (HR. 2759). The identical bills would allow Medicare beneficiaries access to mental health counselor services and marriage and family therapists (MFTs) through Medicare. By providing these mental health professionals the opportunity to participate in the Medicare program, the bills expand the number of mental health providers available to beneficiaries.

Describing the need for the legislation, AMHCA notes that in the United States 20 percent of individuals aged 55 and older experience some type of mental health problem. According to the Health Resources and Services Administration, there are approximately 4,000 Mental Health Professionals Shortage Areas in the United States, and half of all counties in the U.S. have no practicing psychiatrists, psychologists or clinical social workers. Seniors in rural communities are the most adversely affected by these shortage areas. The time to promote Medicare recognition of mental health counselors and MFTs is now. Urge your two Senators and Representative to co-sponsor this vital legislation that would authorize MHCs and MFTs to be paid by Medicare for outpatient mental health services to beneficiaries.

Action Requested
AMHCA members are urged to email their two U.S. Senators and one Representative to urge them to co-sponsor S. 1830/HR. 2759. AMHCA members may find their Senators and Representative’s email address on their office websites.

See these suggested email messages to Senate and House offices.

 

Background and Justification
About 50 percent of rural counties have no practicing psychiatrists or psychologists. Mental Health Counselors and MFTs are often the only mental health providers in many communities, and yet they are not now recognized as covered providers within the Medicare program. These therapists have equivalent or greater training, education and practice rights as currently eligible provider groups that can bill for mental health services through Medicare.

Other government agencies already recognize these professions for independent practice, including The National Health Service Corps, the Dept. of Veterans’ Affairs and TRICARE. Medicare needs to utilize the skills of these providers to ensure that beneficiaries have access to necessary services.

  • Lack of Access in Rural and Underserved Areas--Approximately 20 percent of individuals aged 55 and older experience some type of mental health problem. According to the Health Resources and Services Administration, there are approximately 4,000 Mental Health Professionals Shortage Areas in the United States, and half of all counties in the U.S. have no practicing psychiatrists, psychologists or clinical social workers. However, many of these mental health professional shortage areas have mental health counselors whose services are underutilized due to lack of Medicare coverage.
  • Medicare Inefficiency--Currently, Medicare is a very inefficient purchaser of mental health services. Inpatient psychiatric hospital utilization by elderly Medicare recipients is extraordinarily high when compared to psychiatric hospitalization rates for patients covered by Medicaid, VA, TRICARE, and private health insurance. One-third of these expensive inpatient placements are caused by clinical depression and addiction disorders that can be treated for much lower costs when detected early through the outpatient mental health services of MHCs.
  • Underserved Minority Populations--The United State Surgeon General noted in a report entitled Mental Health: Culture, Race, and Ethnicity that “striking disparities in access, quality, and availability of mental health services exist for racial and ethnic minority Americans.” A critical result of this disparity is that minority communities bear a disproportionately high burden of disability from untreated or inadequately treated mental disorders.
  • Medicare provider eligibility for mental health counselors and MFTs is long overdue--These two professions represent over 40 percent of today’s licensed mental health practitioners. Unfortunately, Medicare has not been modernized to recognize their essential contribution in today’s health delivery system. Congressional scoring rules obscure the dollars saved by utilizing their services to treat mental health conditions before they exacerbate into more serious mental and physical disorders.

Please direct inquiries to James K. Finley, AMHCA Associate Executive Director: jfinley@amhca.org


Mar 11, 2014

Medicare bill introduced in the U.S. House

ACA is proud to announce that for the first time in five years, a bill that calls for the reimbursement of Licensed Professional Counselors by Medicare has been introduced in the United States House of Representatives.

Representative Chris Gibson (R-NY) recently introduced H.R. 3662, the “Mental Health Access Improvement Act”, a companion bill to S. 562.  Representative Mike Thompson (D-CA) served as the co-sponsor of the bill.

Representative Gibson stated that, “This legislation provides an important expansion of mental health access for Medicare recipients.  By adding thousands of highly qualified licensed mental health counselors and marriage and family therapists to the provider network, the bill ensures continuity of care without adding new services or altering the scope of practice.”

Thanks to Representative Gibson’s work and his initiative, we are one step closer towards our goal of Medicare reimbursement. In the coming months, your Government Affairs team will be working to promote this bill with our collation partners and other groups.

If you would like to review the legislation, you can do so by clicking by visiting:
thomas.loc.gov/home/thomas.php and searching for H.R. 3662 

WHAT YOU CAN DO

Please call or e-mail you Representative and ask them to co- sponsor H.R. 3662 the “Mental Health Access Improvement Act”. Let you Representatives know that this is a bi-partisan bill that has been supported by Republicans in the past, and is supported by both parties now. You can also let them know that private sector health plans have been covering counselors for many years.

WHAT YOU CAN DO

Please call or e-mail you Representative and ask them to co- sponsor H.R. 3662 the “Mental Health Access Improvement Act”. Let you Representatives know that this is a bi-partisan bill that has been supported by Republicans in the past, and is supported by both parties now. You can also let them know that private sector health plans have been covering counselors for many years.

Medicare is a federally adminstered program. Currently Federal laws do NOT allow LCPC or LPC to bill medicare for patient services. AMHCA, ACA and other national associations have been working for some time to pass legislation to change this. LCSW and Lic. Psychlogists can bill medicare for patient services.

Contact Us
Phone:
+1 (815) 787-0515
Email: myimhca@gmail.com

Address:
P.O. Box 706
DeKalb, IL 60115

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