110 HR 820 IH: To amend title XVIII of the Social Security Act to
U.S. House of Representatives
2007-02-05
text/xml
EN
Pursuant to Title 17 Section 105 of the United States Code, this file is not subject to copyright protection and is in the public domain.
1.This Act may be cited as the Seniors
Mental Health Access Improvement Act of 2007
.
2.Congress finds the following:
(1)Symptoms of
depression are displayed by 37 percent of seniors (individuals ages 65 and
over) in the United States.
(2)The suicide rate
for seniors is higher than such rate for other age groups in the United
States.
(3)Many Medicare
beneficiaries lack access to mental health services because mental health
providers do not furnish services in many medically underserved communities in
which such beneficiaries inhabit.
(4)Marriage and
family therapists are the only core mental health professionals recognized by
the Department of Health and Human Services but not recognized by the Medicare
program for purposes of coverage of services provided by such professionals and
reimbursement for such services. Psychiatrists, clinical psychologists,
clinical social workers, and psychiatric nurses are recognized Medicare
providers.
(5)Out of all counties
in the United States, nearly 75 percent of such counties do not have
psychiatrists, 58 percent of such counties do not have clinical social workers,
and 50 percent of such counties do not have psychologists with a professional
degree to serve their population. Marriage and family therapists provide
critical, cost-effective mental health services for populations that have no
other mental health providers.
(6)The shortage of
mental health providers who participate in the Medicare program is a result of
the Medicare program not covering the services of the 50,0000 licensed marriage
and family therapists.
(7)Many marriage and family therapists work in
medically underserved communities. Twenty-five percent of patients are ethnic
minorities and in 2006, 27 percent of marriage and family therapy students were
ethnic minorities, a percentage that continues to increase annually.
(8)There are 25
percent more marriage and family therapists than psychiatrists in rural
counties, and in the most rural areas, there are twice as many marriage and
family therapists than psychiatrists.
(9)Medicare coverage of marriage and family
therapy services can increase Medicare beneficiaries' access to mental health
care in rural areas.
3.Coverage of
marriage and family therapist services under part B
(a)Section 1861(s)(2) of the Social Security Act (42 U.S.C. 1395x(s)(2)) is
amended—
(1)in subparagraph
(Z), by striking and
at the end;
(2)in subparagraph
(AA), by striking the period at the end and inserting ; and
;
and
(3)by adding at the
end the following new subparagraph:
(BB)marriage and
family therapist services (as defined in subsection
(ccc)(1));
.
(b)Section
1861 of such Act (42 U.S.C. 1395x) is amended by adding at the end thereof the
following new subsection:
(ccc)Marriage and family
therapist services(1)The term marriage
and family therapist services means services performed by a marriage and
family therapist (as defined in paragraph (2)) for the diagnosis and treatment
of mental illnesses, which the marriage and family therapist is legally
authorized to perform under State law (or the State regulatory mechanism
provided by State law) of the State in which such services are performed, as
would otherwise be covered if furnished by a physician or as an incident to a
physician’s professional service, but only if no facility or other provider
charges or is paid any amounts with respect to the furnishing of such
services.
(2)The term marriage and family
therapist means an individual who—
(A)possesses a master’s or doctoral
degree which qualifies for licensure or certification as a marriage and family
therapist pursuant to State law;
(B)after obtaining such degree has
performed at least two years of clinical supervised experience in marriage and
family therapy; and
(C)in the case of an individual
performing services in a State that provides for licensure or certification of
marriage or family therapists, is licensed or certified as a marriage and
family therapist in such
State.
.
(c)Provision for
payment under part BSection 1832(a)(2)(B) of such Act (42 U.S.C.
1395k(a)(2)(B)) is amended by adding at the end the following new
clause:
(v)marriage and
family therapist
services;
.
(d)Section 1833(a)(1) of such Act (42 U.S.C. 13951(a)(1)) is
amended—
(1)by striking
and (V)
and inserting (V)
; and
(2)by inserting
before the semicolon at the end the following: , and (W) with respect to
marriage and family therapist services under section 1861(s)(2)(BB), the
amounts paid shall be 80 percent of the lesser of the actual charge for the
services or 75 percent of the amount determined for payment of a psychologist
under clause (L)
.
(e)Exclusion of
marriage and family therapist services from skilled nursing facility
prospective payment systemSection 1888(e)(2)(A)(ii) of such Act
(42 U.S.C. 1395yy(e)(2)(A)(ii)) is amended by inserting marriage and
family therapist services,
after qualified psychologist
services,
.
(f)Inclusion of
marriage and family therapists as practitioners for assignment of
claimsSection 1842(b)(18)(C) of such Act (42 U.S.C.
1395u(b)(18)(C)) is amended by adding at the end the following new
clause:
(vii)A marriage and family therapist (as
defined in section
1861(ccc)(2)).
.
4.Coverage of
marriage and family therapist services provided in certain settings
(a)Section 1861(aa)(1)(B) of the
Social Security Act (42 U.S.C.
1395x(aa)(1)(B)) is amended by inserting , by a marriage and family
therapist (as defined in subsection (ccc)(2)),
after by a
clinical psychologist (as defined by the Secretary)
.
(b)Section 1861(dd)(2)(B)(i)(III) of such Act (42 U.S.C.
1395x(dd)(2)(B)(i)(III)) is amended by inserting or marriage and family
therapist (as defined in subsection (ccc)(2))
after social
worker
.
5.Authorization of
marriage and family therapists to develop discharge plans for post-hospital
servicesSection
1861(ee)(2)(G) of the Social Security
Act (42 U.S.C. 1395x(ee)(2)(G)) is amended by inserting
marriage and family therapist (as defined in subsection
(ccc)(2)),
after social worker,
.
6.The amendments made by
this Act apply with respect to services furnished on or after January 1,
2008.