[Congressional Record Volume 145, Number 23 (Tuesday, February 9, 1999)]
[Extensions of Remarks]
[Page E170]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                  THE MEDICARE SOCIAL WORK EQUITY ACT

                                 ______
                                 

                        HON. FORTNEY PETE STARK

                             of california

                    in the house of representatives

                       Tuesday, February 9, 1999

  Mr. STARK. Mr. Speaker, I join with Representative Leach (R-Iowa) and 
22 of our colleagues to introduce the Medicare Social Work Equity Act 
of 1999 to ensure that clinical social workers can continue to receive 
reimbursement under Part B of Medicare.
  Due to changes in the Balanced Budget Act of 1997, clinical social 
workers can no longer bill Medicare under Part B for counseling and 
other professional mental health services. Under current law, clinical 
social workers must now seek reimbursement under the consolidated 
payment system. Unfortunately, the prospective payment system was not 
designed to cover ancillary services such as psychotherapy.
  If Congress does not amend the laws to allow separate billing for 
psychotherapy service, clinical social workers will not be able to 
provide much-needed mental health services to long-term care facility 
residents. Doing so will needlessly harm seniors because clinical 
social workers have the professional training and expertise to work 
with seniors as do psychologists and psychiatrists.
  If we fail to fix this problem, Medicate will pay more. The services 
of psychologists and psychiatrists cost more than the services of a 
clinical social worker. Currently, clinical social workers receive from 
Medicare only 75% of what would be paid to a psychologist or 
psychiatrist. In addition, many skilled nursing facilities operate in 
communities where psychologists and psychiatrists are not available to 
treat seniors in skilled nursing facilities.
  Our legislation excludes clinical social workers from the prospective 
payment system. This small fix corrects what we believe to be a serious 
error created by the Balanced Budget Act. It is time to act quickly and 
decisively to preserve access to needed counseling services for 
residents in thousands of our nation's long-term care facilities.

                                 H.R.--

       Be it enacted by the Senate and House of Representatives of 
     the United States of America in Congress assembled,

     SECTION 1. SHORT TITLE.

       This Act may be cited as the ``Medicare Social Work Equity 
     Act of 1999''.

     SEC. 2 EXCLUDING CLINICAL SOCIAL WORKER SERVICES FROM 
                   COVERAGE UNDER THE MEDICARE SKILLED NURSING 
                   FACILITY PROSPECTIVE PAYMENT SYSTEM AND 
                   CONSOLIDATED PAYMENT.

       (a) In General.--Section 1888(e)(2)(A)(ii) of the Social 
     Security Act (42 U.S.C. 1395yy(e)(2)(A)(ii)) is amended by 
     inserting ``clinical social worker services,'' after 
     ``qualified psychologist services,''.
       (b) Conforming Amendments.--Section 1861(hh)(2) of such Act 
     (42 U.S.C. 1395x(hh)(2)) is amended by striking ``and other 
     than services furnished to an inpatient of a skilled nursing 
     facility which the facility is required to provide as a 
     requirement for participation''.
       (c) Effective Date.--The amendments made by this section 
     apply as if included in the enactment of section 4432(a) of 
     the Balanced Budget Act of 1997.

     

                          ____________________