[Congressional Record Volume 147, Number 87 (Thursday, June 21, 2001)]
[Senate]
[Pages S6616-S6617]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Ms. MIKULSKI (for herself, Mr. Bingaman, Mrs. Murray, and Mr. 
        Inouye):
  S. 1083. A bill to amend title XVIII of the Social Security Act to 
exclude clinical social worker services from coverage under the 
Medicare skilled nursing facility prospective payment system; to the 
Committee on Finance.
  Ms. MIKULSKI. Mr. President, I rise today to introduce the Clinical 
Social Work Medicare Equity Act of 2001. I am proud to sponsor this 
legislation that will ensure that clinical social workers can receive 
Medicare reimbursement for the mental health services they provide in 
skilled nursing facilities. This bill will give clinical social workers 
parity with other mental health providers who are exempted from the 
Medicare Part B Prospective Payment System.
  Since my first days in Congress, I have been fighting to protect and 
strengthen the safety net for our Nation's seniors. Making sure that 
seniors have access to quality, affordable mental health care is an 
important part of this fight. I know that millions of seniors are not 
receiving the mental health services they need. For example, depression 
effects nearly 6 million seniors, but only one-tenth ever get treated. 
This is unacceptable. Protecting seniors' access to clinical social 
workers can help make sure that our most vulnerable citizens get the 
quality, affordable mental health care they need.
  Clinical social workers, much like psychologists and psychiatrists, 
treat and diagnose mental illnesses. In fact, clinical social workers 
are the primary mental health providers for many nursing home 
residents. But unlike other mental health providers, clinical social 
workers often cannot bill directly for the important services they 
provide to their patients. This bill will correct this inequity and 
make sure clinical social workers are paid for the valuable services 
they provide.
  Before the Balanced Budget Act of 1997, clinical social workers 
billed Medicare Part B directly for mental health services provided in 
nursing facilities to each patient they served. Under the new 
Prospective Payment System, services provided by clinical social 
workers are lumped, or ``bundled,'' along with the services of other 
health care providers for the purposes of billing and payments. 
Psychologists and psychiatrists, however, were exempted from this new 
system and continue to bill Medicare directly. This bill would exempt 
clinical social workers, like their mental health colleagues, from the 
Prospective Payment System, and would make sure that clinical social 
workers are paid for the services they provide to patients in skilled 
nursing facilities. The Medicare, Medicaid, and SCHIP Benefits 
Improvement and Protection Act addressed some of these concerns, but 
this legislation would remove the final barrier to ensuring that 
clinical social workers are treated fairly and equitably for the care 
they provide.
  This bill is about more than paperwork and payment procedures. This 
bill is about equal access to Medicare payments for the equal and 
important

[[Page S6617]]

work done by clinical social workers. And it is about making sure our 
Nation's most vulnerable citizens have access to quality, affordable 
mental health care. Without clinical social workers, many nursing home 
residents may never get the counseling they need when faced with 
illness or the loss of a loved one. I think we can do better by our 
Nation's seniors, and I'm fighting to make sure we do.
  The Clinical Social Work Medicare Equity Act of 2001 is strongly 
supported by the National Association of Social Workers and the 
Clinical Social Work Federation. I look forward to the Senate's support 
of this important legislation.
                                 ______