[Congressional Record Volume 157, Number 41 (Thursday, March 17, 2011)]
[Senate]
[Pages S1829-S1830]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. WYDEN (for himself, Mr. Barrasso, Mr. Brown of Ohio, Mr. 
        Inouye, Mr. Johnson of South Dakota, Mr. Begich, and Mr. 
        Durbin):
  S. 604. A bill to amend title XVIII of the Social Security Act to 
provide for the coverage of marriage and family therapist services and 
mental health counselor services under part B of the Medicare program, 
and for other purposes; to the Committee on Finance.
  Mr. WYDEN. Mr. President. I am honored to join my colleague from 
Wyoming, Senator John Barrasso, in introducing a bill essential to 
enhancing the delivery of mental health services to our senior 
citizens, The Seniors Mental Health Access Improvement Act of 2011. We 
are pleased to be joined by Sens. Sherrod Brown, Inouye, Tim Johnson, 
Begich, and Durbin in this effort.
  Currently, there are limitations on the types of mental health 
practitioners who may be reimbursed for services in the Medicare 
program. Our legislation permits mental health counselors and marriage 
and family therapists to bill Medicare for their services, and it pays 
them at the rate of clinical social workers. With this legislation, 
seniors will have more opportunities as part of their Medicare benefit 
to access professional mental health counseling assistance.
  Throughout the United States there are approximately 77 million older 
adults living in 3,000 so-called ``mental health profession shortage 
areas.'' Moreover, 50 percent of rural counties have no practicing 
psychiatrists or psychologists. Seniors living in these areas will be 
the primary beneficiaries of our efforts.
  Mental health counselors and marriage and family therapists are often 
the only mental health providers in some communities, and yet presently 
they are not recognized within the Medicare program appropriately. 
These therapists have equivalent or greater training, education and 
practice rights as some existing provider groups that can bill for 
their services through Medicare.
  Additionally, other government agencies, including The National 
Health Service Corp, the Veteran's Administration and TRICARE, already

[[Page S1830]]

recognize these mental health professionals and reimburse for their 
services. We need to utilize the skills of these providers and ensure 
that seniors have access to them. These professionals play a critical 
role in the delivery of our nation's mental health care.
  In Oregon, the passage of this legislation will focus the talents of 
over 2,000 additional, qualified providers on the mental health issues 
of one of our most vulnerable populations. This represents a common 
sense approach to relieving a persistent and chronic healthcare 
workforce shortage.
  I would also like to take a moment to recognize the contributions of 
one of our former colleagues in the Senate who led our efforts in the 
last Congress to pass similar legislation. Sen. Blanche Lincoln was a 
strong advocate for health policies that benefited seniors and those in 
rural areas. This bill is a testament to her decade long commitment to 
these issues and her unflagging support for those in need of mental 
health care in underserved areas.
  Finally, I commend our mental health professionals nationwide, for 
their dedicated work and efforts, and I encourage passage of this 
legislation.
  Mr. BARRASSO. Mr. President, I am honored to join my colleague from 
Oregon, Senator Ron Wyden, to introduce the Seniors Mental Health 
Access Improvement Act. For over a decade, Senator Wyden has been a 
strong voice advocating for rural specific health care policies here in 
the United States Senate. I am proud to join him as we fight to ensure 
Medicare patients living in rural and frontier states have access to 
and choice of mental health professionals.
  The Seniors Mental Health Access Improvement Act would permit 
Marriage and Family Therapists and Licensed Professional Counselors to 
bill Medicare directly for services. These providers would receive 75 
percent of the psychiatrist and psychologist rate for the same 
services. I want my colleagues to know that this legislation does not 
expand covered Medicare services. It would simply give Medicare 
patients living in isolated, frontier States like Wyoming more mental 
health provider choices.
  Today, approximately 75 percent of the over 3,000 nationally 
designated Mental Health Professional Shortage Areas are located in 
rural areas. Over half of all rural counties have no mental health 
services of any kind. Frontier counties have even more drastic numbers 
as 95 percent do not have a psychiatrist, 68 percent do not have a 
psychologist and 78 percent do not have a social worker.
  Virtually all of Wyoming is designated a mental health professional 
shortage area. Wyoming has approximately 215 psychologists, 37 
psychiatrists and 418 clinical social workers for a total of 670 
Medicare eligible mental health providers. Enactment of the Seniors 
Mental Health Access Improvement Act would almost double the number of 
mental health providers available to treat seniors in my State--with 
the addition of 659 licensed professional counselors and 83 marriage 
and family therapists currently licensed to practice.
  Medicare patients in Wyoming are often forced to travel long 
distances to see mental health providers currently recognized by the 
Medicare program. To make matters worse, rural and frontier communities 
have extreme difficulty recruiting and retaining providers, especially 
mental health providers. In many small towns, a Licensed Professional 
Counselor or a Marriage and Family Therapist is the only mental health 
care provider in the area. Medicare law--as it exists today--only 
compounds the situation because psychiatrists, clinical psychologists, 
clinical social workers, and clinical nurse specialists are the only 
providers able to bill Medicare for mental health services.
  It is time the Medicare program recognized the qualifications of 
Licensed Professional Counselors and Marriage and Family Therapists. 
They play a critical role in the Nation's mental health care delivery 
system. These providers go through rigorous training, similar to the 
curriculum of a masters level social worker, and yet are excluded from 
the Medicare program.
  I believe this bill is critically important to the health and well-
being of our nation's seniors, and I strongly urge all my colleagues to 
become a cosponsor.
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