[Congressional Record Volume 159, Number 37 (Thursday, March 14, 2013)]
[Senate]
[Pages S1855-S1856]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
By Mr. WYDEN (for himself, Mr. Barrasso, and Mr. Merkley):
S. 562. 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.
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 as covered providers within the Medicare
program. 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 Corps, the Veteran's Administration and TRICARE, already
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
commonsense approach to relieving a persistent and chronic healthcare
workforce shortage.
Finally, I commend our mental health professionals nationwide, for
their dedicated work and efforts, and I encourage passage of this
legislation.
Mr. President, I ask unanimous consent that the text of the bill be
printed in the Record.
There being no objection, the text of the bill was ordered to be
printed in the Record, as follows:
S. 562
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 ``Seniors Mental Health Access
Improvement Act of 2013''.
SEC. 2. COVERAGE OF MARRIAGE AND FAMILY THERAPIST SERVICES
AND MENTAL HEALTH COUNSELOR SERVICES UNDER PART
B OF THE MEDICARE PROGRAM.
(a) Coverage of Services.--
(1) In general.--Section 1861(s)(2) of the Social Security
Act (42 U.S.C. 1395x(s)(2)) is amended--
(A) in subparagraph (EE), by striking ``and'' after the
semicolon at the end;
(B) in subparagraph (FF), by inserting ``and'' after the
semicolon at the end; and
(C) by adding at the end the following new subparagraph:
``(GG) marriage and family therapist services (as defined
in subsection (iii)(1)) and mental health counselor services
(as defined in subsection (iii)(3));''.
(2) Definitions.--Section 1861 of the Social Security Act
(42 U.S.C. 1395x) is amended by adding at the end the
following new subsection:
``Marriage and Family Therapist Services; Marriage and Family
Therapist; Mental Health Counselor Services; Mental Health Counselor
``(iii)(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 2
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 and family therapists, is licensed or certified as a
marriage and family therapist in such State.
``(3) The term `mental health counselor services' means
services performed by a mental health counselor (as defined
in paragraph (4)) for the diagnosis and treatment of mental
illnesses which the mental health counselor is legally
authorized to perform under State law (or the State
regulatory mechanism provided by the State law) of the State
in which such services are performed, as would otherwise be
covered if furnished by a physician or as 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.
``(4) The term `mental health counselor' means an
individual who--
``(A) possesses a master's or doctor's degree in mental
health counseling or a related field;
``(B) after obtaining such a degree has performed at least
2 years of supervised mental health counselor practice; and
``(C) in the case of an individual performing services in a
State that provides for licensure or certification of mental
health counselors or professional counselors, is licensed or
certified as a mental health counselor or professional
counselor in such State.''.
(3) Provision for payment under part b.--Section
1832(a)(2)(B) of the Social Security 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 (as defined in
section 1861(iii)(1)) and mental health counselor services
(as defined in section 1861(iii)(3));''.
(4) Amount of payment.--Section 1833(a)(1) of the Social
Security Act (42 U.S.C. 1395l(a)(1)) is amended--
(A) by striking ``and (Z)'' and inserting ``(Z)''; and
(B) by inserting before the semicolon at the end the
following: ``, and (AA) with respect to marriage and family
therapist services and mental health counselor services under
section 1861(s)(2)(GG), 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 subparagraph (L)''.
(5) Exclusion of marriage and family therapist services and
mental health counselor services from skilled nursing
facility prospective payment system.--Section
1888(e)(2)(A)(ii) of the Social Security Act (42 U.S.C.
1395yy(e)(2)(A)(ii)) is amended by inserting ``marriage and
family therapist services (as defined in section
1861(iii)(1)), mental health counselor services (as defined
in section 1861(iii)(3)),'' after ``qualified psychologist
services,''.
(6) Inclusion of marriage and family therapists and mental
health counselors as practitioners for assignment of
claims.--Section 1842(b)(18)(C) of the Social Security Act
(42 U.S.C. 1395u(b)(18)(C)) is amended by adding at the end
the following new clauses:
``(vii) A marriage and family therapist (as defined in
section 1861(iii)(2)).
``(viii) A mental health counselor (as defined in section
1861(iii)(4)).''.
(b) Coverage of Certain Mental Health Services Provided in
Certain Settings.--
(1) Rural health clinics and federally qualified health
centers.--Section 1861(aa)(1)(B) of the Social Security Act
(42 U.S.C. 1395x(aa)(1)(B)) is amended by striking ``or by a
clinical social worker (as defined in subsection (hh)(1))''
and inserting ``, by a clinical social worker (as defined in
subsection (hh)(1)), by a marriage and family therapist (as
defined in subsection (iii)(2)), or by a mental health
counselor (as defined in subsection (iii)(4))''.
(2) Hospice programs.--Section 1861(dd)(2)(B)(i)(III) of
the Social Security Act (42 U.S.C. 1395x(dd)(2)(B)(i)(III))
is
[[Page S1856]]
amended by inserting ``, marriage and family therapist, or
mental health counselor'' after ``social worker''.
(c) Authorization of Marriage and Family Therapists and
Mental Health Counselors To Develop Discharge Plans for Post-
Hospital Services.--Section 1861(ee)(2)(G) of the Social
Security Act (42 U.S.C. 1395x(ee)(2)(G)) is amended by
inserting ``, including a marriage and family therapist and a
mental health counselor who meets qualification standards
established by the Secretary'' before the period at the end.
(d) Effective Date.--The amendments made by this section
shall apply with respect to services furnished on or after
January 1, 2014
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