[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
                                 ______