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Legislative Advocacy

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New Legislation to Cover Mental Health Counseling Under Medicare

Co-Sponsors Needed--Contact Your Senators

On March 14, 2013, Senators Ron Wyden (D-OR) and John Barrasso (R-WY) reintroduced Medicare legislation covering the services of mental health counselors (MHCs) and marriage and family therapists (MFTs) under part B of the Medicare program. The time to promote Medicare recognition of MHCs and MFTs is now. Urge your U.S. Senators to support S.562, which would authorize MHCs and MFTs to be paid by Medicare for outpatient mental health services to beneficiaries. (To view the bill text and sponsor introductory comments in the Congressional Record, please click here and go to page S1853.)


Action Requested
OMHCA members are urged to email our two U.S. Senators and urge them to co-sponsor S.562, sponsored by Senators Ron Wyden and John Barrasso. The contact information for our Senators is:

Brown, Sherrod - (D - OH)
713 Hart Senate Office Building
Washington, DC 20510
(202) 224-2315
Contact: http://www.brown.senate.gov/contact/

Portman, Rob - (R - OH)
448 Russell Senate Office Building
Washington, DC 20510
(202) 224-3353
Contact:  https://www.portman.senate.gov/public/index.cfm/contact-form

A sample letter that can be sent to the Senators is included here on the OMHCA website.

Background and Justification

About 50 percent of rural counties have no practicing psychiatrists or psychologists. MHCs and MFTs are often the only mental health providers in many communities, yet they are not now recognized as covered providers within the Medicare program. These therapists have equivalent or greater training, education and practice rights as currently eligible provider groups that can bill for mental health services through Medicare.

Other government agencies already recognize these professions for independent practice, including The National Health Service Corps, the Dept. of Veterans' Affairs, and TRICARE. Medicare needs to utilize the skills of these providers to ensure that beneficiaries have access to these services.

  • Lack of Access in Rural and Underserved Areas—Approximately 77 million older adults live in 3,000 mental health professional shortage areas. Fully 50 percent of rural counties in America have no practicing psychiatrists, psychologists, or social workers. However, many of these mental health professional shortage areas have MHCs whose services are underutilized due to lack of Medicare coverage.
  • Medicare Inefficiency—Currently, Medicare is a very inefficient purchaser of mental health services. Inpatient psychiatric hospital utilization by elderly Medicare recipients is extraordinarily high when compared to psychiatric hospitalization rates for patients covered by Medicaid, VA, TRICARE, and private health insurance. One-third of these expensive inpatient placements are caused by clinical depression and addiction disorders that can be treated for much lower costs when detected early through the outpatient mental health services of MHCs.
  • Underserved Minority Populations—The United State Surgeon General noted in a report entitled "Mental Health: Culture, Race, and Ethnicity" that "striking disparities in access, quality, and availability of mental health services exist for racial and ethnic minority Americans." A critical result of this disparity is that minority communities bear a disproportionately high burden of disability from untreated or inadequately treated mental disorders.

Medicare provider eligibility for MHCs and MFTs is long overdue—These two professions represent over 40 percent of today's licensed mental health practitioners. Unfortunately, Medicare has not been modernized to recognize their essential contribution in today's health delivery system. Congressional scoring rules obscure the dollars saved by utilizing their services to treat mental health conditions before they exacerbate into more serious mental and physical disorders..  

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Sample Letter:

Subject: Please Support Medicare Coverage for MHCs & MFTs (S. 562)

Dear Senator _______:

I am a constituent, licensed mental health counselor and member of the American Mental Health Counselors Association. I strongly urge you to co-sponsor S. 562, the “Seniors Mental Health Access Improvement Act.” This bi-partisan legislation, sponsored by Senators Ron Wyden and John Barrasso, authorizes Medicare payment of outpatient psychotherapy services provided by mental health counselors (MHCs) and marriage and family therapists (MFTs). This bill has twice passed the House and the Senate, just not simultaneously.

The current exclusion of MHCs from treating Medicare beneficiaries often results in denial of vital mental health services to those in need. Some beneficiaries are fortunate and find a Medicare eligible provider; others never receive needed care, driving up costs and tragically increasing morbidity and mortality among beneficiaries with mental health needs.

Medicare provider eligibility for MHCs and MFTs is long overdue. These two professions represent over 40 percent of today’s licensed mental health practitioners. Unfortunately, Medicare has not been modernized to recognize their essential contribution in today’s health delivery system. Congressional scoring rules obscure the dollars saved by utilizing their services to treat mental health conditions before they exacerbate into more serious mental and physical disorders. Benefits of this bill include:

  • Improved mental health access for rural and underserved populations
  • Earlier and more efficient use of Medicare mental health benefits
  • Better integration of mental health and physical health care
  • Reduced cost of physical health care, particularly for chronic conditions

 

I urge you to co-sponsor S. 562 to help ensure Medicare beneficiaries obtain needed and timely mental health care.

 

Sincerely,

Name
Address

 

 

 

 

 

 

 

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