It’s time for Metro DC social workers to use their clout and expertise to ask Congressional Delegate Eleanor Holmes Norton to support and advocate for the Improving Access to Mental Health Act (S. 870/H.R. 2035) to reduce barriers to care! The reintroduced bipartisan act is crucial to modernizing Medicare mental health and ensuring that this major federal program can meet the pressing needs of millions of beneficiaries. Clinical social workers (CSWs) are the largest provider of mental health services in the nation and have been Medicare providers since 1989. However, due to the narrow, outdated definition of clinical social work and other regulatory factors, they aren’t able to practice at the top of their license, and their reimbursement rates are inadequate.

The legislation will

  • Increase Medicare Reimbursement Rates for CSWs: The bill increases the reimbursement rate from 75% to 85% of the psychologist fee schedule, thereby ensuring payment parity and equity.

  • Increase Access to Mental Health Services for Residents of Skilled Nursing Facilities (SNF): Currently, independent CSWs who are not employed by the SNF are unable to seek reimbursement under Medicare Part B for providing psychotherapy services to SNF residents receiving care under Medicare Part A. S. 870/H.R. 2035 would rectify this problem by excluding CSW services from SNF consolidated billing.

  • Increase Supports for Medicare Beneficiaries Coping with Physical Health Conditions: Although Health and Behavior Assessment and Intervention (HBAI) services are within the scope of practice for CSWs, Medicare only reimburses CSWs for the “diagnosis and treatment of mental illnesses.” S. 870/H.R. 2035 would broaden this narrow definition of CSW services to enable CSWs to receive Medicare reimbursement for HBAI services, which are cognitive, behavioral, social, and psychophysiological interventions to prevent, treat, and improve physical health and well-being.

Currently, the bills have 42 cosponsors in the House and five in the Senate. We need at least 175 cosponsors in the House and over 50 in the Senate to demonstrate broad support for the legislation and to elevate the bill for potential consideration before the Congressional committees of jurisdiction. Unfortunately, if we don’t secure enough cosponsors in this Congress, the bill will likely not advance through the legislative process and would need to be reintroduced in future Congresses.

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Please encourage Delegate Eleanor Holmes Norton to support and advocate for this legislation by responding to this NASW Action Alert. Reimbursement for services in Medicare substantially influence the rates paid by private-sector insurers. Many private insurers simply adopt Medicare’s levels of reimbursement to providers. For this reason, it is especially critical that members of Congress hear from social workers.