GOVERNMENT RELATIONS ACTION ALERT
Senate & House Cosponsors Needed for the Clinical Social Work Medicare Equity Act of 2001
June 1, 2001
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Clinical Social Work Medicare Equity Act
The CSWMEA, formerly known as the Medicare Social Work Equity
Act, was reintroduced for the 107th Congress on June 21, 2001.
All bills that have not been passed and signed into law by the end of each
Congress (the 106th Congress ended in December 2000) must be
reintroduced in the next Congress in order to remain viable.
It’s to rectify the problem that clinical social workers in some
areas of the United States are being denied Medicare Part B reimbursement for
psychotherapy services furnished to skilled nursing facility
patients.
In the Senate, the primary sponsor of the CSWMEA is social
worker Senator Barbara Mikulski (D-MD) one of the two social workers
currently serving in the Senate. There are six other cosponsors:
Senator Lincoln Chafee (R-RI), Senator Jeff Bingaman (D-NM), Senator
Daniel K. Inouye (D-HI), Senator Tim Johnson (D-SD), Senator Patty Murray
(D-WA), and Senator Harry M. Reid (D-NV), Senator Debbie Stabenow (D-MI) [a
social worker], and Senator Ron Wyden (D-OR).
In the House of Representatives, there are two primary
cosponsors, Representative Pete Stark (D-CA) and Representative Jim Leach
(R-IA). There are 25 other cosponsors: Representative Neil
Abercrombie (D-HI), Representative John Baldacci (D-ME), Representative Tammy
Baldwin (D-WI), Representative Dave Bonior (D-MI), Representative Sherrod Brown
(D-OH), Representative Bob Clement (D-TN), Representative William Coyne (D-PA),
Representative Susan Davis (D-CA) [a social worker], Representative Peter
DeFazio (D-OR), Representative Michael Doyle (D-PA), Representative Lane Evans
(D-IL), Representative Barney Frank (D-MA) Representative Martin Frost (D-TX),
Representative Maurice Hinchey (D-NY), Representative Sheila Jackson-Lee (D-TX),
Representative Dale Kildee (D-MI), Representative Barbara Lee (D-CA) [social
worker], Representative James McGovern (D-MA), Representative Cynthia McKinney
(D-GA), Representative Michael McNulty (D-NY) , Representative Marty Meehan
(D-MA), Representative Gregory Meeks (D-NY), Representative David Price (D-NC),
Representative Lynn Rivers (D-MI), Representative Ciro Rodriguez (D-TX) [social
worker], Representative Janice Schakowsky (D-IL), Representative
John Tierney (D-MA), and Representative Ed Towns (D-NY) [social
worker].
Senate version of the bill has been referred to the Finance
Committee and the House version was sent to the Ways and means Committee where
it was directed to the Subcommittee on
Health. |
THE ISSUE AT HAND
Unlike psychiatrists and psychologists, as of April 1, 2001, clinical social
workers (CSWs) were no longer permitted to bill Medicare Part B directly for
services rendered to Skilled Nursing Facility patients. U.S. Representatives
Pete Stark (D-CA) and Jim Leach (R-IA) and Senator Barbara Mikulski (D-MD) in
the U.S. Senate have taken the lead on legislation that would rectify this
inequity. The Clinical Social Work Medicare Equity Act of 2001 would restore the
ability of clinical social workers to bill Medicare Part B directly for services
furnished to Skilled Nursing Facility patients.
ACTION NEEDED
NASW needs its members to contact their Representative and Senators and ask
them to cosponsor this legislation. We have provided a draft letter on Congress
Web for members to email, fax, or mail to their Members of Congress. Your
advocacy on this issue is critical to helping get this piece of legislation
through the House and Senate.
If you need further information regarding this issue, please contact Debbie J. Allen, NASW National Field Organizer at dallen@naswdc.org.
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TIMING
It is estimated that this legislation will not be introduced until late June.
The sponsors of this legislation would like to acquire original cosponsors from
all parties in the House and Senate before introduction to help push the Bill.
BACKGROUND
CSWs treat and diagnose mental illness in the same manner as psychiatrists,
psychologists, and psychiatric clinical nurse specialists. In order to practice,
a clinical social worker must be awarded a master’s degree in social work,
complete roughly 3000 hours of supervised post-master’s experience in a clinical
setting, and obtain a state license or certification at the state level. CSWs
are often independent providers that provide roughly 60% of the mental health
services in the nation, often in the private practice setting.
Through the creation of the Prospective Pay System and Consolidated Billing
for Medicare, Section 4432 of the Balanced Budget Act of 1997 abolished the
ability of CSWs to bill directly for psychotherapy services rendered to Skilled
Nursing Facility patients. However, psychiatrists and psychologists are
statutorily exempt for the Consolidated Billing requirement while CSWs are not.
Due to the Health Care Financing Administration system limitations, the
implementation of this particular change was delayed until April 1, 2001.
The National Association of Social Workers (NASW) believes that Congress did
not intend to bundle mental health services with other medical-social services
under the Consolidated Billing system, as demonstrated by the exclusion of
psychiatrist and psychologists. Since 1998, NASW has been seeking a statutory
change to add CSWs to the list of providers excluded from Consolidated Billing,
which would provide a permanent solution to this problem.
In the last two Congresses this legislation was introduced as the Medicare
Social Work Equity Act. NASW is fighting this battle again in the
107th Congress through the introduction and support of the Clinical
Social work Medicare Equity Act of 2001, which is identical to the prior
legislation except for the title.
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