GOVERNMENT RELATIONS ACTION ALERT
Senate & House Cosponsors Needed for the Clinical Social Work Medicare Equity Act of 2001
June 1, 2001
Clinical Social Work Medicare Equity ActThe 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.
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.