Senate & House Cosponsors Needed for the Clinical Social
Work Medicare Equity Act of 2003 (S. 343/H.R. 707) October 8, 2003 The Issue at Hand
Seniors are not getting the mental health services they need
because clinical social workers are excluded from billing
Medicare directly for psychotherapy services rendered in
skilled nursing facilities (SNFs).
Section 4432 of the Balanced Budget Act of 1997, through the
creation of the Prospective Pay System (PPS) for Medicare SNFs,
revoked clinical social workers’ ability to bill Medicare
directly for psychotherapy services rendered in the SNF setting.
Section 4432 fails to exempt clinical social workers from the
PPS, in contrast to physicians and psychologists, who are statutorily
exempt, and thus do not face such restrictions. The situation is further complicated by the fact that the
Centers for Medicare and Medicaid Services delegate most decision-making
on mental health services to the regional Medicare fiscal intermediaries
(FIs). Although some FIs continue to reimburse clinical social
workers for SNF patients, others do not. Therefore, it is often
the case in many areas of the country that clinical social
workers may no longer bill Medicare directly for psychotherapy
services in SNFs, even though they may bill Medicare independently
in other settings. The Clinical Social Work Medicare Equity Act of 2003?sponsored
by Reps. Pete Stark (D-CA) and Jim Leach (R-IA), along with
30 cosponsors, and by Sen. Barbara Mikulski (D-MD), along with
seven (7) cosponsors?would rectify this inequity. It would
restore the ability of clinical social workers to bill Medicare
Part B directly for services furnished to SNF patients nationwide.
ACTION NEEDED
- Contact your Republican senators and request that they
join Sen. Mikulski (D-MD) in supporting mental health services
for seniors by becoming cosponsors of S.343, the Clinical
Social Work Medicare Equity Act. NASW is targeting Republican
members
of the Senate Finance Committee. It is critical, however,
that all Republican senators are contacted!
Key senators to contact
Members of the Senate Finance Committee:
- Finance Committee Chairman Charles Grassley (R-IA)
- Sen. Olympia Snowe (R-ME)
- Sen. Gordon Smith (R-OR)
- Contact your Republican representatives and request
that they join Reps. Stark (D-CA) and Leach (R-IA) in
supporting
mental health services for seniors by becoming cosponsors
of H.R.707, the Clinical Social Work Medicare Equity
Act. NASW
is targeting Republican members of the House Ways and Means
and House Energy and Commerce Committees. It is critical,
however, that all Republican representatives are contacted!
Key representatives to contact
Members of the House Ways and Means Committee:
- Subcommittee on Health Chairman Nancy Johnson
(R-CT)
- Rep. Jim Ramstad (R-MN)
Members of the House Energy and Commerce
Committee:
- Subcommittee on Health Chairman Michael Bilirakis
(R-FL)
- Rep. Fred Upton (R-MI)
- Rep. James Greenwood (R-PA)
- Vice Chairman Charlie Norwood (R-GA)
- Rep. Heather Wilson (R-NM)
- Rep. John Shadegg (R-AZ)
- Rep. Mike Ferguson (R-NJ)
- Rep. Mike Rogers (R-MI)
CSWMEA Action Tool Kit
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