Improving access to essential mental health and behavioral health services for Medicare beneficiaries remains a top NASW policy priority. Medicare payment policy is routinely looked to as a minimum standard that guides both commercial and Medicaid payers as it relates to quality and reimbursement standards. Medicare sets provider reimbursement trends across the U.S. health care system, so disparities in its rate-setting process, which tend to undervalue mental health, behavioral health and substance use disorder services, are unfortunately replicated elsewhere. NASW continues to advocate for improved access to mental health and behavioral health services in Medicare.
NASW as part of a learning collaborative organized by the Legal Action Center (LAC) contributed to the development of the Modernize Medicare to Treat Substance Use Disorders: Roadmap for Reform, which outlines significant coverage gaps along with recommendations to strengthen Medicare. LAC is collecting stories to help improve Medicare coverage of substance use disorders (SUDs) and other behavioral health services and we encourage social workers and others to submit their experiences to LAC because we are using the stories in our advocacy in coalition.
Several recent developments at the federal level are encouraging and may increase the likelihood that much-needed changes in Medicare coverage and related access to mental health care could be on the horizon. On March 28 President Biden released the FY2023 Federal Budget, which includes historic unprecedented investments in mental and behavioral health, including aspirational goals that we have long advocated, like Medicare adhering to parity standards and implementing integrated care. On March 29, the Senate Finance Committee released its report highlighting stakeholder comments in response to its Request for Information (RFI) last fall, which was inclusive of the comments submitted by NASW to the Senate Finance Committee in response to their RFI.
On March 30, the Senate Finance Committee held a hearing on parity and behavioral health care integration. Senators and witnesses identified the need for parity in Medicare as well as the need to promote innovative integrative care models. NASW has endorsed bills such as the Collaborate in an Orderly and Cohesive Manner Act, which would further enable access to behavioral health services in primary care settings.
Additionally, the Government Accountability Office released a March 2022 report to the Senate Finance Committee on access barriers to behavioral health care, and the National Academies of Sciences, Engineering, and Medicine released a report entitled “The National Imperative to Improve Nursing Home Quality.” These publications and their recommendations support our advocacy.
This aforementioned activity coincides with ongoing work being done by the U.S. House and Senate developing mental health packages for consideration during the current Congress. These are potential vehicles for provisions of the Improving Access to Mental Health Act (S. 870/H.R. 2035) which is a social work-specific bill supported by NASW, that will increase clinical social worker reimbursement rate in Medicare and expand access to social work services in Medicare. The scope of practice for social workers in Medicare is limited and our relative reimbursement rates have not been adjusted for 33 years, since we became eligible to bill under Medicare. Medicare reimbursement rates have an impact on rates in commercial insurance and therefore its imperative that we increase cosponsors on S.870 and H.R 2035 and find ways to advance the bill.
We invite members to join us in our advocacy efforts to use our action alert
to urge your Senators and Representatives to cosponsor The Improving Access to Mental Health Act.