Milestone for Medicare Payments

Supporters of NASW’s advocacy efforts celebrated a milestone victory in July when the U.S. Senate and House overrode President Bush’s veto of Medicare legislation, H.R. 6331, that restores funding for clinical social work payments cut in 2007.

NASW Executive Director Elizabeth J. Clark said she wanted to thank the thousands of NASW members who took the time to contact their senators and representatives to support passage of the bill vital to clinical social workers.

“NASW is thrilled that mental health services are finally receiving full recognition by this Congress,” Clark said.

The bill, known as the Medicare Improvements for Patients and Providers Act of 2008, was designed primarily to halt a scheduled 10.6 percent cut in all Part B provider payment rates. The new law also contains little-noticed mental health coverage improvements, according to James Finley, NASW senior government relations associate. Among the positive changes are a rate increase for clinical social workers billing Part B and a critical Medicare coinsurance parity provision, which reduces beneficiary cost-sharing by 5 percent per year until it reaches 20 percent in 2014.

“Given strong pressure from the White House to narrow the bill, this is a huge victory for clinical social workers and psychologists who worked hard to restore psychotherapy rates in Medicare,” Finley said. “The sentiment of mental health advocates on final passage was exuberant, as this is a major victory on Medicare’s outpatient mental health benefit.”

Finley noted that clinical social worker and psychology rates will increase for psychotherapy and related services by 5 percent for 18 months from July 1, 2008 through Dec. 31, 2009. The psychotherapy rate increase is above the rate given to other medical services under Part B, which all clinicians, including social workers, will receive, Finley said.

The new law also provides Medicare coinsurance parity on mental health services, reducing beneficiaries’ copayments by 5 percent per year until reaching 20 percent in 2014, which will be full parity with Medicare outpatient benefits. This legislative goal has been supported by NASW and other mental health advocates since Medicare was enacted in 1965, Finley said. In addition, the law postpones a rate cut for 18 months beginning July 1, 2008, and increases payments for all providers by 1.1 percent for 2009, including clinical social workers participating in Part B.