After more than a decade of working to secure Medicare coverage for counselors’ services, NBCC, the Medicare Mental Health Workforce Coalition, and counselors across the country can celebrate the passing of the omnibus package, which achieved our goal! The package, which includes language from the Mental Health Access Improvement Act (S. 828/H.R. 432) that expands coverage of mental health counselors (MHCs) and marriage and family therapists (MFTs) under Medicare Part B, was signed into law by President Biden on Dec. 29, 2022.
Coverage of MHCs and MFTs under Part B of the Medicare program will begin Jan. 1, 2024. Medicare is the largest health care program in the country, covering more than 55 million people. It currently recognizes psychiatrists, psychologists, clinical social workers, and psychiatric nurses for outpatient mental health services, and now counselors and MFTs will be added to the list. Because Medicare is the country’s flagship health care program, counselor inclusion is key to ensuring parity with other professions.
The Centers for Medicare & Medicaid Services (CMS) will now develop specific rules on how counselors can apply for provider status, receive a Provider ID number, and bill for services. The rules will be developed in 2023 ahead of the Jan.1, 2024, implementation.
The NBCC Government Affairs team will work in conjunction with CMS to develop these rules and inform counselors about the enrollment process.
On Dec. 29, 2022, the Consolidated Appropriations Act, 2023 (H.R. 2617) was signed into law by President Biden after a bipartisan vote of approval in both of the United States legislative chambers. Included in the omnibus package is language from the Mental Health Access Improvement Act (S. 828/H.R. 432), which has added mental health counselors to the list of Medicare providers. Coverage of counselors will begin Jan. 1, 2024.
S. 828/H.R. 432, the Mental Health Access Improvement Act of 2021, is introduced by Sen. John Barrasso (R-WY), Sen. Debbie Stabenow (D-MI), Rep. Mike Thompson (D-CA-5), and Rep. John Katko (R-NY-24).
The House Committee on Energy and Commerce reports S. 286/H.R. 945 favorably out of a markup, the first time the legislation has been included in a markup in 11 years.
In response to the COVID-19 pandemic, the Centers for Medicare & Medicaid Services issues a temporary emergency rule that allows mental health counselors working in Rural Health Centers and Federally Qualified Health Centers to be reimbursed by Medicare for telehealth services.
S. 286/H.R. 945 gains 123 cosponsors in the House and 31cosponsors in the Senate, the most in the bill's history.
S. 286/H.R. 945, the Mental Health Access Improvement Act of 2019, is introduced by Sen. John Barrasso (R-WY), Sen. Debbie Stabenow (D-MI), Rep. Mike Thompson (D-CA-5), and Rep. John Katko (R-NY-24).
The President's Interdepartmental Serious Mental Illness Coordinating Committee (ISMICC), an advisory body composed of federal officials and behavioral health experts, recommended inclusion of counselors in the Medicare program. please feel free to download and read the full report.
U.S. Sens. John Barrasso (R-WY) and Debbie Stabenow (D-MI) introduce S. 1879, the Seniors Mental Health Access Improvement Act of 2017, seeking to establish mental health counselors and marriage and family therapists as authorized Medicare providers.
U.S. Reps. John Katko (R-NY) and Mike Thompson (D-CA) introduce H.R. 3032, the Mental Health Access Improvement Act of 2017, seeking to establish mental health counselors and marriage and family therapists as authorized Medicare providers.
Representative Chris Gibson (R-NY) , Senator John Barrasso (R-WY) and counselor/MFT organizations pushed to include Medicare legislation in the pending mental health reform package.
Retiring Representative Chris Gibson (R‐NY) made it a priority to pass H.R. 2759 and added 10 Republican cosponsors to the bill (the most House Republicans ever), raising the total to 50 cosponsors.
Representative Robin Kelly (D-IL) introduced H.R. 5475, the Health Equity and Accountability Act. H.R. 5475 was sponsored by the House Tri-Caucus and addresses health disparities for minority populations.
Senators John Barrasso (R‐WY) and Debbie Stabenow (D‐MI) introduced the Seniors Mental Health Access Improvement Act (S 1830), a companion Bill to H.R. 2759.
Congressmen Chris Gibson (R‐NY) and Mike Thompson (D‐CA) introduced H.R. 2759, The Mental Health Improvement Act of 2015. The bill provides Medicare reimbursement for counselors and MFTs, mirroring bills introduced in prior sessions.
On Dec. 29, 2022, the Consolidated Appropriations Act (H.R. 2617) was signed into law by President Biden after a bipartisan vote of approval in both of the United States legislative chambers. Included in the omnibus package is language from the Mental Health Access Improvement Act (S. 828/H.R. 432) adding mental health counselors as providers. Coverage of counselors will begin Jan. 1, 2024.
Congressmen John Katko (R-NY) and Mike Thompson (D-CA) introduced H.R. 3032, the Mental Health Access Improvement Act, on June 23. Senators John Barrasso (R-WY) and Debbie Stabenow (D-MI) introduced a companion bill in the Senate, S.1879, the Seniors Mental Health Access Improvement Act, on September 27.
Companion stand-alone bills S. 1830, the Seniors Mental Health Access Improvement Act of 2015, and H.R. 2759, the Mental Health Access Improvement Act, are introduced by Sens. John Barrasso (R-WY) and Debbie Stabenow (D-MI) and Reps. Chris Gibson (R-NY) and Mike Thompson (D-CA). The House TriCaucus health disparities bill, H.R. 5475, is introduced by Rep. Robin Kelly (D-IL).
Sen. Ron Wyden (D-OR) introduces stand-alone bill S. 604, the Seniors Mental Health Access Improvement Act of 2011. The MHC and MFT language is also included in S. 1680, the Craig Thomas Rural Hospital and Provider Equity Act of 2011, introduced by Sens. John Barrasso (R-WY), Pat Roberts (R-KS), Kent Conrad (D-ND) and Tom Harkin (D-IA).
Sen. Ron Wyden (D-OR) introduces stand-alone bill S. 604, the Seniors Mental Health Access Improvement Act of 2011. The MHC and MFT language is also included in S. 1680, the Craig Thomas Rural Hospital and Provider Equity Act of 2011, introduced by Sens. John Barrasso (R-WY), Pat Roberts (R-KS), Kent Conrad (D-ND) and Tom Harkin (D-IA).
The provision is re-introduced in companion stand-alone bills S. 671 and H.R. 1693 by Sens. Blanche Lincoln (D-AR) and John Barrasso (R-WY) and Rep. Bart Gordon (D-TN). The provision is included in H.R. 3200, the House reform legislation that passed the Energy and Commerce, Ways and Means, and Education and Labor Committees. The language passes the House as part of the health reform bill (H.R. 3962). The provision was reportedly in the final House-Senate compromise legislation until the election of Sen. Scott Brown (R-MA) changed the Senate balance.
Companion stand-alone bills S. 921 and H.R. 1588 are introduced by Sens. Craig Thomas (R-WY) and Blanche Lincoln (D-AR) and Rep. Barbara Cubin (R-WY). Rep. Pete Stark (D-CA) includes the MHC and MFT language in his omnibus Medicare mental health bill (H.R. 1663). The provision passes the House as part of the SCHIP Reauthorization Act (H.R. 3162). The Senate declines to consider the SCHIP bill.
In addition to companion bills S. 784 and H.R. 5324, introduced by Sens. Craig Thomas (R-WY) and Blanche Lincoln (D-AR) and Rep. Barbara Cubin (R-WY), the MHC and MFT provision is again included in the omnibus Medicare mental health bill (S. 927 and H.R. 1946) and the Medicare rural access bills (S. 3500 and H.R. 6030). The provision passes the Senate as part of the Deficit Reduction Act of 2005 (S. 1932) but does not make it through conference.
Sen. Craig Thomas (R-WY) introduces S. 310 as a stand-alone bill. The language is also included in the omnibus Medicare mental health bill (S. 646) and the omnibus Medicare rural access bill (S. 1185 and H.R. 2333). In 2003, the provision passes the Senate in the Medicare prescription drug bill (S. 1) but is not accepted during conference.
The provision to provide reimbursement for MHCs and MFTs in the Medicare program is introduced as stand-alone bill S.1760 by Sens. Craig Thomas (R-WY) and Blanche Lincoln (D-AR). The companion bill, H.R. 3899, is subsequently introduced on the House side by Rep. Brad Carson (D-OK). The same provision is additionally included in an omnibus Medicare mental health bill (S. 690 and H.R. 1522), but does not make it out of committee.
Through the collaborative efforts of the coalition, we have achieved counselor inclusion in the Medicare program. Other members of the coalition are:
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