Pennsylvania Mental Health Counselors Association

The Affordable Care Act passed by Congress and signed by President Obama this year will provide you and your family greater savings and increased quality health care. It will also ensure accountability throughout the health care system so that you, your family, and your doctor—not insurance companies—have greater control over your care.

These are needed improvements that will keep Medicare strong and solvent. Your guaranteed Medicare benefi ts won’t change—whether you get them through Original Medicare or a Medicare Advantage plan. Instead, you will see new benefi ts and cost savings, and an increased focus on quality to ensure that you get the care you need.

This brochure provides you with accurate information about the new services and benefi ts to help you and your family now and in the future. The Centers for Medicare & Medicaid Services (the federal agency that runs the Medicare, Medicaid, and Children’s Health Insurance Program) will continue to provide you with up-to-date information about these new benefi ts and will ensure that your personal information is safe.

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ACA/AMHCA/NBCC Update: Senate Bill Introduced on TRICARE Independent Practice Authority

The counseling profession took a significant step forward with the introduction of Senate legislation (S. 3371) that will make it easier for TRICARE beneficiaries to see a professional mental health counselor. TRICARE is the health care system for service members and their dependents, and licensed professional counselors are the only mental health professionals still required by law to see beneficiaries following physician referral and under physician supervision.

Senators Joseph Lieberman (I-CT), Claire McCaskill (D-MO) and Susan Collins (R-ME) jointly introduced the “TRICARE Mental Health Care Access Act,” S. 3371 to allow licensed professional counselors to independently treat and diagnose TRICARE beneficiaries. The American Mental Health Counselors Association, the American Counseling Association and the National Board for Certified Counselors applaud the senators for sponsoring this legislation, as it is a much-needed step forward in giving TRICARE beneficiaries better access to highly skilled outpatient mental health professionals. Our three organizations are working closely together to gain the enactment of legislative language providing counselors independent practice rights as part of this year’s National Defense Authorization Act (NDAA).

Introduction of S. 3371 comes on the heels of a recently released Institute of Medicine (IOM) report that recommends independent practice of mental health counselors in TRICARE. The Institute of Medicine’s report, titled “Provision of Mental Health Counseling Services under TRICARE,” was conducted pursuant to a request by Congress contained in the National Defense Authorization Act for Fiscal Year 2008. The IOM panel recommended granting independent practice authority for counselors who have: A master’s (or higher) degree in mental health counseling from a program accredited by the Council for Accreditation of Counseling and Related Education Programs (CACREP); Obtained state licensure in mental health counseling at the “clinical” or highest level available;

Passed the National Clinical Mental Health Counselor Examination (NCMHCE);
and
Have a well-defined scope of practice sufficient to permit a counselor to see TRICARE beneficiaries absent primary care physician supervision and referral.

Representatives Tom Rooney (R-FL) and Mike McMahon (D-NY) introduced a similar bill, H.R. 3839, last October. The Rooney-McMahon legislation would let any counselor participating in the TRICARE program practice independently, just like clinical social workers and marriage and family therapists have done for years. The legislation is currently being cosponsored by Reps. Bordallo (GU), Courtney (CT), Israel (NY), Jones (NC), Kilpatrick (MI), McMorris Rodgers (WA), Rodriguez (TX) and Shuster (PA).

AMHCA, ACA, and NBCC are working with members of the House and Senate Armed Services Committees to gain adoption of legislative language based on H.R. 3839 and S. 3371 as part of the defense authorization legislation being considered over the coming weeks. We urge counselors to contact their representatives to ask them to cosponsor H.R. 3839, and to contact senators to ask for cosponsorship of S. 3371. The more cosponsors we have on the legislation, the greater our chances of establishing independent practice authority for as many counselors as possible within the TRICARE system.

For more information, contact Scott Barstow with ACA’s public policy office, at 800-347-6647 x234, email: sbarstow@counseling.org.

NCC ALERT Health Reform Passes without Counselor Medicare Language
March 22, 2010

On Sunday, March 21, the House of Representatives passed the Senate health care reform bill, sending it to President Obama for signature. While language adding counselors to the list of Medicare providers made it through a preliminary vote in the House Budget Committee, it didn’t survive compromise with the Senate in the Rules Committee, thus ending its chance for inclusion in the final package.

NBCC, along with ACA, AMHCA, AAMFT, and CAMFT worked aggressively to get and keep our language in the reform package throughout the process. While the original House-passed legislation included our provision, the Senate bill did not. Development of the final product became a highly political process that hinged heavily on budgetary issues. Our cost was modest compared to the overall reform price tag, but all new spending was closely scrutinized and many similar provisions did not make it through this screening--including the social work Medicare priority relating to skilled nursing facilities. Success of the reform package was uncertain until the very end, when the House marshaled the votes to pass the Senate bill 219-212, along with a “reconciliation” bill on a vote of 220-211 that incorporates the House-Senate compromises. The reconciliation bill must still pass the Senate, but only 50 votes are required so approval is almost certain. Both measures will be sent to the President for signature.

While we did not succeed in final passage, we have again moved the ball even closer to the goal. We will continue our push for inclusion of Medicare counselor coverage in all relevant health care vehicles, and potential opportunities this year are already being rumored. Your advocacy efforts helped bring us to the brink of success and we hope you will keep up the calls and letters in our next big push. We cannot succeed without your help and will not stop until we get the ball across the goal line. If you have any questions, please contact NBCC at advocacy@nbcc.org.

Thank you for your support and perseverance.
Sincerely,
Dave Bergman
NBCC VP for Legal and External Affairs

Health Bill Fine Print—and Counselor Medicare Coverage—Comes Down to Final Hours

Later this week, House leaders will finalize a package of changes to make to the Senate’s version of health care reform legislation. We need Medicare coverage of licensed professional counselors to be included in this package!

Although ACA is working to get Medicare coverage of counselors included in the reconciliation package, this effort will not be successful unless members of Congress hear from counselors.

We need counselors from across the country to call their members of Congress and congressional leaders to ask for approval of health care legislation which includes Medicare coverage of medically-necessary outpatient mental health services provided by licensed professional counselors.

To find out who your members of Congress are—and find phone numbers for their offices and those for House Speaker Nancy Pelosi and Senate Majority Leader Harry Reid—go to ACA’s internet action center at capwiz.com/counseling.

Do you want to even the playing field between counselors and other master’s level mental health professionals? If so, it is imperative that we gain recognition under Medicare, and to gain recognition under Medicare it is imperative that counselors make their voices heard in Congress.

NOW IS OUR CHANCE!
For more information or to share your comments, contact:
Scott Barstow, Director of Public Policy and Legislation
American Counseling Association
5999 Stevenson Avenue Alexandria, VA 22304
703.823.9800, sbarstow@counseling.org, www.counseling.org