MEDICARE PROVIDER BILL UPDATE

S. 1605 and S.1893

Ahh, it’s summer and many of us are on vacation. While we rest by the beach our future is being threatened and we only have a moment to act.

The House of Representatives passed H.R. 3162, the “Children’s Health and Medicare Protection (CHAMP) Act of 2007,” legislation to reauthorize and strengthen the State Children’s Health Insurance Program (SCHIP). A bill which does many things, and many of them positive. However, it also provides Medicare Provider status for the rest of the mental health profession except Masters Degreed Psychologists. If this bill is signed into law Mental Health Counselors (LMHC’s) and Marriage and Family Therapists (LMFT’s) will be added to the list of providers who will be able to directly bill Medicare. Only Masters Degreed Psychologists will be excluded from providing services to those who are insured by Medicare, the majority of the elderly and many of the disabled in our country.

On the Senate side there are two important bills. The twin to H.R. 3162, S. 1893 and S. 1605

S. 1605 A bill to amend title XVIII of the Social Security Act to protect and preserve access of Medicare beneficiaries in rural areas to health care providers under the Medicare program, and for other purposes was last acted on in June when it was referred to Finance. This bill also makes LMFT’s and LMHC’s Medicare providers and excludes Masters Degreed Psychologists. S. 1605 is authored by Senator Kent Conrad of North Dakota and has 22 co-sponsors listed below:

CO-SPONSORS
Sen Bingaman, Jeff [NM]
Sen Cantwell, Maria [WA]
Sen Collins, Susan M. [ME]
Sen Domenici, Pete V. [NM]
Sen Dorgan, Byron L. [ND]
Sen Enzi, Michael B. [WY]
Sen Hagel, Chuck [NE]
Sen Harkin, Tom [IA]
Sen Inouye, Daniel K. [HI]
Sen Johnson, Tim [SD]
Sen Klobuchar, Amy [MN]
Sen Landrieu, Mary L. [LA]
Sen Lincoln, Blanche L. [AR]
Sen Murray, Patty [WA]
Sen Nelson, E. Benjamin [NE]
Sen Pryor, Mark L. [AR]
Sen Roberts, Pat [KS]
Sen Salazar, Ken [CO]
Sen Smith, Gordon H. [OR]
Sen Snowe, Olympia J. [ME]
Sen Stabenow, Debbie [MI]
Sen Thune, John [SD]

S 1893 An original bill to amend title XXI of the Social Security Act to reauthorize the State Children's Health Insurance Program, and for other purposes does not currently include this provision. However, at the close of the August recess, this could easily change as the Senate has been favorable to including LMFT’s and LMHC’s in the past. This bill was sponsored by Senator Max Baucus of Montana and currently has no co-sponsors.

It is time to come out of the water. We must all act now in these next two weeks.

Our congressional delegates are home for the month to hear from their constituents. If you have never chosen to be politically active before, please make this your first effort. If we loose this effort, our profession will suffer a tremendous blow and each of our identities as psychologists will be threatened. Conversely, if we succeed, we will have a great opportunity to build on. We should not let this slip out of our hands if we can help it.

If you live in a state that has independent practice for Masters Degreed Psychologists, contact your Senators today. Ask them to co-sponsor either S. 1605 or S. 1893 with changes that would include Masters Degreed Psychologists. Educate them about your education. Masters Degreed Psychologists have equal to and often more hours of training than LMFT’s or LMHC’s. If you live in a state with of one the co-sponsors listed above, contact these Senators today and ask them to request language changes that would include mental health clinicians licensed for independent practice by the state licensing board. Email is the most effective way to communicate with Congress. It’s fast, and it allows them to keep track of the numbers of constituents interested in a particular issue.

Make your voices heard!!!

You can link to the sample letter and proposed language here. Just edit the letter and email to the representatives in your state. The efforts of every Masters Psychologists in every state are needed to change this bill and afford us the same opportunity as other licensed mental health clinicians.

Sample Letter
Proposed Language

Licensed Masters Psychologists in Vermont live in a state that recognizes Masters and Doctorate level psychologists with parity. This has been long standing since the licensure requirements were written in the 1970s. In Vermont, Masters and Doctoratally degreed candidates for licensure have the same 4000 hour supervision requirement before taking the same exam. We are licensed for private practice and can direct bill insurance companies for services that we provide to their subscribers. However, Masters Psychologists in Vermont and around this country do not have that same opportunity with Medicare. Due to Medicare restrictions, those of us who have chosen to focus our practice on the elderly and disabled are limited to working only with clients who have other insurances or can afford to pay privately. In this group, the clients who fit these criteria are few.

In 2005, bill H. 1447 was co-sponsored by 28 Representatives from 18 states. This year’s version of the bill is H. 5324 and has been submitted by Rep. Barbara Cubin (R-WY). If this bill passes as is, Mental Health Counselors and Marriage and Family Therapists will be added to the list of providers who will be able to direct bill Medicare. Only Masters Psychologists will be excluded from providing services to those who are insured by Medicare, the majority of the elderly in our country. In the small state of Vermont, 223 licensed Masters Psychologists are not currently nor will we be able to provide mental health services directly to the majority of the aging and disabled population. Although Masters Psychologists are able to bill Medicaid, more and more recipients of this program are losing their eligibility and their only source of insurance is Medicare.

Earlier this year on the NAMP website, past-president Margaret Joyal asked all NAMP members to send letters of concern to their representatives, especially the co-sponsors of H. 5324. In July, all licensed Masters Psychologists in Vermont were mailed information making them aware of the situation and asking them to join together and contact their representatives in Washington. This mailing included a cover letter explaining the issues, a copy of the changes Joyal sent to Congressman Bernie Sanders (VT-I), one of the co-sponsors of last year’s bill, and a sample letter to send to all of our officials elected to represent Vermont in Washington.

Now, we’re asking all Masters Psychologists to join us in this effort and to send letters to your representatives, especially those who were co-sponsors of this bill. If the wording in this bill isn’t changed and the bill is passed we will be the ONLY mental health clinicians without the option of being Medicare providers.

COSPONSORS of H. 1447:

Rep Abercrombie, Neil [HI-1]
Rep Berman, Howard L. [CA-28]
Rep DeLauro, Rosa L. [CT-3]
Rep Ford, Harold E., Jr. [TN-9]
Rep Gordon, Bart [TN-6]
Rep Herseth, Stephanie [SD]
- Rep Hinchey, Maurice D. [NY-22]
Rep Honda, Michael M. [CA-15]
Rep Kennedy, Patrick J. [RI-1]
Rep Kildee, Dale E. [MI-5]
Rep LaHood, Ray [IL-18]
Rep Lewis, John [GA-5]
Rep McNulty, Michael R. [NY-
21] Rep Miller, George [CA-7]
Rep Napolitano, Grace F. [CA-3
8] Rep Olver, John W. [MA-1]
Rep Payne, Donald M. [NJ-10]
Rep Pickering, Charles W. (Chip) [MS-3]
Rep Reyes, Silvestre [TX-16]
Rep Ros-Lehtinen, Ileana [FL-18]
Rep Sanders, Bernard [VT]
Rep Smith, Christopher H. [NJ-4
] Rep Towns, Edolphus [NY-10]
Rep Walden, Greg [OR-2]
Rep Waxman, Henry A. [CA-30]
Rep Westmoreland, Lynn A. [GA-8]
Rep Wexler, Robert [FL-19]
Rep Wilson, Joe [SC-2]

As Joyal requested on the website forum, ‘If your rep is on this list please contact them and encourage them to change the language to "mental health clinicians licensed for independent practice by their state." if your representative is not on this list please write and call to ask them to oppose the language as written and suggest this alternative language. We have to get our voices heard on this subject.’

You can link to the information that was mailed to all of the licensed Masters Psychologists in Vermont in July. If your time is limited you can make a copy of any of this information and send or email to the representatives in your state. The efforts of every Masters Psychologists in every state are needed to change this bill and afford us the same opportunity as other licensed mental health clinicians.