US House includes counselors in Medicare legislation

This is off the usual topic of this blog, but I want to note it anyway. The following news release just came via email from Beth Powell at AMHCA:

U.S. House Passes “Children’s Health and Medicare Protection Act,” Including Provision Establishing Medicare Coverage of Mental Health Counselors

August 1, 2007, was a historic day for the mental health counseling profession, as for the first time ever, the U.S. House of Representatives passed legislation to establish coverage of state-licensed mental health counselors under Medicare. The Medicare coverage provision was included in H.R. 3162, the “Children’s Health and Medicare Protection Act,” or CHAMP Act, a bill which seeks to increase access to health insurance for uninsured children and strengthen the Medicare program.

Passage of the provision has been a long standing goal of the American Mental Health Counselors Association (AMHCA), the American Counseling Association (ACA) and the National Board for Certified Counselors (NBCC). House passage of the counselor-coverage provision brings us a step closer to achieving this objective. The bill also eliminates the discriminatory 50% co-payment requirement for outpatient mental health services.

The primary focus of the legislation is to reauthorize and strengthen the State Children’s Health Insurance Program (SCHIP), which supports health insurance coverage for more than 6 million children whose families are low income but do not qualify for coverage under Medicaid. Unless legislation is enacted by September 30th to renew SCHIP, it will expire. H.R. 3162 would expand the program to cover 5 million children who would otherwise be uninsured, and allow states to keep pace with health care cost inflation and population growth. H.R. 3162 passed the House by a largely party-line vote of 225 to 204; all but 10 Democrats voted for the bill, and all but five Republicans voted against it.

The Senate is expected to pass their version of the SCHIP reauthorization bill-which does not include Medicare-related provisions-by the end of this week. Following Senate passage, a conference committee will be appointed to reconcile differences in the House and Senate legislation. Congress will then need to negotiate the legislation with President Bush, who has threatened to veto even the Senate’s more modest bill.

Even if the Medicare-related provisions are removed from the SCHIP legislation, Congress is expected to revisit Medicare soon in order to prevent cuts in physician payment rates scheduled to take effect by the end of the year.

I cut my teeth on advocacy for Medicare recognition in the early 90s when I discovered that my clinical counselor’s license in Ohio did not allow for Medicare reimbursement. Despite a similar scope of practice to social workers and clinical psychologists, mental health counselors (and consequently clients who wanted to see counselors) were at a disadvantage without payment recognition from the Medicare program. Through the 1990s, I helped negotiate recognition from private payers (managed care and insurance companies – e.g., Magellan Healthcare) for counselors but the Federal programs have remained difficult to enter. The Senate may yet add the provision or it may be added during conference. We have been close before but I do not think we have been this close.