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.
The issue here which is really exciting is the potential end of discrimination in the psychotherapy profession. There are 10’s of thousands of highly skilled, deeply and broadly quailifed licensed counselors who are prevented from helping people simply because State or Federal Laws only approve certian types of professionals (who have VERY good lobbyists) even though the training is either identical or in some cases superior to the “approved” professionals. I can (and have) run circles around licensed psychologists in court, for example, but I am prevented from doing some things they do and can’t provide services to certain people (like military or veterans) because of discriminatory laws. IF and WHEN this happens, SO MANY people will be afforded expanded care and help. When stats indicate that 87% of visits to a primary care physician are stress related, can you imagine if ALL (not just some) of the qualified professionals could help people of all ages manage and reduce their stress what potential that wold have on the entire healtcare insurance industry in reducing the cost of insurance? THis is a VERY GOOD THING for everyone!
Oh, sorry; well, Medicaid is a state by state thing. Most states do fund therapy and do so for psychologists. However, again, it must be medically necessary.
Warren said:
Ken – Medicare already reimburses psychologists, psychiatrists and social workers for counseling services.
That’s why I said medicaid not medicare. I agree that seniors are not a big market for reparative therapy. However, teenagers/20-somethings who are depressed over their orientation would certainly make a tempting target for reparative therapists, especially if they can get the government to foot the bill.
Ken – Medicare already reimburses psychologists, psychiatrists and social workers for counseling services. And the services must be medically necessary. I would not worry about a government funded boom in reparative therapy for older Americans on the horizon.
While I think counseling would be an appropriate use for medicaid, I see a downside to this. The government deciding what is or is not appropriate mental health counseling is something I would be concerned about. I’m sure it will require counselors to be licensed in order to be eligible for government funds, but what happens when guys like Nicholosi (sp) start wanting a piece of the action for their counseling services?
this is wonderful news – early intervention with children is so important as well as those who need counseling and otherwise could not afford it.
Or PTSD because of a natural disaster, or other mishap – like 9/11, fallen bridge, public violence ie: shooting, victims of violent crimes, foster children with abuse backgrounds, etc.. etc.. Not all of these people are religious believers or practitioners and children are so vulnerable.
Nemario – Have you been away for awhile? Medicare has been around since the 1960s. Most insurance pays for mental health care. Nothing wrong with seeing a pastor but mine would refer you if you wanted treatment for panic disorder.
In other words, we need to pay for people if they can’t handle their problems on their own. Go to a church, the pastors there are free.
This is very good news. A family member of mine could use some family counseling and she just does not have the money. Her daughter could benefit from this.