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Mar 19, 2013

Medicare Coverage of Licensed Professional Counselors – Bill Introduced in 113th Congress

LEGISLATION

S. 562—the “Seniors Mental Health Access Improvement Act of 2013"
Sponsors: Senator Ron Wyden (D-OR), Senator John Barrasso (R-WY)

LATEST INFORMATION

Bipartisan legislation has been introduced in the Senate to establish Medicare reimbursement of licensed professional counselors and marriage and family therapists.  As with previous versions of the legislation, S. 562 would cover only medically-necessary outpatient mental health services, and would reimburse licensed professional counselors and marriage and family therapists at the same reimbursement rates, and under the same terms and conditions, as clinical social workers.

ACA strongly encourages counselors to contact their Senators to ask them to cosponsor the legislation. 

WHAT YOU CAN DO

Please call or e-mail both of your Senators and ask them to cosponsor S. 562, the "Seniors Mental Health Access Improvement Act of 2013," S. 562. (Only Senators can cosponsor legislation introduced in the Senate.)  Let your Senators know that this same legislation was passed by the Senate in both 2003 and 2005, and that private sector health plans have been covering counselors for many years. 

You can find out who your Senators are by visiting the ACA internet legislative action center at https://www.votervoice.net/COUNSELING/Home and entering your zip code in the box indicated. Senators and Representatives can be reached through the U.S. Capitol Switchboard at 202-224-3121, and telling the operator which office you would like to be connected with.

BACKGROUND

Medicare is the nation's largest health insurance program, covering roughly 43 million older Americans (65 or older), and approximately 9 million Americans with disabilities. The program was established in 1965. 

Medicare has covered psychologists and clinical social workers since 1989, but does not cover licensed professional counselors.  Many Medicare beneficiaries live in mental health professional shortage areas, and there are more than 120,000 licensed professional counselors across the country ready to provide needed treatment. Lack of access to outpatient mental health treatment harms beneficiaries, and contributes to overutilization of more expensive inpatient care.  It also increases the costs of treating chronic medical conditions such as diabetes or congestive heart failure, since many individuals with these conditions have a comorbid depressive disorder.

Medicare coverage of counselors is not a partisan issue, nor is it a new issue. The Senate passed legislation establishing Medicare reimbursement of licensed professional counselors in both 2003 and 2005, during Republican control of that chamber. The House of Representatives has also approved such language twice, in both 2007 and 2009, under Democratic control.

S. 562 will improve Medicare beneficiaries' access to outpatient mental health care in a cost-effective manner, by establishing coverage of highly-qualified LPCs.  The current shortage of mental health professionals available to Medicare beneficiaries is going to get significantly worse over the coming years, as the baby boom generation enrolls in the program and current mental health service providers retire.  Research shows that licensed professional counselors are proportionately more likely to work in rural and underserved areas than are clinical social workers, psychologists, and psychiatrists.

FOR MORE INFORMATION

Art Terrazas
American Counseling Association
5999 Stevenson Avenue
Alexandria, VA 22304
703.823.9800 x242
703.823.0252 fax
800.347.6647
703.823.6828 TDD
aterrazas@counseling.org
www.counseling.org

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