REPS STARK, LEACH, SENATOR MIKULSKI, OFFER ADDED MENTAL HEALTH OPTIONS TO MEDICARE BENEFICIARIES

WASHINGTON, D.C. – Today, Rep. Pete Stark (D-CA) and Rep. Jim Leach (R-IA) introduced the Clinical Social Work Medicare Equity Act. This simple, bipartisan bill would greatly improve access to mental health services for Medicare beneficiaries in skilled nursing facilities (SNFs) by allowing clinical social workers to directly bill Medicare for their services. Sen. Mikulski (D-MD) is introducing the companion bill in the Senate.

Currently, Medicare cannot reimburse clinical social workers in a SNF for treating a Medicare beneficiary. This restriction effectively excludes these highly skilled professionals from providing mental health services.  

“The ultimate victims of the current regulations are the vulnerable seniors who need mental health care,” Stark said. “If Congress does not fix this law, clinical social workers will not be able to provide mental health care to Medicare beneficiaries in SNFs. This bipartisan legislation would help residents of skilled nursing facilities better access needed mental health care."

Approximately 20% of seniors suffer from mental illness, including severe depression and debilitating anxiety, and among nursing home residents the prevalence is as high as 80%. Furthermore, older people have a 20 percent suicide rate, the highest of any age group.

"I am pleased to be an original cosponsor of the Clinical Social Work Medicare Equity Act.  This legislation is intended to ensure that residents of nursing homes, particularly in rural areas, have access to the critical mental health services provided by social workers," Leach said.
 
This legislation seeks to correct a flaw in the Balanced Budget Act of 1997 that omits Certified Social Workers (CSWs) from a list of clinical professionals allowed to provide mental health services to Medicare beneficiaries in SNFs for which they can bill Medicare Part B.  

Clinical social workers are highly trained mental health professionals and provide 61% of mental health treatment in our country. They constitute the single largest group of mental health providers in the United States.

“It is unfortunate that most skilled nursing facility residents are currently precluded from receiving mental health services from clinical social workers given the fact clinical social workers comprise the largest group of mental health providers nationwide and are often the only local mental health providers in many communities and especially in medically underserved areas,” said Elizabeth J Clark, Ph.D., Executive Director of the National Association of Social Workers.