Legislation

Medicare Provider Status for Mental Health Counselors

The American Mental Health Counselors Associations Four Part Strategy to

Gain Medicare Provider Status for Clinical Mental Health Counselors through the

Seniors Mental Health Access Improvement Act (H.R. 3032 and S. 1879) new bill

numbers will be assigned when the bills are re-introduced in the 2019 Congress.

  1. Increase legislators awareness of CHMC’s role/and ability to help their constituents through strategic meetings
  2. Modify messaging to legislators – tell legislators why CHMC provider status is vital to their constituents for their wellbeing and as a significant way to save dollars
  3. Utilize legislative alternatives – for example adding Medicare provider status as an amendment to a bill related to the opioid crisis
  4. Grassroots Activities

AMHCA organizes “Call Your Congressman/woman Days

AMHCA is a coalition partner working with the following groups to promote Medicare Provider Status:

National Board of Certified Counselors (NBCC), the American Counseling Association(ACA), the American Association for Marriage and Family Therapists (AAMFT), the National Council for Behavioral Health (NCBH) and the Association for Behavioral Health and Wellness (ABHW)

Source “The Advocate Magazine” Fall 2018

APA Division 44 Opposes Anti-Transgender Ban and Encourages Challenging Stigma

APA Division 44, The Society for the Psychology of Sexual Orientation and Gender Diversity, is opposed to the March 23rd, 2018, White House memorandum disqualifying transgender persons from service who have received a gender dysphoria diagnosis.

Division 44, The Society for the Psychology of Sexual Orientation and Gender Diversity affirms the American Psychological Association’s opposition to this ban:

“The American Psychological Association is alarmed by the administration’s misuse of psychological science to stigmatize transgender Americans and justify limiting their ability to serve in uniform and access medically necessary health care….

No scientific evidence has shown that allowing transgender people to serve in the armed forces has an adverse impact on readiness or unit cohesion. What research does show is that discrimination and stigma undermine morale and readiness by creating a significant source of stress for sexual minorities that can harm their health and well-being.”

The memorandum reinforces mental health stigma and transphobia. The order detailed in this memorandum is discriminatory.

In recognition that such acts of discrimination and the perpetuation of stigma can be harmful to our community members (e.g., Barry, 2009), we encourage Division 44 members to take this opportunity to confront and challenge transphobia (prejudice against transgender people) and cissexism (a bias for cis-gender people, or those whose gender identity corresponds with their assigned sex at birth).

What can I do to take positive action?

Transphobia and cissexism are social toxins. In addition to practicing respectful communication, busting myths, and learning about gender diversity from organizations like the National Center for Transgender Equality, we encourage seeking out personal connections with transgender people and those closest with transgender people and amplifying their personal stories. Consider the power of contact (e.g., Allport, 1954, Pettigrew & Tropp, 20062008) and personal stories (e.g., Brookman & Kalla, 2016). Division 44 members are also encouraged to educate others, including friends, students, colleagues, and representatives. Education – including sharing the ways you are impacted by transphobia and cissexism – can have positive ripple effects.

OERA  Summary/Outline

Sec. 1 – Opioid Emergency Response Act)/Table of Contents

Sec. 2 – Alternatives to Opioids Prescribing Act, introduced by Buchanan

  • This section will create a Medicare demonstration program to evaluate the benefits of using alternatives to opioids (ALTOs) in emergency departments. Hospital emergency departments will voluntarily apply to participate (thirty to fifty will be selected). They will have the opportunity to earn bonus payments based on their ability to reduce their use of opioids and increase their use of alternatives (such as nerve blockers or laughing gas) to treat specific conditions.

Sec. 3 – H.R. 4733, the Opioids and STOP Pain Initiative Act, Rep. Peter Welch (D-VT)

  • This section of the bill will provide $500 million to the National Institutes of Health (NIH) over five years to increase their ability to research the science behind pain and addiction as well as new non-opioid treatments for these medical conditions.

Sec. 4 – S. 788, the Veteran Overmedication Prevention Act, Sen. John McCain (R-AZ)

  • This section of the bill requires the Department of Veterans Affairs to work with the National Academies of Sciences, Engineering and Medicine to conduct a review of all veterans who died by suicide in the last five years. The report will look at the correlations between suicide and use of medications, including legal and illegal opioids.

Sec. 5 – Extension of the grants created in the 21st Century Cures Act

  • This section of the bill will continue the Congressionally-passed CARA grants for an additional five years at the current funding level of $500 million per year.

Sec. 6 – H.R. 3032, the Mental Health Access Improvement Act, Rep. John Katko (R-NY)

  • This section of the bill will allow mental health counselors and marriage and family therapists to participate in the Medicare program. These master’s level providers are currently excluded from Medicare, even though they are the most common types of providers in many rural areas.

Sec. 7 – S. 372, the STOP Act, Sen. Rob Portman (R-OH)

  • This section of the bill will require the postal service to provide advanced electronic data to U.S. Customs and Boarder Protection (CBP) on all international packages. Under current law, private carriers (FedEx, UPS) are already required to submit this data, but USPS is not. This change will make it easier for CBP to flag and inspect packages that may contain illicit drugs, especially fentanyl and other synthetic opioids coming primarily from China.

Sec. 8 – H.R. 2851, the SITSA Act, Rep. John Katko (R-NY)

  • This section of the bill will make it easier for law enforcement and prosecutors to keep drugs off our streets. It allows the DEA to temporarily outlaw drugs chemically similar to fentanyl, and gives prosecutors new sentencing guidelines for convicted dealers. Charges of simple possession are explicitly excluded.

  • Summary/Outline

  • Sec. 1 – Short title (Opioid Emergency Response Act)/Table of Contents

  • Sec. 2 – Alternatives to Opioids Prescribing Act, introduced by Buchanan

  • This section will create a Medicare demonstration program to evaluate the benefits of using alternatives to opioids (ALTOs) in emergency departments. Hospital emergency departments will voluntarily apply to participate (thirty to fifty will be selected). They will have the opportunity to earn bonus payments based on their ability to reduce their use of opioids and increase their use of alternatives (such as nerve blockers or laughing gas) to treat specific conditions.

  • Sec. 3 – H.R. 4733, the Opioids and STOP Pain Initiative Act, Rep. Peter Welch (D-VT)

  • This section of the bill will provide $500 million to the National Institutes of Health (NIH) over five years to increase their ability to research the science behind pain and addiction as well as new non-opioid treatments for these medical conditions.

  • Sec. 4 – S. 788, the Veteran Overmedication Prevention Act, Sen. John McCain (R-AZ)

  • This section of the bill requires the Department of Veterans Affairs to work with the National Academies of Sciences, Engineering and Medicine to conduct a review of all veterans who died by suicide in the last five years. The report will look at the correlations between suicide and use of medications, including legal and illegal opioids.

  • Sec. 5 – Extension of the grants created in the 21st Century Cures Act

  • This section of the bill will continue the Congressionally-passed CARA grants for an additional five years at the current funding level of $500 million per year.

  • Sec. 6 – H.R. 3032, the Mental Health Access Improvement Act, Rep. John Katko (R-NY)

  • This section of the bill will allow mental health counselors and marriage and family therapists to participate in the Medicare program. These master’s level providers are currently excluded from Medicare, even though they are the most common types of providers in many rural areas.

  • Sec. 7 – S. 372, the STOP Act, Sen. Rob Portman (R-OH)

  • This section of the bill will require the postal service to provide advanced electronic data to U.S. Customs and Boarder Protection (CBP) on all international packages. Under current law, private carriers (FedEx, UPS) are already required to submit this data, but USPS is not. This change will make it easier for CBP to flag and inspect packages that may contain illicit drugs, especially fentanyl and other synthetic opioids coming primarily from China.

  • Sec. 8 – H.R. 2851, the SITSA Act, Rep. John Katko (R-NY)

  • This section of the bill will make it easier for law enforcement and prosecutors to keep drugs off our streets. It allows the DEA to temporarily outlaw drugs chemically similar to fentanyl, and gives prosecutors new sentencing guidelines for convicted dealers. Charges of simple possession are explicitly excluded.

Medicare language fails to be included in the omni-budget

But, The Good News is This:

While the language to Amend Title XVIII (Inclusion of MH Counselors and MFTS) failed to make the cut, the following was included with the report that accompanied the release of the Omni-Budget of 2018.

Mental Health Providers:  The agreement is aware that Medicare beneficiaries have limited access to substance use disorder and mental health services, particularly in rural and underserved areas. The agreement notes concern about the shortage of eligible mental health providers for the Medicare population and supports efforts to explore the expansion of the mental and behavioral health workforce.  (Division H – L-HHS-ED p. 50)

According to Jordan Hayman of the House Budget Office:

Report language [such as this] is generally the first step in calling attention to a problem and the beginning of further discussions.

In my email exchange with Jacob Jackson, Legislative Assistant with NBCC, we can see this as a victory in that such a statement serves to buttress our efforts to persist in Washington.

 . . . it sets us up well for an opioid package that Congress is preparing currently. This package will be included an array of opioid bills that lawmakers have prepared and will either be one large piece of legislation with several provisions, or a series of smaller bills. Either way, we are working to have our Medicare bill be made one of the provisions. The language included in the spending bill is a step in that direction.

Louise will clarify with AMHCA and NBCC as to how we are to specifically move in getting our own legislators to step up and make this happen.

The FMHCA membership will be fully informed as information and actions are presented.

STAY UP TO DATE WITH NEWS AND INFORMATION FROM GMHCI.
EVENT INFORMATION, SPECIAL OFFERS, HELPFUL TIPS AND MORE