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Legislative Update
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AMHCA Seeks Advancement for the Profession on Several Fronts

By James K. Finley, Associate Executive Director, 
and Director of Public Policy

AHMCA this month is pressing Congress on a host of issues on behalf of the profession. Along with our coalition partners, we recently sat down with several friendly congressional offices to seek stepped-up pressure on the Department of Veterans Affairs (VA) to hire more mental health counselors and marriage and family therapists. 

The House is currently considering annual funding legislation providing $6,453,027,000 for VA mental health programs, a 4.3 percent increase over current-year levels. Congressional committees have come down hard on the agency in recent weeks for its continuing delays in making mental health services available to veterans and called again for the VA to redouble its efforts to provide timely access. 

AMHCA is pleased that the pending VA funding bill calls for the agency to conduct a staffing analysis to determine whether mental health vacancies represent a systemic problem, and if so, to develop an action plan to correct the impediments. 

(Editor’s note: Finley was quoted in the May 7 issue of Mental Health Weekly about the VA’s efforts to hire more mental health counselors.)

Medicare Legislation

Congress remains deadlocked on Medicare revisions as the congressional elections cycle becomes more active. Election-year politics on Medicare are considered combustible for congressional and presidential candidates, meaning Congress for now is unwilling to consider changes. 

AMHCA’s Medicare provider status legislation in the Senate is S. 604, the Seniors Mental Health Access Improvement Act, which was introduced by Sen. Ron Wyden (D–Ore.) and Sen. John Barrasso (R–Wyo.). In the House, the Medicare provider status legislation is part of an omnibus bill—H.R. 2954, the Health Equity and Accountability Act of 2011, which was introduced by Rep. Barbara Lee (D–Calif.)—that addresses health disparities. 

Along with our coalition partners, AMHCA is making regular visits to congressional offices to build awareness of the legislation, thereby paving the way for consideration once a legislative window appears, hopefully at the year-end. Next year many legislators anticipate consideration of more substantive changes in the program. 

Possible Repeal of Healthcare Reform?

Congressional Republicans are divided over what to propose if the Supreme Court strikes down in June all or part of the president’s healthcare overhaul. Some Republicans feel they need to offer credible alternatives to present to their constituents if the court strikes down the law and would like to restore some popular provisions. Others believe only total repeal is acceptable. 
Meanwhile, Congress is hearing how the law is beginning to transform the way care is delivered. Many private insurers and large physician groups advocate retention of key components of the law, including those that

  • Pay a fixed amount to doctors and hospitals for a bundle of services;
  • Create medical homes with a primary-care physician to coordinate services for each patient; and
  • Impose financial penalties on hospitals with large numbers of patients who are readmitted within a few weeks after they are discharged.

Physician groups say such provisions are needed to transition Medicare’s current payment formula to a modern system that rewards efficient, high-quality care. Definitely in the conversation will be what to do about mental-health parity rules for all beneficiaries.


We are hopeful that long-delayed provider credentialing of clinical mental health counselors (CMHCs) for independent practice under TRICARE will begin very soon. The timetable for TRICARE Management implementation of its December 2011 rule for independent practice by CMHCs is coming into focus.

New TRICARE Policy Manual Instructions were recently sent to TRICARE intermediaries for implementation, and AMHCA will send out a summary shortly to members with information on the timeframe for implementation. 

Members who want to learn the latest public policy news from AMHCA should regularly check the public policy page on our homepage, or “like” our Facebook page to interact with colleagues about the latest public policy developments that impact the profession of mental health counseling.