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Legislative Update
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Congress Leaves CMHCs Out in the Cold, But AMHCA & LMFTs Are Regrouping

By James K. Finley
Associate Executive Director and Director of Public Policy
Medicare Legislation Falters

House and Senate consideration of the Medicare “doc fix” legislation took an abrupt detour onto the Road to Confusion the last full week of March, but ultimately Congress produced a bill on March 31, which President Obama is expected to sign shortly. The legislation is essential to prevent a 24 percent cut in Medicare outpatient fees that will otherwise occur on April 1, but consensus on how or what to pass broke down suddenly during the final days of March. 

This must-pass Medicare legislation is the target vehicle for all Medicare legislative changes this year. Unfortunately, each version of several different bills under consideration at the end of March omitted AMHCA’s provider status provision (S.562/HR.3662)

Battle lines over Medicare legislation have converged over issues such as offsets for additional Medicare spending and whether to pass a short- or long-term bill.

The new legislation is, in effect, a short-term bill that runs through March 2015, when a new Congress will be seated. AMHCA and its coalition of mental health counselors and marriage and family therapists are deeply disappointed that neither version of the key House 

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and Senate bills included our provider status legislation. 

This omission will compel us to focus on next March, when once again Congress will consider provider-fee legislation that will be the vehicle for our bill. 

AMHCA’s strategy now will shift to expanded work with our membership and coalition partners to build up stronger grassroots support for the bill. 

Medicare Bill Will Delay ICD-10 Conversion

In a bit of a surprise, hospital groups and some physician groups were able to add a provision to the House Medicare legislation that would delay the transition deadline for the International Classification of Diseases codes, ICD-10, for one year. The deadline had been Oct. 1, 2014. 

When the Medicare bill is signed in a few days, it will contain a delay in the mandatory adoption of ICD–10 billing code sets as the standard for all code sets until Oct. 1, 2015. This proposed delay remains controversial however; many groups, including the American Medical Association, remain opposed to its inclusion in the final bill. 

(For more information about the changing ICD-10 codes, see the February 2014 Advocate.)

AMHCA Testimony on Medicare and Medicaid

Several key members of Congress were so impressed with AMHCA’s recent “Dashed Hopes” report on state Medicaid expansion that they invited AMHCA to testify March 26  before a House committee on solutions to the back up of emergency department patients seeking hospital psychiatric care. 

AMHCA’s witness, Director-at-Large LaMarr Edgerson, PsyD, LMFT, NBCCH, came in from New Mexico on short notice, and we were delighted to raise AMHCA’s congressional profile and represent the views of our members. One of the central themes in AMHCA’s testimony was the need to address coverage and provider disparities to meet patient needs before they escalate into psychiatric emergencies. 

We also used our time in the U.S. House of Representatives hearing to stress that Medicare must be modernized to include the professional services of clinical mental health counselors and marriage and family therapists, as was proposed in HR.3662. 

Veterans Legislation

Very large omnibus veterans legislation that includes AMHCA’s provision to hire clinical mental health counseling interns at the VA (S.1982) unexpectedly failed a procedural vote on the Senate floor in late February. Veterans Affairs Committee Chair Sen. Bernie Sanders (D–Vt.) has placed the larger bill on hold while he tries to round up more Republican support for the additional spending.