LEGISLATIVE ALERT Contact Congress to Urge Support for LMHC Medicare Reimbursement Bills

May 11, 2009

The time for enhanced recognition of LMHCs is now. Urge your federal legislators to support S.671 and H.R. 1693, legislation that, if enacted, will allow you as a Licensed Mental Health Counselors (LMHC) to be reimbursed at 75 percent of the Medicare allowable rate for the outpatient services you provide to seniors.

Today, health care comprises almost 20 percent of the United States's gross domestic product (GDP). In the next few weeks, legislators on the Senate Finance and House Ways and Means Committees will come together to decide how to restructure this significant chunk of U.S. GDP.

• Notify your legislators, via e-mail letters or phone calls to their DC and state district offices, of the need for LMHC Medicare reimbursement.
• Explain how Medicare reimbursement of outpatient psychotherapy services will benefit Medicare eligible seniors and the mental health care needs of society in general.

President Obama has asked congressional leaders to have a major health care reform bill on his desk by October; key congressional leaders have indicated that they will begin marking up health care reform bills in mid-June. Legislators are attuned to the fact that changes to the health care system will impact everyone. Please let them know how Medicare reimbursement will affect you and the senior population in your locale. Go to www.senate.gov to find contact information for your U.S. Senators and to www.house.gov to find contact information for your U.S. Representatives. Download a list of members of the key committees voting on this legislation.

Please stress to your legislators who sit on these committees our need for their possible cosponsorship and, at a minimum, their support of S. 671/H.R. 1693.

Why should your federal legislators support
LMHC Medicare Reimbursement bills, S. 671 and H.R. 1693?

Lack of Access to Mental Health Services – Fully 50 percent of rural counties in America have no practicing mental health providers that are currently covered under Medicare. However, many of these mental health shortage areas have well-educated and experienced LMHCs who desire to deliver outpatient mental health services to the senior population but are obstructed by Medicare's current lack of reimbursement.

Medicare Inefficiency – Medicare has proven to be a very inefficient purchaser of mental health services, choosing to fund a disproportionate share of more costly inpatient mental health services, rather than less costly, preventive outpatient mental health services. An American Psychiatric Journal study on private health insurance recipients' mental health care purchases evidences that increased availability of outpatient treatment for mild to moderate mental health disorders, like depression and anxiety, can result in as much as a 30 percent decrease in mental health costs expended by private insurers and their insured population.

Underserved Minority Populations – In a report by the United States Surgeon General entitled "Mental Health: Culture, Race, and Ethnicity," it was noted that "striking disparities in access, quality, and availability of mental health services exist for racial and ethnic minority Americans." Minority communities bear a disproportionately high burden of disability from untreated or inadequately treated mental disorders. Many minority communities have a shortage of mental health providers, like clinical psychologists and clinical social workers, whose services are covered by Medicare.

Education and Training Comparable to Covered Social Workers – Today, LCSWs with education hours and training hours comparable to LMHCs receive reimbursement under Medicare for outpatient services they provide to Medicare insured clients. LMHCs, like clinical social workers, have a minimum of a Master's degree, thousands of hours of counseling experience and direct client contact, and passage of a clinical examination.

Please contact AMHCA's Director of Legislative Affairs, Julie A. Clements, J.D., at (703)-548-6002 X 105 or via email at jclements@amhca.org, if you have further inquiries.

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DRAFT LETTER TO CONGRESS
Please use this text as a template and personalize as you see fit.

May____, 2009

The Honorable_______
____House/Senate Office Building
Washington, DC 20510

RE: Please Co-Sponsor S. 671/H.R. 1693:
The Seniors Mental Health Access Improvement Act of 2009.

Dear Senator/Representative_________:

I am writing to strongly urge you to co-sponsor S. 671/H.R. 1693, The Seniors Mental Health Access Improvement Act, which would establish Medicare coverage for licensed professional mental health counselors. With the exception of a recent federal law that finally equalized outpatient co-payments for mental health and medical/surgical services, the baseline Medicare mental health benefit has not been updated in almost 20 years. This inaction has consequences.

Improve Access in Rural Areas and among Underserved Minority Populations:
Approximately 77 million older adults live in 3,000 mental health professional shortage areas. Yet over 50% of rural counties have no practicing psychologists, psychiatrists or social workers. It is shocking to note that fully two thirds of rural residents with mental illness symptoms receive no treatment at all. As a direct result of this lack of access, older Americans with chronic medical conditions and major depression (nearly 2 million senior citizens nationwide) have significantly higher rates of disability than those with either condition alone. Similarly, in a report entitled "Mental Health: Culture, Race and Ethnicity," the United State Surgeon General noted that "striking disparities in access, quality and availability of mental health services exist for racial and ethnic minority Americans." A critical result of this disparity is that minority communities bear a disproportionately high burden of disability from untreated or inadequately treated mental disorders.

Making Medicare a Better Purchaser of Mental Health Care:
Inpatient psychiatric hospital utilization by elderly Medicare recipients is extraordinarily high-particularly when compared to psychiatric hospitalization rates for patients covered by Medicaid, VA, TRICARE and private health insurance. To the extent that fully one third of these expensive inpatient placements are caused by clinical depression and addiction disorders, it is strikingly clear that additional community-based mental health services provided by licensed professional mental health counselors will reduce unneeded hospitalizations.

The bottom line is the lack of access to mental health care is increasing both the burden of disability on our senior citizens and minority communities as well as the financial burden on the Medicare program. Take action today. Co-sponsor S. 671/H.R. 1693.

Sincerely,

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TARGET LIST
The Senate Finance Health Subcommittee and the House Ways and Means Health Subcommittee have jurisdiction over S 671/ HR 1693. Help ensure that members from your states on these committees support S. 671/H.R. 1693.

Click here for a list of members of the Senate Finance Health Subcommittee and House Ways and Means Health Subcommittee.

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Affect Public Policy

Pass S.671/H.R. 1693 -- Help LMHCs Achieve Medicare Reimbursement

Download Veterans Access Issue Brief

Keep public policy supporting you, your profession and your clients with AMHCA's powerful advocacy initiatives in Congress and state legislatures.

The Office of Public Policy and Legislation (PP&L) works with Federal and State legislatures to protect AMHCA members' interests and their right to practice throughout the United States. The PP&L Office works with AMHCA state chapters, for example, to help enact counselor licensure laws and other legislation to ensure that members maintain their right to practice. At the Federal level, the PP&L Office works with Congress and the Executive Branch to ensure that counselors are recognized in applicable federal laws; to educate policymakers about the role of mental health counselors; and to increase lawmakers' awareness about mental illness and its effects on people's lives.

AMHCA's legislative advocacy program provides grassroots support for the association's lobbying in Washington, and is necessary for the success of AMHCA's legislative agenda. To join, contact AMHCA Director of Legislative Affairs, Julie A. Clements, J.D, at jclements@amhca.org or 1-800-326-2642, ext. 105. We need your name, address, phone numbers and e-mail address. Get involved. Join Now!

American Mental Health Counselors Association Public Policy and Legislation Committee Dan Holdinghaus, LPC, Chair 111th Congress, First Session Federal Legislative Issues Enact legislation to allow mental health counselors to be reimbursed by Medicare; Eliminate discriminatory physician referral and supervision requirements under TRICARE; Enact legislation to ensure that that mental health counselors are fully recognized by a full range of federal programs, including the Federal Employee Health Benefits (FEHB) Program and as Department of Transportation (DOT) Substance Abuse Professionals (SAPs); Monitor implementation of mental health and substance abuse parity law (P.L. 110-343) Monitor federal medical records confidentiality regulations; Monitor implementation of legislation recognizing state licensed mental health counselors as mental health specialists within the Department of Veterans Affairs (P.L. 109-461). State Legislative Issues Enact counselor licensure law in California; Protect the rights of mental health counselors to utilize testing instruments; Enact legislation to name mental health counselors as providers for state employee health benefits plans; Update title laws to practice acts in applicable states; Ensure that mental health counselors are named as providers for Medicaid; and Enact mandatory reimbursement laws for mental health counselors.