Mental Health Access Improvement Act of 2021

II 117TH CONGRESS 1ST SESSION S. 828 To amend title XVIII of the Social Security Act to provide for the coverage of marriage and family therapist services and mental health counselor services under part B of the Medicare program, and for other purposes. IN THE SENATE OF THE UNITED STATES MARCH 18, 2021 Mr. BARRASSO (for himself and Ms. STABENOW) introduced the following bill; which was read twice and referred to the Committee on Finance A BILL To amend title XVIII of the Social Security Act to provide for the coverage of marriage and family therapist services and mental health counselor services under part B of the Medicare program, and for other purposes. Be it enacted by the Senate and House of Representa- 1 tives of the United States of America in Congress assembled, 2 SECTION 1. SHORT TITLE. 3 This Act may be cited as the ‘‘Mental Health Access 4 Improvement Act of 2021’’. 5 VerDate Sep 11 2014 20:38 Apr 10, 2021 Jkt 019200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\S828.IS S828 pamtmann on DSKBC07HB2PROD with BILLS 2 •S 828 IS SEC. 2. COVERAGE OF MARRIAGE AND FAMILY THERAPIST 1 SERVICES AND MENTAL HEALTH COUNSELOR 2 SERVICES UNDER PART B OF THE MEDICARE 3 PROGRAM. 4 (a) COVERAGE OF SERVICES.— 5 (1) IN GENERAL.—Section 1861(s)(2) of the 6 Social Security Act (42 U.S.C. 1395x(s)(2)) is 7 amended— 8 (A) in subparagraph (GG), by striking 9 ‘‘and’’ after the semicolon at the end; 10 (B) in subparagraph (HH), by inserting 11 ‘‘and’’ after the semicolon at the end; and 12 (C) by adding at the end the following new 13 subparagraph: 14 ‘‘(II) marriage and family therapist services (as 15 defined in subsection (lll)(1)) and mental health 16 counselor services (as defined in subsection 17 (lll)(3));’’. 18 (2) DEFINITIONS.—Section 1861 of the Social 19 Security Act (42 U.S.C. 1395x) is amended by add- 20 ing at the end the following new subsection: 21 ‘‘Marriage and Family Therapist Services; Marriage and 22 Family Therapist; Mental Health Counselor Serv- 23 ices; Mental Health Counselor 24 ‘‘(lll)(1) The term ‘marriage and family therapist 25 services’ means services performed by a marriage and 26 VerDate Sep 11 2014 20:38 Apr 10, 2021 Jkt 019200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\S828.IS S828 pamtmann on DSKBC07HB2PROD with BILLS 3 •S 828 IS family therapist (as defined in paragraph (2)) for the diag- 1 nosis and treatment of mental illnesses, which the mar- 2 riage and family therapist is legally authorized to perform 3 under State law (or the State regulatory mechanism pro- 4 vided by State law) of the State in which such services 5 are performed, as would otherwise be covered if furnished 6 by a physician or as an incident to a physician’s profes- 7 sional service, but only if no facility or other provider 8 charges or is paid any amounts with respect to the fur- 9 nishing of such services. 10 ‘‘(2) The term ‘marriage and family therapist’ means 11 an individual who— 12 ‘‘(A) possesses a master’s or doctoral degree 13 which qualifies for licensure or certification as a 14 marriage and family therapist pursuant to State 15 law; 16 ‘‘(B) after obtaining such degree has performed 17 at least 2 years of clinical supervised experience in 18 marriage and family therapy; and 19 ‘‘(C) in the case of an individual performing 20 services in a State that provides for licensure or cer- 21 tification of marriage and family therapists, is li- 22 censed or certified as a marriage and family thera- 23 pist in such State. 24 VerDate Sep 11 2014 20:38 Apr 10, 2021 Jkt 019200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\S828.IS S828 pamtmann on DSKBC07HB2PROD with BILLS 4 •S 828 IS ‘‘(3) The term ‘mental health counselor services’ 1 means services performed by a mental health counselor (as 2 defined in paragraph (4)) for the diagnosis and treatment 3 of mental illnesses which the mental health counselor is 4 legally authorized to perform under State law (or the 5 State regulatory mechanism provided by the State law) of 6 the State in which such services are performed, as would 7 otherwise be covered if furnished by a physician or as inci- 8 dent to a physician’s professional service, but only if no 9 facility or other provider charges or is paid any amounts 10 with respect to the furnishing of such services. 11 ‘‘(4) The term ‘mental health counselor’ means an 12 individual who— 13 ‘‘(A) possesses a master’s or doctor’s degree in 14 mental health counseling or a related field; 15 ‘‘(B) after obtaining such a degree has per- 16 formed at least 2 years of supervised mental health 17 counselor practice; and 18 ‘‘(C) in the case of an individual performing 19 services in a State that provides for licensure or cer- 20 tification of mental health counselors or professional 21 counselors, is licensed or certified as a mental health 22 counselor or professional counselor in such State.’’. 23 (3) PROVISION FOR PAYMENT UNDER PART 24 B.—Section 1832(a)(2)(B) of the Social Security 25 VerDate Sep 11 2014 20:38 Apr 10, 2021 Jkt 019200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\S828.IS S828 pamtmann on DSKBC07HB2PROD with BILLS 5 •S 828 IS Act (42 U.S.C. 1395k(a)(2)(B)) is amended by add- 1 ing at the end the following new clause: 2 ‘‘(v) marriage and family therapist 3 services (as defined in section 1861(lll)(1)) 4 and mental health counselor services (as 5 defined in section 1861(lll)(3));’’. 6 (4) AMOUNT OF PAYMENT.—Section 1833(a)(1) 7 of the Social Security Act (42 U.S.C. 1395l(a)(1)) 8 is amended— 9 (A) by striking ‘‘and (CC)’’ and inserting 10 ‘‘(CC)’’; and 11 (B) by inserting before the semicolon at 12 the end the following: ‘‘, and (DD) with respect 13 to marriage and family therapist services and 14 mental health counselor services under section 15 1861(s)(2)(II), the amounts paid shall be 80 16 percent of the lesser of the actual charge for 17 the services or 75 percent of the amount deter- 18 mined for payment of a psychologist under sub- 19 paragraph (L)’’. 20 (5) EXCLUSION OF MARRIAGE AND FAMILY 21 THERAPIST SERVICES AND MENTAL HEALTH COUN- 22 SELOR SERVICES FROM SKILLED NURSING FACILITY 23 PROSPECTIVE PAYMENT SYSTEM.—Section 24 1888(e)(2)(A)(ii) of the Social Security Act (42 25 VerDate Sep 11 2014 20:38 Apr 10, 2021 Jkt 019200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\S828.IS S828 pamtmann on DSKBC07HB2PROD with BILLS 6 •S 828 IS U.S.C. 1395yy(e)(2)(A)(ii)) is amended by inserting 1 ‘‘marriage and family therapist services (as defined 2 in section 1861(lll)(1)), mental health counselor 3 services (as defined in section 1861(lll)(3)),’’ after 4 ‘‘qualified psychologist services,’’. 5 (6) INCLUSION OF MARRIAGE AND FAMILY 6 THERAPISTS AND MENTAL HEALTH COUNSELORS AS 7 PRACTITIONERS FOR ASSIGNMENT OF CLAIMS.—Sec- 8 tion 1842(b)(18)(C) of the Social Security Act (42 9 U.S.C. 1395u(b)(18)(C)) is amended by adding at 10 the end the following new clauses: 11 ‘‘(vii) A marriage and family therapist (as de- 12 fined in section 1861(lll)(2)). 13 ‘‘(viii) A mental health counselor (as defined in 14 section 1861(lll)(4)).’’. 15 (b) COVERAGE OF CERTAIN MENTAL HEALTH SERV- 16 ICES PROVIDED IN CERTAIN SETTINGS.— 17 (1) RURAL HEALTH CLINICS AND FEDERALLY 18 QUALIFIED HEALTH CENTERS.—Section 19 1861(aa)(1)(B) of the Social Security Act (42 20 U.S.C. 1395x(aa)(1)(B)) is amended by striking ‘‘or 21 by a clinical social worker (as defined in subsection 22 (hh)(1))’’ and inserting ‘‘, by a clinical social worker 23 (as defined in subsection (hh)(1)), by a marriage 24 and family therapist (as defined in subsection 25 VerDate Sep 11 2014 20:38 Apr 10, 2021 Jkt 019200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\S828.IS S828 pamtmann on DSKBC07HB2PROD with BILLS 7 •S 828 IS (lll)(2)), or by a mental health counselor (as defined 1 in subsection (lll)(4))’’. 2 (2) HOSPICE PROGRAMS.—Section 3 1861(dd)(2)(B)(i)(III) of the Social Security Act (42 4 U.S.C. 1395x(dd)(2)(B)(i)(III)) is amended by in- 5 serting ‘‘, marriage and family therapist, or mental 6 health counselor’’ after ‘‘social worker’’. 7 (c) AUTHORIZATION OF MARRIAGE AND FAMILY 8 THERAPISTS AND MENTAL HEALTH COUNSELORS TO 9 DEVELOP DISCHARGE PLANS FOR POST-HOSPITAL SERV- 10 ICES.—Section 1861(ee)(2)(G) of the Social Security Act 11 (42 U.S.C. 1395x(ee)(2)(G)) is amended by inserting ‘‘, 12 including a marriage and family therapist and a mental 13 health counselor who meets qualification standards estab- 14 lished by the Secretary’’ before the period at the end. 15 (d) EFFECTIVE DATE.—The amendments made by 16 this section shall apply with respect to services furnished 17 on or after January 1, 2022. 18 Æ VerDate Sep 11 2014 20:38 Apr 10, 2021 Jkt 019200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6301 E:\BILLS\S828.IS S828 pamtmann on DSKBC07HB2PROD with BILLS