Addiction Treatment Access Act

II 116TH CONGRESS 1ST SESSION S. 2412 To amend title XVIII of the Social Security Act to provide coverage of addiction counselor services under part B of the Medicare program. IN THE SENATE OF THE UNITED STATES AUGUST 1, 2019 Mr. TESTER 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 coverage of addiction counselor services under part B of the Medicare program. 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 ‘‘Addiction Treatment 4 Access Act’’. 5 SEC. 2. COVERAGE OF ADDICTION COUNSELOR SERVICES 6 UNDER PART B OF THE MEDICARE PROGRAM. 7 (a) COVERAGE OF SERVICES.— 8 VerDate Sep 11 2014 01:12 Aug 09, 2019 Jkt 089200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\S2412.IS S2412 kjohnson on DSK79L0C42 with BILLS 2 •S 2412 IS (1) IN GENERAL.—Section 1861(s)(2) of the 1 Social Security Act (42 U.S.C. 1395x(s)(2)) is 2 amended— 3 (A) in subparagraph (GG), by striking 4 ‘‘and’’ at the end; 5 (B) in subparagraph (HH), by striking the 6 period at the end and inserting ‘‘; and’’; and 7 (C) by adding at the end the following new 8 subparagraph: 9 ‘‘(II) addiction counselor services (as defined in 10 subsection (kkk)(1));’’. 11 (2) DEFINITIONS.—Section 1861 of the Social 12 Security Act (42 U.S.C. 1395x) is amended by add- 13 ing at the end the following new subsection: 14 ‘‘Addiction Counselor Services; Addiction Counselor 15 ‘‘(kkk)(1) The term ‘addiction counselor services’ 16 means services performed by an addiction counselor (as 17 defined in paragraph (2)) for the diagnosis and treatment 18 of substance abuse and addiction that the addiction coun- 19 selor is legally authorized to perform under State law (or 20 the State regulatory mechanism provided by the State 21 law) of the State in which such services are performed, 22 as would otherwise be covered if furnished by a physician 23 or as incident to a physician’s professional service, which 24 may include— 25 VerDate Sep 11 2014 01:12 Aug 09, 2019 Jkt 089200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\S2412.IS S2412 kjohnson on DSK79L0C42 with BILLS 3 •S 2412 IS ‘‘(A) addiction assessment; 1 ‘‘(B) addiction counseling; 2 ‘‘(C) crisis management; 3 ‘‘(D) drug therapy; 4 ‘‘(E) treatment planning; and 5 ‘‘(F) treatment of co-occurring disorders, 6 but only if no facility or other provider charges or is paid 7 any amounts with respect to the furnishing of such serv- 8 ices. 9 ‘‘(2) The term ‘addiction counselor’ means an indi- 10 vidual who— 11 ‘‘(A) has completed coursework or training spe- 12 cific to treating substance use disorders, including 13 with respect to the addiction counseling com- 14 petencies identified in the document published by the 15 Substance Abuse and Mental Health Services Ad- 16 ministration as part of the Technical Assistance 17 Publication (TAP) series, number 21, entitled ‘Ad- 18 diction Counseling Competencies: The Knowledge, 19 Skills, and Attitudes of Profressional Practice’ (or 20 any successor publication); and 21 ‘‘(B) in the case of an individual performing 22 services in a State that provides for licensure or cer- 23 tification of addiction counselors, is licensed or cer- 24 VerDate Sep 11 2014 01:12 Aug 09, 2019 Jkt 089200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\S2412.IS S2412 kjohnson on DSK79L0C42 with BILLS 4 •S 2412 IS tified as an addiction counselor or alcohol and drug 1 counselor in such State.’’. 2 (3) PROVISION FOR PAYMENT UNDER PART 3 B.—Section 1832(a)(2)(B) of the Social Security 4 Act (42 U.S.C. 1395k(a)(2)(B)) is amended— 5 (A) by striking ‘‘and’’ at the end of clause 6 (iv); and 7 (B) by adding at the end the following new 8 clause: 9 ‘‘(v) addiction counselor services;’’. 10 (4) AMOUNT OF PAYMENT.—Section 1833(a)(1) 11 of the Social Security Act (42 U.S.C. 1395l(a)(1)) 12 is amended— 13 (A) by striking ‘‘and’’ before ‘‘(CC)’’; and 14 (B) by inserting before the semicolon at 15 the end the following: ‘‘, and (DD) with respect 16 to addiction counselor services under section 17 1861(s)(2)(II), the amounts paid shall be 80 18 percent of the lesser of the actual charge for 19 the services or 60 percent of the amount deter- 20 mined for payment of a psychologist under sub- 21 paragraph (L).’’. 22 (5) INCLUSION OF ADDICTION COUNSELORS AS 23 PRACTITIONERS FOR ASSIGNMENT OF CLAIMS.—Sec- 24 tion 1842(b)(18)(C) of the Social Security Act (42 25 VerDate Sep 11 2014 03:58 Aug 10, 2019 Jkt 089200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\S2412.IS S2412 kjohnson on DSK79L0C42 with BILLS 5 •S 2412 IS U.S.C. 1395u(b)(18)(C)) is amended by adding at 1 the end the following new clause: 2 ‘‘(vii) An addiction counselor (as defined in sec- 3 tion 1861(kkk)(2)).’’. 4 (b) COVERAGE IN RURAL HEALTH CLINICS AND 5 FEDERALLY QUALIFIED HEALTH CENTERS.—Section 6 1861(aa)(1)(B) of the Social Security Act (42 U.S.C. 7 1395x(aa)(1)(B)) is amended by striking ‘‘or by a clinical 8 social worker (as defined in subsection (hh)(1)),’’ and in- 9 serting ‘‘, by a clinical social worker (as defined in sub- 10 section (hh)(1)), or by an addiction counselor (as defined 11 in section 1861(kkk)(2)).’’. 12 (c) EFFECTIVE DATE.—The amendments made by 13 this section shall apply with respect to services furnished 14 on or after January 1, 2020. 15 Æ VerDate Sep 11 2014 01:12 Aug 09, 2019 Jkt 089200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6301 E:\BILLS\S2412.IS S2412 kjohnson on DSK79L0C42 with BILLS