I 

108TH CONGRESS 

1ST SESSION H. R. 1655

To amend title XVIII of the Social Security Act to provide for the coverage 

of marriage and family therapist services under part B of the Medicare 

Program, and for other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

APRIL 7, 2003

Mr. STRICKLAND introduced the following bill; which was referred to the Committee on Energy and Commerce, and in addition to the Committee on 

Ways and Means, for a period to be subsequently determined by the 

Speaker, in each case for consideration of such provisions as fall within 

the jurisdiction of the committee concerned 

A BILL

To amend title XVIII of the Social Security Act to provide 

for the coverage of marriage and family therapist services 

under part B of the Medicare Program, and for other 

purposes.

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled,

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Seniors Mental Health 

5 Access Improvement Act of 2003’’. 
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1 SEC. 2. COVERAGE OF MARRIAGE AND FAMILY THERAPIST 

2 SERVICES UNDER PART B. 

3 (a) COVERAGE OF SERVICES.—Section 1861(s)(2) of 

4 the Social Security Act (42 U.S.C. 1395x(s)(2)) is amend5 ed—

6 (1) in subparagraph (U), by striking ‘‘and’’ at 

7 the end; 

8 (2) in subparagraph (V), by striking the period 

9 at the end and inserting ‘‘; and’’; and 

10 (3) by adding at the end the following new sub11 paragraph: 

12 ‘‘(W) marriage and family therapist serv13 ices (as defined in subsection (ww)(1));’’. 

14 (b) DEFINITION.—Section 1861 of such Act (42 

15 U.S.C. 1395x) is amended by adding at the end thereof 

16 the following new subsection: 

17 ‘‘Marriage and Family Therapist Services 

18 ‘‘(ww)(1) The term ‘marriage and family therapist 

19 services’ means services performed by a marriage and 

20 family therapist (as defined in paragraph (2)) for the diag21 nosis and treatment of mental illnesses, which the mar22 riage and family therapist is legally authorized to perform 

23 under State law (or the State regulatory mechanism pro24 vided by State law) of the State in which such services 

25 are performed, as would otherwise be covered if furnished 

26 by a physician or as an incident to a physician’s profes-
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1 sional service, but only if no facility or other provider 

2 charges or is paid any amounts with respect to the fur3 nishing of such services. 

4 ‘‘(2) The term ‘marriage and family therapist’ means 

5 an individual who—

6 ‘‘(A) possesses a master’s or doctoral degree 

7 which qualifies for licensure or certification as a 

8 marriage and family therapist pursuant to State 

9 law; 

10 ‘‘(B) after obtaining such degree has performed 

11 at least two years of clinical supervised experience in 

12 marriage and family therapy; and 

13 ‘‘(C) in the case of an individual performing 

14 services in a State that provides for licensure or cer15 tification of marriage or family therapists, is li16 censed or certified as a marriage and family thera17 pist in such State.’’. 

18 (c) PROVISION FOR PAYMENT UNDER PART B.—Sec19 tion 1832(a)(2)(B) of such Act (42 U.S.C. 

20 1395k(a)(2)(B)) is amended by adding at the end the fol21 lowing new clause: 

22 ‘‘(v) marriage and family therapist 

23 services;’’. 

24 (d) AMOUNT OF PAYMENT.—Section 1833(a)(1) of 

25 such Act (42 U.S.C. 13951(a)(1)) is amended—
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1 (1) by striking ‘‘and (U)’’ and inserting ‘‘(U)’’; 

2 and 

3 (2) by inserting before the semicolon at the end 

4 the following: ‘‘, and (V) with respect to marriage 

5 and family therapist services under section 

6 1861(s)(2)(W), the amounts paid shall be 80 percent 

7 of the lesser of the actual charge for the services or 

8 75 percent of the amount determined for payment of 

9 a psychologist under clause (L)’’. 

10 (e) EXCLUSION OF MARRIAGE AND FAMILY THERA11 PIST SERVICES FROM SKILLED NURSING FACILITY PRO12 SPECTIVE PAYMENT SYSTEM.—Section 1888(e)(2)(A)(ii) 

13 of such Act (42 U.S.C. 1395yy(e)(2)(A)(ii)) is amended 

14 by inserting ‘‘marriage and family therapist services,’’ 

15 after ‘‘qualified psychologist services,’’. 

16 (f) INCLUSION OF MARRIAGE AND FAMILY THERA17 PISTS AS PRACTITIONERS FOR ASSIGNMENT OF

18 CLAIMS.—Section 1842(b)(18)(C) of such Act (42 U.S.C. 

19 1395u(b)(18)(C)) is amended by adding at the end the 

20 following new clause: 

21 ‘‘(vii) A marriage and family therapist (as de22 fined in section 1861(ww)(2)).’’. 
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1 SEC. 3. COVERAGE OF MARRIAGE AND FAMILY THERAPIST 

2 SERVICES PROVIDED IN CERTAIN SETTINGS. 

3 (a) RURAL HEALTH CLINICS.—Section 

4 1861(aa)(1)(B) of the Social Security Act (42 U.S.C. 

5 1395x(aa)(1)(B)) is amended by inserting ‘‘, by a mar6 riage and family therapist (as defined in subsection 

7 (ww)(2)),’’ after ‘‘by a clinical psychologist (as defined by 

8 the Secretary)’’. 

9 (b) HOSPICE PROGRAMS.—Section 

10 1861(dd)(2)(B)(i)(III) of such Act (42 U.S.C. 

11 1395x(dd)(2)(B)(i)(III)) is amended by inserting ‘‘or mar12 riage and family therapist (as defined in subsection 

13 (ww)(2))’’ after ‘‘social worker’’. 

14 SEC. 4. AUTHORIZATION OF MARRIAGE AND FAMILY 

15 THERAPISTS TO DEVELOP DISCHARGE PLANS 

16 FOR POST-HOSPITAL SERVICES. 

17 Section 1861(ee)(2)(G) of the Social Security Act (42 

18 U.S.C. 1395x(ee)(2)(G)) is amended by inserting ‘‘mar19 riage and family therapist (as defined in subsection 

20 (ww)(2)),’’ after ‘‘social worker,’’. 

21 SEC. 5. EFFECTIVE DATE. 

22 The amendments made by this Act apply with respect 

23 to services furnished on or after January 1, 2004.

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