I 

109TH CONGRESS 

2D SESSION H. R. 5324 

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 HOUSE OF REPRESENTATIVES 

MAY 9, 2006 

Mrs. CUBIN 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 

and mental health counselor 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 2006’’. 


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1 SEC. 2. COVERAGE OF MARRIAGE AND FAMILY THERAPIST 

2 SERVICES AND MENTAL HEALTH COUNSELOR 

3 SERVICES UNDER PART B OF THE MEDICARE 

4 PROGRAM. 

5 (a) COVERAGE OF SERVICES.— 

6 (1) IN GENERAL.—Section 1861(s)(2) of the 

7 Social Security Act (42 U.S.C. 1395x(s)(2)), as 

8 amended by section 5112(a)(1) of the Deficit Reduc9 tion Act of 2005, is amended— 

10 (A) in subparagraph (Z), by striking 

11 ‘‘and’’ after the semicolon at the end; 

12 (B) in subparagraph (AA), by inserting 

13 ‘‘and’’ after the semicolon at the end; and 

14 (C) by adding at the end the following new 

15 subparagraph: 

16 ‘‘(BB) marriage and family therapist services 

17 (as defined in subsection (ccc)(1)) and mental health 

18 counselor services (as defined in subsection 

19 (ccc)(3));’’. 

20 (2) DEFINITIONS.—Section 1861 of the Social 

21 Security Act (42 U.S.C. 1395x), as amended by sec22 tion 5112(a)(2) of the Deficit Reduction Act, is 

23 amended by adding at the end the following new 

24 subsection: 


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1 ‘‘Marriage and Family Therapist Services; Marriage and 

2 Family Therapist; Mental Health Counselor Serv3 ices; Mental Health Counselor 

4 ‘‘(ccc)(1) The term ‘marriage and family therapist 

5 services’ means services performed by a marriage and 

6 family therapist (as defined in paragraph (2)) for the diag7 nosis and treatment of mental illnesses, which the mar8 riage and family therapist is legally authorized to perform 

9 under State law (or the State regulatory mechanism pro10 vided by State law) of the State in which such services 

11 are performed, as would otherwise be covered if furnished 

12 by a physician or as an incident to a physician’s profes13 sional service, but only if no facility or other provider 

14 charges or is paid any amounts with respect to the fur15 nishing of such services. 

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

17 an individual who— 

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

19 which qualifies for licensure or certification as a 

20 marriage and family therapist pursuant to State 

21 law; 

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

23 at least 2 years of clinical supervised experience in 

24 marriage and family therapy; and 


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

2 services in a State that provides for licensure or cer3 tification of marriage and family therapists, is li4 censed or certified as a marriage and family thera5 pist in such State. 

6 ‘‘(3) The term ‘mental health counselor services’ 

7 means services performed by a mental health counselor (as 

8 defined in paragraph (4)) for the diagnosis and treatment 

9 of mental illnesses which the mental health counselor is 

10 legally authorized to perform under State law (or the 

11 State regulatory mechanism provided by the State law) of 

12 the State in which such services are performed, as would 

13 otherwise be covered if furnished by a physician or as inci14 dent to a physician’s professional service, but only if no 

15 facility or other provider charges or is paid any amounts 

16 with respect to the furnishing of such services. 

17 ‘‘(4) The term ‘mental health counselor’ means an 

18 individual who— 

19 ‘‘(A) possesses a master’s or doctor’s degree in 

20 mental health counseling or a related field; 

21 ‘‘(B) after obtaining such a degree has per22 formed at least 2 years of supervised mental health 

23 counselor practice; and 

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

25 services in a State that provides for licensure or cerVerDate Aug 31 2005 22:28 May 12, 2006 Jkt 049200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\H5324.IH H5324

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1 tification of mental health counselors or professional 

2 counselors, is licensed or certified as a mental health 

3 counselor or professional counselor in such State.’’. 

4 (3) PROVISION FOR PAYMENT UNDER PART

5 B.—Section 1832(a)(2)(B) of the Social Security 

6 Act (42 U.S.C. 1395k(a)(2)(B)) is amended by add7 ing at the end the following new clause: 

8 ‘‘(v) marriage and family therapist 

9 services (as defined in section 

10 1861(ccc)(1)) and mental health counselor 

11 services (as defined in section 

12 1861(ccc)(3));’’. 

13 (4) AMOUNT OF PAYMENT.—Section 1833(a)(1) 

14 of the Social Security Act (42 U.S.C. 1395l(a)(1)) 

15 is amended— 

16 (A) by striking ‘‘and (V)’’ and inserting 

17 ‘‘(V)’’; and 

18 (B) by inserting before the semicolon at 

19 the end the following: ‘‘, and (W) with respect 

20 to marriage and family therapist services and 

21 mental health counselor services under section 

22 1861(s)(2)(BB), the amounts paid shall be 80 

23 percent of the lesser of the actual charge for 

24 the services or 75 percent of the amount deterVerDate Aug 31 2005 20:55 May 13, 2006 Jkt 049200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\H5324.IH H5324

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1 mined for payment of a psychologist under sub2 paragraph (L)’’. 

3 (5) EXCLUSION OF MARRIAGE AND FAMILY

4 THERAPIST SERVICES AND MENTAL HEALTH COUN5 SELOR SERVICES FROM SKILLED NURSING FACILITY

6 PROSPECTIVE PAYMENT SYSTEM.—Section 

7 1888(e)(2)(A)(ii) of the Social Security Act (42 

8 U.S.C. 1395yy(e)(2)(A)(ii)) is amended by inserting 

9 ‘‘marriage and family therapist services (as defined 

10 in section 1861(ccc)(1)), mental health counselor 

11 services (as defined in section 1861(ccc)(3)),’’ after 

12 ‘‘qualified psychologist services,’’. 

13 (6) INCLUSION OF MARRIAGE AND FAMILY

14 THERAPISTS AND MENTAL HEALTH COUNSELORS AS

15 PRACTITIONERS FOR ASSIGNMENT OF CLAIMS.—Sec16 tion 1842(b)(18)(C) of the Social Security Act (42 

17 U.S.C. 1395u(b)(18)(C)) is amended by adding at 

18 the end the following new clauses: 

19 ‘‘(vii) A marriage and family therapist (as de20 fined in section 1861(ccc)(2)). 

21 ‘‘(viii) A mental health counselor (as defined in 

22 section 1861(ccc)(4)).’’. 

23 (b) COVERAGE OF CERTAIN MENTAL HEALTH SERV24 ICES PROVIDED IN CERTAIN SETTINGS.— 


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1 (1) RURAL HEALTH CLINICS AND FEDERALLY

2 QUALIFIED HEALTH CENTERS.—Section 

3 1861(aa)(1)(B) of the Social Security Act (42 

4 U.S.C. 1395x(aa)(1)(B)) is amended by striking ‘‘or 

5 by a clinical social worker (as defined in subsection 

6 (hh)(1))’’ and inserting ‘‘, by a clinical social worker 

7 (as defined in subsection (hh)(1)), by a marriage 

8 and family therapist (as defined in subsection 

9 (ccc)(2)), or by a mental health counselor (as de10 fined in subsection (ccc)(4))’’. 

11 (2) HOSPICE PROGRAMS.—Section 

12 1861(dd)(2)(B)(i)(III) of the Social Security Act (42 

13 U.S.C. 1395x(dd)(2)(B)(i)(III)) is amended by in14 serting ‘‘or one marriage and family therapist (as 

15 defined in subsection (ccc)(2))’’ after ‘‘social work16 er’’. 

17 (c) AUTHORIZATION OF MARRIAGE AND FAMILY

18 THERAPISTS TO DEVELOP DISCHARGE PLANS FOR POST19 HOSPITAL SERVICES.—Section 1861(ee)(2)(G) of the So20 cial Security Act (42 U.S.C. 1395x(ee)(2)(G)) is amended 

21 by inserting ‘‘marriage and family therapist (as defined 

22 in subsection (ccc)(2)),’’ after ‘‘social worker,’’. 


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1 (d) EFFECTIVE DATE.—The amendments made by 

2 this section shall apply with respect to services furnished 

3 on or after January 1, 2007. 

Æ 


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