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. 

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 ‘‘Addiction Treatment 

5 Access Act’’. 

6 SEC. 2. COVERAGE OF ADDICTION COUNSELOR SERVICES 

7 UNDER PART B OF THE MEDICARE PROGRAM. 

8 (a) COVERAGE OF SERVICES.— 


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•S 2412 IS

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

2 Social Security Act (42 U.S.C. 1395x(s)(2)) is 

3 amended— 

4 (A) in subparagraph (GG), by striking 

5 ‘‘and’’ at the end; 

6 (B) in subparagraph (HH), by striking the 

7 period at the end and inserting ‘‘; and’’; and 

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

9 subparagraph: 

10 ‘‘(II) addiction counselor services (as defined in 

11 subsection (kkk)(1));’’. 

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

13 Security Act (42 U.S.C. 1395x) is amended by add14 ing at the end the following new subsection: 

15 ‘‘Addiction Counselor Services; Addiction Counselor 

16 ‘‘(kkk)(1) The term ‘addiction counselor services’ 

17 means services performed by an addiction counselor (as 

18 defined in paragraph (2)) for the diagnosis and treatment 

19 of substance abuse and addiction that the addiction coun20 selor is legally authorized to perform under State law (or 

21 the State regulatory mechanism provided by the State 

22 law) of the State in which such services are performed, 

23 as would otherwise be covered if furnished by a physician 

24 or as incident to a physician’s professional service, which 

25 may include— 


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•S 2412 IS

1 ‘‘(A) addiction assessment; 

2 ‘‘(B) addiction counseling; 

3 ‘‘(C) crisis management; 

4 ‘‘(D) drug therapy; 

5 ‘‘(E) treatment planning; and 

6 ‘‘(F) treatment of co-occurring disorders, 

7 but only if no facility or other provider charges or is paid 

8 any amounts with respect to the furnishing of such serv9 ices. 

10 ‘‘(2) The term ‘addiction counselor’ means an indi11 vidual who— 

12 ‘‘(A) has completed coursework or training spe13 cific to treating substance use disorders, including 

14 with respect to the addiction counseling com15 petencies identified in the document published by the 

16 Substance Abuse and Mental Health Services Ad17 ministration as part of the Technical Assistance 

18 Publication (TAP) series, number 21, entitled ‘Ad19 diction Counseling Competencies: The Knowledge, 

20 Skills, and Attitudes of Profressional Practice’ (or 

21 any successor publication); and 

22 ‘‘(B) in the case of an individual performing 

23 services in a State that provides for licensure or cer24 tification of addiction counselors, is licensed or cerVerDate Sep 11 2014 01:12 Aug 09, 2019 Jkt 089200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\S2412.IS S2412

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•S 2412 IS

1 tified as an addiction counselor or alcohol and drug 

2 counselor in such State.’’. 

3 (3) PROVISION FOR PAYMENT UNDER PART

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

5 Act (42 U.S.C. 1395k(a)(2)(B)) is amended— 

6 (A) by striking ‘‘and’’ at the end of clause 

7 (iv); and 

8 (B) by adding at the end the following new 

9 clause: 

10 ‘‘(v) addiction counselor services;’’. 

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

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

13 is amended— 

14 (A) by striking ‘‘and’’ before ‘‘(CC)’’; and 

15 (B) by inserting before the semicolon at 

16 the end the following: ‘‘, and (DD) with respect 

17 to addiction counselor services under section 

18 1861(s)(2)(II), the amounts paid shall be 80 

19 percent of the lesser of the actual charge for 

20 the services or 60 percent of the amount deter21 mined for payment of a psychologist under sub22 paragraph (L).’’. 

23 (5) INCLUSION OF ADDICTION COUNSELORS AS

24 PRACTITIONERS FOR ASSIGNMENT OF CLAIMS.—Sec25 tion 1842(b)(18)(C) of the Social Security Act (42 


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•S 2412 IS

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

2 the end the following new clause: 

3 ‘‘(vii) An addiction counselor (as defined in sec4 tion 1861(kkk)(2)).’’. 

5 (b) COVERAGE IN RURAL HEALTH CLINICS AND

6 FEDERALLY QUALIFIED HEALTH CENTERS.—Section 

7 1861(aa)(1)(B) of the Social Security Act (42 U.S.C. 

8 1395x(aa)(1)(B)) is amended by striking ‘‘or by a clinical 

9 social worker (as defined in subsection (hh)(1)),’’ and in10 serting ‘‘, by a clinical social worker (as defined in sub11 section (hh)(1)), or by an addiction counselor (as defined 

12 in section 1861(kkk)(2)).’’. 

13 (c) EFFECTIVE DATE.—The amendments made by 

14 this section shall apply with respect to services furnished 

15 on or after January 1, 2020. 

Æ 


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