Addiction Treatment Access Act

To amend title XVIII of the Social Security Act to provide coverage of addiction counselor services under part B of the Medicare program. 1. Short title This Act may be cited as the Addiction Treatment Access Act 2. Coverage of addiction counselor services under part B (a) Coverage of Services (1) In general Section 1861(s)(2) of the Social Security Act 42 U.S.C. 1395x(s)(2) (A) in subparagraph (GG), by striking and (B) in subparagraph (HH), by striking the period at the end and inserting ; and (C) by adding at the end the following new subparagraph: (II) addiction counselor services (as defined in subsection (kkk)(1)); . (2) Definitions Section 1861 of the Social Security Act ( 42 U.S.C. 1395x (kkk) Addiction counselor services; addiction counselor (1) The term addiction counselor services (A) addiction assessment; (B) addiction counseling; (C) crisis management; (D) drug therapy; (E) treatment planning; and (F) treatment of co-occurring disorders, but only if no facility or other provider charges or is paid any amounts with respect to the furnishing of such services. (2) The term addiction counselor (A) has completed coursework or training specific to treating substance use disorders, including with respect to the addiction counseling competencies identified in the document published by the Substance Abuse and Mental Health Services Administration as part of the Technical Assistance Publication (TAP) series, number 21, entitled Addiction Counseling Competencies: The Knowledge, Skills, and Attitudes of Profressional Practice (B) in the case of an individual performing services in a State that provides for licensure or certification of addiction counselors, is licensed or certified as an addiction counselor or alcohol and drug counselor in such State. . (3) Provision for payment under part B Section 1832(a)(2)(B) of the Social Security Act ( 42 U.S.C. 1395k(a)(2)(B) (A) by striking and (B) by adding at the end the following new clause: (v) addiction counselor services; . (4) Amount of payment Section 1833(a)(1) of the Social Security Act ( 42 U.S.C. 1395l(a)(1) (A) by striking and (CC) (B) by inserting before the semicolon at the end the following: , and (DD) with respect to addiction counselor services under section 1861(s)(2)(II), the amounts paid shall be 80 percent of the lesser of the actual charge for the services or 60 percent of the amount determined for payment of a psychologist under subparagraph (L). (5) Inclusion of addiction counselors as practitioners for assignment of claims Section 1842(b)(18)(C) of the Social Security Act ( 42 U.S.C. 1395u(b)(18)(C) (vii) An addiction counselor (as defined in section 1861(kkk)(2)). . (b) Coverage in rural health clinics and federally qualified health centers Section 1861(aa)(1)(B) of the Social Security Act 42 U.S.C. 1395x(aa)(1)(B) or by a clinical social worker (as defined in subsection (hh)(1)), , by a clinical social worker (as defined in subsection (hh)(1)), or by an addiction counselor (as defined in section 1861(kkk)(2)). (c) Effective Date The amendments made by this section shall apply with respect to services furnished on or after January 1, 2020.

Summary: Addiction Treatment Access Act This bill provides for Medicare coverage of addiction counselor services that are used to diagnose and treat substance abuse and that would otherwise be covered if provided by a physician, including incidental services, as long as no payment is made to other providers for such services.