I
106TH CONGRESS
1ST SESSION
H. R. 2945
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
SEPTEMBER 24, 1999
Mr. DEAL of Georgia (for himself and Mr. STRICKLAND) introduced the fol-
lowing bill; which was referred to the Committee on Commerce, and in
addition to the Committee on Ways and Means, for a period to be subse-
quently 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.
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ‘‘Seniors Mental Health
Access Improvement Act of 1999’’.
SEC. 2. COVERAGE OF MARRIAGE AND FAMILY THERAPIST
SERVICES UNDER PART B.
(a) COVERAGE OF SERVICES.—Section 1861(s)(2) of
the Social Security Act (42 U.S.C. 1395x(s)(2)) is
amended—
(1) in subparagraph (S), by striking ‘‘and’’ at
the end;
(2) in subparagraph (T), by striking the period
at the end and inserting ‘‘; and’’; and
(3) by adding at the end the following new sub-
paragraph:
‘‘(U) marriage and family therapist serv-
ices (as defined in subsection (uu)(1));’’.
(b) DEFINITION.—Section 1861 of such Act (42
U.S.C. 1395x) is amended by adding at the end thereof
the following new subsection:
‘‘Marriage and Family Therapist Services
‘‘(uu)(1) The term ‘marriage and family therapist
services’ means services performed by a marriage and
family therapist (as defined in paragraph (2)) for the diag-
nosis and treatment of mental illnesses, which the mar-
riage and family therapist is legally authorized to perform
under State law (or the State regulatory mechanism pro-
vided by State law) of the State in which such services
are performed, as would otherwise be covered if furnished
by a physician or as an incident to a physician’s profes-
sional service, but only if no facility or other provider
charges or is paid any amounts with respect to the fur-
nishing of such services.
‘‘(2) The term ‘marriage and family therapist’ means
an individual who—
‘‘(A) possesses a master’s or doctoral degree
which qualifies for licensure or certification as a
marriage and family therapist pursuant to State
law;
‘‘(B) after obtaining such degree has performed
at least two years of clinical supervised experience in
marriage and family therapy; and
‘‘(C)(i) is licensed or certified as a marriage
and family therapist in the State in which marriage
and family therapist services are performed, or
‘‘(ii) in the case of a State that does not pro-
vide for such licensure or certification, meets such
other criteria as the Secretary establishes.’’.
(c) PROVISION FOR PAYMENT UNDER PART B.—Sec-
tion 
1832(a)(2)(B) 
of 
such 
Act 
(42 
U.S.C.
1395k(a)(2)(B)) is amended by adding at the end the fol-
lowing new clause:
‘‘(v) marriage and family therapist
services;’’.
(d) AMOUNT OF PAYMENT.—Section 1833(a)(1) of
such Act (42 U.S.C. 13951(a)(1)) is amended—
(1) by striking ‘‘and (S)’’ and inserting ‘‘(S)’’;
and
(2) by inserting before the semicolon at the end
the following: ‘‘, and (T) with respect to marriage
and 
family 
therapist 
services 
under 
section
1861(s)(2)(U), the amounts paid shall be 80 percent
of the lesser of the actual charge for the services or
75 percent of the amount determined for payment of
a psychologist under clause (L)’’.
(e) EXCLUSION OF MARRIAGE AND FAMILY THERA-
PIST SERVICES FROM SKILLED NURSING FACILITY PRO-
SPECTIVE PAYMENT SYSTEM.—Section 1888(e)(2)(A)(ii)
of such Act (42 U.S.C. 1395yy(e)(2)(A)(ii)) is amended
by striking ‘‘qualified psychologist services’’ and inserting
‘‘qualified psychologist services, marriage and family ther-
apist services (as defined in section 1861(uu)(1))’’.
SEC. 3. COVERAGE OF MARRIAGE AND FAMILY THERAPIST
SERVICES PROVIDED IN CERTAIN SETTINGS.
(a) 
RURAL
HEALTH
CLINICS.—Section
1861(aa)(1)(B) of the Social Security Act (42 U.S.C.
1395x(aa)(1)(B)) is amended by striking ‘‘Secretary),’’
and inserting ‘‘Secretary) or marriage and family thera-
pist (as defined in subsection (uu)(2)),’’.
(b) 
HOSPICE
PROGRAMS.—Section
1861(dd)(2)(B)(i)(III) 
of 
such 
Act 
(42 
U.S.C.
1395x(dd)(2)(B)(i)(III)) is amended by striking ‘‘work-
er,’’ and inserting ‘‘worker or marriage and family thera-
pist (as defined in subsection (uu)(2))’’.
SEC. 4. AUTHORIZATION OF MARRIAGE AND FAMILY
THERAPISTS TO DEVELOP DISCHARGE PLANS
FOR POST-HOSPITAL SERVICES.
Section 1861(ee)(2)(G) of the Social Security Act (42
U.S.C. 1395x(ee)(2)(G)) is amended by striking ‘‘social
worker,’’ and inserting ‘‘social worker, marriage and fam-
ily therapist (as defined in subsection (uu)(2)),’’.
SEC. 5. EFFECTIVE DATE.
The amendments made by this Act apply with respect
to services furnished on or after January 1, 2000.
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