Title: Mental Health Access Improvement Act of 2019
Policy area: Health

Summary:
Mental Health Access Improvement Act of 2019
This bill provides for coverage of marriage and family therapist services and mental health counselor services under Medicare. It also excludes such services from the skilled nursing facility prospective payment system, and authorizes marriage and family therapists and mental health counselors to develop discharge plans for post-hospital services.

[Congressional Bills 116th Congress]
[From the U.S. Government Publishing Office]
[S. 286 Introduced in Senate (IS)]

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116th CONGRESS
  1st Session
                                 S. 286

  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 SENATE OF THE UNITED STATES

                            January 31, 2019

 Mr. Barrasso (for himself and Ms. Stabenow) 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 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.

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

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Mental Health Access Improvement Act 
of 2019''.

SEC. 2. COVERAGE OF MARRIAGE AND FAMILY THERAPIST SERVICES AND MENTAL 
              HEALTH COUNSELOR SERVICES UNDER PART B OF THE MEDICARE 
              PROGRAM.

    (a) Coverage of Services.--
            (1) In general.--Section 1861(s)(2) of the Social Security 
        Act (42 U.S.C. 1395x(s)(2)) is amended--
                    (A) in subparagraph (GG), by striking ``and'' after 
                the semicolon at the end;
                    (B) in subparagraph (HH), by striking the period at 
                the end and inserting ``; and''; and
                    (C) by adding at the end the following new 
                subparagraph:
            ``(II) marriage and family therapist services (as defined 
        in subsection (kkk)(1)) and mental health counselor services 
        (as defined in subsection (kkk)(3));''.
            (2) Definitions.--Section 1861 of the Social Security Act 
        (42 U.S.C. 1395x) is amended by adding at the end the following 
        new subsection:

     ``Marriage and Family Therapist Services; Marriage and Family 
  Therapist; Mental Health Counselor Services; Mental Health Counselor

    ``(kkk)(1) The term `marriage and family therapist services' means 
services performed by a marriage and family therapist (as defined in 
paragraph (2)) for the diagnosis and treatment of mental illnesses, 
which the marriage and family therapist is legally authorized to 
perform under State law (or the State regulatory mechanism provided 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 professional service, 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 `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 2 
        years of clinical supervised experience in marriage and family 
        therapy; and
            ``(C) in the case of an individual performing services in a 
        State that provides for licensure or certification of marriage 
        and family therapists, is licensed or certified as a marriage 
        and family therapist in such State.
    ``(3) The term `mental health counselor services' means services 
performed by a mental health counselor (as defined in paragraph (4)) 
for the diagnosis and treatment of mental illnesses which the mental 
health counselor is legally authorized to perform under State law (or 
the State regulatory mechanism provided by the State law) of the State 
in which such services are performed, as would otherwise be covered if 
furnished by a physician or as incident to a physician's professional 
service, but only if no facility or other provider charges or is paid 
any amounts with respect to the furnishing of such services.
    ``(4) The term `mental health counselor' means an individual who--
            ``(A) possesses a master's or doctor's degree in mental 
        health counseling or a related field;
            ``(B) after obtaining such a degree has performed at least 
        2 years of supervised mental health counselor practice; and
            ``(C) in the case of an individual performing services in a 
        State that provides for licensure or certification of mental 
        health counselors or professional counselors, is licensed or 
        certified as a mental health counselor or professional 
        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)) is amended by adding at the end the following 
        new clause:
                            ``(v) marriage and family therapist 
                        services (as defined in section 1861(kkk)(1)) 
                        and mental health counselor services (as 
                        defined in section 1861(kkk)(3));''.
            (4) Amount of payment.--Section 1833(a)(1) of the Social 
        Security Act (42 U.S.C. 1395l(a)(1)) is amended--
                    (A) by striking ``and (CC)'' and inserting 
                ``(CC)''; and
                    (B) by inserting before the semicolon at the end 
                the following: ``, and (DD) with respect to marriage 
                and family therapist services and mental health 
                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 75 percent of the 
                amount determined for payment of a psychologist under 
                subparagraph (L)''.
            (5) Exclusion of marriage and family therapist services and 
        mental health counselor services from skilled nursing facility 
        prospective payment system.--Section 1888(e)(2)(A)(ii) of the 
        Social Security Act (42 U.S.C. 1395yy(e)(2)(A)(ii)) is amended 
        by inserting ``marriage and family therapist services (as 
        defined in section 1861(kkk)(1)), mental health counselor 
        services (as defined in section 1861(kkk)(3)),'' after 
        ``qualified psychologist services,''.
            (6) Inclusion of marriage and family therapists and mental 
        health 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)) is amended by adding at the end the following 
        new clauses:
            ``(vii) A marriage and family therapist (as defined in 
        section 1861(kkk)(2)).
            ``(viii) A mental health counselor (as defined in section 
        1861(kkk)(4)).''.
    (b) Coverage of Certain Mental Health Services Provided in Certain 
Settings.--
            (1) 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)) is amended by striking ``or by a 
        clinical social worker (as defined in subsection (hh)(1))'' and 
        inserting ``, by a clinical social worker (as defined in 
        subsection (hh)(1)), by a marriage and family therapist (as 
        defined in subsection (kkk)(2)), or by a mental health 
        counselor (as defined in subsection (kkk)(4))''.
            (2) Hospice programs.--Section 1861(dd)(2)(B)(i)(III) of 
        the Social Security Act (42 U.S.C. 1395x(dd)(2)(B)(i)(III)) is 
        amended by inserting ``, marriage and family therapist, or 
        mental health counselor'' after ``social worker''.
    (c) Authorization of Marriage and Family Therapists and Mental 
Health Counselors 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 inserting ``, including a marriage and 
family therapist and a mental health counselor who meets qualification 
standards established by the Secretary'' before the period at the end.
    (d) Effective Date.--The amendments made by this section shall 
apply with respect to services furnished on or after January 1, 2020.
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