Title: Addiction Treatment Access Act
Policy area: Health

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.

[Congressional Bills 116th Congress]
[From the U.S. Government Publishing Office]
[S. 2412 Introduced in Senate (IS)]

<DOC>






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.

    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 ``Addiction Treatment Access Act''.

SEC. 2. COVERAGE OF ADDICTION 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'' 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) addiction counselor services (as defined in 
        subsection (kkk)(1));''.
            (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:

          ``Addiction Counselor Services; Addiction Counselor

    ``(kkk)(1) The term `addiction counselor services' means services 
performed by an addiction counselor (as defined in paragraph (2)) for 
the diagnosis and treatment of substance abuse and addiction that the 
addiction 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, which may include--
            ``(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' means an individual who--
            ``(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' (or any successor publication); and
            ``(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)) is amended--
                    (A) by striking ``and'' at the end of clause (iv); 
                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)) is amended--
                    (A) by striking ``and'' before ``(CC)''; and
                    (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)) is amended by adding 
        at the end the following new clause:
            ``(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)) 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)), 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.
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