In March of 2021, the Improving Access to Mental Health Act of 2021 was introduced in the House. This bipartisan bill, co-sponsored by Senator Debbie Stabenow (D-MI), Senator John Barrasso (R-WY), and Representative Barbara Lee, MSW (D-CA), will address gaps in services that Clinical Social Workers are able to provide under current law. 

There are 42 cosponsors in the House and 5 in the Senate. Per the NASW advocacy alert, we need at least 175 cosponsors in the House and over 50 in the Senate to demonstrate broad support for this bill and elevate it to potential consideration. It is anticipated that this might be a topic of focus in the coming months due to a recent request from the Senate Finance Committeeabout concerns that every American should be able to access high-quality behavioral health care when needed. 

Under current law, clinical social workers can furnish services related to the diagnosis and treatment of mental illness in the Medicare program. This act allows for clinical social workers to also receive Medicare reimbursement for Health and Behavior Assessment and Intervention (HBAI). These services focus on psychological barriers that affect someone’s ability to manage and adjust to their chronic illness. For example, these issues could be emotional like being anxious or overwhelmed, or they could be financial such as inadequate income to pay for basic needs. This aligns well with the work that palliative care social workers engage in as we support patients and could be used by community programs to bill for social work services. 

The bill would increase Medicare payment rates for Clinical Social Workers so that it aligns with most non-physician providers by increasing the rate from 75% to 85% of the physician fee schedule. Medicare reimbursement levels have a great influence on the rates paid by private insurers. 

Lastly, the bill allows Clinical Social Workers to provide services to residents of skilled nursing facilities under Medicare B by excluding them from consolidated billing. Independent social workers, not employed by the facility, would be able to seek reimbursement for services provided, which would include not just the diagnosis and treatment of mental illness but also health and behavior assessment and intervention. This greatly increases the access to mental health services for nursing home residents receiving care under Medicare Part A.