Lobby Senate on Medicare SWRI Agenda

Congratulations to NASW’s Advocacy Network, on August 1, 2007 the U.S. House of Representatives passed a key component of NASW’s SWRI agenda, the Clinical Social Work Medicare Equity Act along with an across the board 5% increase in CSW payments under Medicare Part B. Your advocacy was a huge help!


The House and Senate will return next week from a month-long recess to begin a difficult conference over Medicare and child health insurance legislation (CHAMP, HR. 3162). NASW members should contact their Senators now to urge their support for critical provisions for clinical social workers in this conference on CHAMP. NASW has prepared a suggested message to send your Senators, click here to send your message today.


CHAMP must still be reconciled with the Senate’s child health insurance proposal and signed by the President, two very high hurdles. The Senate supports a narrower bill that does not include any Medicare provisions. NASW seeks retention of Sections 606, 610 and 203 from HR. 3162 in the final conference agreement, but it is unclear how these two very different bills will be reconciled. The President has pledged to veto either the House or Senate bills, but Democratic leaders and NASW anticipate an eventual political accommodation that enacts much of the CHAMP legislation. It is therefore vital that NASW support our provisions during the conference process.


The House of Representatives passed crucial legislation on August 1, 2007 for clinical social workers, the Children’s Health and Medicare Protection Act (CHAMP, H.R. 3162). NASW scored a major early victory for its Social Work Reinvestment Initiative (SWRI) by attaching our legislation to CHAMP. This bill both increases Medicare payment rates for all clinical social workers billing Part B and restores clinical social workers’ ability to bill Medicare independently for services provided to Part A skilled nursing facility residents. One key SWRI component, the Clinical Social Work Medicare Equity Act (S. 1212 sponsored by Sen. Mikulski) has long been sought by NASW was included in CHAMP. Additionally, NASW has recently sought relief for CSW payments under Part B, which were cut 9% late last year by federal administrative action. CHAMP will increase CSW payments by 5% above their current level beginning on January 1, 2008. This special payment increase applies only to psychotherapy and behavioral services that were cut on January 1, 2007. In addition to the increase in 2008, CSWs will receive the same percent payment update that CHAMP authorizes for all physician services in the program, currently a positive .5% payment update under CHAMP.

NASW has been working aggressively with its advocacy network and behind the scenes to secure these crucial social worker payment increases. CHAMP is the necessary vehicle for our changes, and it contains many different components. Other key provisions include a significant expansion of the State Children’s Health Insurance Program (SCHIP), increases in physician payments, and other benefit improvements in both Medicare and Medicaid. These improvements are offset by cuts in managed care payments for Medicare, nursing home rates and a substantial increase in tobacco taxes. NASW strongly supports passage of CHAMP to protect the Medicare program and expand child health insurance coverage.

The following CHAMP provisions are NASW’s top priorities in the upcoming CHAMP/child health insurance (HR. 3162) conference:

  • Retain Section 606: Removes clinical social worker services from coverage under the Medicare SNF prospective (consolidated) payment system, permitting CSWs to bill Medicare separately, the same as psychiatrists and psychologists services for Medicare Part A beneficiaries served in skilled nursing facilities.
  • Retain Section 610: Increases Medicare Part B payments to CSWs and psychologists by 5% starting on January 1, 2008. This increase will partially restore a CMS cut for these professional services that occurred on the first of this year. This “bump up” is limited to four years, after which, another administrative rebalancing will occur among payments for Part B professional services. Additionally, CSWs will receive the same SGR payment update as physicians, now a positive .5% in the bill.
  • Retain Section 203: Corrects Medicare’s current discriminatory co-payment on outpatient mental health services from 50/50 beneficiary cost sharing to the standard 80/20 coverage for other Part B services. This “Medicare parity” provision would go into effect on January 1, 2008.

For further information, contact Jim Finley at NASW: jfinley@naswdc.org.

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