Medicare Bill Gives Victory to Social Workers

Jul 17, 2008

€”In a milestone victory, NASW commends the U.S. Senate and House for overriding President Bush’s veto of the Medicare legislation, H.R. 6331, restoring funding for clinical social work payments cut in 2007 and greatly improving coverage of outpatient psychotherapy services. The final House vote on the Medicare Improvements for Patients and Providers Act of 2008 was 383 to 41 and 70 to 26 in the Senate. Numerous Republicans joined united Democrats in overriding the veto.

NASW is thrilled that mental services are finally receiving full recognition by this Congress. €œWe thank the thousands of NASW advocates who contacted their Senators and Representatives to support passage of the bill.€

The new law contains a rate increase for psychotherapy services cut in 2007. The Medicare package was designed primarily to halt a scheduled 10.6% cut in all Part B provider payment rates, but the new law also contains little noticed mental health coverage improvements.

Among these are a rate increase for clinical social workers billing Part B and a critical Medicare coinsurance parity provision that reduces beneficiary cost-sharing by 5% per year from 50% currently down to 20% in 2014 – reaching full parity with other Medicare outpatient benefits. This is a crucial legislative goal long sought by NASW and other mental health groups.

€œGiven strong pressure from the White House to narrow the bill, this is a huge victory for clinical social workers and psychologists who worked hard to restore psychotherapy rates in Medicare. €œThe sentiment of mental health advocates on final passage was exuberant, as this is a major victory on Medicare€™s outpatient mental health benefit.€

Clinical social worker and psychology rates will increase for psychotherapy and related services by 5% (adding $45 million in new spending) for 18 months from July 1, 2008 through December 31, 2009. This psychotherapy rate increase is above the rate given to other medical services under Part B, which all clinicians, including social workers will receive.

The law also provides for Medicare coinsurance parity on mental health services, reducing beneficiaries’ co-payments by 5% per year, reducing the rate from 50% to 45% in 2009 and finally reaching 20% in 2014 achieving full parity with Medicare outpatient benefits.

This legislative goal has been supported by NASW and other mental health advocates since Medicare was enacted in 1965. In addition, the law postpones a rate cut for 18 months beginning July 1, 2008 and increases payments for all providers by 1.1% for 2009, including clinical social workers participating in Part B.