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More Information on Medicare Recognition of Counselors

For counselors to be eligible for reimbursement under Medicare, a law must add the profession to the program. For this reason, NBCC’s advocacy on this issue has primarily been in the form of lobbying before Congress. NBCC is part of a coalition of counselor and marriage and family therapist (MFT) organizations working together to pass legislation adding counselors and MFTs to Medicare. (Like counselors, MFTs are excluded from Medicare despite meeting education and training requirements comparable to those of included professions.)

Legislative History

A stand-alone bill adding counselors to Medicare was first introduced in 2001, in the 107th Congress. Since then, NBCC’s advocacy has ensured that such a bill has introduced by at least one of the houses of Congress during every subsequent session. Both chambers of Congress have passed legislation adding Medicare recognition of counselors, but not at the same time. The Senate passed legislation in 2003 and 2005, and the House passed legislation in 2007 and 2009.

Legislative Highlights

In the 112th Congress, Sens. Ron Wyden (D-OR) and John Barrasso (R-WY) introduced bipartisan, stand-alone bill S. 604, the Seniors Mental Health Access Improvement Act of 2011. The counselor language was also included in S. 1680, the Craig Thomas Rural Hospital and Provider Equity Act of 2011, and in H.R. 2954, the Health Equity and Accountability Act of 2011. NBCC submitted a letter of support for S. 1680.

Eight bills from the 111th Congress included language to add professional counselors to Medicare, including the health reform bill that passed the House (H.R. 3962). The provision was reportedly in the final House-Senate compromise legislation until the election of Sen. Scott Brown (R-MA) changed the Senate balance.

In the 110th Congress, the provision passed the House as part of the SCHIP (State Children’s Health Insurance Program) Reauthorization Act (H.R. 3162). However, the Senate declined to consider the SCHIP bill.

During the 109th Congress, NBCC’s Medicare provision passed the Senate as part of the Deficit Reduction Act of 2005 (S. 1932), but did not make it through conference.

In 2003, during the 108th Congress, the provision passed the Senate in the Medicare prescription drug bill (S. 1), but was not accepted during conference.

In the 107th Congress, the counselor provision was included in an omnibus Medicare mental health bill (S. 690 and H.R. 1522), but did not make it out of committee. Both chambers also introduced stand-alone bills.

News Archive

On December 5, 2013, Reps. Christopher Gibson (R-NY) and Mike Thompson (D-CA) introduced H.R. 3662. The bill is a companion to S. 562 and is the first standalone House Medicare bill since 2009. The bipartisan bill is an important step forward in the House of Representatives, providing a mechanism to show support for the legislation. NBCC and our coalition partners are meeting with congressional offices to grow cosponsorship of the legislation. A parallel process is underway in the Senate, which has increased support for S. 562 by 10 senators.

The coalition made a big push to include its Medicare language in legislation to permanently fix the sustainable growth rate that was marked up by the Senate Finance Committee on December 12. Sen. Wyden (D-OR) filed an amendment to add our provision in an effort to get it wrapped into the Chairman’s Mark. Unfortunately, the provision did not make it into the substitute package, as only a handful of the 130 amendments were included in the final bill. NBCC will continue to push for inclusion as the proposal moves through Congress.