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Counselors and MFTs need to be recognized by the Federal Government

20 Feb 2018 12:50 PM | Paul Callister (Administrator)

Fact Sheet: Medicare and Mental Health

Prepared by the American Mental Health Counselors Association

Mental Health Counselors (MHCs) and Marriage and Family Therapists (MFTs) need to be recognized by Medicare. Here are five good reasons: 
  1. Elderly Mental Health Problems—Several recent reports have indicated that limited access to mental health services is a serious problem in the Medicare program. According to a Surgeon General’s report, 37% of seniors display symptoms of depression in a primary care environment. 
  2. Comparable Education—The covered mental health professionals recognized by Medicare presently include psychiatrists, psychologists, mental health clinical nurse specialists, and clinical social workers. MHCs and MFTs are not listed as Medicare-covered providers despite the fact that both groups have education, training, and practice rights equivalent to or greater than existing covered providers.
  3. Lack of Access—Approximately 77 million people live in 3,000 mental health professional shortage areas. Fully 50% of rural counties in America have no practicing psychiatrists, psychologists, or social workers. Research shows that MHCs and MFTs are located in many rural and underserved areas that do not have any of the current Medicare providers.
  4. Medicare Inefficiency—Inpatient psychiatric hospital utilization by elderly Medicare recipients is extraordinarily high when compared to psychiatric hospitalization rates for patient covered by Medicaid, VA, TRICARE, and private health insurers. One third of these expensive inpatient placements are caused by clinical depression and addiction disorders which can be treated for much lower costs when detected early through the outpatient mental health services of MHCs and MFTs: Studies conducted by the Centers for Medicare and Medicaid Services (CMS) show Medicare is spending on average $9,000 per inpatient mental health claimant and only $400 per outpatient mental health claimant. Medicare’s greater ratio of spending on inpatient mental health versus outpatient mental health is the inverse of mental health purchases exercised by other insurers. 
  5. Costs—The addition of MHCs and MFTs should save money over time. The Congressional Budget Office (CBO) cost is $100 million over five years/$400 million over ten years, but these do not include any cost offsets. Our proposal proposes to pay MHCs and MFTs only 75% of the psychologist’s rate for mental health services, thereby saving money when the lower cost provider is accessed. This legislation would not change the Medicare mental health benefit or modify the MHC or MFT scope of practice, but instead allow seniors access to the high quality “medically necessary” mental health care services of MHCs and MFTs. 

We need Utah Senators and House Representatives to support and cosponsor: 
H.B.3032 https://www.congress.gov/bill/115th-congress/house-bill/3032 
S.1879 https://www.congress.gov/bill/115th-congress/senate-bill/1879

Utah Mental Health Counselors Association is Utah's hub for enhancing the profession of mental health counselors. 
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