The AAMFT Blog

Breaking News on MFTs in Medicare!

AAMFT is thrilled to announce that the Mental Health Access Improvement Act (S. 828/H.R. 432), legislation that would allow MFTs, as well as MHCs, to serve as Medicare-eligible providers, has been included in the proposed omnibus package currently making its way through Congress. It is heavily anticipated that both houses of Congress will take action on this proposed legislation within the coming days.

As stated in the AAMFT Blog post from December 15, AAMFT and its allies have been advocating that Congress include the language from the Mental Health Access Improvement Act into the end of year omnibus spending package that Congress has been developing. We are pleased to report that the language from the Mental Health Access Improvement Act was included in the omnibus bill!

At over 4,100 pages, this massive omnibus bill will fund the federal government through the end of the current fiscal year, which ends on September 30, 2023. In addition to funding the federal government, this legislation also includes many policy provisions that change federal law. One of several changes to Medicare would finally allow MFTs and MHCs to serve as recognized providers under Medicare. This legislation would allow MFTs in private practice or other settings to become Medicare-eligible providers. The effective date for allowing MFTs to start serving as Medicare providers is a year from now – January 1, 2024.

 Below are a few FAQs concerning this legislation:

• Has this omnibus package been signed into law? - No, it has not. The Senate will first vote on this legislation. If it passes the Senate, the House of Representatives must vote on it, then it would be presented to President Biden for his signature.

• When should Congress pass this omnibus package? - Congress is expected to vote and send this legislation to the President by Friday, December 23. As of Tuesday afternoon, the Senate is expected to vote on this legislation on Wednesday, with the House voting on the legislation about a day after the Senate approves the package. Funding for the federal government will end on Friday evening if Congress does not act. Therefore, there is some pressure on Congress to act this week to prevent a government shutdown.

• Is passage of this omnibus package guaranteed?  -  No. Although a majority of Members of Congress are believed to support the omnibus package as it is now, passage of any legislation is not guaranteed.

• If this legislation is signed into law, when can I enroll as a Medicare provider and start providing services to Medicare beneficiaries? - Under this legislation, MFTs and MHCs would not be able to serve as Medicare-eligible providers and bill Medicare until January 1, 2024.  This delay is needed so that the federal government can make arrangements for MFTs and MHCs to serve as Medicare providers.

Please follow AAMFT through our social media pages and the AAMFT Blog to stay informed of the progress of this legislation. Please also consider sending a grassroots message to your Members of Congress urging them to pass the omnibus package as introduced.

Thank you in advance for advocating for MFTs as Medicare providers. Your messages and outreach to Congress in support of the Mental Health Improvement Act made the difference! Please contact us at [email protected] if you have any questions. 

Additional information:

Statement of Support from Finance Committee Chair Senator Ron Wyden (D-OR) for Mental Health Provisions in Omnibus Package

Statement from Energy and Commerce Committee Chair Frank Pallone, Jr. (D-NJ) and Health Subcommittee Chair Anna G. Eshoo (D-CA)  in Support of Healthcare Provisions in Omnibus Package

Description of Medicare Policy Changes in the Omnibus Package

Urgent: Please Contact Congress Now to Advocate for MFTs as Medicare Providers

This week, Congress is drafting a large end of year package that will fund the federal government through September 2023, as well as make some helpful changes to federal law. MFT advocates are pushing Congress to include in this package the Mental Health Access Improvement Act (S. 828/H.R. 432), legislation that would allow MFTs and MHCs to serve as Medicare-eligible providers. We need this package to include the MFTs in Medicare legislation. Please contact your Members of Congress today to advocate for MFTs as Medicare providers. 

Contact Congress Now 

As of December 15, high-level negotiations are taking place on Capitol Hill as to how to fund the government for the rest of fiscal year 2023. These negotiations will wrap up soon. If Congress decides to pass an end of year package, also known as an Omnibus funding bill, as opposed to a Continuing Resolution which simply continues funding levels from already passed bills, Congress COULD include other policy initiatives, such as the Mental Health Access Improvement Act. For this reason, we urge you to contact your Senators and Representative in Congress NOW and urge them to include MFTs in Medicare as part of the end of the year funding legislation.  

    

Background and Progress 

Introduced in 2021 as H.R. 432 by Rep. Mike Thompson (D-CA) and Rep. John Katko (R-NY) and as S. 828 by Sen. John Barrasso (R-WY) and Sen. Debbie Stabenow (D-MI), the Mental Health Access Improvement Act is a bill that would finally allow both  Marriage and Family Therapists and Mental Health Counselors to serve as independent Medicare Part B practitioners. This legislation would allow MFTs and MHCs to bill Medicare for providing covered mental health and substance use services to older adults and other Medicare beneficiaries.   

Since this legislation was introduced in early 2021, AAMFT and its allies in the Medicare Mental Health Workforce Coalition, who also advocate for passage of the Mental Health Access Improvement Act, have made substantial progress in advancing this legislation so that it could be eligible for inclusion in the end of year package: 

Support in the House of Representatives: Currently, 97 Members in the House of Representatives are cosponsoring H.R. 432, with strong bipartisan support. Earlier this year, the Mental Health Access Improvement Act was passed by a key House committee with jurisdiction over Medicare. On September 21, the House Ways and Means Committee met to discuss and vote to move several bills to the full House of Representatives, a process known as a committee markup. At this markup, the Ways and Means committee unanimously voted to move to the full House for consideration the Mental Health Access Improvement Act (H.R. 432). This vote was an important step in the process of moving this legislation forward. Legislation that has been approved by a committee is more likely to be considered in a larger package than bills that have not been considered by a committee. 

Support in the Senate: In the Senate, 34 Senators are cosponsoring S. 828, which is a record amount of support for any MFTs and MHCs in Medicare legislation in the Senate. In September, the Senate Finance Committee, which has jurisdiction over Medicare in the Senate, released a discussion draft of legislation to address mental health workforce needs and challenges. This draft includes legislation to add MFTs and MHCs as Medicare providers (S. 828), along with many other provisions to expand the behavioral health workforce. The release of this draft represents the most important action by the Senate in twelve years pertaining to adding MFTs and MHCs as Medicare providers. Please see this AAMFT Blog for additional information on the committee actions from September.   

Support from AAMFT Members and Allies: MFTs, as well as MHCs, other mental health providers, and allies, have been active and engaged in reaching out to their Members of Congress to advocate for the Mental Health Access Improvement Act. Thousands of email messages in support of this legislation have been sent by MFTs and MHCs to Congress. AAMFT members and other mental health providers have met with the offices of Members of Congress to advocate for this issue as well as AAMFT and its allies in the Medicare Mental Health Workforce Coalition. 

In addition, inclusion of the Mental Health Access Improvement Act in the end of year package is supported by a wide number of organizations besides associations representing MFTs and MHCs. Congress has received letters of support for including this legislation in the end of year package from groups as diverse as the Mental Health Liaison Group and the American Hospital Association. 

 

What You Can Do   

 Negotiations are occurring now to determine which bills make it into the omnibus, and it is unknown which bills would be included. These negotiations will end very soon, and a vote on the end of year package will occur next week. This is the best opportunity for passage of the MFTs in Medicare legislation in over twelve years. Therefore, it is imperative to contact your Members of Congress NOW to let them know that you want Congress to include the Mental Health Access Improvement Act in the end of year package.   

Finally, you can advocate for MFTs in Medicare by sending a message to your Members of Congress through AAMFT’s grassroots advocacy platform. If you have friends, family or colleagues who are also constituents of your Member of Congress, they can use this grassroots advocacy platform to send a message advocating for MFTs in Medicare. If you wish to send a more personalized message to your Members of Congress, use this link to find your Members of Congress and click on their profiles to find their D.C. office contact information.  

 

Thank you in advance for advocating for MFTs as Medicare providers. Please contact us at [email protected] if you have any questions.   

The Respect for Marriage Act – The MFT Perspective

Just last week, the Respect for Marriage Act passed in the House 258-169, marking an incredibly historic moment for not only the country, but also for marriage and family therapists. The first version of this bill was originally introduced back in 2009 and was reintroduced into Congress this past summer. The revised version still included protections for same-sex marriages, but now extends protections to interracial couples. The Senate previously passed the bill in November. 

The bill is on its way to Biden’s desk, which he says upon House passage of the bill, President Biden said he “looks forward to signing into law” this landmark legislation. Biden writes, “The House’s bipartisan passage of the Respect for Marriage Act—by a significant margin—will give peace of mind to millions of LGBTQI+ and interracial couples who are now guaranteed the rights and protections to which they and their children are entitled.” Biden signed the bill yesterday afternoon during a large celebration at the White House, marking a huge step forward for the field of marriage and family therapy.  

This past year, the Journal of Marital and Family Therapy (JMFT) released its Decade In Review– a special issue released every ten years that reviews what the past 10 years of systemic therapy research has to say about various topics within the field. This review included a special article on how couple and family therapy research can reduce mental health disparities for racially and ethnically diverse populations. The article reviewed research surrounding minority, interracial and LGBTQI+ couples, advocating for their inclusion in systemic therapy research and studies in order to advance the field.  

LGBTQI+ individuals are already more likely to struggle with issues like depression and anxiety, due to the stigmas and discrimination they face. Similarly, interracial couples face issues with stereotyping, isolation, negative comments, and rejection, which can often lead and contribute to mental health issues. These mental health concerns impact more than just the individual– they affect the entire family, marriage, and relationship structure. Thus, marriage and family therapy can help address and resolve these issues from a systemic perspective, mitigating any stressors or implications they may cause in marriages.  

JMFT’s Decade in Review article on mental health disparities noted that only 68 of the 271 (25%) articles they examined included predominantly racial/ethnic minority samples or globally underserved populations. Among the 60 relevant articles examined, there was a pattern of inattention to methodological considerations relevant to diverse populations. LGBTQI+ and interracial couples deserve to have the mental health and marriage therapy resources they need to maintain healthy relationships. The passing of this bill is just the first step towards including, accepting, and appreciating LGBTQI and interracial couples, both inside and outside the therapy room.