AAMFT shared recent announcements regarding the June 30th Congressional hearing by the Energy and Commerce subcommittee. In the hearing, the MFTs in Medicare bill, H.R. 945 was discussed along with 20 other mental health bills. Our bill was mentioned in a positive light during the hearing. It was our hope that this would lead the committee to move forward in trying to present the bill to the House and pass the bill through Congress.
The committee announced they would be holding a markup of a selection of the bills discussed during the June 30th hearing and on other topics the committee oversees during a meeting held on July 15th. A markup is the process by which congressional committees and subcommittees debate, amend, and rewrite proposed legislation before presenting to the full House. 30 bills on various topics were discussed during the markup. Four of the bills from the June 30th hearing were selected for the markup, of which H.R. 945 was not selected.
However, the subcommittee has insinuated that there is a chance for additional bills to be presented at markups that would occur in the upcoming months. This means that MFTs still have a chance to advocate for the progression of H.R. 945. We will continue to advocate for the MFTs in Medicare bill, as well as continuing to reach out to membership as we work together to try and get into the next markup. While MFTs cannot yet bill Medicare for reimbursement, efforts to be able to do so continue.
Participation from MFTs is incredibly important during this time. While we continue to advocate for the MFTs in Medicare bill, the most effective voices will always be that of the professionals who live across the country. The voice that Congress cares most to hear from is that of the constituent from their own state. If you have not already done so, please contact your Members of Congress and urge them to support the MFTs in Medicare legislation.
AAMFT continues to hold the inclusion of MFTs as Medicare providers as the top federal advocacy priority. In addition to your grassroots advocacy to Congress in support of the MFTs in Medicare legislation, we need your help in one other effort: sustaining AAMFT’s Practice Protection Fund. The AAMFT Practice Protection Fund is used to help pay for items related to advancing pro-MFT policies at the state and federal level and protecting the profession from serious threats.
Due to funding from the PPF, AAMFT has been able to bring members to Washington in order to advocate for MFTs in Medicare legislation with Congress. In order to continue these visits and other pro-MFT advocacy activities, we need to have the funds to continue doing so. Please help advocate for MFTs by donating to the Practice Protection Fund today. Thank you to the Family TEAM for all your advocacy efforts, and for your continued support of the MFTs in Medicare bill.
The House Energy and Commerce Committee’s Health Subcommittee will hold a remote legislative hearing on Tuesday, June 30 to discuss legislation that would add LMFTs as recognized Medicare providers - H.R. 945, the Mental Health Access Improvement Act of 2019 – along with several other bills to improve mental health during crisis.
AAMFT appreciates the House Energy and Commerce Committee for scheduling this important hearing on improving mental health during crisis. This hearing is one of the first steps in moving the MFTs in Medicare legislation through Congress. To advocate for MFTs as Medicare providers, please contact your Members of Congress and urge them to support MFTs as Medicare providers. Stay up to date on the hearing, and visit the AAMFT Blog for additional updates as more information is made available.
This week, the U.S. Department of Health and Human Services (HHS) announced that $15 billion would be available to eligible state Medicaid and Children's Health Insurance Program (CHIP) providers. This funding is available to Medicaid and CHIP providers under the Provider Relief Fund, which was established by the Coronavirus Aid, Relief, and Economic Security (CARES) Act, and funded by appropriations through the CARES Act and an additional supplemental funding bill.
According to the announcement, payments are now available to eligible Medicaid and CHIP providers equal to at least 2 percent of reported gross revenues from patient care in calendar years 2017, 2018, or 2019, as selected by the provider. This funding is supposed to provide relief to eligible providers who are now experiencing lost revenues or increased expenses due to COVID-19. According to HHS, the types of providers eligible for this funding include behavioral health providers, dentists, and other healthcare providers. Therefore, MFTs who are Medicaid or CHIP providers should be eligible to apply and receive funding under this distribution.
Eligible providers must apply online to HHS for funding. There are many terms and conditions pertaining to this funding, which can be found here, including the following:
To apply to funding, please apply through the enhanced provider relief portal.
For additional information on the distribution of funds to MFTs and other providers who are state Medicaid or CHIP providers, please see the Provider Relief Fund FAQs on the HHS website, especially the section on this website pertaining to the Medicaid distribution. Members are strongly urged to read the relevant terms and conditions and FAQs before applying. The government has the ability to change the terms and conditions of this program, so it is possible that some of the terms and conditions may change.
Providers with questions can call the HHS vendor’s provider support line at (866) 569-3522. The application deadline for applying is July 20, 2020.
AAMFT is glad that the federal government is finally distributing funds under the Provider Relief Fund to Medicaid and CHIP providers. The first distributions under the fund were made in April. However, only Medicare providers were eligible to receive these funds, thus leaving out many providers not enrolled in Medicare, such as LMFTs. On April 17, AAMFT sent a letter to HHS urging the Department to make additional funds available to all providers impacted by COVID-19, including Medicaid providers and other behavioral health and other healthcare providers who are not currently Medicare providers. We thank HHS for distributing these funds to eligible Medicaid and CHIP providers. We encourage the government to distribute additional funds to MFTs and other behavioral health providers impacted by the COVID-19 pandemic.
If you have any questions to AAMFT about this program, please contact us at FamilyTEAM@aamft.org.
A prominent national mental health coalition, the Mental Health Liaison Group (MHLG), has just released a letter to Congress in support of legislation (HR 945) to add licensed marriage and family therapists, as well as licensed mental health counselors, as Medicare providers. The MHLG is a coalition if national organizations representing behavioral health providers, consumers, payers and other organizations committed to increasing access to behavioral healthcare for all Americans. AAMFT is a longtime member of the MHLG.
The MHLG releases official letters of support for legislation if the legislation is supported by at least a majority of the 70+ full members of the MHLG. The MHLG letter in support of adding LMFTS and LMHCs as Medicare providers was cosigned by AAMFT and 43 other MHLG members. This letter is a significant step in the fight to add LMFTs as Medicare providers. This letter demonstrates to Congress that the mental health community supports including LMFTs and LMHCs as Medicare-eligible providers. The MHLG letter will be shared with Members of Congress. We believe that this letter will lead to more support among Members of Congress for including LMFTs and LMHCs as providers of behavioral health services to Medicare beneficiaries.
AAMFT has signed two letters to Congress sent by the Mental Health Liaison Group, a coalition of over 60 national behavioral health associations, including AAMFT, that advocate for access to behavioral healthcare services.
The first letter to Congress urges legislation to require insurers to cover teletherapy services. Read the full letter here.
The second letter asks Congress to subsidize COBRA coverage for those who have lost their jobs so that healthcare coverage might continue. Read the full letter here: Download MHLG COBRA COVID 19 Letter 4.23.2020 FINAL
Earlier today, the Bipartisan Policy Center’s Rural Health Care Task Force, which is made up of former Members of Congress and other health policy experts, issued a report on its policy recommendations to transform rural health care. One of its recommendations is for the inclusion of marriage and family therapists and mental health counselors as Medicare providers. The report can be found here.
This report contains many solid recommendations for improving health care in rural America. This task force recommends that Congress add LMFTs and LMHCs as Medicare providers by enacting into law the Mental Health Access Improvement Act (HR 945 / S 286), legislation that AAMFT is currently supporting. The report correctly states that adding MFTs and MHCs as Medicare providers does have cost, but that cost projections do not include long-term savings to Medicare by treating Medicare beneficiaries who need the services of MFTs or MHCs.
Founded by former leaders of the US Senate, the Bipartisan Policy Center (BPC) is a distinguished think tank that is led by former Members of Congress, former senior congressional staff members, and other experts who combine ideas from both political parties to promote health, security and opportunity for Americans. The Rural Health Care Task Force was created last year by the BPC in order to research health challenges in rural America and make recommendations for consideration by Congress and other policymakers.
AAMFT has been following the progress of this task force from the beginning, as AAMFT staff attended the kick-off event for the task force, along with Hollyn Smith, an AAMFT member and Family TEAM leader who was in Washington DC to participate in the Family TEAM Capitol Hill visits last June. Hollyn Smith brought attention to the MFTs in Medicare issue during the event, and she shared her experience in an AAMFT Advocacy blog posting. After this kick-off, AAMFT wrote to the BPC staff and requested an opportunity to meet with them and discuss how adding MFTs as Medicare providers would help address the shortage of providers available to Seniors in rural locales. In July, AAMFT staff and lobbyist met with BPC staff, along with other representatives from the Medicare Mental Health Workforce Coalition, to discuss how adding MFTs and MHCs as providers to Medicare would help Rural America.
In August, the Rural Health Task Force requested comments and suggestions from interested parties on ideas to improve healthcare in rural areas. AAMFT submitted comments (view letter here: Download AAMFT ltr to BPC 2019.9.7) in September in response to this request.
AAMFT congratulates the Bipartisan Policy Center leadership and staff on its comprehensive recommendations to transform rural health care. We urge Congress to consider these recommendations.
AAMFT has signed onto a letter of support with over 40 other organizations urging Congress to provide billions in emergency funding to behavioral health organizations so that they can remain open and continue operating during this crisis.
Download the full letter here: Download COVI_4_BH_Approps_Request_4.7.20
The COVID-19 pandemic has led to many MFTs transitioning to telehealth-based practice in order to abide by the recommended social distancing preventative measure, or to abide by mandatory stay-at-home orders. Moving from in-person therapy to tele-therapy may have been easy for some MFTs, especially those that have already incorporated telehealth into their pre-pandemic routines. For some MFTs, the transition was much more difficult, particularly those in states that had barriers to practicing using telehealth. AAMFT is happy to announce two recent state successes, after recent intervention from AAMFT, dedicated state MFT leaders and other MFTs.
Under normal circumstances, the telehealth policies that were recently promulgated by the Kentucky Board of Marriage and Family Therapists would be hardly an issue. Effective January 2020, LMFTs would need to obtain 15 hours of telehealth training from a Board-approved source in order to use telehealth legally. This rule had also previously left out MFT associates, which meant that an MFT associate could not practice telehealth at all. To further complicate things, in order to practice tele-supervision, the supervisor had to complete the 15 hours of training. Again, under normal circumstances, an LMFT would have time to take the 15 hours of training, to schedule around it, and continue to see clients in-person to earn an income and continue care. Given the public health crisis, and the recommendation to socially distance, this rule presented as a cumbersome barrier that could have resulted in client abandonment and no way to earn an income while the economy is crashing.
AAMFT worked with other MFTs, and the AAMFT Kentucky Network, to have this rule changed. AAMFT wrote two letters and attended two separate licensing board meetings to advocate for this rule to be lifted during this state of emergency. During the first licensing board meeting, the board unanimously voted to allow MFT associates to practice using telehealth, but the Board Members reinforced the 15 hour training, and applied it to associates. While that change was helpful, AAMFT sought to have the 15 hour restriction completely lifted so that LMFTs and associates would not have to budget for an expensive training course during a public health crisis. It was during the second emergency-scheduled licensing board meeting that the 15 hour training requirement was finally lifted. All of the changes in Kentucky regarding telehealth during COVID-19 can be found in this Memo from the Board.
Alabama MFTs faced very similar barriers: in order for a licensee to practice using telehealth, they must complete 15 hours of training on the topic. This rule also applied to associates; however, supervision presented as a major challenge in Alabama. Supervisors needed to take an additional 9 hours of training on the topic of tele-supervision if they wished to supervise virtually. Unfortunately, only two (2) supervisors in the entire state had taken the 9 hours of training to be able to tele-supervise, which would have left associates with very few options to practice virtually and properly socially-distanced.
The same reasoning behind lifting the 15 hour training in Kentucky applies to Alabama. AAMFT worked with other MFTs, and the Alabama Association for Marriage and Family Therapy to submit letters to the licensing board to urge them to lift the 15 hour requirement, as well as the restriction on tele-supervision. The Alabama Board of Examiners in Marriage and Family Therapy scheduled an emergency board meeting to address our concerns, and quickly voted to waive these requirements. Success! All of the details regarding telehealth during COVID-19 in Alabama can be found in this Memo.