U.S. Senator Barbara A. Mikulski (D-MD) today introduced legislation to ensure that social workers can receive Medicare reimbursements for mental health services they provide in skilled nursing facilities. The Medicare Social Work Equity Act of 1999 will correct section 4432 of the Balanced Budget Act of 1997 (BBA) that prevents clinical social workers from directly billing Medicare for the mental health services they provide nursing home residents.

"Clinical social workers are the primary providers of mental health care to the residents of nursing facilities," said Senator Mikulski. "Health care is not just about pills and paperwork, it is about the people who make a difference in the everyday lives of their patients. This bill is about equal access to Medicare payments for the equal and important work done by social workers. It is about providing our seniors with high quality, affordable health care."

Before the 1997 BBA provision, social workers billed Medicare Part B directly for mental health services provided in nursing facilities and were directly reimbursed by Medicare. Under the new system, social workers are forced to bill the skilled nursing facility, which in turn bills Medicare. The nursing home then reimburses the social worker. Psychologists and psychiatrists, who provide similar counseling, were not included in this consolidated billing provision and remain able to separately bill Medicare for their services.

"We need to prevent inequities in our health care system, especially those that reduce the quality of care, " said Senator Mikulski. "Without skilled clinical social workers, many nursing home residents may never get the counseling they need when faced with a life threatening illness or the loss of a loved one. This legislation will make sure that does not happen."

Specifically, Senate bill 847 revises the section of the Balanced Budget Act which revises Medicare billing requirements that could force nursing homes to reduce the mental health services that social workers provide to their residents. In addition, it prevents clinical social workers from being replaced by other professionals who are reimbursed at a higher cost to Medicare and allows nursing homes to continue to employ social workers who might otherwise lose their jobs as a result of difficult and inadequate Medicare reimbursements for their services.

"As a former social worker, I understand the role that social workers play in the overall care of patients and seniors," said Senator Mikulski. "This bill protects patients across the country and ensures that seniors living in underserved urban and rural areas, where clinical social workers are often the only available option for mental health care, continue to receive the treatment they need."

Senators Jeff Bingaman (D-NM), Ernest Hollings (D-SC ), Daniel Inouye (D-HI), Tim Johnson (D-SD), Patty Murray (D-WA), Harry Reid (D-NV) and Ron Wyden (D-OR) joined Senator Mikulski in sponsoring this legislation.