|
|
|
Joint Letter from CSWF President Golnar Simpson DSW, BCD
Dear Representatives Leach and Stark: We are writing today to express our strong support for the Medicare Social Work Equity Act of 1999. As presidents of the National Association of Social Workers and the Clinical Social Work Federation, we represent more than 100,000 clinical social workers in the United States. Our members greatly appreciate your efforts on behalf of our country's mental health care patients and professionals. We are extremely concerned that recent legislative and regulatory changes will affect Medicare beneficiaries receiving skilled nursing care or residing in nursing homes. Many nursing home patients could lose access to services provided by clinical social workers because of these very changes. Section 4432 of the Balanced Budget Act of 1997 authorized a prospective payment system for all Medicare Skilled Nursing Facilities ("SNFs"). Prospective payment and consolidated billing have led to the bundling of many previously separate Medicare payments into a single payment received by the nursing facility. Congress made this change in order to stem the rapidly increasing costs of additional patient services delivered by Medicare providers in SNFs, specifically physical, occupational and speech-related therapy services. In so doing, Congress recognized that some services, including mental health services, are still better provided on an individually arranged basis, and excluded the following providers from the SNF prospective payment system: physicians, clinical psychologists, certified nurse-midwives and registered nurse-anesthetists. Unfortunately, due to an unintentional oversight in drafting the legislation, the mental health services provided through clinical social work services were not placed on this exclusion list. In 1996, Department of Health and Human Services Inspector General June Gibbs Brown published a report entitled "Mental Health Services in Nursing Facilities." The purpose of the OIG study was to draw a picture of the kinds of mental health services being provided in nursing facilities and to identify potential vulnerabilities in the Medicare program. In the study, 70% of the nursing home respondents said that allowing clinical social workers and clinical psychologists to bill independently had a beneficial effect on providing mental health services in nursing facilities. The Medicare Social Work Equity Act helps maintain this beneficial effect by ensuring continued direct reimbursement for treatment by clinical social workers of Medicare patients in SNFs. Again, on behalf of the National Association of Social Workers and the Clinical Social Work Federation, thank you for sponsoring this legislation. Golnar Simpson, DSW,
BCD Josephine Allen,
Ph.D., ACSW
CSWF National Advocates' Reports page | Return to the CSWF home page |
