Kiggans and Davis Introduce Bill to Improve Mental Healthcare for Medicare Patients

WASHINGTON, DC: Today, Congresswoman Jen Kiggans (VA-02) announced that she and Congressman Danny Davis (IL-07) have introduced H.R. 4638, the Integrating Social Workers Across Health Care Settings Act. This bipartisan legislation will improve healthcare and lower costs for patients across America by amending the Social Security Act to allow clinical social workers (CSWs) to fully practice proactive mental healthcare and be reimbursed for that service.

“Clinical social workers play important roles in the lives of millions of Americans, particularly our older adults,” said Congresswoman Kiggans, Vice Chair of the Bipartisan Congressional Nursing Caucus. “As a geriatric nurse practitioner, one of my main focuses is increasing access to mental healthcare and lowering costs. Proactive mental healthcare can make life-changing differences for people experiencing emotional distress. For too long, bureaucratic red tape has prevented clinical social workers from providing this type of critical care. I’m proud to join Congressman Davis in introducing this bipartisan legislation to help solve these issues and deliver healthcare solutions for Medicare beneficiaries!”

“Clinical social workers for far too long have not been able to provide social work services across health care settings because of the unnecessary “incident to” billing structure for services related to care coordination within health care settings. This legislation is a testament to the care that clinical social workers provide our nation, both as providers of care coordination across health care settings and as the largest group of professionally trained mental health providers in the United States. I look forward to a future where the compassionate care provided by clinical social workers becomes a cornerstone of our healthcare system,” said Congressman Danny Davis. 

“For patients and families, getting care from a clinical social worker can make all the difference in a health journey. The Integrating Social Workers Across Health Care Settings Act acknowledges the positive impact social workers make in the lives of patients and invests in this workforce accordingly. When everyone can access the care they need and deserve, the health of our nation is stronger,” said the Coalition for Social Work and Health.

BACKGROUND

According to the National Association of Social Workers, clinical social work is an area of social work focusing on the “assessment, diagnosis, treatment, and prevention of mental illness, emotional, and other behavioral disturbance”. Despite their advanced scope of practice, CSWs are currently restricted from billing any services outside of direct care they offer as mental health providers under current Medicare reimbursements.

A 2020 study found that 30% of Medicare beneficiaries have a mental health disorder, which result in significantly higher spending compared to other conditions. According to the study, $2.7 billion of total Medicare spending went toward mental health services and an additional $5.5 billion was spent on medical care associated with mental health disorders, meaning that nearly 13% of Medicare’s total budget is spent on mental health issues and their associated effects.

H.R. 4638 amends Section 1861(hh)(2) of the Social Security Act to allow CSWs to bill for any services within their existing state scope of practice, resulting in improved patient care, lower costs, and enhanced medical outcomes.

This legislation is also endorsed by the following groups:

AgeOptions

American Nephrology Nurses Association

American Society of Nephrology

Area Agencies on Aging Association of Michigan

Camden Coalition

CJE SeniorLife

Coalition for Social Work and Health

Health & Medicine Policy Research Group

Health Leads

Hospice and Palliative Nurses Association

National Association for Geriatrics Education

National Association of Black Social Workers

National Association of Social Workers

National Partnership for Healthcare and Hospice Innovation

Network of Jewish Human Service Agencies

Ohio Association of Area Agencies on Aging

Partners in Care Foundation

Region IV Area Agency on Aging

Renal Physicians Association

Renal Support Network

Rush University System for Health

Social Work Hospice and Palliative Care Network

Society of Transplant Social Work

Waitlist Zero

The full text of the bill can be found here.

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