IN THE SENATE OF THE UNITED STATES
August 1, 2019
Mr. Tester introduced the following bill; which was read twice and referred to the Committee on Finance
To amend title XVIII of the Social Security Act to provide coverage of addiction counselor services under part B of the Medicare program.
This Act may be cited as the
Addiction Treatment Access Act.
Coverage of addiction counselor services under part B of the Medicare program
Coverage of Services
Section 1861(s)(2) of the Social Security Act (42 U.S.C. 1395x(s)(2)) is amended—
in subparagraph (GG), by striking
and at the end;
in subparagraph (HH), by striking the period at the end and inserting
; and; and
by adding at the end the following new subparagraph:
addiction counselor services (as defined in subsection (kkk)(1));
Section 1861 of the Social Security Act (42 U.S.C. 1395x) is amended by adding at the end the following new subsection:
Addiction counselor services; addiction counselor
The term addiction counselor services means services performed by an addiction counselor (as defined in paragraph (2)) for the diagnosis and treatment of substance abuse and addiction that the addiction counselor is legally authorized to perform under State law (or the State regulatory mechanism provided by the State law) of the State in which such services are performed, as would otherwise be covered if furnished by a physician or as incident to a physician’s professional service, which may include—
treatment planning; and
treatment of co-occurring disorders,
The term addiction counselor means an individual who—
has completed coursework or training specific to treating substance use disorders, including with respect to the addiction counseling competencies identified in the document published by the Substance Abuse and Mental Health Services Administration as part of the Technical Assistance Publication (TAP) series, number 21, entitled
Addiction Counseling Competencies: The Knowledge, Skills, and Attitudes of Profressional Practice (or any successor publication); and
in the case of an individual performing services in a State that provides for licensure or certification of addiction counselors, is licensed or certified as an addiction counselor or alcohol and drug counselor in such State.
Provision for payment under part B
Section 1832(a)(2)(B) of the Social Security Act (42 U.S.C. 1395k(a)(2)(B)) is amended—
and at the end of clause (iv); and
by adding at the end the following new clause:
addiction counselor services;
Amount of payment
Section 1833(a)(1) of the Social Security Act (42 U.S.C. 1395l(a)(1)) is amended—
by inserting before the semicolon at the end the following:
, and (DD) with respect to addiction counselor services under section 1861(s)(2)(II), the amounts paid shall be 80 percent of the lesser of the actual charge for the services or 60 percent of the amount determined for payment of a psychologist under subparagraph (L)..
Inclusion of addiction counselors as practitioners for assignment of claims
Section 1842(b)(18)(C) of the Social Security Act (42 U.S.C. 1395u(b)(18)(C)) is amended by adding at the end the following new clause:
An addiction counselor (as defined in section 1861(kkk)(2)).
Coverage in rural health clinics and federally qualified health centers
Section 1861(aa)(1)(B) of the Social Security Act (42 U.S.C. 1395x(aa)(1)(B)) is amended by striking
or by a clinical social worker (as defined in subsection (hh)(1)), and inserting
, by a clinical social worker (as defined in subsection (hh)(1)), or by an addiction counselor (as defined in section 1861(kkk)(2))..
The amendments made by this section shall apply with respect to services furnished on or after January 1, 2020.