Government Relations Action Alert

June 27, 2007

Rep. Schakowsky’s Dear Colleague Letter on Social Worker Medicare Payments

Identical letter to be sent to Chairman Rangel and Ranking Member McCrery

Dear Chairman Dingell and Rep. Barton:

We are writing to ask for your support in addressing the Medicare part B payment cuts for psychologists’ and social workers’ services that were implemented in January by the Centers for Medicare & Medicaid Services (CMS).  Through the “5-year review rule,” CMS cut psychologist and social worker Medicare payments by 9 percent.

Psychologists and social workers provide almost all of the psychotherapy and testing services that Medicare beneficiaries receive.   Patient access to the mental health services that they need is being hampered as psychologists and social workers reduce their caseloads or leave Medicare all together in the face of these significant cuts in reimbursement.  Without action to reverse those cuts, we are deeply concerned that Medicare beneficiaries will lose access to the mental health services they need. 

In its 5-year review rule, (71 Fed. Reg. 37170), CMS increased Medicare payment for evaluation and management (“E&M”) services, which raised Medicare costs by approximately $4.5 billion.  To offset that increase, CMS implemented a 10% work relative value unit (“RVU”) cut for all provider services.  Unfortunately, psychologists and social workers received the greatest cuts under this decision, since their services are heavily work RVU weighted in comparison with other providers and since they are not eligible to use E&M codes.  We believe it is important to make sure that psychologists and clinical social workers do not continue to face a 9 percent cut that will affect their ability to provide timely, quality care

We recognize that the Committee has a difficult task ahead as it develops Medicare legislation over the next few months.  We look forward to working with you to address this important mental health issue and protect this valuable benefit for elderly and disabled individuals in Medicare.

Sincerely,