LEGISLATIVE ALERT
IMMEDIATE ACTION NEEDED
November 21, 1997
ISSUE: The Balanced Budget Act of 1997 (BBA), P.L. 105-33, contains a new Medicare provision that consolidates billing for Medicare Part B services that are provided to residents of skilled nursing facilities (SNFs). The Part B consolidated services, including clinical social worker (CSW) services, would be billed by the SNF, and Medicare payment would be made to the SNF. Although the SNF may in turn reimburse the CSW, the extra administrative step may result in a lower reimbursement for CSW services. The new provision exacerbates an already inequitable reimbursement system for clinical social workers under Medicare. It is a fairness issue for CSWs that may become an access issue for beneficiaries if clinical social workers can no longer afford to provide services to residents of nursing facilities.
GOAL: NASW’s goal is to change this provision before it goes into effect on July 1, 1998, allowing CSWs to continue to independently bill and receive Medicare payment for mental health services provided to residents of SNFs. The best possible way to effect this change is to enact a legislative amendment that specifically excludes CSW services from the Part B consolidated billing arrangement. However, if Congress does not consider changes to the BBA prior to the July 1 date, the next best approach is to encourage the Health Care Financing Administration to exclude CSW services from the consolidated billing arrangement through the implementing regulations.
ACTION: NASW members are urged to: 1) Communicate the need for a legislative change to the new Medicare Part B consolidated billing process to their Representative and Senators, 2) Write to the Department of Health and Human Services, encouraging a regulatory remedy to this problem, and 3) Build support among groups representing senior citizens and groups representing nursing homes in your state to support the continued ability of CSWs to independently bill and receive payment for Medicare Part B services provided to SNF residents. Locate CSWs who know key Members of Congress and ask them to personally communicate this issue.
TARGETS: All social workers are urged to contact their Representative and Senators regarding the importance of a legislative remedy for this issue. Key targets in the House of Representatives are members of the Subcommittee on Health (Committee on Ways and Means) and members of the Subcommittee on Health and the Environment (Committee on Commerce). Key targets in the Senate are members of the Finance Committee. Constituent contacts with key Republican members of the committees are particularly important. Additionally, social workers are urged to communicate the need for a regulatory remedy to The Honorable Donna E. Shalala, Secretary of Health and Human Services.
§ Contact the Capitol Switchboard at (202) 224-3121 to be connected with your Representative’s and Senators’ offices. For fax and e-mail addresses, contact the individual member’s office.
§ All Representatives may be reached through the following mail address: The Honorable ________ __________, U.S. House of Representatives, Washington, DC 20515
§ All Senators may be reached through the following address: The Honorable __________ __________, U.S. Senate, Washington, DC 20510
§ Secretary Shalala may be contacted at the following mailing address: The Honorable Donna E. Shalala, Secretary of Health and Human Services, Hubert H. Humphrey Building, Room 615F, 200 Independence Avenue, SW, Washington, DC 20201.
MATERIALS:
§ Background Information on the Medicare Part B Consolidated Billing Issue
§ List of Key House and Senate Contacts
INFORMATION: Contact Madeleine Golde, Government Relations Associate, at (202) 336-8261 or (800) 638-8799, ext. 237 (telephone), (202) 336-8311 (fax), or mgolde@naswdc.org (e-mail).
Please send copies of letters to Sandy Harding, Government Relations Associate, National Association of Social Workers, Suite 700, 750 First Street, NE, Washington, DC, 20002-4241. Thanks!