NASW Seeks Urgent Meeting with HHS Secretary Shalala on Clinical Social Work Services Reimbursement in Skilled Nursing Facilities Under Medicare

May 28, 1998

Honorable Donna E. Shalala
Secretary, Department of Health and Human Services
Room 615F, Hubert H. Humphrey Building
200 Independence Avenue, SW
Washington, DC 20201

Dear Secretary Shalala:

I am writing to request an urgent meeting with you and to ask for your help concerning the delivery of clinical social work services to residents of skilled nursing facilities (SNFs) through the Medicare Program. The National Association of Social Workers (NASW) is deeply distressed by the final rule on "Medicare Benefits and Application of the Outpatient Mental Health Treatment Limitation to Clinical Psychologist and Clinical Social Worker Services," issued in the Federal Register on April 23, 1998, as it pertains to SNFs. Effective June 22, 1998, the rule will eliminate reimbursement for clinical social worker services provided to residents of SNFs under Medicare Part B. However, clinical psychologists will be permitted to continue to bill Medicare Part B directly for similar psychological services to SNF residents. This is discriminatory action against clinical social workers who are one of the major providers of mental health treatment and diagnosis to SNF residents.

If this new Health Care Financing Administration (HCFA) policy concerning reimbursement for clinical social work services in SNFs goes into effect, thousands of clinical social workers will lose their jobs, beneficiaries will be denied access to needed critical mental health services; and the costs to Medicare for mental health services in SNFs will dramatically increase.

Attached is background material on this issue and related congressional legislation.

We look forward to meeting with you to discuss alternatives for ensuring the continued availability of quality clinical social work services for skilled nursing facility residents under Medicare. Per my conversation with your office yesterday, I will contact Marty Rouse, Director of Scheduling and Advance to arrange a meeting. I can also be reached on (202) 336-8200.

Sincerely,

Josephine Nieves, MSW, PhD
Executive Director