February 14, 2025

In an attempt to respond to the Executive Order on best practices regarding treatment of transgender individuals quickly, the Clinical Social Work Association (CSWA) provided a statement that cited the Cass Review, which according to several specialists working with this population, is not reputable.

CSWA stands by its beliefs that LCSWs have a fundamental ethical responsibility to honor and support patients’ rights to self-determination. We also continue to affirm the right of transgender individuals to express their gender identity in a manner that promotes their mental health.

CSWA is therefore retracting the original Statement and will continue to learn more about the ways that transgender individuals can be supported by LCSWs. A new statement will be issued in the near future.

CSWA apologizes for the reference to the Cass Review and appreciates members who provided us with earnest feedback.

February 10, 2025

Elections for the Social Work Compact Commission’s Executive Committee were held on February 5, 2025. This group will govern the Compact going forward, with the help of Council of State Governments (CSG). The results were as follows:

- Chair: Hank Cecil, Kentucky

- Vice-Chair/Chair-Elect: Kelli Willis, South Dakota

- Secretary: Jana Johansen, Utah

- Treasurer: Kevin Fowler, Ohio

- Member at Large: Dr. Deborah Sills, Georgia

- Member at Large: Dr. Hyacinth Mckee, Louisiana

- Member at Large: Justin Bennet, Missouri

The Social Work Compact Commission is made up of delegates from all 22 states that have passed the Compact bill; future states that pass the Compact bill will also have delegates to the Commission.

Additionally, after lengthy discussion and deliberation, three of the six groups that applied to become Ex Officio members were named in the Commission’s bylaws as having permanent Ex Officio (non-voting) seats at meetings of the Commission’s Executive Committee – CSWA, NASW, and ASWB. Laura Groshong, CSWA Director of Policy and Practice, was pleased to be named by CSWA President Stephanie Payne as the delegate from CSWA. The Ex Officio delegates will attend the Executive Committee meetings and have direct input into the decisions made by the Executive Committee for how the Compact will be run.

CSWA will keep its members informed on the progress of the Compact.

February 6, 2025

Please visit the CSWA Position Papers page to view the Position Paper on Protecting Patients from Deportation.

December 21, 2024

At the last minute, Congress finally passed a bill as part of the continuing funding resolution that will allow Medicare coverage of telemental health (and all telehealth) until March 31, 2025, and keep the Federal government running. The Senate and the President signed the bill before midnight today. Thanks to all CSWA members who wrote legislators to ask that telemental health coverage be continued.

This is far less than the two-year extension that had been proposed earlier in the week, which was stopped by the incoming administration and Republicans in Congress. Instead, a new bill will have to be passed before this one runs out to extend telemental health further.

CSWA will continue to push Congress to make a more meaningful extension of telemental health. Let me know if you have any questions.

- Laura Groshong, LICSW, CSWA Director of Policy and Practice

December 17, 2024

By Laura Groshong, LICSW, Director of Policy and Practice

Along with the concerns LCSWs have about telemental health rules, there is one additional concern that several members have asked me about, the Beneficial Ownership Information Report (BOIR) rule, which will require some paperwork for LCSWs that have incorporated as S-Corps or LLCs. However, the BOIR has been put on hold for the moment in a court order. If you want more information, please read the helpful summary of BOIR below, written by Rob Reinhardt, LMHC, of Tame Your Practice, a non-profit that offers a wealth of information on computer systems and software for LCSWs and other clinicians. ~LWG

What is BOIR?

The Beneficial Ownership Information Reporting (BOIR) rule, mandated by the Corporate Transparency Act (CTA), requires certain entities to report beneficial ownership information to the Financial Crimes Enforcement Network (FinCEN). This measure aims to enhance transparency and combat financial crimes like money laundering and tax evasion.

Who Needs to File a BOIR?

BOIR applies to many small businesses, including certain private practices and solo practitioners organized as corporations or LLCs. This also includes LLCs that are filed as sole proprietors. Generally, entities that meet the following criteria must file:

1. Existence: Formed by filing with a state (e.g., LLCs, corporations).

2. Inactivity Exclusion: Active entities are required; inactive or dissolved entities may be exempt.

3. Exemptions: Larger companies meeting specific criteria (e.g., revenue, workforce size) and certain professional services firms are excluded.

To confirm your status, refer to the FinCEN BOIR Small Entity Compliance Guide.

Impact of the Recent Court Order

A recent court order has stayed enforcement of BOIR requirements, temporarily halting the need to comply with the December 31, 2024, filing deadline. This stay means:

- No Immediate Filing Required: Until further notice, enforcement is paused, and non-compliance penalties will not apply.

- Monitor Updates: Businesses should remain informed, as the stay may be lifted, reinstating the deadline.

December 11, 2024

As we head toward the holiday recess in Congress, there is increased pressure to pass legislation that will extend the Medicare coverage of telemental health. For those of you who have sent messages to your members of Congress in the past two weeks, thank you. The over 150 messages CSWA members have sent are making a difference. It is still not too late to send a message to your members of Congress about this crucial delivery service.

There are now two possible avenues for getting the telemental health extension passed: one is connecting the two-year extension to the pharmacy benefits managers bill (no number yet); another is to ask legislators to pass H. R. 8261, which is a stand-alone bill for the telemental health extension. Please send a message to your legislators like this: “I am a clinical social worker, a member of the Clinical Social Work Association, and a constituent. Please make sure that an extension to Medicare telemental health coverage is passed before the end of the year to protect the necessary mental health treatment that has been given virtually since 2020. Attaching this provision to the pharmacy benefits managers bill or H. R. 8261 are two good options. Please protect the mental health of our citizens.”

As always, let me know when you have sent your messages.

- Laura Groshong, CSWA Director of Policy and Practice

December 3, 2024

By Laura Groshong, LICSW, Director of Policy and Practice

Thanks to the many CSWA members who have written their members of Congress about the need for legislative action to extend or make permanent coverage of virtual videoconferencing for telemental health treatment.

Also, thanks to the members who have sent messages about the CMS rule that may allow LCSWs to continue to receive coverage for videoconferencing treatment in 2025. The reason Medicare rules are so important is that they usually influence the coverage allowed by commercial insurers.

There is some confusion about whether this rule has to be confirmed by Congress or not. I am working to determine whether this rule can stand on its own or requires Congressional approval. Three members of Congress have responded to our message that they are working on passing a bill. The bills that would extend telemental health coverage are HE 6534 (Home-Based Telemental Health Care Act); S. 1077 (Home-Based Telemental Health Care Act); S. 3651 (Telemental Health Care Act of 2024); S. 2016 (CONNECT for Health Act), which you can mention in your messages.

I encourage CSWA members to continue to send messages to members of Congress on this issue. Some staff for Medicare have confirmed the rule to guarantee coverage in 2025, some staff have not. These mixed messages are frustrating and difficult for LCSWs.

To help resolve this problem, please contact your regional MAC office at https://www.hhs.gov/guidance/document/cms-regional-offices to find out what the rule will be in your state/jurisdiction. Additionally, prudent LCSWs should contact any commercial insurers they are paneled with and ask whether they intend to change their coverage of telemental health treatment. Let me know what results you have, if any.

As for audio only treatment, coverage should continue as it is now. Be sure to document that the patient is 1) uncomfortable with videoconferencing; 2) not able to use computer technology; or 3) unwilling to consent to using videoconferencing.

CSWA hopes to provide clarity on this issue shortly.

November 21, 2024

by Laura Groshong, LICSW, CSWA Director of Policy and Practice

I have received several questions about Medicare coverage of virtual telemental health which is currently scheduled to end on December 31, 2024. This would be a significant problem for the many LCSWs that have continued to see patients through videoconferencing since the pandemic first led to coverage of this option. Audio-only coverage is also being challenged.

It may be hard to remember that four and a half years ago, these delivery systems were not covered by Medicare; all patients were seen in person unless they lived in rural areas or had a disability that made it impossible for them to be seen in person. Commercial insurers, as they often do, generally followed the lead of CMS in their willingness to cover therapy through videoconferencing and audio-only means.

There are some bills in Congress now that would extend and/or make permanent the ability to have videoconferencing and audio-only treatment covered by Medicare. There is a good chance that one of them may pass or be attached to another bill. CMS has already recommended that videoconferencing and audio-only psychotherapy services be covered permanently, but Congress must pass a bill that will make that law.

Therefore, please send the following message to your members of Congress by visiting https://www.congress.gov/members/find-your-member and to the Senate at https://www.senate.gov/senators/senators-contact.htm?Class=1: "I am a licensed clinical social worker, a member of the Clinical Social Work Association, and a constituent. Please pass a bill that will allow me to continue treating Medicare patients with mental health and substance use problems virtually. This has become the only way many patients can receive treatment. If not changed, these patients will be unable to continue to work on these serious problems after December 31, 2024." As always, please let me know when you have sent your messages.

As for the issue of seeing patients in person every six or twelve months, that rule has been delayed for two years, and will be reviewed during that time.

It is frustrating to be faced with these changes that may significantly affect our practices. With any luck, we will be able to continue to do our work in ways that are best for our patients and for us as LCSWs.

November 18, 2024

It has been almost two weeks since we received the results of our 2024 elections. While clinical social workers are by no means a political monolith, we are hearing from our members as well as our clients that many people are feeling discouraged, unsafe, and uncertain about the future.

CSWA's role will be as important as ever in these next four years. It is uncertain how a new administration will impact Medicaid, Medicare, Social Security, the Affordable Care Act, regulations protecting mental health care, disability rights, and reimbursement rates. We will continue to monitor upcoming legislative and policy changes and inform you, as well as advocate tirelessly for you as clinical social workers. This allows us to focus on our core values of clinical social work, namely service, social justice, dignity and worth of the person, importance of human relationships, integrity, and competence.

If you are so inclined, here are some ways that clinical social workers can be involved in these coming years:

1. Get to know your local and national elected representatives. Your calls, letters, and emails matter!

2. Consider joining advocacy groups that fit with your values.

3. Get to know your neighbors. Our micro-communities are important, and we need to care for each other.

4. Consider watching for advocacy opportunities for those groups who may be disenfranchised in our society, such as trans people, queer people, or undocumented immigrants.

5. Continue to read the information that CSWA sends about protecting mental health treatment. We will be your eyes and ears for our profession nationally!

CSWA is here for you. The Town Hall last week was called a “safe space” where members could talk to each other about the many feelings they had about the elections. Our next Town Hall will be on December 10th.

We're grateful for your support, today and in the future!

- Stephanie Payne, LCSW, CSWA President

November 6, 2024

By Laura Groshong, LICSW, CSWA Director of Policy and Practice

There is some important information about changes - and potential changes - to LCSW reimbursement that we wanted to let you know about.

Physician Fee Schedule

The Physician Fee Schedule (PFS) came out on Friday, November 1, and outlines changes to reimbursement rates for the over 300 categories of Medicare providers, including LCSWs. The PFS is not finalized, but the recommendation is that there be a 4% raise in LCSW rates for all CPT codes that we are eligible to use. This is one of the largest increases suggested for any group. Of course, our rates are still much lower than other mental health clinicians, so this is only a start toward the reimbursement we should be receiving. But it is a start.

Telemental Health

Another important issue that many members are concerned about is the continuation of coverage for telemental health and audio-only psychotherapy. These delivery systems are currently scheduled to end on December 31, 2024. There are several bills in Congress that would extend coverage in some way. The most likely bill to pass is one which would continue it for two years until December 31, 2026, when it would be reviewed again. The likelihood is that nothing will happen until after elections are counted, so probably next week at the earliest. We will keep you posted on developments as they occur.

Optum Audits

Finally, Optum, without explaining why they engaged in audits of LCSWs, is reporting that the audits of LCSWs (and others) who received overpayments are over. If you are still having problems with reimbursement as a result of the Optum error, please let us know.