April 16, 2021

Good news on the Medicare fee-for-service sequestration front! The 2% cut which was scheduled for April 14, 2021, has been suspended until December 31, 2021. See the announcement from CMS below:

The Coronavirus Aid, Relief, and Economic Security (CARES) Act suspended the sequestration payment adjustment percentage of 2% applied to all Medicare Fee-for-Service (FFS) claims from May 1 through December 31, 2020. The Consolidated Appropriations Act, 2021, extended the suspension period to March 31, 2021. An Act to Prevent Across-the-Board Direct Spending Cuts, and for Other Purposes, signed into law on April 14, 2021, extends the suspension period to December 31, 2021.

Medicare Administrative Contractors will:

For more information, go to https://www.cms.gov/outreach-and-educationoutreachffsprovpartprogprovider-partnership-email-archive/2021-04-16-mlnc#_Toc69394754

Let me know if you have any questions.

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

March 24, 2021

Today CSWA had its first meeting with members of the Council of State Governments, sponsored by the Department of Defense. For more information, see the original post sent on March 15.

The goal of building a compact for states that want to have reciprocity for clinical social workers was outlined. This project will take approximately 12-16 months to develop and will then be presented to the legislatures in the states and jurisdictions. Therefore, this project will require at least 2-3 years to be implemented.

CSWA is very pleased to have the support of DoD and CSG. We will keep you you apprised of the progress of the compact development.

March 19, 2021

CSWA is pleased to send you the announcement from Sen. Debbie Stabenow (D-MI), Sen. John Barrasso (R-WY), and Rep Barbara Lee (D-CA) about the re-introduction of the Improving Access to Mental Health Act of 2021.

This may be the year that this bill is finally passed with the exponential increase in mental health needs due to the COVID pandemic. See the text of the announcement below.

Please send the following message to your members of Congress, using your own words if you wish, at https://www.congress.gov/members?q={%22congress%22:117}&searchResultViewType=expanded:

“I am a member of the Clinical Social Work Association and a constituent. Please consider becoming a co-sponsor of the Improving Access to Mental Health Act of 2021. As a clinical social worker, I have been working twice as hard during the pandemic, learning to work through telemental health, and handle a substantially increased caseload. However, I am still being paid 25% less by Medicare than other mental health clinicians. I need your help to give clinical social workers, the backbone of the mental health treatment community, fair compensation and recognition of the way we are helping to maintain the mental health of our citizens. Thanks for your consideration.”

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

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

----------------------------

FOR IMMEDIATE RELEASE

March 18, 2021

Eliza Duckworth (Stabenow), Eliza_Duckworth@Stabenow.senate.gov

Barrasso Press Office (Barrasso), Press@barrasso.senate.gov

Sean Ryan (Lee), Sean.Ryan@mail.house.gov

Senators Stabenow, Barrasso and Representative Lee Introduce Bill to Increase Seniors’ Access to Behavioral Health Services

WASHINGTON, D.C. — U.S. Senators Debbie Stabenow (D-MI), John Barrasso (R-WY) and U.S. Representative Barbara Lee (D-CA-13) today reintroduced their bill to increase seniors’ access to behavioral health services. The Improving Access to Mental Health Act of 2021 would ensure clinical social workers can provide their full range of services to Medicare beneficiaries and increase the Medicare program’s reimbursement rate for clinical social workers, aligning it with that of other non-physician providers.

“Increased stress and isolation during the COVID-19 crisis has resulted in an urgent need for behavioral health services, especially among our seniors,” said Senator Stabenow. “Seniors should be able to receive care from the provider of their choice, and this bill ensures that clinical social workers are among those providers.”

“As a doctor, I know how vital it is for seniors to have access to mental health services,” said Senator Barrasso. “In particular, for those living in rural communities, finding a mental health provider is challenging. This is why I am proud to support bipartisan solutions that help more patients get the care they need.”

“As a former psychiatric social worker, I know the critical high-quality mental health services and care social workers provide in our communities,” said Congresswoman Barbara Lee. “Especially during a pandemic impacting the mental health of many, it is critical that we ensure Medicare beneficiaries have access to the essential mental health services provided by clinical social workers on a daily basis. I’m proud to join fellow social worker Senator Debbie Stabenow in reintroducing this critical bill and working to expand mental health services for all.”

The Improving Access to Mental Health Act of 2021 would increase the Medicare payment reimbursement rate for clinical social workers from 75 percent to 85 percent of the physician fee schedule. This would align Medicare payments for clinical social workers with that of other non-physician providers such as nurse practitioners and physician assistants. This new payment structure would incentivize trained and licensed professionals to care for more seniors in their communities. The bill also ensures clinical social workers can provide psychosocial services to patients in nursing homes, and the full range of Health and Behavior Assessment and Intervention (HBAI) services within their scope of practice.

The Improving Access to Mental Health Act of 2021 is supported by Aging Life Care Association, American Academy of Social Work and Social Welfare, Clinical Social Work Association, Congressional Research Institute for Social Work and Policy, Council on Social Work Education, Gerontological Society of America, National Association of County Behavioral Health and Developmental Disability Directors, National Association of Social Workers, National Association for Rural Mental Health, the International OCD Foundation, and the Jewish Federations of North America.

“There is great need and a demand for mental health and behavioral health services due to the COVID-19 pandemic, especially among individuals of color and underserved communities who are disproportionately impacted,” said Angelo McClain, PhD, LICSW, NASW Chief Executive Officer. “This legislation ensures a sufficient number of clinical social workers will be there to provide much-needed support and services to Medicare beneficiaries.”

For years, Senator Stabenow has been a champion for increasing access to behavioral health and addiction services. She created a new permanent funding system through the creation of Certified Community Behavioral Health Clinics, which provide a comprehensive set of high-quality behavioral health services. Her bipartisan Excellence in Mental Health and Addiction Treatment Act secured the most significant expansion of community mental health and addiction services in decades.

March 15, 2021

We are delighted to inform you that we will be working with the US Department of Defense, National Center of Interstate Compacts and other key social work stakeholders to establish clinical social work reciprocity across states. This effort has become increasingly important as we work utilizing telemental health; the requirement that we be licensed in the state where the patient is located is burdensome and amounts to restraint of trade.

Below is the message that CSWA received today from the US Department of Defense:

We are excited to inform you that the U.S. Department of Defense has selected your profession to receive technical assistance from The Council of State Governments to develop an interstate compact for occupational licensing portability. Based on the applications received from three organizations representing social work, DoD believes the Association of Social Work Boards is best suited to lead compact development efforts on behalf of the profession.

However, we believe that CSWA will be a crucial stakeholder in developing a compact for social workers. CSG would like to invite representatives from CSWA to join the compact technical assistance group that will engage in compact development activities jointly with ASWB and other social work regulatory stakeholders.

Thank you for your commitment to removing barriers to multistate practice for licensed practitioners. We will be in touch in the coming days to set up a call with our team at CSG. Please do not hesitate to reach out if you have any questions.

Sincerely,

National Center for Interstate Compacts, The Council of State Governments, 1776 Avenue of the States, Lexington, KY 40511

CSWA will keep you informed on the progress of this helpful project.

- Kendra C. Roberson, PhD, LCSW | CSWA President & Education Committee, Social Work Consultant

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

February 25, 2021

You may have been hearing about part of a new law called Section 123 contained in the 1,000-page Consolidated Appropriations Act of 2021 (CAA) at the very end of 2020. This Section requires all mental health clinicians who are working virtually to see their patients at least once every six months in-person, once the Public Health Emergency (PHE) ends.

Meeting in-person would of course be dangerous in the time of COVID which is why we are working through videoconferencing and audio only in the first place. There has been a lot of concern about the implementation of Section 123. An article from the law firm of Foley and Lardner about Section123 is being circulated which is somewhat inaccurate, as it does not highlight the start of Section 123 only when the PHE ends. Here is what CSWA believes Section 123 means at this point:

Please know that CSWA is working in collaboration with the American Psychological Association to eliminate this section. A bill is being drafted and we are confident that Section 123 can be changed.

CSWA will also work to find out why HHS inserted this section into the CAA and will let you know what we find.

Let me know if you have any other questions.

- Laura Groshong, CSWA Director of Policy and Practice

February 18, 2021

Below is an excellent summary of the legal protections for telehealth services, including behavioral health treatment, in all 50 states and District of Columbia (seven states do not have laws about telehealth coverage including AL, ID, PA, NC, SC, WI, WY) put together by the law firm of Foley and Lardner. The link is https://www.foley.com/-/media/files/insights/publications/2021/02/21mc30431-50state-telemed-reportmaster-02082021.pdf.

The areas covered include state laws about coverage for telehealth and audio-only treatment; reimbursement requirements; how long coverage will last; the actual language of the laws in each state; and more.

Even if you think you know your state’s laws about telemental health, this is a good review and offers ways to improve telemental health laws based on what other states have done.

Let me know if you have any questions about this information.

- Laura Groshong, LICSW, Director, Policy and Practice

January 26, 2021

CSWA is thrilled to see President Biden’s new executive orders today which will be huge steps toward anti-racism and true equity in our country. They are:

• To require fair housing policies and eliminate ‘red-lining’ of housing for BIPOC individuals and families
• To end private prisons which have consistently promoted discriminatory policies and actions toward BIPOC incarcerated individuals
• To combat the xenophobia that exists toward Pacific Islanders and Asian Americans
• To strengthen nation-to-nation relationships with Native Americans and Alaska Natives

In addition, President Biden is embedding racial equity in all Federal agencies. The President wants his team to serve as a model on diversity, including hiring, purchasing, data and access. He has called racial inequality one of the four “converging crises” facing the nation.

To hear the President’s complete remarks on his new policies go to https://www.whitehouse.gov/briefing-room/speeches-remarks/2021/01/26/remarks-by-president-biden-at-signing-of-an-executive-order-on-racial-equity/.

CSWA is about to begin a series of six presentations on “Racism and the Clinical Process” in a virtual collaborative format on Wednesday evenings. For more information go to https://www.clinicalsocialworkassociation.org/event-4134868.

CSWA encourages all members to join us in the anti-racism effort which is finally being addressed at the Federal level.

- Kendra Roberson, PhD, LCSW, CSWA President

January 8, 2021

Below is a summary of the way that the CMS Physicians’ Fee Schedule Rule will impact Medicare psychotherapy reimbursement and telemental health services for LCSWs in 2021. The final Rule was implemented at the end of December 2020.

CPT Code Reimbursement Changes

*Group Psychotherapy, 90853, has been added to the permanent list of telemental health services.

In short,

Telemental Health Services

Telemental health videoconferencing services have been extended indefinitely which is great news. Audio only telemental health services, however, will only be covered through the Public Health Emergency, currently scheduled to end on January 20, 2021. CSWA is working with the Mental Health Liaison Group to have Congress make audio only treatment covered indefinitely as well. CMS believes that Congress must make a legislative change before audio only services can be covered. It is likely that the Public Health Emergency will again be extended past January 20th but has not been extended yet.

In summary, the cuts were not as severe as had been planned for individual psychotherapy, but somewhat more difficult for family and group therapy and psychoanalysis. To reiterate: Stay tuned for the extension of the Public Health Emergency, which will allow the continuation of audio only treatment, but videoconferencing has been extended indefinitely.

January 6, 2021

Given the chaos of the situation in Washington, DC, I wanted to let you know that CSWA is thinking of our many members who live in and around the area. It is very disturbing and frightening to watch from a distance; it would be exponentially worse to be in proximity to the destruction that has been inflicted on the heart of our democracy.

Please take care of yourselves. We hope this misery will come to a quick conclusion. On top of the pandemic, this traumatic situation will only escalate the anxiety and depression we are seeing in our practices. We must take care of ourselves so that we can take care of others. CSWA is here for you.

- Kendra Roberson, LICSW, CSWA President

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

January 6, 2021

CSWA leadership has been trying to come to terms with the hatred unleashed by our President and his followers on January 6, the very real threat to our democracy, and the blatant racist actions that were on full display.

CSWA first reached out to our members, mindful of the traumatic impact experienced by those near the riot and desecration of the Capitol and of the secondary trauma affecting those watching on TVs, phones, and computers. The immediate message was a reminder that we must take care of ourselves, emotionally and physically. As we all know, unless we take care of ourselves, we will have difficulty continuing to treat our patients.

What the so-called “racial-reckoning” of the past summer taught us, was that unjust, unfair treatment of Black and Brown people has, tragically, always been an issue in America. The country, with its obvious privileges for White citizens, has a shaky foundation built on the premise that it is acceptable to colonize and steal Indigenous land, enslave Africans and subjugate anyone non-White, or otherwise marginalized, to second class citizenship. This foundation allowed Trump’s rhetoric and hate speech to be successful in riling a literal lynch mob to storm the Capitol. The Confederate flag, the White supremacy slogans, and the disturbingly tepid response of the Capitol police to the rioters all conveyed these ideas. As more comes to light, CSWA will continue working to learn, to educate, to advocate, and to stand with you against institutional and systemic racism and for undisputed equity.

Our actions now must be to hold the President accountable for his role in promoting the riot, in promoting racism, in promoting police and National Guard brutality in BLM protests throughout 2020, and in undermining the electoral process. Impeachment will thus create a lasting record of his unlawful behavior and prevent him from holding further federal office. CSWA encourages all members to notify their members of Congress immediately that the President be impeached for his actions.

Here is a possible way to send that message: “I am a member of the Clinical Social Work Association and a constituent. Given the President’s reckless fomenting of destructive acts on the Capitol, police and our elected officials, I believe he should be impeached.“ Email addresses and phone numbers can be found at https://www.congress.gov/members?q={%22congress%22:117}&searchResultViewType=expanded

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

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