,,ii  #aacth ,,congress  #ast ,session  
,s4 #efb  ,,in ,,the ,,senate ,,of ,,the
 ,,united ,,states  ,march #ad1 #bjac   
,mr4 ,wyden 7for himself1 ,mr4          
,barrasso1 and ,mr4 ,merkley7 introduced
 the following bill2 which was read     
twice and referred to the ,committee on 
,finance  ,a ,,bill  ,to amend title    
,,xviii of the ,social ,security ,act to
 provide for the coverage of marriage   
and family therapist services and mental
 health counselor services under part ,b
 of the ,medicare program1 and for other
 purposes4  #a4 ,short title ,this ,act 
may be cited as the ,seniors ,mental    
,health ,access ,improvement ,act of    
#bjac4  #b4 ,coverage of marriage and   
family therapist services and mental    
health counselor services under part ,b 
of the ,medicare program  7a7 ,coverage 
of ,services  7#a7 ,in general ,section 
#ahfa7s77#b7 of the ,social ,security   
,act 7#db ,u4,s4,c4 #aciex7s77#b77 is   
amended--  7,a7 in subparagraph 7,,ee71 
by striking and after the semicolon at  

the end2  7,b7 in subparagraph 7,,ff71  
by inserting and after the semicolon at 
the end2 and  7,c7 by adding at the end 
the following new subparagraph3  7,,gg7 
marriage and family therapist services  
7as defined in subsection 7iii77#a77 and
 mental health counselor services 7as   
defined in subsection 7iii77#c772  4    
7#b7 ,definitions ,section #ahfa of the 
,social ,security ,act 7#db ,u4,s4,c4   
#aciex7 is amended by adding at the end 
the following new subsection3  7iii7    
,marriage and ,family ,therapist        
,services2 ,marriage and ,family        
,therapist2 ,mental ,health ,counselor  
,services2 ,mental ,health ,counselor   
7#a7 ,the term marriage and family      
therapist services means services       
performed by a marriage and family      
therapist 7as defined in paragraph 7#b77
 for the diagnosis and treatment of     
mental illnesses1 which the marriage and
 family therapist is legally authorized 
to perform under ,state law 7or the     
,state regulatory mechanism provided by 

,state law7 of the ,state in which such 
services are performed1 as would        
otherwise be covered if furnished by a  
physician or as an incident to a        
physician's professional service1 but   
only if no facility or other provider   
charges or is paid any amounts with     
respect to the furnishing of such       
services4  7#b7 ,the term marriage and  
family therapist means an individual    
who--  7,a7 possesses a master's or     
doctoral degree which qualifies for     
licensure or certification as a marriage
 and family therapist pursuant to ,state
 law2  7,b7 after obtaining such degree 
has performed at least #b years of      
clinical supervised experience in       
marriage and family therapy2 and  7,c7  
in the case of an individual performing 
services in a ,state that provides for  
licensure or certification of marriage  
and family therapists1 is licensed or   
certified as a marriage and family      
therapist in such ,state4  7#c7 ,the    
term mental health counselor services   

means services performed by a mental    
health counselor 7as defined in         
paragraph 7#d77 for the diagnosis and   
treatment of mental illnesses which the 
mental health counselor is legally      
authorized to perform under ,state law  
7or the ,state regulatory mechanism     
provided by the ,state law7 of the      
,state in which such services are       
performed1 as would otherwise be covered
 if furnished by a physician or as      
incident to a physician's professional  
service1 but only if no facility or     
other provider charges or is paid any   
amounts with respect to the furnishing  
of such services4  7#d7 ,the term mental
 health counselor means an individual   
who--  7,a7 possesses a master's or     
doctor's degree in mental health        
counseling or a related field2  7,b7    
after obtaining such a degree has       
performed at least #b years of          
supervised mental health counselor      
practice2 and  7,c7 in the case of an   
individual performing services in a     

,state that provides for licensure or   
certification of mental health          
counselors or professional counselors1  
is licensed or certified as a mental    
health counselor or professional        
counselor in such ,state4  4  7#c7      
,provision for payment under part ,b    
,section #ahcb7;a77#b77;,b7 of the      
,social ,security ,act 7#db ,u4,s4,c4   
#aciek7a77#b77;,b77 is amended by adding
 at the end the following new clause3   
7v7 marriage and family therapist       
services 7as defined in section         
#ahfa7;iii77#a77 and mental health      
counselor services 7as defined in       
section #ahfa7;iii77#c772  4  7#d7      
,amount of payment ,section             
#ahcc7;a77#a7 of the ,social ,security  
,act 7#db ,u4,s4,c4 #aciel7a77#a77 is   
amended--  7,a7 by striking and 7,z7 and
 inserting 7,z72 and  7,b7 by inserting 
before the semicolon at the end the     
following3 1 and 7,,aa7 with respect to 
marriage and family therapist services  
and mental health counselor services    

under section #ahfa7s77#b77;,,gg71 the  
amounts paid shall be #hj percent of the
 lesser of the actual charge for the    
services or #ge percent of the amount   
determined for payment of a psychologist
 under subparagraph 7,l74  7#e7         
,exclusion of marriage and family       
therapist services and mental health    
counselor services from skilled nursing 
facility prospective payment system     
,section #ahhh7;e77#b77;,a77ii7 of the  
,social ,security ,act 7#db ,u4,s4,c4   
#acieyy7e77#b77;,a77ii77 is amended by  
inserting marriage and family therapist 
services 7as defined in section         
#ahfa7;iii77#a771 mental health         
counselor services 7as defined in       
section #ahfa7;iii77#c771 after         
qualified psychologist services14  7#f7 
,inclusion of marriage and family       
therapists and mental health counselors 
as practitioners for assignment of      
claims ,section #ahdb7;b77#ah77;,c7 of  
the ,social ,security ,act 7#db         
,u4,s4,c4 #acieu7b77#ah77;,c77 is       

amended by adding at the end the        
following new clauses3  7vii7 ,a        
marriage and family therapist 7as       
defined in section #ahfa7;iii77#b774    
7viii7 ,a mental health counselor 7as   
defined in section #ahfa7;iii77#d774  4 
7b7 ,coverage of ,certain ,mental       
,health ,services ,provided in ,certain 
,settings  7#a7 ,rural health clinics   
and federally qualified health centers  
,section #ahfa7;aa77#a77;,b7 of the     
,social ,security ,act 7#db ,u4,s4,c4   
#aciex7aa77#a77;,b77 is amended by      
striking or by a clinical social worker 
7as defined in subsection 7hh77#a77 and 
inserting 1 by a clinical social worker 
7as defined in subsection 7hh77#a771 by 
a marriage and family therapist 7as     
defined in subsection 7iii77#b771 or by 
a mental health counselor 7as defined in
 subsection 7iii77#d774  7#b7 ,hospice  
programs ,section                       
#ahfa7;dd77#b77;,b77i77,,iii7 of the    
,social ,security ,act 7#db ,u4,s4,c4   
#aciex7dd77#b77;,b77i77,,iii77 is       

amended by inserting 1 marriage and     
family therapist1 or mental health      
counselor after social worker4  7c7     
,authorization of marriage and family   
therapists and mental health counselors 
,to develop discharge plans for         
post-,hospital services ,section        
#ahfa7;ee77#b77;,g7 of the ,social      
,security ,act 7#db ,u4,s4,c4           
#aciex7ee77#b77;,g77 is amended by      
inserting 1 including a marriage and    
family therapist and a mental health    
counselor who meets qualification       
standards established by the ,secretary 
before the period at the end4  7d7      
,effective ,date ,the amendments made by
 this section shall apply with respect  
to services furnished on or after       
,january #a1 #bjad4