Federal Policy Archive 2014
A Positive ‘Win’ with Tricare
The U.S. Department of Defense published a final rule July 17, 2014, to implement the TRICARE Certified Mental Health Counselor (TCMHC) provider type as a qualified mental health provider authorized to independently diagnose and treat TRICARE beneficiaries and receive payment for services.
The final rule goes into effect on August 18, 2014.
The Tricare rule includes at least three major requests MaMHCA and our advocacy partners made:
a. An extended “transition period” (grand-parenting) period to January 1, 2017.
b. Expansion of the pool of qualified supervisors so more LMHCs and LPCs will be eligible;
c. Keeping the current Tricare providers intact with the ability to practice with physician referral.
Essentially, this means no current LMHC need be locked out of the Tricare system; and future LMHCs will have a path to continue with Tricare, even if they do not graduate from a CACREP approved program.
We are disappointed that Tricare seems to have kept the CACREP-only policy for approval of graduate programs, but we intend to continue to lobby rigorously to have this aspect of the rule amended. We believe Tricare misunderstood the role that counseling psychology grad programs play in LMHC and LCPC licensure and that they need to be considered as well.
MaMHCA and Maryland’s LCPCM leaders are now working with Tricare to make the Tricare application more LMHC/LCPC suitable.
Again, we urge all members who want to work in the federal system (which we hope will include Medicare someday) to apply to Tricare ASAP. To apply to Tricare, contact MHN (Medical Health Network) via their website or at 800-541-3353.
If you have problems with your contact with MHN, or with receiving an application, please send an e-mail to MaMHCA Executive Director, Midge Williams.
View the final rule on the Federal Register or download.
ACTION ALERT: Medicare Recognition of Mental Health Counselors
AMHCA and MaMHCA have long sought bipartisan support for its Medicare provider status legislation in the U.S. House of Representatives, and on December 5, 2013, HR.3662 was introduced by our new sponsors Rep. Chris Gibson (R-NY) and Rep. Mike Thompson (D-CA). The House bill contains language identical to that used in the Senate version, S.562 (Wyden/Barrasso), which amends Medicare to add the outpatient services of licensed mental health counselors ("LMHCs") and licensed marriage and family therapists ("LMFTs") under part B of the Medicare program.
ACTION REQUESTED: Now is the time to contact your House member to show their support HR. 3662 and request they cosponsor the bill.
• Download a sample e-mail message for a Representative
• Find your Representative's contact information
• Lack of Access: Approximately 77 million older adults live in 3,000 mental health professional shortage areas. Fully 50 percent of rural counties in America have no practicing psychiatrists, psychologists, or social workers. Many of these mental health professional shortage areas have LMHCs whose services are underutilized due to the lack of Medicare coverage.
• Medicare Inefficiency: Currently, Medicare is a very inefficient purchaser of mental health services. Inpatient psychiatric hospital utilization by Medicare beneficiaries is extraordinarily high when compared to psychiatric hospitalization rates for patients covered by Medicaid, VA, TRICARE, and private health insurance. One third of these expensive inpatient placements are caused by clinical depression and addiction disorders that can be treated for much lower costs when detected early through the outpatient mental health services of LMHCs.
• Underserved Minority Populations: The United State Surgeon General noted in a report entitled "Mental Health: Culture, Race, and Ethnicity," that "striking disparities in access, quality, and availability of mental health services exist for racial and ethnic minority Americans." A critical result of this disparity is that minority communities bear a disproportionately high burden of disability from untreated or inadequately treated mental disorders.