Bills introduced allowing psychologists to practice independently under Medicare

Medicare Mental Health Access Act would add psychologists to physician definition statute.

In the first weeks of the 115th Congress, members of the House of Representatives and the Senate introduced bipartisan legislation that would allow psychologists to practice independently without physician supervision in all treatment settings under Medicare.

The legislation, entitled the “Medicare Mental Health Access Act” (H.R. 1173, S. 448) is sponsored by U.S. Reps. Kristi Noem, R-S.D., and Jan Schakowsky, D-Ill., in the House and by Senators Sherrod Brown, D-Ohio, and Susan Collins, R-Maine in the Senate.

If enacted, the Medicare Mental Health Access Act would add psychologists to the list of health care providers included in Medicare’s definition of a “physician.” Inclusion of psychologists in Medicare’s “physician” definition would not only allow independent practice in all Medicare-covered treatment settings, it would also make psychologists eligible for 10 percent Medicare bonus payments for services delivered in federally-designated mental health professional shortage areas.

The statutory definition of a “physician” has long included non-physician, doctoral-degreed providers — including dentists, chiropractors, optometrists and podiatrists — in addition to medical doctors and doctors of osteopathic medicine. Practicing psychologists are the only doctoral-level providers in Medicare not on the list.

Moreover, Medicare is the only health care payer which continues to require physician oversight or supervision of psychologists in outpatient rehabilitation facilities, partial hospitalization programs, and other treatment settings outside of a psychologist’s own office. This unnecessary oversight leads to delays in providing mental health services to beneficiaries.

Psychology leaders visited the offices of their members of Congress during the 2017 Practice Leadership Conference held in Washington, D.C., asking members to cosponsor H.R. 1173 and S. 448. Although Congress is currently preoccupied with attempts to repeal and replace the Affordable Care Act, there is also strong interest among lawmakers for making changes to Medicare. Building a robust number of congressional cosponsors of H.R. 1173 and S. 448 will strengthen the Practice Organization’s case that the Medicare Mental Health Access Act should be included as part of any Medicare legislation enacted during the 115th Congress.

For more information on the legislation, and to see our action alert on the legislation, visit our Advocacy webpage.