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Online Newsletter Committed to Excellence in the Fields of Mental Health, Addiction, Counseling, Social Work, and Nursing

Managed Care and MFTs

Nicole Hiltibran February 3, 2010 BBs Approved CEUs for LCSWs LCSW, BBS Approved CEUs for MFTs MFT, Managed Care CEUs, Managed Care Continuing Education

Managed Care and MFTs

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Managed Care and MFTs

In 2009, legislation that would provide Medicare coverage for MFTs was passed in the House of Representatives (H.R. 3962) version of Health Care Reform (“HCR”). Further, a commitment was made to include the MFT provision in the Senate version of HCR. Although CAMFT was hopeful that Medicare inclusion for MFTs be placed in the final HCR bill (which was scheduled to go forward in 2010), based on the new make-up of Congress, it is unlikely that HCR will move forward. Whether or not HCR does move forward, does not mean our issue is dead. Congress is likely to enact some type of Medicare legislation in 2010, and our challenge will be to get into the vehicle that will go to the President.

The Department of Veterans Affairs (“DVA”) recently indicated that their plan was to complete the new MFT qualification standards by September 2010. Subject Matter Expert (SME) workgroups have been established and are meeting weekly to develop separate qualification standards. Once the draft qualification standards are developed, the DVA will formally submit a request to the Office of Personnel Management (OPM) to establish a new, separate occupational series for MFTs. CAMFT remains committed to helping usher these long overdue standards into reality to enable the VA facilities to recruit and hire MFTs in VA Medical Centers, Outpatient Clinics, and Veterans Outreach Centers.

Federal Mental Health Parity Regulations for MFTs

Federal regulations (which are necessary to implement the Federal Mental Health Parity law which passed in 2009) were released on January 29, 2010. The public comment period to express concerns or suggestions about the parity regulations will close April 29, 2010. CAMFT will be submitting comments requesting greater clarification of certain sections, including but not limited to scope of services, and exact conditions/diagnoses included within mental health and substance use coverage. If you wish to view or comment on the parity regulations, please see the following link:

U.S. Nuclear Regulatory Commission

Currently, federal regulations only allow licensed psychiatrists, licensed psychologists, and licensed clinical social workers to work as “Substance Abuse Experts” within the Nuclear Regulatory Commission (“NRC”.) The stated knowledge, training, and education requirements to become an NRC Substance Abuse Expert are well within the MFT scope of practice, and therefore MFTs should be included as potential providers. CAMFT will submit a Petition for Rulemaking (or a 10 CFR 2.802 action) to request that the NRC amend their regulations to allow MFTs to be included as Substance Abuse Experts.

Government Employees Health Association

Effective January 1, 2010, the Government Employees Health Association (a company that provides health care insurance to federal employees/retirees) will include MFTs as covered health care providers. The Government Employees Health Association provides health care insurance to over 400,000 employees/retirees. For more information about becoming a panel provider for the Government Employees Health Association, please call 816-257-5500.

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