1. Short title
This Act may be cited as the “Addiction Treatment Access Act”.
Addiction Treatment Access Act
A BILL
To amend title XVIII of the Social Security Act to provide coverage of addiction counselor services under part B of the Medicare program.
2. Coverage of addiction counselor services under part B of the Medicare program
Coverage of Services—
in subparagraph (GG), by striking “and” at the end;
in subparagraph (HH), by striking the period at the end and inserting “; and”; and
by adding at the end the following new subparagraph:
“(II) addiction counselor services (as defined in subsection (kkk)(1));”
Definitions— Section 1861 of the Social Security Act (42 U.S.C. 1395x) is amended by adding at the end the following new subsection:
“(kkk) Addiction counselor services; addiction counselor
“(1) The term addiction counselor services means services performed by an addiction counselor (as defined in paragraph (2)) for the diagnosis and treatment of substance abuse and addiction that the addiction counselor is legally authorized to perform under State law (or the State regulatory mechanism provided by the State law) of the State in which such services are performed, as would otherwise be covered if furnished by a physician or as incident to a physician’s professional service, which may include—
“(A) addiction assessment;
“(B) addiction counseling;
“(C) crisis management;
“(D) drug therapy;
“(E) treatment planning; and
“(F) treatment of co-occurring disorders,
“(2) The term addiction counselor means an individual who—
“(A) has completed coursework or training specific to treating substance use disorders, including with respect to the addiction counseling competencies identified in the document published by the Substance Abuse and Mental Health Services Administration as part of the Technical Assistance Publication (TAP) series, number 21, entitled “Addiction Counseling Competencies: The Knowledge, Skills, and Attitudes of Profressional Practice” (or any successor publication); and
“(B) in the case of an individual performing services in a State that provides for licensure or certification of addiction counselors, is licensed or certified as an addiction counselor or alcohol and drug counselor in such State.”
Provision for payment under part B— Section 1832(a)(2)(B) of the Social Security Act (42 U.S.C. 1395k(a)(2)(B)) is amended—
by striking “and” at the end of clause (iv); and
by adding at the end the following new clause:
“(v) addiction counselor services;”
Amount of payment— Section 1833(a)(1) of the Social Security Act (42 U.S.C. 1395l(a)(1)) is amended—
by striking “and” before “(CC)”; and
by inserting before the semicolon at the end the following: “, and (DD) with respect to addiction counselor services under section 1861(s)(2)(II), the amounts paid shall be 80 percent of the lesser of the actual charge for the services or 60 percent of the amount determined for payment of a psychologist under subparagraph (L).”.
Inclusion of addiction counselors as practitioners for assignment of claims— Section 1842(b)(18)(C) of the Social Security Act (42 U.S.C. 1395u(b)(18)(C)) is amended by adding at the end the following new clause:
“(vii) An addiction counselor (as defined in section 1861(kkk)(2)).”
Coverage in rural health clinics and federally qualified health centers— Section 1861(aa)(1)(B) of the Social Security Act (42 U.S.C. 1395x(aa)(1)(B)) is amended by striking “or by a clinical social worker (as defined in subsection (hh)(1)),” and inserting “, by a clinical social worker (as defined in subsection (hh)(1)), or by an addiction counselor (as defined in section 1861(kkk)(2)).”.
Effective Date— The amendments made by this section shall apply with respect to services furnished on or after January 1, 2020.