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Summer 2006
August 18
Effective May 23,
2007, the National Provider Identifier (NPI) replaces the Medicaid
provider number(s) you use today in HIPAA standard transactions. The
Health Insurance Portability and Accountability Act (HIPAA) of 1996
required the adoption of a standard unique identifier for healthcare
providers. The National Provider Identifier (NPI) was adopted as this
national standard. BCBS and other insurance/managed care companies will
also be requiring a NPI on the billing claim.
LMFTs who submit electronic transactions such as electronic claims,
eligibility inquiries, and claims status inquiries must have their NPI
and be ready to use it to identify themselves in those transactions
by May 23, 2007. In addition to the standard electronic transactions,
BCBS and Medicaid will also require the NPI on paper claims (CMS-1500
and UB-04).
To obtain an NPI number for yourself and your practice (if you are incorporated),
go to: https://nppes.cms.hhs.gov.
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AAMFT Medicare
Update (August 3)
Here are some talking
points for you to utilize during your conversations regarding AAMFT
Medicare pursuits. Please note that Medicare is the most pressing concern
right now because two bills on doc Medicare fee fix were just introduced
separately by Reps. Burgess (GOP) - H.R. 5688, and Dingell (Dem). We
think that these (particularly Burgess's) might be possible legislative
vehicles for the inclusion of our "beneficiary access" to
providers language on MFT Medicare eligibility. Word on the street is
that the Burgess bill will likely get some action in early September
when Congress returns from summer recess, so we need to increase our
efforts now...
MOST IMPORTANT - encourage Rep. Myrick's sign-on and/or support
for 1) H.R. 1447, and indicate that we hope for our legislation [preferably
H.R. 1447, but we also could handle H.R. 5324] to be attached as a relevant
provider "access" provision within the Burgess bill.
FYI - the most recent CBO cost-estimate of the Senate's MFT Medicare
bill - S. 784 (w/LPCs and MFTs) was $88 million over five years - splitting
it in half due to equivalent membership numbers would make it $45 million
over five years for just adding MFT services (which comes out to only
$9 million a year, for five years).
MFT Legislative Goal = improving access for those Americans utilizing
Medicare health benefits by adding MFTs to the list of qualified Medicare
mental health professionals (noting that there are over 50,000 MFTs
around the country).
MFTs are recognized by the Health Services and Resources Administration
(HRSA) as one of the five "core" mental health professionals,
alongside Clinical Psychologists; Psychiatrists; Psychiatric Nurses;
and Clinical Social Workers.
MFTs are not seeking to expand the scope of mental health services
covered by Medicare - we would solely like to correct an inequity that
restricts beneficiaries access to MFT services.
Important point - shortages of MH providers exist in rural areas
around the country and MFTs are often the only MH professionals residing
in there. YET, MFTs cannot treat rural Medicare beneficiaries in need
because of our present exclusion from Medicare!
Also important to note, MFTs have licensure in 48 states, plus
the District of Columbia...an improvement from when original Medicare
legislation was created.
Hope this helps!
Melissa E. Stamps,
Legislative Affairs, AAMFT
NCAMFT Professional
Practice Legislative Update (August 1)
from John Mader email address: jmaderlmft@earthlink.net
I spoke with Melissa Stamps of AAMFT this afternoon about strategies
to pass legislation to allow LMFTs to participate in Medicare, to be
included as providers in the school systems via "No Child Left
Behind," and to be included as VA Service Providers.
The immediate priority is Medicare legislation with 2 bills pending
(and possibly a rider on a 3rd bill) that would include LMFTs as Medicare
providers. (click here
for Medicare Fact Sheet)
I have asked Melissa if she would provide us with bullet points on what
we need to emphasize to our legislators and responses to possible questions
a legislator might pose to us.
The AAMFT website will have a page ("DISTRICT ADVOCACY HEADQUARTERS")
with background information on the Medicare issue to enable us to be
adequately informed.
Go to http://www.aamft.org/Advocacy/index_nm.asp for useful background
information on these issues.
Here is what we need to do...
1A) Meet with Rep. Sue Myrick of the 9th District (Charlotte).
She is on the Energy and Commerce Committee that is going to be voting
on H.R. 1447, the Seniors Mental Health Access Improvement Act of 2005
which would add MFTs and mental health counselors to the list of approved
providers. There is another bill with fewer sponsors at this time, H.R.
5324 that would also add MFTs and LPCs.
She is personally interested in MH issues as her gr'da has a bipolar
dx. We really need our LMFTs in the South Central Chapter or those of
you who have some relationship with Rep. Myrick or her staff to make
some headway on this.
1B) Meet with Rep. Virginia Foxx of the 5th District (Boone).
She is on the Education committee that will be addressing the inclusion
of MFTs working in the schools (No Child Left Behind).
1C) Meet with Sen. Richard Burr. As a member of the Senate Committee
on Health, Education, Labor, and Pensions, he will have input on the
inclusion of MFTs working in the schools (No Child Left Behind). It
would be helpful to have MFTs informing him of our perspective on this.
***If we can gain letters of support from agencies, school systems,
physicians, psychologists and social workers, then we can further demonstrate
the value and need for inclusion of MFTs in Medicare, the schools and
the VA hospitals. These letters could be delivered by those MFTs who
arrange to meet with the officials mentioned above. I plan to ask some
MH Center directors for just such letters to forward to Sen. Burr and
legislators on the Medicare bills.
2) Make calls to your representative and ask to speak with the
Health Legislation Assistant. Or you can send a fax. Some legislators
are not attending to email due to an increase in spamming. Support of
Medicare, Education and VA legislation is needed.
3) Join Family TEAM Website (see below)
4) Email me if you want to participate. Any help will be welcome.
I will send you the latest information and help coordinate next steps.
email address: jmaderlmft@earthlink.net
Melissa will be sending me additional relevant information.
*** and I have a request... Would Chapter Directors follow-up with their
members (amap) and let me know how its going by mid-August?
Melissa emphasized that until SEPTEMBER 1, members of Congress will
be in their home districts/states.
One-on-one constituent/legislator interaction is the most effective
means for winning support on MFT eligibility pursuits.
WE STRONGLY ENCOURAGE YOU TO MEET WITH YOUR ELECTED OFFICIAL (S) DURING
THIS TIME PERIOD.
The sooner a meeting is scheduled, the better your chances.
Again, the page
with useful resources is http://www.aamft.org/Advocacy/index_m.asp
You will need your AAMFT Number to log in to this site. If you need
assistance in logging in, Melissa Stamps will gladly help--email her
at mstamps@aamft.org.
Here is what you will find on this site:
Advocacy Resources
MFT Fact Sheets
Studies and Information
FTM Advocacy Update Articles
Family TEAM Website
AAMFT 2006 Voter Tool
District Advocacy Headquarters
Advocacy Issues
Medicare
HIPAA Resources
IDEA
Veterans' Affairs MFTs as VA Providers
ESEA MFTs in the Schools
Military / Dept. of Defense
FEHBP
Mental Health Parity
Transportation
