MEDICARE

Exclusive: Bipartisan Pair of House Lawmakers Introducing Bill to Improve Peer Support Access for Patients With Mental Health Issues

Bill would clarify that Medicare can pay for peer support services for patients struggling with mental health, substance use issues

Reps. Judy Chu (D-Calif.), pictured March 3, 2020, in Washington, D.C., and Adrian Smith (R-Neb.) are introducing a bill that would clarify that Medicare can pay for peer support services for patients struggling with mental health or substance use issues. (Mark Makela/Getty Images)
  • Reps. Judy Chu (D-Calif.) and Adrian Smith (R-Neb.) are set to reintroduce the legislation Thursday.

  • Chu said she’s “encouraged” by the bipartisan support and hopes the bill will pass on its own, but that it could also be wrapped into a larger package later in the year.

A bipartisan pair of House lawmakers will reintroduce legislation Thursday to make it easier for Medicare to pay for peer support specialists — a group mental health advocates describe as underutilized in the mental health workforce.

The bill, obtained by Morning Consult and set to be introduced by Reps. Judy Chu (D-Calif.) and Adrian Smith (R-Neb.), would clarify that services provided by certified peer support specialists — people in recovery for mental health or substance use disorders who often work alongside clinicians to help patients struggling with similar issues — can be reimbursed through Medicare.

Advocates for the bill say it’s currently unclear whether Medicare will cover peer support, meaning clinicians may not be referring patients who could benefit from these services or billing for them when they do. In most states, Medicaid reimburses for peer support services for patients with substance use disorder, but Medicare’s coverage for mental and behavioral health care is more opaque.

“There aren’t many who recognize what a peer support counselor even is,” Chu, a member of the House Ways and Means health subcommittee and a clinical psychologist, said in an interview. She added that “there is a stigma against using mental health services, but peer support” can make it easier for people who are struggling to get help.

The new bill, dubbed the “Promoting Effective and Empowering Recovery Services in Medicare Act of 2021,” or the PEERS Act, would require peer support specialists to work with clinicians. Advocates hope it would prompt more providers to take advantage of the services, particularly in the primary care setting.

The PEERS bill could also help address a workforce issue: Peer support specialists are “not paid a living wage in many states,” said Caren Howard, director of policy and advocacy at Mental Health America, which worked on the legislation with Chu’s and Smith’s offices.

“We think that by having Medicare bill, there will be a national standard set for how much to pay peers, and then it will be a lot more attractive for commercial insurance companies to follow suit,” Howard said. The ultimate goal is for all health plans to cover peer support services “in the same way that a provider can be reimbursed for doing a mental health screening,” she said.

The bill comes as lawmakers increasingly look to address the mental health toll of the COVID-19 pandemic. Thirty-five percent of adults are reporting symptoms of anxiety or depression, according to the latest data from the Centers for Disease Control and Prevention, while access to treatment remains spotty.

“Mental health services are critically important across America, and COVID-19 has made the need for mental health care even more prevalent,” Smith said in an email.

Chu and Smith first introduced the PEERS bill last year. Chu said she’s “encouraged” by the bipartisan support and hopes the bill will pass on its own, but that it could also be wrapped into a larger package later in the year.

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