Congress Passes NDAA Recommending Independent TRICARE Practice for Counselors

On December 22nd, Congress passed legislation that directs the Secretary of Defense to implement regulations authorizing counselors to practice independently under TRICARE by June 20, 2011. TRICARE is the health services program operated by the Department of Defense (DoD) for military personnel, retirees, and their dependents. For many years, counselors have been the only master's level mental health professionals required by TRICARE to operate under physician referral and supervision. The TRICARE reimbursement policy issue is under the jurisdiction of DoD, and is separate and distinct from the issue of recognition of licensed professional counselors within health care programs operated by the Department of Veterans Affairs (VA).

The language enacted on TRICARE is a significant accomplishment for the counseling profession and the culmination of many years of hard work by ACA, the American Mental Health Counselors Association (AMHCA), and the National Board for Certified Counselors (NBCC), and is a significant improvement over earlier versions of the legislation. The language was included in the National Defense Authorization Act (NDAA), H.R. 6523, which authorizes spending for defense programs for fiscal year 2011. The president is expected to sign the legislation into law shortly.

Section 724 of H.R. 6523 (entitled "Licensed Mental Health Counselors and the TRICARE Program") states in full:
Not later than June 20, 2011, the Secretary of Defense shall prescribe the regulations required by section 717 of the National Defense Authorization Act for Fiscal Year 2008 (Public Law 110-181; 10 U.S.C. 1073 note).

Section 717 of the 2008 NDAA gave DoD the authority to prescribe counselor independent practice regulations, but no movement had occurred due to an intervening study by the Institute of Medicine, and the possibility of Congress weighing in on the issue. With adoption of the June 20th deadline, Congress has indicated DoD needs to go forward under existing authority.

Section 724 is similar to past House language, but significantly different than earlier Senate defense bill language on this issue, which had included an array of specific criteria counselors would have to meet in order to practice independently under TRICARE. Rather, the language directs DoD to establish the criteria for independent practice. ACA, NBCC, and AMHCA successfully convinced Congress to leave specific criteria out of the law in order to avoid tying DoD's hands, and to allow greater flexibility in counselor participation in the future.

Once signed by the President, the new law will set a deadline of June 20, 2011 for new regulations authorizing counselors to practice independently. ACA, AMHCA, and NBCC will be trying to work with DoD to ensure the regulations are inclusive of all qualified professional counselors.

For more information, contact Scott Barstow, Director of Public Policy & Legislation, at sbarstow@counseling.org, or at (800) 347-6647, x234.