HGSAdministrators (HGSA) has published a letter dated January 10, 2003 that was sent to social workers with Medicare Part B billing privileges. In the letter HGSA states:
"Since the State [Pennsylvania] now distinguishes between social workers and clinical social workers in its licensure process, the fact that you [the social worker] are not licensed as a clinical social worker is an issue. Medicare Law (Section 1862 (hh) of the Social Security Act) and the Medicare Carriers Manual (Section 2152.A) requires, among other things, that providers have a valid clinical social worker license in states that issue such licenses in order to be eligible for Medicare payments as clinical social workers. The Law does not recognize any alternative Medicare enrollment procedures in those states that license clinical social workers. This interpretation has been confirmed by the federal agency that oversees the Medicare program, the Centers for Medicare and Medicaid Services (CMS)."
Licensed clinical social workers must send HGSA a copy of their clinical social worker license or certification within 120 days from the date of the letter. Social workers who do not submit this information in a timely manner will have their provider identification number (PIN) revoked.
Information about the licensure process may be obtained by contacting the Pennsylvania State Board of Social Workers, Marriage and Family Therapists and Professional Counselors at 717-783-1389.
Updated licenses may be faxed to 717-612-4577 or mailed to:
HGSAdministrators
Provider Enrollment Services
PO Box 890157
Camp Hill, PA 17089-0157
Questions regarding this matter may be directed to an Enrollment Specialist at 866-488-0549.
PCPA is concerned about the impact this letter will have on services to Medicare recipients and will provide more information to PCPA members as it becomes available. Direct any questions to Rebecca May Cole at the Association.