The Department of Defense is retaining supervised psychologists as part of its TRICARE military health insurance program.
The Department of Defense enacted new uniform standards in 2011 to ensure quality mental health care among service members does not differ from state to state.
In the beginning, the department intended to allow mental health practitioners with specific credentials to serve TRICARE patients independently and phase out psychologists who had to work under the supervision of a physician.
Due to new regulations, DoD believes that patients will have more access to mental health providers and improve the quality of care. Unfortunately, few psychologists possess these credentials.
In response, the department has extended the time for counselors supervised by physicians to become certified to work independently. The document also points out that counselors who have not completed all the requirements can continue to work with their supervising doctor.
According to the 2011 interim rule, certain providers of mental health services may see patients independently of physician referral and supervision and be reimbursed under TRICARE. Until Dec. 31, 2014, counselors without a specific certification were allowed to work under physician supervision.
In the meantime, the rule anticipated that these counselors would pursue certification and subsequently be able to practice independently.
The department expected that the interim rule would expand patients' access to mental health providers. Yet detractors have argued that the Dec. 31 deadline would result in a dramatic reduction in counselor availability at a time when counselors are in particularly short supply.
However, very few counselors in the TRICARE system meet the initial criterion, which is graduation from a college accredited by the Council for Accreditation of Counseling and Related Educational Programs (CACREP).
As a result, the agency has relaxed the requirements during a transition period and extended the compliance deadlines.
The final rule calls for the following qualifications: a master's degree in counseling, accredited by CACREP; a regulated license from the state at 'clinical' or the highest level available in states with tiered licensing schemes; and a well-defined scope of practice.