APA Hails House Action Ending 40 Years Of Discrimination

Main Category: Medicare / Medicaid / SCHIP
Also Included In: Mental Health
Article Date: 26 Jun 2008 - 15:00 PST

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The American Psychiatric Association (APA) applauds House passage of the Medicare Improvements for Patients and Providers Act, which overhauls key features in Medicare coverage of treatment for mental health, most notably by reducing the discriminatory 50 percent coinsurance patients must pay for outpatient mental health services to the same 20 percent co-payment charged for all other Medicare Part B services. The House passed H.R. 6331 by a vote of 355 to 59.

In addition to ending the disparity with mental health care out-of-pocket costs, H.R. 6331 includes numerous provisions that will strengthen the Medicare program, and block a scheduled 10.6 percent cut in payments to physicians and other health professionals through 2009.

Since the Medicare program was established some 40 years ago, enrollees using outpatient psychiatric services have by law had to pay an effective co-payment of 50 percent - two-and-a-half times the customary 20 percent co-payment paid for other Medicare Part B services.

"The House showed great foresight in taking steps to finally end 40 years of discrimination against patients just because they need mental health treatments ," said Nada Stotland, M.D, M.P.H. "It is unconscionable to require the elderly and disabled to pay half the cost of their mental health care out of pocket. This change makes social and economic sense. The APA will continue to advocate for this legislation until it becomes law."

Action now shifts back to the Senate, which has yet to reach agreement on a bill of its own.
The House passed legislation also includes language to:

- Require Medicare Part D coverage of benzodiazepines and barbiturates, which are medications commonly used to treat anxiety and other psychiatric illnesses;

- Codify the "All or Substantially All" policy (currently a regulatory guideline to ensure that Part D drug plans cover all or substantially all of the medications within certain classes: antipsychotics, antidepressants, anticonvulsants and antivirals, for example).

About the American Psychiatric Association

The American Psychiatric Association is the nation's leading medical specialty society whose more than 38,000 physician members specialize in diagnosis, treatment, prevention and research of mental illnesses including substance use disorders. Visit the APA at http://www.psych.org and http://www.HealthyMinds.org.

American Psychiatric Association