APA Continues Fight For Fair Coverage For Mental Health Care

Main Category: Mental Health
Also Included In: Medicare / Medicaid / SCHIP
Article Date: 17 Jun 2008 - 16:00 PDT

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The American Psychiatric Association (APA) will continue to fight for legislation to end discrimination against Medicare patients seeking mental health care, said APA President Nada Stotland, MD, MPH., after the Senate failed to get enough votes to consider S.3101, the Medicare Improvements for Patients and Providers Act of 2008.

Dr. Stotland's comments came after a key vote to cut off debate on the bill failed Thursday by a vote of 54-39, six votes shy of the 60 needed.

Stotland praised Senate Finance Committee Chairman Sen. Max Baucus, D-Mont., for introducing S. 3101, which would have reduced the 50 percent coinsurance for outpatient mental health services under Medicare Part B. The measure also would have blocked the 10.6 percent payment reduction scheduled to go into effect on July 1, replacing it with small increases for the rest of the year, and in 2009.

"This bill would have strengthened the Medicare program, addressed problems with payments to physicians and other health professionals and, most importantly, improved access to mental health services," Stotland said. "By introducing this bill, Senator Baucus and his allies showed continued support for improving mental health services for Medicare, Part B, recipients." Cosponsors of the bipartisan legislation were Sens. John Rockefeller, D-W.V.; Olympia Snowe, R-Maine, and Gordon Smith, R-Ore.

"Higher co-pays for mental health care discriminate against people with mental disorders," Stotland said. "Eliminating these discrepancies will improve health outcomes and save healthcare dollars in the long-term." The APA has led the charge for decades to end discriminatory practices against patients who need psychiatric care and will continue to work for fundamental changes in Medicare policy to benefit patients.

S. 3101 would have delayed by 18 months devastating reductions in Medicare's payment schedule to provide Congress additional time to permanently fix the underlying problems with the payment update formula. It would have replaced the pending cuts with a 0.5 percent increase for the remainder of 2008, and a 1.1 increase in 2009.

S. 3101 also included other APA long-standing legislative priorities:

- Coverage of benzodiazepines and barbiturates under Medicare Part D; and
- Codification of the protection that requires coverage of "all or substantially all" medications in six classes of clinical concern in all Part D plans.

"There is no clinical justification for Medicare's failure to cover benzodiazepines and barbiturates, but current law prevents drug plans from doing so. That, together with action to guarantee access to medications for medically vulnerable patients, will help ensure that beneficiaries get the medications they need," Stotland said.

With versions of these beneficiary improvements already passed by the House, the APA is urging strong continued support for the Baucus Medicare legislation. Stotland offered particular praise for the nine GOP Senators who joined 45 Democrats in voting for cloture on Thursday.

"APA members and their patients are deeply grateful to all Senators who voted for cloture, but in particular I wish to commend Republican Senators Olympia Snowe and Susan Collins (Maine), Gordon Smith, Ore.; Norm Coleman, Minn.; Elizabeth Dole, N.C.; Lisa Murkowski, Ark.; Arlen Specter, Penn.; and Ted Stevens, Ark. for their courage in defying party pressure and voting for cloture. They stood up for an end to discrimination against patients needing mental health care that has been an unfortunate part of Medicare's history since the program was first established."

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

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