Legislative Issues: Medicare
Today, more than 34 million Americans receive Medicare benefits — but these benefits do not include access to mental health and addictions treatment on an equal basis with treatment for other types of illnesses.
Under current Medicare policy, beneficiaries must pay 50 percent of the cost of outpatient mental health treatment — compared to just 20 percent of the cost of outpatient treatment for other illnesses. Prescription drugs to treat mental illness are not covered by Medicare. The program also does not cover such important community-based services as psychiatric rehabilitation, intensive case management, and day treatment. Important treatment settings such as crisis residential programs, therapeutic family or group treatment homes, and residential detoxification and addictions treatment centers are also not covered under Medicare.
Because Medicare's coverage of core mental health professionals is limited, beneficiaries have fewer choices of providers and less access to care. The unfortunate result is that many Medicare beneficiaries are not seen by a mental health or addictions treatment specialist from whom they need treatment.
The Medicare Mental Health Modernization Act of 2007 (HR 1663), introduced by Representative Pete Stark (R-CA) on March 23, 2007, would extend parity to mental health services and treatments under Medicare. The bill would update Medicare's mental health benefits by reducing equal co-payments and removing the 190-day lifetime cap on inpatient mental health treatment, giving Medicare beneficiaries much needed access to mental health services and treatments.
The National Council calls on Congress to support the Medicare Mental Health Modernization Act of 2007.












