The Medicare Rights Center joined nearly 250 national, state and local organizations in a letter to the leaders of the Senate Finance and House Ways and Means Committees, urging them to improve Medicare coverage of treatments for people with substance use disorder and mental health needs.
Medicare is not subject to the Mental Health Parity and Addiction Equity Act of 1996 (Parity Act). Instead, mental health treatment was brought into some economic parity under the Medicare Improvements for Patients and Providers Act of 2008 (MIPPA). Prior to that Act, Medicare beneficiaries faced higher cost sharing for mental health services than for other health services. MIPPA, however, does not include some of the access requirements of the Parity Act and also left in place disparate lifetime limits for certain mental health related hospitalizations. As a result, Medicare has limitations on coverage that would violate the Parity Act, if it applied.
These discrepancies reflect real access issues for Medicare beneficiaries with mental health or substance use disorder treatment needs across the continuum of treatment options and locations. The letter asks congressional leaders to expand Medicare coverage for the more intensive outpatient and partial hospitalization services currently unavailable under the program to allow for treatment in the least restrictive setting appropriate, to allow for coverage of community-based facilities where substance use disorder treatment is commonly delivered, and to authorize certain counselors and other credentialed providers to bill Medicare directly for their services.
Read the letter here.