Psych hospital limitations under Medicare to be eliminated

By Phyllis Hanlon
May 1st, 2010

The passage of the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 has paved the way for other types of reform related to behavioral health care. Four New England senators are continuing the fight against discrimination as it relates to seniors who suffer mental health issues.

On February 24, Senators John Kerry (D-Mass.) and Olympia Snowe (R-Maine) filed the Medicare Mental Health Inpatient Equity Act (S.3028), a bill that would eliminate the 190-day limit for Medicare recipients who obtain care in a psychiatric healthcare facility. Susan Collins (R-Maine) and Bernard Sanders (I-Vt.) co-sponsored the bill.

Legislation relating to Medicare issues typically occurs every year, often in relation to cost issues, according to Kirsten Beronio, vice president of public policy and advocacy for Mental Health America (MHA). She indicates that the House version of the health care reform legislation had contained a comprehensive Medicare equity act. “But it was eliminated due to funding scores,” she says.

MHA has been a strong advocate for the passage of bills pertaining to mental health matters in the past, such as the legislation to phase out increased co-insurance rates for mental health care, the result of Congressional bipartisanship as well as lobbying efforts from several groups including the MHA, says Beronio. “A gradual change phase-out will begin this year and it will be completely eliminated by 2014.”

Beronio also says that MHA, along with other entities, helped convince Congress to include parity in the Children’s Health Insurance Program (CHIP) bill. “It was a big year for parity,” she says.

The new proposed legislation regarding the elimination of the 190-day lifetime limit for Medicare beneficiaries receiving inpatient psychiatric care earns kudos from MHA, according to Beronio. “This will primarily remove all discriminatory restrictions on all mental health care in federal programs,” she says, adding that reluctance to recognize mental health conditions as “real and treatable” amounts to “archaic” thinking.

Beronio emphasizes that this legislation applies only to psychiatric hospitals and not to psychiatric units in general or other specialty health care facilities.

While she is hopeful the bill will move quickly through Congress, Beronio is not assuming it will pass without a fight. “We’ll push to include this [legislation]. But it will be a cost issue,” she says.

Toby Fisher MBA/MSW, policy director for the National Alliance on Mental Illness of Massachusetts (NAMI-MASS), says that his organization believes the current limit is discriminatory against those living with mental illness. “Can you imagine a health plan limiting how many heart attacks you can have? This bill addresses a long overdue problem of health insurance discrimination against the mentally ill and calls for parity of mental health care benefits,” he says.

Michael Briggs, communications director in Senator Sanders’ office says, “The senator believes mental health care should be provided on the same basis as all other health care services.”

Forty-eight organizations, including the American Group Psychotherapy Association, American Mental Health Counselors Association, the American Psychological Association, the Association for the Advancement of Psychology and the National Alliance on Mental Illness, have expressed support for the bill.

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