Date Published: 3 July 2007

APA, Coalition Praise Effort to End Medicare Discrimination

Health News from the United States of America (USA).

Today the American Psychiatric Association (APA) restated its strong support for ending Medicare’s discriminatory and antiquated practice of forcing patients to pay higher out-of-pocket costs for outpatient mental health services than for other medical services. As part of the Medicare Mental Health Equity Coalition (MMHEC), the APA sent a letter to U.S. Sens. John Kerry (D-Mass.) and Olympia Snowe (R-Maine), applauding legislation the two members reintroduced in the Senate this week. The Medicare Mental Health Copayment Equity Act would phase out the inequitable practice over six years.

Patients who receive outpatient mental health services should be treated the same way as those receiving other health services,” said APA Medical Director and CEO James H. Scully Jr., M.D., who helped initiate the letter.
It is time to end the discriminatory practice of Medicare patients paying 50% for their mental health services, while patients receiving other medical care pay 20%. Patients deserve access to the best care available, and we applaud this effort by Senators Kerry and Snowe advocating to that end. I urge the Senate to pass this long overdue legislation.”

The full text of the MMHEC letter is as follows:

The undersigned organizations of the Medicare Mental Health Equity Coalition, representing patients, health professionals, health care systems and family members, applaud your introduction of the Medicare Mental Health Copayment Equity Act of 2007 (S.1715). Your legislation will eliminate the unfair provision in federal law imposing a 50% coinsurance rate for outpatient mental health services under Medicare instead of the usual 20% coinsurance for outpatient services. Our coalition supports enactment of legislation like this that will bring payments for mental health care in line with those required for all other Medicare Part B services.

The Medicare program was established to guarantee health care coverage for all older adults and people with disabilities. However, the 50% coinsurance for mental health services has proven to be a harmful barrier preventing many Medicare beneficiaries from accessing services they need. Since its enactment in 1965, we have learned that mental health disorders are highly prevalent in the elderly and disabled populations covered by the Medicare program. A landmark report by the Surgeon General on mental illness in 1999 found that 20% of the population aged 55 and older experience mental disorders that are not part of what should be considered as normal aging. In addition, a 2006 report by George Washington University found that 59% of Medicare beneficiaries with disabilities have a mental illness and 37% have a severe mental illness. Tragically, only about half of those experiencing a mental illness receive mental health treatment, due in large part to antiquated and discriminatory health coverage provisions, such as the 50 percent coinsurance rate under Medicare.

There is simply no reason for maintaining a discriminatory barrier to mental health care for America’s seniors and individuals with disabilities, particularly since these populations present a high incidence of mental health concerns.

We greatly appreciate your leadership in addressing this fundamentally unfair Medicare policy for the 44 million Americans that depend on this program.

MMHEC member organizations include the American Association of Geriatric Psychiatry, the American College of Physicians, the American Psychiatric Association, the American Psychological Association, the Association for Behavioral Health and Wellness, the Center for Medicare Advocacy, Inc., the Medicare Rights Center, Mental Health America, the National Alliance on Mental Illness, the National Association of Social Workers, the National Committee to Preserve Social Security and Medicare, the National Council for Community Behavioral Healthcare, Psychologists for Long Term Care, Inc., and the Suicide Prevention Action Network USA.


Source: American Psychiatric Association.

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