Psychiatry’s Role in Fighting Barriers to Access and Coverage

 

Under Medicare, beneficiaries are limited to just 190 days of inpatient psychiatric care in their lifetimes. Because many beneficiaries who use psychiatric services are eligible for Medicare due to a disability, they are often younger beneficiaries who can easily reach the 190-day limit over their lifetimes.

Eliminating the 190-day lifetime limit would equalize Medicare mental health coverage with private health insurance coverage. It would also expand beneficiary choice, increase access for the most seriously ill, improve continuity of care, and create a more cost-effective Medicare program.

Congress is hearing from constituents about access challenges, and a number of measures are now under consideration.  Your voice — calling on Congress to pass comprehensive mental health reform — can truly make a difference.

In the House of Representatives, Rep. Tim Murphy (R-Penn.) is about to reintroduce comprehensive mental health reform legislation, the Helping Families in Mental Health Crisis Act. This broad-ranging bill fights discrimination by modifying the IMD exclusion; aims to improve quality by giving psychiatric hospitals and other behavioral health providers incentives for health information technology; supports integration with provisions to better coordinate behavioral health with overall health care; and elevates behavioral health within the federal government by creating an Assistant Secretary for Mental Health and Substance Use within the Department of Health and Human Services. 

In the Senate, Sens. Ben Cardin (D-Md.), Patrick Toomey (R-Penn.), and Susan Collins (R-Maine) have introduced S.599, the Improving Access to Emergency Psychiatric Care Act. This bill would extend and expand a federal Medicaid Emergency Psychiatric Demonstration Project.  The demonstration — which is set to end this year if Congress does not act — addresses the IMD exclusion by giving adults with mental illness access to the same hospital treatment that their Medicaid insurance card covers for all other conditions.

Recent polls⁴ have shown that the American public believes it’s time for comprehensive mental health reform. As psychiatrists, it’s our time to support national efforts to make that change a reality. 

Lisa Shea, MD, is medical director at Butler Hospital in Providence, R.I., and 2015 Board Chair for the National Association of Psychiatric Health Systems (NAPHS). She will be speaking at the NAPHS Annual Meeting in Washington, D.C., which runs from March 16-18.

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