MINNEAPOLIS, July 17, 2008—In addition to averting the 10.6 percent pay cut, the Medicare bill passed this week contains important provisions relating to the way mental health service are reimbursed.

The Medicare bill repeals the 50 percent coinsurance for mental health care and ends the inequality in coinsurance required for all mental health services under Medicare Part B. The Medicare program has required a 50 percent coinsurance for outpatient psychiatric care for the past 40 years, while all other Part B services require the standard 20 percent coinsurance. H.R. 6331 ensures that, effective 2014 and beyond, the coinsurance for mental health services will be the same 20 percent as for all other Part B services.

It provides coverage of benzodiazepines and barbiturates, drugs commonly and safely used to manage psychiatric and other health conditions, under Medicare Part D. Without clinical justification, these medications were specifically excluded from the Medicare drug program. 

It codifies the six classes of clinical concern. The Centers for Medicare and Medicaid Services took action to ensure that all or substantially all of certain types of medications commonly used for the treatment of medically vulnerable populations will be available under Part D.

The American Psychiatric Association describes these three changes as "the most sweeping changes in Medicare’s coverage of treatment for mental illness in 40 years."

In non-Medicare mental health care news, the House and Senate have reached an agreement on the policy framework for legislation that would require employers and health insurers to cover mental illnesses at the same level as physical illnesses.

Under the agreement, the terms of which will be set this week, mental health benefits would be required to be on par with medical and surgical benefits, including treatments such as hospital stays, physician visits and cost sharing such as copayments, deductibles and out-of-pocket expenses. If a plan offers medical coverage for treatment outside its provider network, it must offer the same for mental health treatment.

Medical News Today article