Community Mental Health System Reports $304 Million in Uncompensated Costs on Medicare Drug Benefit

National Council concerned about access to care and continuing costs

Contact: Communications@thenationalcouncil.org 301.984.6200, ext. 228.

Rockville, MD-July 27, 2006—Community mental health agencies across the country have spent an estimated $304 million of their operating funds to help persons with mental illnesses access the Medicare prescription drug benefit, according to a survey conducted by the National Council for Community Behavioral Healthcare.

The National Council has released The Hidden Costs of Implementing the Medicare Part D Program, the results of a survey among community mental health agencies.

The survey revealed that community mental health agencies spent $304 million, between July 2005 and June 2006, on buying medications, funding co-pays for low-income patients, and paying for staff time to help beneficiaries navigate the Medicare prescription drug benefit.

“While the Medicare prescription benefit has helped many access vital medications, it has made things very difficult for those with serious mental illness and their treatment providers. Staff has been spending their time on more paperwork, on repeated calls to CMS, prescription plans and local pharmacies and on finding money for co-pays. Community mental health agencies have stepped up to the plate, but at a cost — longer waiting lists and less time to provide services. It is ironic that the new benefit has had such unfortunate unintended consequences,” said Linda Rosenberg, MSW, President and CEO of the National Council.

Survey results show that 40 agencies, serving 115,000 people, spent more than 250,000 hours in 12 months on a range of activities to help individuals with mental illnesses transition to the Medicare prescription drug benefit. Agency staff helped these individuals learn about the new benefit, manage documents associated with the new benefit, select plans and address problems relating to coverage and co-pays.

“Implementing the new Medicare drug benefit has already imposed a huge unfunded mandate on community mental health agencies that can ill afford it. Our survey quantifies the stories we’ve heard over and over again from the field,” said Charles Ingoglia, the National Council’s director of government relations. “Agency staff will continue to counsel new enrollees and current beneficiaries who experience problems or want to change plans. These agencies must be properly compensated and funded so they can continue to help vulnerable persons with mental illnesses.”

The National Council surveyed community mental health agencies in 25 states on how they helped beneficiaries access prescription drugs under Medicare between July 2005 and June 2006. The survey was conducted among a statistically significant sampling of agencies, based on their location, type, budget, and number of clients served.

The National Council for Community Behavioral Healthcare is a not-for-profit 501(c)(3) association representing 1,300 mental health and addictions treatment and rehabilitation organizations that serve nearly six million adults, children, and families in communities across America.