Policy Issues & Resources: Medicare
Medicare covers over 44 million beneficiaries, with 15.3% receiving coverage due to disability.
On July 15, 2008, Congress voted to override President Bush's veto of the Medicare Improvements for Patients and Providers Act of 2008 (HR 6331), protecting physicians from a 10.6 percent cut in the Medicare physician payment rate. Most importantly, HR 6331 ends Medicare’ discriminatory 50 percent outpatient copayment for mental illness and addiction treatment and achieves parity with other medical/surgical conditions in a phased-in plan over six years, beginning on October 1, 2009. The bill also allows states to apply grant funds to provide mental health services to veterans and individuals who live in rural areas and adds community mental health centers to the list of sites where Medicare beneficiaries may receive tele-health services.
The National Council continues to advocate for increased access to mental health and addiction services through Medicare, including expanding the types of mental health services and providers covered by Medicare.
Recent News I Official Comments I Official Letters I Issue Briefs I Summaries & Charts I Additional Resources
Recent News
- CMS Publishes Changes to 2013 Payment Rates for Partial Hospitalization
- Medicare Pay Fix Déjà vu: Rocky Congressional Negotiations Call to Mind December Impasse on Offsets
- Medicare Pay Fix Stalled Amid Payroll Tax Standoff
Official Comments
- Comments to CMS on proposed partial hospitalization rate cut
- Comments to CMS on Coverage of Alcohol Misuse Screening
- Comments to CMS on Proposed Conditions of Participation in Medicare for Community Mental Health Centers
- Comments to U.S. Pharmacopeia on Medicare Model Guidelines and Access to Medications
- Comments to CMS on Six Protected Classes of Drugs
- Comments on CY2010 Medicare Part D Transition Letter
- Comments on 2010 Part D Plan Year Call Letter
- Comments to CMS on Interim Final Rule for MA and Part D Drug Formulary and Protected Classes Policies
- Comments to CMS on Proposed Changes to the Hospital Outpatient Prospective Payment System and CY 2008 Payment Rates
Official Letters
- MAPRx Letter to Rep. Henry Johnson, thanking him for introducing the Affordable Access to Prescription Medications Act of 2009
- Letter to Senate Finance Committee on Access to "Off Label" Prescriptions in Medicare Part D
- Letter in Strong Support for S. 3101 Which Removes Discriminatory Co-Pay Rules and Part D Out-of-Pocket Costs for Dual-Eligibles
- Letter in Support of HR 6331 To End Discriminatory Co-Pay Rules
- Letter in Support of the Conrad/Stabenow Medicare Telehealth Improvement Act
Issue Briefs
- CMS 855: An Essential Requirement for Medicare Billing Privileges
- GAO Report on Part D Fraud & Abuse Programs
- Growth in Medicare Advantage Enrollment
Summaries & Charts
- National Council Fact Sheet on Phase-in of Mental Health Parity in Medicare Part B
- Detailed Results of National Council Survey on Part D Beneficiaries' Access to Medications
- Summary of Mental Health Provisions in the Medicare Improvements for Patients and Providers Act of 2008
- Data on Medicare Service Use
Additional Resources
- MAPRx Q&A on 2011 Medicare Prescription Drug Annual Open Enrollment
- MAPRx Fact Sheet on Medicare Prescription Drug Plan Enrollment for People with Both Medicare & Medicaid
- CMS Open Enrollment Center
- MAPRx Fact Sheet on The ABCs of LIS: Tips on Assisting People with Medicare to Apply for Help with Medicare Prescription Drug Plan Costs
- SSA Releases Resources on Changes to the LIS "Extra Help" Program
- Medicare Part B: Competitive Acquisition Program
- Resources for Caregivers
- CMS Guidance on CPT Codes for Psychological and Neuropsychological Tests
- OIG Guidance on Retroactive Payment Increases
- American Psychiatric Association Website with information for psychiatrists who serve patients through Medicare and Medicaid
