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
- Change in Medicare Law Improves Access to Low-Income Subsidies for Prescription Drugs
- CMS Issues Guidance on Implementing Mental Health Parity in Medicare; National Council Releases Fact Sheet for Patients and Providers
- National Council Submits Comments to CMS on Six Protected Classes of Drugs
Official Comments
- 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 Fact Sheet on 2010 Medicare Prescription Drug Annual Open Enrollment
- MAPRx Fact Sheet on Medicare Prescription Drug Plan Enrollment for People with Both Medicare & Medicaid
- 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 Access for Patients to Prescription Drugs Coalition: 2009 MAPRx Priority Issues
- Medicare Part B: Competitive Acquisition Program
- Resources for Caregivers
- CMS Guidance on CPT Codes for Psychological and Neuropsychological Tests
- Medicare Part B Premiums & Deductibles for 2009
- OIG Guidance on Retroactive Payment Increases
