National Council for Mental Wellbeing

Skip to content National Council for Mental Wellbeing
Find a Provider
National Council for Mental Wellbeing logo
Your source for the latest updates from Capitol Hill. We translate policy into practice so you can learn how policy trends will affect your work and how best to prepare.

Rebecca Farley

Director, Policy & Advocacy, National Council for Behavioral Health

Bipartisan Legislation Introduced to Protect Medicare Enrollees’ Access to Mental Health Medications

Share on LinkedIn

New legislation in Congress would protect Medicare enrollees’ access to mental health medications by codifying an open access requirement that came under attack last year. The bipartisan Medicare Formulary Improvement Act (S. 648) is a response to a widely-condemned attempt by the Center for Medicare and Medicaid Services to limit patients’ access to these drugs – an effort that would have had a devastating effect on millions of Americans who rely on these therapies for their health and well-being.

Authored by Senators Charles Grassley (R-IA) and Sherrod Brown (D-OH), the Medicare Formulary Improvement Act forces Medicare to preserve its current “six protected classes” policy. The longstanding Medicare policy, which has been in effect since the inception of Part D and has enjoyed strong bipartisan support in Congress, requires Part D formularies to cover all or substantially all drugs within six classes: antidepressants, antipsychotics, anticonvulsants, antiretrovirals, antineoplastics, and immunosuppressants.

The protected classes policy came under attack last year when the Centers for Medicare and Medicaid Services (CMS) proposed to exclude antidepressants, antipsychotics, and immunosuppressants from protected status. The move prompted a massive outcry among patients, provider groups, Members of Congress, and other stakeholders, led by the National Council and the Partnership for Part D Access. Ultimately, CMS withdrew its proposal while leaving the door open for future changes to the protected classes policy.

Without permanent statutory protection, the protected classes remain at risk. The Medicare Formulary Improvement Act would require CMS to permanently preserve protected status for the six classes of drugs, ensuring that seniors, people with disabilities, and Medicare-Medicaid dual enrollees will not be denied their access to these lifesaving drugs.

“We are grateful to Senators Grassley and Brown for their efforts today. With the introduction of this legislation, they’re demonstrating a keen understanding of the need to maintain beneficiary access to the life-saving drugs provided under Medicare Part D,” said Chuck Ingoglia, Senior Vice President of the National Council for Mental Wellbeing, which spearheads the Partnership for Part D Access. “This legislation also has the potential to provide millions of seniors and particularly vulnerable Americans with the peace of mind that the medications they rely on every day will continue to be available to them through Medicare.”

 

Take Action. The National Council strongly supports the Medicare Formulary Improvement Act and urges all Senators to sign on in support. Please join us in encouraging Congress to support this important legislation! Click here to send a short message urging your Senators to sign on.