New Medicare Bill Would Help
> 11/14/2005 2:41:20 PM

A new bill that would expand Medicare coverage for mental health services has received opposition from an unlikely place: the American Psychiatric Association. Senator Craig Thomas, a Republican from Wyoming introduced thelegislation.  In his sparsely populated western state adequatemental health services are often tough to come by, and this isparticularly true for those underprivileged folks who benefit fromMedicare coverage.

This new bill would allow Medicare to cover therapists who are notphysicians.  The APA contends that this new measure would addundue stress to Medicare because the newly added therapists wouldprimarily bill for those things that they are qualified to bill for;mainly marriage and addiction counseling.  According to the APA,this would increase the billable hours to Medicare without providingthe mental health services that are desperately needed (e.g. treatmentof depression, bipolar disorder, adult ADD, etc.) because many statesdo not allow non-M.D.s to diagnose these higher level mental healthdisorders.

Sen. Thomas' bill has raised an important debate because at its heart,the bill has sound intentions: provide more mental health serviceoptions to those who are on Medicare. The APA's opposition which on itssurface seems odd, also makes sense.  The APA's argument, thatthis bill will be more costly while providing no added support in thearea of higher level mental health disorders, has merit.  It isundermined however, by the fact that the APA is clearly trying toprotect the financial interests of psychiatrists who would more thanlikely lose patients because of the proposed changes.  The realissue is that different states have a variety of laws that preventnon-M.D. therapists and counselors from providing help to those withmore severe mental health issues.  While these therapists andcounselors cannot prescribe the medication needed by those sufferingfrom schizophrenia or bipolar disorder, they can provide much neededhelp as the beginning of a support network.  And in places likeWyoming where mental health services are often few and far between,allowing non-M.D. therapists and counselors the right to bill Medicarewill, in the end, increase the amount of care available.  This isan important step toward more comprehensive mental health carecoverage, and one that hopefully will find its way into practice in oneform or another.

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