[Congressional Record Volume 151, Number 53 (Wednesday, April 27, 2005)]
[Extensions of Remarks]
[Page E779]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




    INTRODUCING THE MEDICARE MENTAL HEALTH MODERNIZATION ACT OF 2005

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                        HON. FORTNEY PETE STARK

                             of california

                    in the house of representatives

                       Wednesday, April 27, 2005

  Mr. STARK. Mr. Speaker, I rise to introduce the Medicare Mental 
Health Modernization Act of 2005. Medicare's mental health coverage is 
woefully inadequate. Instead of the standard 20 percent coinsurance 
payment required of beneficiaries, mental health services require a 50 
percent copayment. Further, only limited community-based treatments are 
covered and, unlike treatment for physical illness, there is a 190-day 
lifetime cap on mental health hospitalization days. The bill we are 
introducing today eliminates this blatant mental health discrimination 
under Medicare and modernizes the Medicare mental health benefit to 
meet today's standards of care.
  One in five members of our senior population displays mental 
difficulties that are not part of the normal aging process. In primary 
care settings, over a third of senior citizens demonstrate symptoms of 
depression and impaired social functioning. Yet only one out of every 
three mentally ill seniors receives the mental health services he/she 
needs. Older adults also have the highest rate of suicide of any 
segment of our population. In addition, mental illness is the single 
largest diagnostic category for Medicare beneficiaries on disability. 
There is a critical need for effective and accessible mental health 
care for the Medicare population. Recent research has found a direct 
relationship between treating depression in older adults and improved 
physical functioning associated with independent living. Unfortunately, 
the current structure of Medicare mental health benefits is inadequate 
and presents multiple barriers to access of essential treatment. This 
bill addresses these problems.
  The Medicare Mental Health Modernization Act of 2005 is a 
straightforward bill that improves Medicare's mental health benefits as 
follows:
  It reduces the discriminatory co-payment for outpatient mental health 
services from 50 percent to the 20 percent level charged for most other 
Part B medical services.
  It eliminates the arbitrary 190-day lifetime cap on inpatient 
services in psychiatric hospitals.
  It improves beneficiary access to mental health services by including 
within Medicare a number of community-based residential and intensive 
outpatient mental health services that characterize today's state-of-
the-art clinical practices.
  It further improves access to needed mental health services by 
addressing the shortage of qualified mental health professionals 
serving older and disabled Americans in rural and other medically 
underserved areas by allowing state licensed marriage and family 
therapists and mental health counselors to provide Medicare-covered 
services.
  Similarly, it corrects a legislative oversight that will facilitate 
the provision of mental health services by clinical social workers 
within skilled nursing facilities.
  It requires the Secretary of Health and Human Services to conduct a 
study to examine whether the Medicare criteria to cover therapeutic 
services to beneficiaries with Alzheimer's and related cognitive 
disorders discriminates by being too restrictive.

  The push for mental health parity is ongoing. We've made important 
strides forward for the under-65 population. Twenty-three states have 
already enacted full mental health parity and the Federal Employees 
Health Benefits Plan was improved in 2001 to assure that all federal 
employees and members of Congress are provided mental health parity. In 
April 2002, President Bush called for Congress to enact legislation to 
provide equivalence for private sector health insurance coverage of 
mental and physical conditions (though he has yet to endorse any 
legislation to achieve that goal).
  What has been too-often missing from this overall mental health 
parity debate is the fact that the Medicare program continues to fail 
to meet the mental health needs of America's seniors and those with 
disabilities. That's why we've introduced the Medicare Mental Health 
Modernization Act. That's also why this bill has received support from 
numerous mental health advocacy and provider organizations including: 
the National Alliance for the Mentally Ill, the Federation of Families 
for Children's Mental Health, the American Association of Geriatric 
Psychiatry, the American Psychological Association, the American 
Association for Marriage and Family Therapy, the American Mental Health 
Counselors Association, and the Clinical Social Work Federation.
  It is past time for us to take action with regard to Medicare's 
inadequate mental health benefits. Over the years, Congress has updated 
Medicare's benefits for treatment of physical illnesses as the practice 
of medicine has changed. The mental health field has undergone many 
advances over the past several decades. Effective, research-validated 
interventions have been developed for many mental conditions that 
affect stricken beneficiaries. Most mental conditions no longer require 
long-term hospitalizations, and can be effectively treated in less 
restrictive community settings. This bill recognizes these advances in 
clinical treatment practices and adjusts Medicare's mental health 
coverage to account for them.
  The Medicare Mental Health Modernization Act of 2005 removes 
discriminatory features from the Medicare mental health benefits and 
helps facilitate access to up-to-date and affordable mental health 
services for our elderly and disabled. I encourage my colleagues to 
support its passage into law.

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