The legislation would remove an arbitrary cap on inpatient psychiatric care that disproportionately harms non-elderly Medicare beneficiaries
Washington, D.C. – In a bipartisan effort to improve mental health care across the nation, U.S. Senators Susan Collins (R-ME) and Tina Smith (D-MN), members of the Senate Health Committee, introduced the Medicare Mental Health Inpatient Equity Act, legislation that would permanently repeal the Medicare 190-day lifetime limit for inpatient psychiatric care.
“During their life, people with serious mental illnesses may need repeated psychiatric inpatient hospital stays to manage their condition and regain quality of life in their community of choice,” said Senator Collins. “Medicare’s 190-day lifetime cap on inpatient services in psychiatric hospitals can hurt people by arbitrarily ending coverage and can disrupt care from a provider who is most familiar with the patient. Moreover, when individuals with mental illness cannot receive care in the right setting, they often end up in hospital emergency rooms, in jails, or on the streets—leading to worse long-term outcomes for the individual, more pain and suffering for family members, and a greater cost to the taxpayer. I urge my colleagues to support this legislation to bring greater mental health parity to the Medicare program and give those suffering with serious mental illness access to the care they so desperately need.”
“Millions of Americans are living with serious and persistent mental health issues and many need ongoing care in an inpatient setting,” said Senator Smith. “Unfortunately, many of them hit the 190-day lifetime cap on coverage for care before they complete their inpatient treatment, disrupting their care and potentially setting them back. Our legislation would end this cap and allow them to get the inpatient care they need.”
“The Alliance applauds Senator Collins on her work to enhance our mental health system of care. The elimination of this 190-day inpatient psychiatric care limit will bring Medicare one step closer to parity in mental health coverage, as well as increase access to care and improve continuity of care for those with serious and persistent mental illness,” said Malory Shaughnessy, Executive Director of Maine Alliance for Addiction and Mental Health Services. “It is time to change this discriminatory policy and ensure that Medicare beneficiaries receive the care they need and deserve.”
“The 190-day lifetime limit on coverage for inpatient psychiatric treatment under Medicare remains an obstacle to parity between behavioral and physical health. With the nation’s population aging and an increasing number of seniors and people with disabilities seeking inpatient care to address their behavioral health needs, now is the time to repeal this discriminatory policy and ensure Medicare beneficiaries can receive the inpatient psychiatric care they need,” said Stacey Hughes, Executive Vice President of the American Hospital Association.” The American Hospital Association is grateful for the leadership of Senators Collins and Smith in working to enact this long overdue change.”
“Access to care and elimination of barriers in coverage is an important tenant in preventing suicide. We commend Senator Collins and Senator Smith for introducing the Medicare Mental Health Inpatient Equity Act, which will allow Medicare beneficiaries to receive the parity protections they deserve,” said Laurel Stine, J.D., M.A., Senior Vice President for Public Policy, American Foundation for Suicide Prevention.
“This important legislation eliminates one of the most discriminatory provisions of federal law. Medicare beneficiaries deserve the protections parity provides. Eliminating the 190-day lifetime limit ensures our seniors can access the benefits they need and deserve,” said Shawn Coughlin, President and CEO of National Association for Behavioral Healthcare.
An estimated 13.1 million adults aged 18 or older in the United States are living with serious mental illness, representing 5.2 percent of all adults nationwide. These illnesses, such as schizophrenia and bipolar disorder, are chronic conditions that require ongoing treatment and care over a lifetime. When left untreated, they can be some of the most debilitating and destructive illnesses afflicting Americans.
The Medicare Mental Health Inpatient Equity Act would remove the 190-day lifetime limit on inpatient psychiatric hospital services under Medicare. This lifetime limit does not apply to psychiatric units in general hospitals, and no other Medicare inpatient service has these types of arbitrary caps, which is why its elimination was a recommendation of the 2016 White House Mental Health and Substance Use Disorder Parity Task Force.
Most Medicare beneficiaries treated in psychiatric hospitals qualify because of a disability. Consequently, the current restriction disproportionately impacts non-elderly Medicare beneficiaries—mainly those living with schizophrenia and bipolar disorder who may be diagnosed at a younger age and stay on Medicare longer as a result. Sadly, it is young adults aged 18 to 25 years who currently have the highest prevalence of serious mental illness of any age group.
The bipartisan legislation is supported by a wide range of organizations, including the American Hospital Association and the Mental Health Liaison Group, which represents a coalition of 57 national organizations including consumer groups and mental health and addiction providers. Click HERE to read the bill text.