CHAMP Curbs Discrimination by Diagnosis for Outpatient Mental Health

The House deserves thanks for voting to end 40-plus years of Medicare discrimination against mental health services as part of the CHAMP Act.

Medicare Part B coinsurance is ordinarily 20%, but since the program was established in the 1960’s, Medicare law has forced elderly and disabled Medicare enrollees to pay 50% of the cost of their outpatient mental health treatment out of their own pockets. There has never been any defensible policy justification for making the elderly and disabled pay two and a half times the usual Part B coinsurance just because they need mental health care – it’s blatant discrimination by diagnosis.
Fortunately, with House passage of the CHAMP Act, Congress is halfway to taking the landmark, pro-patient action of asking Medicare enrollees to pay just the same 20% coinsurance for mental health services as they would pay for treatment for diabetes, heart disease, or cancer.

In other good news on the mental health front, the CHAMP Act also includes provisions to protect patient access to critical drugs for treatment mental illness, AIDS, and other serious health conditions under Medicare Part D, and offers at least the future promise of requiring Medicare to pay for anti-anxiety drugs known as benzodiazepines that were specifically – and unwisely – excluded when the Medicare drug program was enacted.

There is bipartisan and widespread support for these major policy changes in order to help some of our most vulnerable patients. In the House, Reps. Tim Murphy (R-Pa.) and Grace Napolitano (D-Calif.) have championed legislation supported by my association to phase-out the 50% coinsurance. Rep. Pete Stark (D-Calif.) was instrumental not only in ensuring inclusion of the bill in the CHAMP Act, but also in acting to cut the coinsurance to 20% effective next year. Rep. Lloyd Doggett (D-Texas) has been our House champion on the “all-or-substantially-all

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