Category Medicare

Nursing Homes Are Turning Away Patients with Mental Health Issues

Daniel D. Sewell Photo

Daniel D. Sewell, MD, Director, Senior Behavioral Health, UC San Diego Medical Center

Care For Your Mind acknowledges and appreciates the collaboration of the National Network of Depression Centers and the American Association for Geriatric Psychiatry in developing this post.

Chemical restraint is a serious problem in nursing homes. History has shown that psychotropic medications tend to be overused in order to keep residents with problem behaviors such as wandering or combativeness subdued or “under control.”

In other words, there are documented instances when serious psychiatric drugs are given to people who might not have needed them.

To address this and other nursing home quality issues, the Centers for Medicare & Medicaid Services (CMS) created a Five-Star Quality Rating System. One of the rating criteria is the number of residents at the facility who are receiving antipsychotic medications: the larger the number, the lower the score the facility receives.

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Putting Profits Over Patients: Medicare Part D Changes Mean Disaster for People with Depression

Daniel D. Sewell Photo

Care For Your Mind acknowledges and appreciates the collaboration of the National Network of Depression Centers and the American Association for Geriatric Psychiatry in developing this post.

Putting Profits Over Patients: Medicare Part D Changes Mean Disaster for People with Depression
Daniel D. Sewell, MD, Director, Senior Behavioral Health, UC San Diego Medical Center

In older adults, depression can have severe consequences. It’s associated with an increased risk of suicide; decreased physical, cognitive and social functioning; and greater self-neglect; all of which are associated with increased mortality. This is a vulnerable population that needs effective, affordable access to mental health care.

Unfortunately, proposed changes to the Medicare Part D drug program would put older patients living with depression at even greater risk.

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Older Adults Are Being Overlooked When it Comes to Mental Health Care

Daniel D. Sewell Photo

Care For Your Mind acknowledges and appreciates the collaboration of the National Network of Depression Centers and the American Association for Geriatric Psychiatry in developing this post.

Daniel D. Sewell, MD, Director, Senior Behavioral Health, UC San Diego Medical Center

For most individuals in the U.S., accessing mental health care is a struggle, but older adults may have it worst of all. Due to stigma, misinformation, and false beliefs about aging, they frequently go without adequate care for depression and other psychiatric illnesses and psychological problems. Too often, doctors offer prescription drugs as a cure-all solution, and fail to address the overall mental health and well-being of the older patient.

The truth is, addressing mental health issues in older populations requires paying more attention, not less. In aging adults, depressive symptoms can point to a physical illness, while physical pain or other physical complaints can often be a sign of mental health issues.

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Medicare Part D Users are Feeling the Squeeze

If concerns about being able to retain access to the correct medications to treat their mood disorders was not enough, individuals utilizing Medicare Part D must also be concerned about whether or not they can even afford to take their prescribed medications.

When Medicare Part D took effect in 2006, it arrived with mixed reviews. Today, according to a survey conducted by Medicare Today, 86% of seniors say they are satisfied with their prescription drug plan. One reason they site for the satisfaction is that the costs are reasonable. Given the way things are trending however, the Center for Medicaid and Medicare Services (CMS) may see satisfaction dip.

Cost related non-adherence to medication protocols is growing. The inability to pay for costly medicines causes patients to stretch out their prescriptions by skipping or taking smaller doses than prescribed. In in a recent Health Affairs study, (Medication Affordability Gains Following Medicare Part D Are Eroding Among Elderly with Multiple Chronic Conditions) seniors experiencing four or more chronic conditions reported a cost-related non-adherence rise from a low of 14.4% in 2009 to 17% in 2011.

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Speak Out About Potential Reductions to Medicare Part D Benefits

Last Tuesday, September 30, DBSA participant Trudy Lapin shared her story during two Congressional briefings sponsored by the Partnership for Part D Access. Trudy used her time to explain to Congressional staff from both the House and the Senate why a proposed regulation by CMS to restrict access to medication that aids in the treatment of mood disorders is misguided. You can read Trudy’s statement below, and learn how you can share your story with your own elected officials.

Treatment is not one size fits all
Although I was first diagnosed officially with major depression in 1993, signs of that particular mood disorder appeared in childhood. While attending college, an over achieving pattern went into high gear. I elected a double major in French and English literature with a minor in secondary education. I graduated with highest honors; accepted a full fellowship to Yale Graduate School to pursue my doctorate in Romance Languages and Literatures; taught French language, literature, and film at Yale College and at the University of Chicago; and was awarded a National Endowment for the Humanities grant, where I enjoyed the privilege of working with humanities scholars at Princeton University.

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How Will You Protect Access to Quality Mental Health Care for Seniors?

Today the Partnership for Medicare Part D will hold a Congressional briefing to discuss the significance of Medicare’s “Six Protected Classes” policy giving seniors access to quality mental health care. While you may not be able to attend in person, it is still critical that you educate your Congressional Representative and Senators on the importance of retaining these benefits.

How Will You Protect Access to Quality Mental Health Care for Seniors?
According to the Geriatric Mental Health Foundation depression impacts more than 6 million of the 40 million Americans over 65. Health problems become more common and increasingly complex as seniors age. With the onset of more serious conditions such as heart disease, stroke, cancer, arthritis, Alzheimer’s disease, and Parkinson’s disease, individualized medicine becomes increasingly critical to helping seniors manage their mental and physical health.

This is why Congress carved out six protected classes of medications when they authorized Medicare Part D. Their intent was that seniors would have access to these medications without regulatory burdens. The preservation of the six protected classes is critical to providing treatment for serious, complex health conditions without delay or restricted access to essential treatment.

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You Did It! CMS Rescinds Proposed Protected Classes Rule!

Over the past two months, Care for Your Mind has closely followed the Centers for Medicare and Medicaid Services’ (CMS) proposed ruling around Medicare Part D’s six protected classes. Thanks in large part to the combination of the mental health community’s expert and peer perspectives as well as your insightful comments and willingness to take action to oppose this rule, CMS Administrator Marilyn Tavenner announced yesterday that the agency would not move forward to remove antidepressants and immunosuppresants from Medicare Part D’s six protected classes at this time.

Yesterday’s decis...

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It Doesn’t Add Up

Walker_St LouisNamiDar Walker
Executive Director of NAMI St. Louis

For nine years, Medicare beneficiaries have had access to the antidepressants and antipsychotics that work best for them. Now, a proposed change threatens to revoke that access. The resulting effect will be devastating for individuals with mental illness and their families, and costly to society at large.

It Doesn’t Add Up

Back in 2005, when the Centers for Medicare and Medicaid Services (CMS) launched the Medicare Part D prescription drug benefit, it ensured patients would have unrestricted access to life-saving medicine by granting “protected-class” status to six drug categories, including antidepressants and antipsychotics.

In granting antidepressants and antipsychotics protected-class status, CMS acknowledged that these drugs are chemically distinct and not interchangeable, and patients must have access to the full category of drugs in order to appropriately manage their Illness. In 2010, the unique nature of mental health drugs was reaffirmed when the Affordable Care Act specified that the six protected classes should remain protected.

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