In Tuesday’s Expert Perspective, Mark Covall discussed Medicare’s 190-day limit for inpatient care for mental illness. Today, we offer a bit of background on this confounding—and life-threatening—limit.
Fear and Politics
Eliminating the 190-day lifetime limit on has been on the stove—albeit not the front burner—for more than two decades.
The limitation originated in the Social Security Act of 1965, when Medicare came into being. In 1965, people feared mental illness; they were biased against psychiatric hospitals and those who received care there. Combined with political strife over whether the states or the federal government should bear the costs of that care, this bias could explain the arbitrary and discriminatory limit.
Despite numerous changes in mental health care administration, medical practice, insurance, and—arguably most important—perceptions and understanding of mental health conditions, the 190-day lifetime limit persists.
And to get rid of it, there needs to be a change to federal law.