Nearly 50 Years of Legal Discrimination

capitolIn 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.

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Poll: Reaching the 190-Day Limit

In yesterday’s Expert Perspective, Mark Covall called Medicare’s 190-day lifetime limit on inpatient psychiatric hospital services “arbitrary and medically irresponsible.”

Today, we want to hear from you! To better understand how the 190-day limit affects you and those you love, we want to know:

 

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Vote in the poll and share your personal experiences in the comments below!

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Arbitrary and Medically Irresponsible: The 190-Day Limit

Mark J. Covall
President and CEO, National Association of Psychiatric Health Systems

Medicare denies specialty inpatient care for mental illness but not any other medical condition.

stockvault-stop-sign103079Over the past few years, we’ve made great strides in eliminating barriers to mental health treatment. In 2008, Congress passed the Mental Health Parity and Addiction Equity Act, which requires private insurers to cover mental health and addiction treatment at the same level as other medical disorders.

However, lawful discrimination against mental illnesses still exists for seniors and disabled adults who receive benefits through Medicare.

That’s because Medicare beneficiaries have a lifetime limit of 190 days of inpatient psychiatric hospital care. There is no such lifetime limit for any other Medicare specialty inpatient hospital service.

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Once in the Door: What the ACA Does for You

Ron Manderscheid, Ph.D.
Executive Director, NACBHDD

Ron Manderscheid

Earlier this week, I outlined seven ways that the Patient Protection and Affordable Care Act (ACA) helps get individuals with mental health conditions in the door to access mental health services.

Today, I’ll examine the ways in which the ACA helps individuals retain access and benefit from individualized, consumer-centered care and services.

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A Foot (or Seven) in the Door: The Affordable Care Act

Ron Manderscheid, Ph.D.
Executive Director, NACBHDD

Ron ManderscheidIt is said that a problem well-stated is half-solved. In my last post, I identified the significant economic, geographic, service system, and interpersonal challenges that can slow or thwart entirely the ability to get needed prevention, diagnosis, and treatment services for behavioral health conditions. I pointed out how, as a result, few people with mental health problems ever get either behavioral or physical health care services, resulting in shortened lives by as many as 25 years.

In this post, I examine ways in which the challenges to accessing behavioral health care can be overcome. In particular, I look at ways in which implementation of the Patient Protection and Affordable Care Act (ACA) is a real and vital tool to help people with mental conditions get, retain, and benefit from individualized, consumer-centered care and services.

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Locked Behind Door #3

BrandyDistance-Related Challenges
In Tuesday’s Expert Perspective, Ron Manderscheid outlined three common kinds of challenges to accessing mental health care: insurance-related, provider-related, and distance-related challenges. We’ve heard first-hand from Jennifer and Doug how these barriers have impeded their access to mental health care.

Today we hear from Brandy, whose distance-related and other challenges are not uncommon for people who live in rural areas and elsewhere.

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Locked Behind Door #2

stockvault-locked99163Provider-Related Challenges
In Tuesday’s Expert Perspective, Ron Manderscheid outlined three common kinds of challenges to accessing mental health care: insurance-related, provider-related, and distance-related challenges. Yesterday we heard from Jennifer, who experienced the first of these roadblocks, and tomorrow we’ll hear yet another story from someone who experienced these barriers first-hand.

Today’s story is from Doug. His provider-related challenges may sound familiar to you: he was denied access to quality care because a provider stopped seeing individuals on Medicare.

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Locked Behind Door #1

JenniferInsurance-Related Challenges
In yesterday’s Expert Perspective, Ron Manderscheid outlined three common kinds of challenges to accessing mental health care: insurance-related, provider-related, and distance-related challenges. Over the next three days, we’ll hear personal stories from individuals who’ve experienced these roadblocks first-hand.

Today, we hear from Jennifer, who, like many of you, experienced insurance-related challenges first-hand.

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