Medical Malpractice

Healthcare reform is becoming a reality and the importance of mental health and behavioral healthcare is receiving due notice. We find evidence of this achievement throughout the healthcare reform law - mental health and substance use services must be provided by all plans that participate in the new exchanges, and these benefits must be offered at parity. Healthcare home and Accountable Care Organization pilots must address substance use and mental health disorders. Additionally, the law includes a number of provisions specific to mental health and substance use, including authorization for new grants to co-locate services as well as new workforce development grants.

Even with all the progress that has been made, many areas of policy and payment need to be improved for the behavioral health sector to fulfill its intended role in a reformed healthcare system. National and community mental health organizations around U.S. are committed to advancing the following issues:

1.) Extension of the temporary Federal Medicaid Assistance Percentage increase

As part of the American Recovery and Reinvestment Act, Congress provided a temporary increase to the Federal Medicaid Assistance Percentage to help cash-strapped states meet their Medicaid obligations. An extension of this important provision is critical, given the combination of state revenue projections and Medicaid growth.

2.) Federal policy and payment equity for behavioral health organizations

In recognition of the healthcare access and use challenges confronting communities that are low income or have high rates of illness and few medical providers, Congress has enacted a number of policy and payment preferences for "safety net" providers, including enhanced reimbursement under Medicaid, federal funding to provide care to uninsured people, loan guarantees, and access to federally subsidized malpractice insurance. Unfortunately, the safety net does not offer equity. To correct this situation, mental health advocates are working with other national organizations to advance the notion of federally qualified behavioral health centers. This effort includes establishing national treatment and reporting standards for organizations that choose to obtain this designation as well as a proposed reimbursement model that more accurately reflects the costs of providing services.

3.) Healthcare information technology funding fix

For healthcare reform to be successful, all medical providers need to share information to better coordinate care, reduce inefficiencies, and improve client outcomes. Behavioral healthcare providers need access to federal funding for the meaningful use of health IT (information technology). One solution is to extend Medicare and Medicaid facility payments to community mental health and addiction organizations as well as private and public psychiatric hospitals.

4.) Medicare parity implementation

In June 2008, Congress enacted payment parity in Medicare's Part B benefit, which provides copayment equity for mental health and addiction services. Although this is an important step, much more needs to be done in Medicare for there to be true parity. First, the types of outpatient mental health interventions paid for by Medicare need to be extended to include, for example, case management, psychiatric rehabilitation, and other intensive community-based interventions. Medicare also must recognize mental health counselors and marriage and family therapists as independent practitioners.

The policy successes of the last few years would not have been possible without the active involvement of advocates of mental healthcare - down to the individual level. Passage of healthcare reform is only the first of many steps necessary to improve the lives of people with addiction disorders and mental illness. National and community mental health organizations must continue to reply on the support and voice of the general public to bring this "unfinished business" to completion.