News: KHN Column: Social Security's Disabled Adult Child Program: A Key Program Often Below The Radar
In this Kaiser Health News essay about Medicare and Medicaid benefits for older, disabled adults, Harold Pollack explains how Social Security has become an effective insurance policy that was patched together by Republican and Democratic leadership over the past 75 years. Yet, despite its centrality as a social support for disabled adults, it still falls short of providing security, and individuals are forced to rely on other help, especially family, to plug the holes.
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Consider This: Applauding the Berwick appointment
. . .it's about time
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News: Threats to Medicaid in Senate vote
June 16 Update The Senate Finance Committee released details of modifications of a bill (HR 4213) the Senate failed to pass yesterday extending federal benefits to help states pay for Medicaid, to continue Medicare physician reimbursements through 2011, and to extend COBRA for people unemployed during the recession. The details of the changes can be downloaded here: Summary of Modifications and Additions
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News: Passing health reform energizes advocates
Historic, jubilant, transformative were among the adjectives enunciated in the on-going celebrations of Sunday's historic pass of health reform in America. Recalling his mother who battled insurance companies on her deathbed, Pres. Barack Obama said passing this law represents the "core principles that everybody should have security." . .
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News: Ending Medicare hospital cap
Continuing their efforts to end discrimination in Medicare coverage for mental health, Sens. John Kerry (D-MA) and Olympia Snowe (R-MAINE) introduced a bill (S 3028) to end the 190-day lifetime cap on psychiatric hospitalization. . .
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Did You Know: Medicaid accounts for 42 percent of state mental health revenues.
Read more about Medicaid and Medicare from National Health Policy Forum....
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News: Lilly settles
Eli Lilly and the Department of Justice reached a series of settlements resulting from illegal marketing, defrauding the government, and making false claims related to Zyprexa. The company will pay more than $1.4 billion (including a criminal fine of $515 million) for a scheme that broadly affected patient health, government spending and the credibility of federal regulatory agencies. A five-year corporate integrity agreement specifying reporting, written standards, and tracking of information, was part of the settlement....
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News: Psychiatric hospitalizations increasing
After nearly five decades of a steady drop in the numbers of people admitted to state psychiatric hospitals, a reversal might be underway say the authors of a study appearing in Psychiatric Services. Between 2002 and 2005, and based on patterns in 11 states, admissions increased 21 percent and the number of residents increased by 1 percent. The authors question the implications of this reversal for community-based mental health care. Medicare parity An article appearing in Journal of the American...
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News: Antidepressants fall through "doughnut hole"
An analysis of the impact of the "doughnut hole" for seniors with Medicare Part D with chronic illnesses found that "45% of patients on antidepressants reached the coverage gap in 2007." The study is available from the Kaiser Family Foundation....
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News: Parity for Medicare mental health
By an overwhelming majority in both houses, Congress reversed a bias built into the 1965 law for seniors when it overturned a presidential veto of a Medicare bill. It will take six years for the rates to drop from the current 50 percent to the same 20 percent older Americans pay for physical health, but the reversal is a symbolic and a real achievement and was the focus of intense lobbying by advocacy and consumer organizations. In addition to establishing...
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News: The year of insurance parity
Negotiations over a law for mental health insurance parity appear to be ending, according to a mid-day report from CQ Politics. This ends a 15-year drive to end discrimination, and caps the careers of two of its congressional sponsors. A sticking point was allegedly resolved when Reps. Patrick Kennedy and Jim Ramstad (who is retiring from Congress), dropped requirements making diagnosis for psychiatric and substance abuse disorders depend on the American Psychiatric Association's Diagnostic and Statistical Manual. The Senate's bill,...
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News: Senate ends Medicare fillibuster
The Senate delivered a veto-proof, bipartisan vote to end a Republican filibuster, end discrimination in paying for mental health services, and prevent a 10.6% cut to doctors paid by Medicare. The vote of 69 to 30 saw 18 Republicans cross over. The only person not voting was Sen. John McCain who said that had he been present, he would have joined the other 30 Republicans. The emotion of this vote, which supporters failed to deliver two weeks ago, was...
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News: Senate fails to halt Medicare cuts
The Senate failed (58-40) to avert cuts for payments to physicians caring for Medicare recipients, raising the prospect that doctors will drop out of the system. On Tuesday payments amounting to a reduction of 10.6 percent go into effect. Even if the bill (S. 3101) passed, as did one in the House, President Bush threatened a veto because it included reducing payments to private insurance companies participating in Medicare Advantage. Medicare Advantage profitable The Senate's vote came on the heels...
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News: House holds on Medicare
By an overwhelming vote of 355 to 59 the House passed a bill (H.R. 6331) stopping cuts to Medicare's physician providers and ended the historic discrimination in co-payments for mental health services. Getting this measure through Congress by July 1 has been a priority of the Democrats and has had the broad support of the American Psychiatric Association and the American Medical Association. Sen. Harry Reid promised the Senate will act swiftly. A second House initiative relevant to mental health...
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Track Legislation: S. 1715
Sen. Olympia J. Snowe (R-ME) introduced the "Medicare Mental Health Copayment Equity Act of 2007," on June 27, 2007, "to amend title XVIII of the Social Security Act to eliminate discriminatory copayment rates for outpatient psychiatric services under the Medicare program."
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News: Senate stalls vote on copay for seniors' mental health
Tucked into a bill (S 3101) to prevent a reduction in Medicare physician fees by 10.6 percent was a provision to reduce the insurance copay for psychiatric services. It is currently set at 50 percent, a rate that was set in the 1960s, and the proposal was to reduce this to 20 percent, equal to other health costs. The American Psychiatric Association has been advocating an equal fee for seniors, and also to retain reimbursements making it possible for doctors...
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News: Barriers to meds for elderly
Two studies in the April issue of Psychiatric Services discuss barriers for the elderly taking psychiatric medicines in Canada and the United States. One article, an NIMH-funded study of co-pays in British Columbia between 1997 and 2005, found that copays delayed seniors from obtaining antidepressant medicines. Another study discussed the United States, and the implications of excluding the anti-anxiety benzodiazepines from Medicare Part D....
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News: Elderly overdosed
The Hartford Courant reports that Connecticut is one of the top four states dispensing antipsychotic medication to elderly nursing home patients having no psychiatric histories....
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News: Bush health plans costly
Sara Rosenbaum writes in the Feb. 27th issue of the New England Journal of Medicine (free article) that it is an effort to redefine “the role of government in organizing and overseeing the health care marketplace,” not budget, which has driven Bush health proposals. Her case in point is SCHIP, which she calls the "proxy war," but others are in the news. Today, the New York Times says that another Government Accounting Office report (scheduled for release) will again...
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News: Seniors pay more for Zoloft
Seniors enrolled in Medicare Part D will pay $369 more for five medications, including Zoloft, according to a study conducted by Consumers Union. Roughly 75 percent of the private insurance plans in Medicare Part D announced hikes for the coming year. Another study released this week, from Annals of Internal Medicine, examined a single pharmacy chain. Results from this national pharmacy indicate out-of-pocket costs had dropped and utilization had increased. Currently, Medicare is prevented from negotiating over price, which Rep....
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News: Dosing elders with antipsychotic meds
Using off-label antipsychotic medication, known for their sedating qualities, to inappropriately quiet elderly patients is coming under fire by the Centers for Medicare and Medicaid Services according to an article in The Wall Street Journal. Roughly one in five of the elderly patients who are being given these medications have no known psychotic condition. In an unrelated story, 54 nursing homes were cited for poor performance by the Centers for Medicare and Medicaid Services....
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News: Open enrollment for Medicare Part D
With six weeks of an open enrollment period to make changes in Medicare Part D coverage beginning Nov. 15, the Kaiser Family Foundation examined 1824 stand alone plans and estimates that premiums are likely to increase an average of 17 percent (for those staying in the same plan), with the top three plans averaging 27 percent. Seniors, and those who advise them, might take note of the October issue of Psychiatric Services which says restrictions in some drug plans under...
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News: Who benefits? Medicare vs. Medicare Advantage
Congressman Pete Stark Press Release, June 27, 2007 While Congressman Pete Stark (D-Cal) continues to hold House hearings about Medicare and Medicare Advantage, he has released charts comparing respective costs, benefits, and lifetime caps. Coverage for inpatient psychiatric hospitalization shows a hodge-podge of co-pay and dollar amounts. Medicare Advantage HMOs generally require pre-authorization, and both plans have a 190-day lifetime cap. Other examples compare costs for skilled nursing facilities, medical hospitalization, medical equipment, and home health visits....
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News: Medicare Proposes 9.9% physician cut
At the same time the federal government is directing the elderly and disabled into Medicare Advantage, a more costly alternative using HMOs and receiving government funding, the Centers for Medicaid and Medicare Services proposes cutting physician reimbursement. The AMA predicts this will discourage doctors from accepting Medicare patients....
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News: Medicare trade-offs
L.A. Times, June 24, 2007 After a drug benefit was added to Medicare with insufficient funding in 2003, numerous proposals have come forth regarding its solvency. Recommendations now facing lawmakers and voters include: changing the age of eligibility for Medicare; ending the more costly, private Medicare Advantage; tweaking the plan to require pre-approval for surgical procedures; and restricting access to drugs. Last week NIMH announced funding for a two-year study to determine “the costs and benefits of excluding a commonly...
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Links: Government Resources
Information about public resources, medication, legislation, or policy.
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Links: Issues / Advocacy
Action oriented non-profit groups with a national base promoting recovery, equity and social justice.
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Links: Find Help
New visitors will find useful resources for narrowing a search or for general information. Updated 11.02.07.
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News: Interruptions of medication under Medicare Part D
American Journal of Psychiatry, May, 2007 abstract $$ The American Journal of Psychiatry reports about a survey asking psychiatrists about the transition months when Medicare Part D was implemented. More than half reported their patients found impediments to obtaining medication. Nearly one-quarter (22.3%) temporarily stopped or discontinued their medicines; slightly more than one-quarter of those had an adverse clinical reaction. Almost one-fifth visited an emergency room....
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News: Campaign to expand Medicare, shorten waiting period
Dallas News April 27, 2007 The lack of health care for 45 million uninsured Americans continues to occupy Congressional attention. In the last week, Rep. John Dingell (D-MI) introduced a bill (H.R. 2034 with12 co-sponsors) calling for a universal Medicare benefit. Too, efforts to close the two-year wait before disabled Americans can enroll in Medicare is gathering momentum on Capitol Hill following a report from The Medicare Rights Center documenting the catastrophic health, financial and family impacts of the 1972...
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Commentary: Meeting the Mental Health Challenges of the Elder Boom

"It's time to make geriatric mental health a front burner issue in America," says advocate Michael B. Friedman. Learn how ageism affects services, surveys and perceptions about what's normal for people over 65 to experience.
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News: Seniors pay more under Medicare Part D
A study released by Families USA shows that drug prices under Medicare Part D grew substantially faster than inflation, and more than claims made by the Bush administration. For the antidepressant Lexepro (10 mg), the price increased to $812.16 from $706.20, or 15 percent. This comes on the same day Senate Republicans held tight preventing the vote on a bill requiring Medicare to negotiate over prices....
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