CMS announces expansion of psychiatric services for seniors

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CMS Administrator and Secretary of the Medicare Trustees Marilyn Tavenner
CMS Administrator and Secretary of the Medicare Trustees Marilyn Tavenner

The Centers for Medicare & Medicaid Services is launching two new initiatives that may improve mental health services for seniors and nursing home residents.

CMS is kicking off a program on March 29 designed to curb the use of antipsychotic medications for nursing home residents with dementia-related behaviors. The CMS action plan will promote awareness of non-drug approaches to treat aggression and agitation; strengthen regulatory oversight; and boost public reporting.

Additionally, CMS announced today that 11 states, plus the District of Columbia, will be participating in a Medicaid Emergency Psychiatric Demonstration project. The program, funded by the Affordable Care Act, was developed to determine whether Medicaid beneficiaries who are experiencing a psychiatric emergency get more effective care when mental health providers receive Medicaid reimbursement.

The funding will allow private institutions for mental diseases (IMDs) to treat Medicaid beneficiaries between the ages of 21 and 64. Federal law has historically prohibited Medicaid from paying for IMDs in this age group. This often can cause a mismatch of services, according to CMS Acting Administrator Marilyn Tavenner.

Beneficiaries often end up in hospital emergency departments which “may not be an efficient use of healthcare dollars, and may be detrimental to vulnerable patients — especially when they could immediately be treated in the setting with more appropriate care,” Tavenner said.  

Mental health emergencies, which can include violent and aggressive behaviors by individuals with dementia, are not uncommon in nursing home residents. Click here for more information on the initiative. Click here for more information on CMS' behavioral health action plan.

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