Older woman with face mask talking on phone

Members of the Senate Finance Committee have put the final touches on a discussion draft including proposed policies that aim to improve mental health coverage parity under Medicare and Medicaid.

The draft, released late last week, would put mental health coverage on par with that of beneficiaries’ physical health coverage, Senate Finance Committee Chair Ron Wyden (D-OR) and colleagues said. The senators cited constituent concerns about so-called ghost networks — listings of physicians who are unavailable to provide care.

Evidence of this issue of access to providers has been growing. A Government Accountability Office report published in March cited a study that found wrong phone numbers for about one fifth of psychiatrists, and another 21% who weren’t taking any new patients, FierceHealthcare has reported

“Too often the notion of mental health parity falls short of reality,” Wyden said in a statement. 

Updated, accurate directories

The discussion draft is the fifth and final legislation draft that the Finance Committee has released since it launched a bipartisan mental health initiative in early 2022. To help improve provider access, it proposes requirements that managed care organizations and states maintain updated and accurate Medicare Advantage plan provider directories that include behavioral health professionals.

The draft would also require that Medicare provide guidance to healthcare providers about the extent to which Medicare beneficiaries with substance use disorders can receive partial hospitalization. It would also direct the Government Accountability Office to study issues such as behavioral health payment rates and enrollee cost-sharing and utilization management in Medicare Advantage.

Critical need

“Mental health services are a critical health care need as our nation recovers from the pandemic,” added committee member Richard Burr, (R-N.C). “This discussion draft lays a foundation for advancing sensible policies that bring to the forefront the importance of ensuring patients have the information necessary to make the best health care decisions for themselves and their families.”

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