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Senate Falls Short on Medicare Package

June 27, 2008

On June 26, the Senate fell just one vote short of moving forward to pass a package of reforms to the Medicare program, the Medicare Improvements for Patients and Providers Act of 2008 (HR 6331).  The vote was 58-40, 2 votes short of the 60 needed close off debate.   Click here to see how your Senators voted.

The House had cleared HR 6331 by an overwhelming bipartisan vote of 355-59 on June 24 – thanks to your advocacy contacting House members.  HR 6331 includes a number of critical provisions for Medicare beneficiaries living with serious mental illness, including:

  • Parity for cost sharing for outpatient mental health services under Part B, gradually moving the current discriminatory 50% requirement down to 20% between 2010 and 2014,
  • Statutory authority under the Part D drug benefit for the Centers for Medicare and Medicaid Services (CMS) to ensure broad coverage on prescription drug plan formularies for antipsychotics, antidepressants and anticonvulsants,
  • Removal of the current ban on Part D plans offering coverage for benzodiazepines (a critical tool in treatment for acute mania in bipolar disorder and severe anxiety disorders),
  • Changes to eligibility for the Part D Low-Income Subsidy (LIS) program (also known as “Extra Help”) – These reforms include an increase the amount of allowable resources, elimination of barriers to enrollment and the current late enrollment penalty and new exemptions for the value of a life insurance policy and in-kind support and maintenance.  Eligibility for the LIS significantly lowers and premiums and cost sharing for drug coverage and exempts beneficiaries from the “doughnut hole” coverage gap.

Congress must revisit this Medicare legislation in July.  As of July 1, payments to physicians under Medicare Part B will be cut by an average of 10% as the physician payment update (known as SGR) expires. 

 


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