Rep. Kennedy Pushes Behavioral Screening Co-Pay Waiver Amendment
health reform legislation a provision that would increase behavioral screenings by eliminating insurance co-payments for the service.(D-RI), a House Appropriations Labor HHS subcommittee member and mental-health parity and advocate, is urging lawmakers to include in
After House leaders unveiled their health reform bill Tuesday without the co-pay waivers for mental health screenings, Kennedy told reporters he is pushing to persuade House Energy and Commerce Committee Chair Henry Waxman (D-CA) to add the provision to the bill. Kennedy said he has sought the support of an Energy and Commerce Republican and written Waxman to ask him to waive the co-pays for screening, brief intervention, referral and treatment (SBIRT) for mental health and substance abuse patients as they enter a health plan.
The bill, as it is, waives co-pays for mammograms or colonoscopies — among other preventive services — and allows plans, eventually, to determine other services for which they can waive coinsurance. Kennedy wants the provision added up front, even though he suggested that the plans would invariably add SBIRT because it has been shown to be cost effective.
These early interventions avoid more complex and costly interventions later, he said. “They say if you get the screening early and you can detect early, you can solve the problem early,” he said shortly after House leaders took questions about the bill. He also made an argument for parity in treatment. “We ought to have at least one behavioral item mandated in the list of preventive items,” he said.
Kennedy said he and Rep. John Sullivan (R-OK), who sits on the Energy and Commerce subcommittee on trade, have penned a letter to committee leaders asking for the addition of the screenings.
Under a small grant program administered by the alcohol abusers or addicts. Of those diagnosed, 16 percent received a brief intervention; 3.7 percent received brief drug treatment; and 3.7 percent were referred to specialized drug treatment (see Inside CMS, June 11)., 850,000 SBIRTs have been performed since 2003. As of February 2008, 605,469 patients received a screening, of which over 22 percent were identified as drug or
GPCI. Kennedy also touted a provision of the legislation that calls for a study of ways to improve and update the current reimbursement formula to address the geographic disparities in Medicare payment. He said Rhode Island often loses doctors to neighboring Massachusetts because of the way the fee-for-service system adjusts payments for geographic variations in overhead and other costs.
The bill requires the Institute of Medicine to report to CMS on the geographic price cost system (GPCI). The agency is charged under the bill with responding to the recommendations and is granted $8 billion over two years to boost payments under Part A for hospitals and Part B for physicians.
A physician stakeholder said the provision falls short because it doesn’t include an index to measure value of services provided, doesn’t take from inefficient providers and the money expires in two years.
Kennedy said the current payment formula is without “much rhyme or reason.” — Brett Coughlin (firstname.lastname@example.org)