Medicare Mental Health Improvement Act

Summary

Medicare Mental Health Improvement Act - Amends title XVIII (Medicare) of the Social Security Act to: (1) include under Medicare coverage inpatient hospital services for up to 60 days during a year when furnished primarily for the diagnosis or treatment of mental illness or substance abuse; (2) require patient payment for services rendered beyond such limit; and (3) make such changes effective on January 1, 1996 (with exceptions and transition provisions). (Sec. 3) Includes under Medicare coverage the following "intensive residential services" for up to 120 days in a year: (1) residential detoxification centers; (2) crisis or mental illness residential treatment programs; (3) therapeutic family or group treatment homes; and (4) residential centers for substance abuse treatment. Requires facilities providing such services to be authorized to do so and to meet quality standards imposed by the Secretary of Health and Human Services. Allows additional days to be taken for intensive residential services from the 60 days permitted for inpatient hospital services (with an actuarial cost limit), requiring at least 15 days to be retained yearly for the latter services. Provides for the determination of payment amounts for intensive residential services. (Sec. 4) Subjects inpatient hospitalization and intensive residential services to the same deductibles and copayment as inpatient hospital services for physical disorders. (Sec. 5) Makes mental health case management services available with no copayment and for an unlimited duration for an adult with serious mental illness, a child with a serious emotional disturbance, or an adult or child with a serious substance abuse disorder. Makes day treatment available for up to 180 days annually for children under 19. Allows additional days for day treatment services for such children to be taken from intensive residential services (with an actuarial cost limit). Authorizes coverage for up to 90 days annually, with a 20 percent copayment requirement, for: (1) partial hospitalization; (2) psychiatric rehabilitation; (3) day treatment for substance abuse and for children under age 19; (4) in-home services; (5) case management; and (6) ambulatory detoxification. Permits non-physician mental health or substance abuse professionals to supervise an individual plan of treatment to the extent permitted under State law. Requires any program furnishing mental health or substance abuse services to be legally authorized under State law or accredited by an organization approved by the Secretary in consultation with the State. Requires such programs to meet standards established by the Secretary for the management of such services.

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Documents

3 official files

• Introduced in House (text)

  Introduced in House · EN · 6 April 1995

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• Introduced in House (PDF)

  Introduced in House · EN · 6 April 1995

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• Introduced in House

  summary · EN · 6 April 1995

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