National Alliance on Mental Illness
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SCHIP-Medicare-Medicaid Extension Package for FY '08 Funding
December 20, 2007
On December 19, the House cleared a scaled-back version of legislation staving off looming reductions to Medicare reimbursement rates for physicians and selected hospitals. The vote was 411-3. The package (S 2499) will prevent a 10.1% cut in reimbursement rates for the first 6 months of 2008, after which the cut will go into effect if Congress fails to act. Added to this legislation were a number of extensions to current law including the State Childrens Health Insurance Program (SCHIP) through March 31, 2009.
Included in S 2499 is a 6 month moratorium (through June 30, 2008) on regulations proposed by the Centers for Medicare and Medicaid Services (CMS) that would severely limit the ability of state to utilize the Medicaid Rehabilitation Option to fund critical mental illness treatment and supportive services. NAMI has fought all year for this moratorium. This will provide additional time for Congress to clarify the appropriate use of the Rehabilitation Option. Click here to view additional information on the proposed Medicaid Rehabilitation Option rules.
What was excluded from the SCHIP-Medicare-Medicaid package?
As the Senate Finance Committee worked over the past few months to develop this legislation, NAMI fought hard for a range of proposals that would make incremental improvements in the Medicare program, including the Part D prescription drug benefit. Most of these improvement were part of legislation (known as the “CHAMP Act” HR 3162) that cleared the House last summer. Unfortunately, all of these proposals fell out of the Senate bill and must be revisited by Congress next year. Among these are:
In addition, the House CHAMP bill included a long awaited change to the current discriminatory 50% cost sharing requirement for outpatient mental health services under Part B. The change would require parity for outpatient mental health cost sharing, moving it to the same level as all other medical outpatient services at 20%.
What was included in the SCHIP-Medicare-Medicaid package?
It is important to note that this slimmed down health care package was shaped largely by objections from the Bush Administration to the offsetting cuts that were proposed by congressional Democrats. These “offsets” were required under “pay-go” rules adopted by Congress in January that require any increase in mandatory spending such as Medicare and Medicaid be accompanied by an corresponding reduction in that offsets the spending resulting in “budget neutrality.” When the Bush Administration rejected the “offsets” proposed by Congress, the package had to be whittled down and shortened to as little as 6 months. As a result, only the following provisions survived: