Medicare to Cover No-Cost Depression, Alcohol Abuse Services

Deborah Brauser

October 18, 2011

October 18, 2011 — Beneficiaries can now take advantage of Medicare's new coverage policies for annual screening and counseling services for alcohol misuse, as well as for annual screenings for depression, at no additional cost, according to a release sent out October 14 from the Centers for Medicare and Medicaid Services (CMS).

"Preventive services bring relief to Medicare beneficiaries for whom preventive care means early identification of disease and greater opportunity for treatment and recovery," Donald M. Berwick, MD, CMS administrator, said in the release.

"It's just as important for our elderly beneficiaries to enjoy access to preventive services as it is for any American," he added.

According to the release, 1 in 6 people older than 65 years suffers from depression.

Under CMS's new policy, the annual depression screenings will be "covered in primary care settings that have staff resources to follow up with appropriate treatment and referrals."

However, emergency departments, inpatient hospital settings or rehabilitation facilities, ambulatory surgical centers, and independent diagnostic testing facilities will not be considered primary care settings.

The CMS reported receiving 22 responses during its initial 30-day comment period for this proposed decision, and 35 during its second comment period. All responses except one were favorable toward coverage of depression screenings.

Annual alcohol misuse screenings from primary care providers will also now be covered, as well as 4 face-to-face behavioral counseling sessions per year for those who screen positive, "but whose levels or patterns of alcohol consumption do not meet criteria for alcohol dependence," according to the CMS Web site.

The organization received 395 responses on this proposal during its 30-day comment period this past summer. Of these responses, 97% agreed with the proposed decision.

"These new coverage policies address important issues related to mental health and prevention of substance abuse," said Patrick Conway, MD, CMS chief medical officer and director of the agency's Office of Clinical Standards and Quality, in the same release.

"We...continue to carefully and systematically review the best available medical evidence to identify those preventive services that can keep Medicare beneficiaries as healthy as possible for as long as possible."

The coverage decisions on depression screening and on alcohol misuse are available on the CMS Web site.

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