MHA Society for Behavioral Health

Senate fails to invoke cloture on bill containing parity measure

The Senate on July 30 failed, by a vote of 51-43, to achieve the 60 votes needed to proceed to a vote on the Jobs, Energy, Families and Disaster Relief Act (S. 3335), which includes a mental health parity provision. That provision includes language agreed to last month by the House and Senate committees of jurisdiction that would require group health plans offering both medical and mental health/substance disorder coverage to provide similar financial and treatment limits for both types of coverage.

[ via AHA News Now ]

Veterans' Hotline Averted More Than 1,200 Suicides in First Year

More than 22,000 veterans have called a veterans suicide hotline since its launch in July 2007, and 1,221 suicides have been averted, according to government data to be released on July 28, the AP/Baltimore Sun reports. Richard McKeon, public health adviser for HHS' Substance Abuse and Mental Health Services Administration, said the hotline, which is part of the National Suicide Prevention Lifeline, receives about 1,575 calls weekly and the callers are divided evenly between veterans from Iraq, Afghanistan and Vietnam.

The hotline connects veterans or people concerned about veterans with specially trained counselors, about one-third of whom are veterans themselves. Counselors are able to review veterans' medical records and refer them to local Department of Veterans Affairs suicide prevention coordinators for follow-up, monitoring and care at local VA medical facilities.

The hotline was developed with SAMHSA after criticism that VA was not doing enough to help wounded service members returning from Iraq and Afghanistan. Approximately 6,500 veterans commit suicide annually, according to VA. VA has spent $2.9 million on the hotline and recently received funding to double its suicide prevention staff, with plans to hire an additional 212 people.

Janet Kemp, national suicide prevention coordinator for VA, said the hotline was developed specifically for veterans who do not receive enough help and are seriously considering suicide. She said, "They have indicated to us that they are in extreme danger, either they have guns in their hand or they're standing on a bridge, or they've already swallowed pills." Kemp added, "We try to get them (callers) to talk about their situation and what they remember and see if they can identify exactly what their issues are. I think there's a comfort in knowing that they can get some help from people who do understand what combat stress is like."

[ via Kaiser Daily Health Policy Report ]

FDA panel votes against black box for epilepsy meds

For a long time now, it's looked like the FDA was gearing up toward putting a black-box warning on epilepsy drugs, since it was discovered that they can potentially increase the risk of suicidal thoughts and behaviors in patients who take them. However, in a surprise move, an FDA-convened panel has ruled 14-4 against imposing a black-box warning on this class of drugs, which includes Pfizer's Lyrica and Johnson & Johnson's Topamax.

The committee concluded that though the risks were real, they weren't high enough to merit a black-box warning. And some panel members noted that imposing a black-box on epilepsy drugs might discourage some patients from taking them, even when the merits of the drug outweigh these risks.

Instead of recommending the black-box warning, the panel is suggesting that the FDA send a medication guide to doctors outlining the drugs' risks. To learn more about the FDA panel's decision, read this Wall Street Journal blog item.

[ via Fierce Healthcare ]

Medicare Mental Health Parity Approved

Just a few days after reconvening from the July recess, the Senate joined the House in passing the Medicare Improvements for Patients and Providers Act of 2008 (H.R. 6331) by a veto-proof 69-30. Less-publicized than the provision that would halt a payment cut for physicians providing treatment to Medicare patients is new equity between mental health and medical coverage.

When enacted, the bill will end a longstanding requirement that affects Medicare beneficiaries who need outpatient mental health services. Currently, they face a discriminatory 50% co-insurance for outpatient psychotherapy and services furnished by non-physician mental health professionals (20% for prescription and monitoring of medications to treat mental illness). In contrast, other outpatient health services require only a 20% co-payment.

The present outdated and unfair higher co-payment for mental health services has served as an incentive to use inpatient or institutional care instead of outpatient services. It has also led seniors and people with disabilities who rely on Medicare to forgo needed mental health treatment.

The bill would establish mental health parity within the Medicare program, phasing in a reduction of the higher co-payment over six years, to 20% in 2014.

The passage of H.R. 6331 is a significant accomplishment and makes great strides in modernizing Medicare. A thank-you call, email or letter to your Senators would be welcomed. See how they voted on H.R. 6331.

The House passed H.R. 6331 by a vote of 355-59 on June 24th. The overwhelming majority in both chambers makes a veto override likely, should the Administration carry out its earlier threat.

For more information, see the summary of H.R. 6331 provided by the House Ways and Means Committee.

[ via Bazelon Center for Mental Health Law ]

Study examines parity in state health coverage initiatives

While more than one in four uninsured U.S. adults has a mental illness or substance-use disorder, many state initiatives to cover the uninsured neglect those conditions, according to a new study by the National Alliance on Mental Illness and National Council for Community Behavioral Healthcare. Eleven of the 18 states examined included parity in mental health coverage in at least one program or proposal for the uninsured, while only five included parity for substance-use disorders, the study found.

Among other concerns, few states included mental illness and substance-use disorders in their wellness and chronic disease management programs, the groups said.

[ via AHA News Now ]

Panel to advise HHS on mental health preparedness

The U.S. Department of Health and Human Services has convened an expert panel to recommend ways to help protect and restore individual and community mental health during and after public health emergencies. The Disaster Mental Health Subcommittee plans to submit recommendations within six months to HHS’ National Biodefense Science Board, which in turn will make recommendations to the HHS secretary.

“We all can experience psychological consequences during and after a disaster, and there are things that can be done to mitigate these effects and improve our overall response and recovery,” said NBSB Chair Patricia Quinlisk. The recommendations will address communication, education and other interventions.

The NBSB advises the secretary regarding chemical, biological, nuclear and radiological health emergencies.

[ via AHA News Now ]