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Medicaid's mental health emergency

A private psychiatric hospital in Washington says its participation in a new federal demonstration project already is helping alleviate the burden of the most acutely mentally ill on emergency departments in the nation's capital. Since July 2012, the Psychiatric Institute of Washington has stabilized and treated 150 patients with acutely chronic and serious mental health conditions under the Medicaid Emergency Psychiatric Demonstration project. Roughly two-thirds of these patients came from local emergency departments. By responding quickly to their needs, “we have been very helpful to those organizations and helping them unclog their emergency rooms,” said Howard Hoffman, MD, the institute's executive medical director. The hospital stabilizes, evaluates and treats these patients either through therapy or medication, and then provides them with aftercare programs when they're discharged. The type of care provided by the institute is not new. What is new under this demo is tha ...

Mental health minimum benefits bolstered

Doctors navigating their way through the Affordable Care Act's final minimum coverage requirements for 2014 face a complex environment in which more people are obtaining access to mental health care and other services, but doing so through benefits that can vary significantly by insurer and by state. On Feb. 20, the Dept. of Health and Human Services issued a final rule mandating a core package of 10 “essential health benefits” categories that qualified plans on health insurance exchanges — and some plans outside of those marketplaces — will need to cover. Each state has been asked to choose a benchmark plan from a selection of popular existing plans to determine more precisely what benefits must be covered under the categories. Although the affected plans now have a benefits floor that will ensure more uniformity, plans will retain some flexibility, not only in benefits design but also in cost sharing and utilization management, said Sonya Schwartz, program director for ...

2% Medicare pay cut set under sequestration

Deep, across-the-board federal budget cuts officially went live for Medicare and other public health programs after Congress and President Obama failed to reach an agreement on avoiding sequestration before the March 1 deadline. More than $85.4 billion will be cut from the federal budget in 2013. Reductions to Medicare will represent about 12% of the total reductions, or $9.9 billion, in part through lower payments to physicians and other health professionals for providing services. The automatic reductions were written into law in 2011 as part of a deal to raise the nation’s debt ceiling. It was designed to act as a fail-safe mechanism in case lawmakers and the White House were unable to agree on more targeted deficit reduction provisions. Those cuts won’t be evident right away. The reductions in Medicare doctor rates will begin with services provided on or after April 1 even though the sequestration order is issued on March 1, according to the Congressional Budget Office. T ...