Medicare and behavioral health

Medicare Increases Emphasis on Behavioral Health

Medicare policy is evolving to encourage providers to take a more active role in addressing the behavioral health needs of their patients. In traditional Medicare, new payment codes encourage practitioners to spend more time identifying and helping patients with their behavioral health challenges. Meanwhile, CMS and its Center for Medicare and Medicaid Innovation have introduced several new care and payment models that place a greater emphasis on beneficiaries’ behavioral health needs. Among them: The LEAD (Long-Term Enhanced ACO Design) Model, which seeks to include more behavioral health providers and encourages greater integration of behavioral health care. The ACCESS (Advancing Chronic [...]

joe2026-03-31T17:02:07-04:00April 1, 2026|Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, Medicare|

Federal Health Policy Update for September 12

The following is the latest health policy news from the federal government for September 6-12. Some of the language used below is taken directly from government documents. 340B A federal court has declined to issue a preliminary order to block implementation of a Maryland law that requires pharmaceutical companies to provide discounts on drugs dispensed by eligible 340B providers by contract pharmacies. The challenge to the Maryland law, filed by Pharmaceutical Research and Manufacturers of America (PhRMA) and several pharmaceutical companies, will be heard without a temporary order suspending the law’s implementation. Learn more from the court order. Centers for [...]

joe2024-09-12T15:22:15-04:00September 12, 2024|340b, Alternative payment models, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, COVID-19, hospitals, Medicaid, Medicaid managed care, Medicaid regulations, Medicare regulations, Medicare reimbursement policy, MedPAC|

Federal Health Policy Update for November 9

The following is the latest health policy news from the federal government for November 3-9. Some of the language used below is taken directly from government documents. Congress Senate Finance Committee Earlier this week the Senate Finance Committee passed the Better Mental Health Care, Lower-Cost Drugs, and Extenders Act of 2023. The bill, which passed out of the committee by a vote of 26-0, would: eliminate $16 billion in cuts to Medicaid DSH for 2024 and 2025; soften the 2024 cut to Medicare physician payments by reducing the conversion factor by 2.15 percent rather than the 3.4 percent that CMS [...]

iqtsupport2023-11-09T15:41:22-05:00November 9, 2023|340b, Centers for Medicare & Medicaid Services, health equity, hospitals, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicaid disproportionate share, Medicaid DSH, Medicare, Medicare regulations, Medicare reimbursement policy, MedPAC|