The U.S. Centers for Medicare & Medicaid Services (CMS) on Wednesday finalized a new rule aimed at expanding access to behavioral health services and integration for seniors and individuals with disabilities.
Specifically, the new rule adds clinical psychologists and licensed clinical social workers to CMS’ list of evaluated specialties. It also requires most Medicare Advantage (MA) plans to include behavioral health services in care coordination programs.
Additionally, Wednesday’s rule finalizes wait-time standards for behavioral and primary care services.
Behavioral health services are in high demand by the senior population. Rates of anxiety, depression and other mental health conditions among seniors continue to increase in the wake of the COVID-19 pandemic. Over 25% of adults ages 65 to 74 report feelings of anxiety or depression, according to a Kaiser Family Foundation report.
CMS initially proposed its plan in December 2022.
“At HHS, we put seniors and people with disabilities first,” U.S. Department of Health and Human Services Secretary Xavier Becerra said in a statement. “That is exactly what we are doing today. “In our latest effort to strengthen Medicare and hold insurance companies accountable, we are putting protections in place so that Medicare Advantage works for beneficiaries and they get the quality care they deserve.”
The final rule is part of a broader effort to hold MA plans accountable for their members’ health and well-being.
The rule also included provisions to streamline prior authorization requirements, rewarding Medicare Advantage and Medicare Part D plans that provide quality care for underserved populations and provide more access to affordable prescription drugs.
This isn’t the only effort by the federal government to expand access to behavioral health services to seniors. Late last year, lawmakers introduced the Increasing Mental Health Options Act of 2022, which sought to ensure that Medicare beneficiaries have access to psychologists and can receive mental health services regardless of their care setting.
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