How Medicare Shapes Behavioral Health Practice with Older Adults in the US: Issues and Recommendations for Practitioners
The Medicare system is the largest healthcare insurance plan in the United States, covering older adults of age 65 and older, individuals with disabilities, and patients with end stage renal disease. Although Medicare went into effect in 1965, the mental healthcare services provided by psychologists and social workers became covered benefits as a result of the Omnibus Reconciliation Act (OBRA) of 1987, but were initially restricted to settings such as community mental health centers. As of July 1990, under OBRA 1989, the Health Care Financing Administration (currently called the Centers for Medicare and Medicaid Services (CMS) ) allowed psychologists and licensed independent social workers to submit claims directly for clinical services under Part B of Medicare. Lack of interest by the leaders of the American Psychological Association in the mid-1960s was the primary factor that delayed inclusion of psychologists into Medicare for 25 years (Cummings & O’Donohue, in press).
KeywordsMedical Necessity Compliance Manual Chart Note Claim Form Mental Healthcare Service
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