I 

110TH CONGRESS 

1ST SESSION H. R. 1571 

To amend title XVIII of the Social Security Act to eliminate discriminatory 

copayment rates for outpatient psychiatric services under the Medicare 

Program. 

IN THE HOUSE OF REPRESENTATIVES 

MARCH 19, 2007 

Mr. TIM MURPHY of Pennsylvania (for himself and Mrs. NAPOLITANO) introduced the following bill; which was referred to the Committee on Energy 

and Commerce, and in addition to the Committee on Ways and Means, 

for a period to be subsequently determined by the Speaker, in each case 

for consideration of such provisions as fall within the jurisdiction of the 

committee concerned 

A BILL 

To amend title XVIII of the Social Security Act to eliminate 

discriminatory copayment rates for outpatient psychiatric 

services under the Medicare Program. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Seniors Access to Men5 tal Health Act of 2007’’. 

6 SEC. 2. FINDINGS. 

7 Congress finds the following: 


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1 (1) The Medicare program currently discrimi2 nates against mental health services for seniors by 

3 charging more in copayments for such services than 

4 for any other outpatient health care services. This 

5 policy creates a barrier for seniors who would benefit 

6 from effective mental health treatments and in7 creases costs to the Medicare program. 

8 (2) Despite the availability of proven treat9 ments, the Substance Abuse and Mental Health Ad10 ministration has shown that 63 percent of seniors 

11 who need mental health treatments do not receive it. 

12 (3) The Surgeon General attributes this large 

13 unmet need to patient barriers (such as the reluc14 tance of patients to discuss psychological problems), 

15 provider barriers (such as difficulty with respect to 

16 diagnosing and treating mental illness), and health 

17 care system barriers (such as payment and coverage 

18 policies). 

19 (4) Adjusting Medicare copayment rates for 

20 outpatient psychiatric care to correspond with Medi21 care copayment rates for all other health care serv22 ices will integrate the diagnosis and treatment of 

23 chronic diseases and mental illnesses, such as de24 pression, for more effective care and lower health 

25 care costs. 


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1 SEC. 3. ELIMINATION OF DISCRIMINATORY COPAYMENT 

2 RATES FOR MEDICARE OUTPATIENT PSY3 CHIATRIC SERVICES. 

4 Section 1833(c) of the Social Security Act (42 U.S.C. 

5 1395l(c)) is amended to read as follows: 

6 ‘‘(c)(1) Notwithstanding any other provision of this 

7 part, with respect to expenses incurred in a calendar year 

8 in connection with the treatment of mental, psycho9 neurotic, and personality disorders of an individual who 

10 is not an inpatient of a hospital at the time such expenses 

11 are incurred, there shall be considered as incurred ex12 penses for purposes of subsections (a) and (b)— 

13 ‘‘(A) for expenses incurred in any year before 

2008, only 621 14 ⁄2 percent of such expenses; 

‘‘(B) for expenses incurred in 2008, only 683 15 ⁄4

16 percent of such expenses; 

17 ‘‘(C) for expenses incurred in 2009, only 75 

18 percent of such expenses; 

‘‘(D) for expenses incurred in 2010, only 811 19 ⁄4

20 percent of such expenses; 

‘‘(E) for expenses incurred in 2011, only 871 21 ⁄2

22 percent of such expenses; 

‘‘(F) for expenses incurred in 2012, only 933 23 ⁄4

24 percent of such expenses; and 

25 ‘‘(G) for expenses incurred in 2013, or any sub26 sequent year, 100 percent of such expenses. 


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1 ‘‘(2) For purposes of subparagraphs (A) through (F) 

2 of paragraph (1), the term ‘treatment’ does not include 

3 brief office visits (as defined by the Secretary) for the sole 

4 purpose of monitoring or changing drug prescriptions used 

5 in the treatment of such disorders or partial hospitaliza6 tion services that are not directly provided by a physi7 cian.’’. 

Æ 


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