Medicare, Medicaid to Cover Screening for Alcoholism, Depression

Here is news that may be of interest both to older readers and ones with older relatives and friends. It’s from the website. The article does assume that alcohol abuse is a “disease,” which some may find off-putting.

WASHINGTON — Medicare will pay for annual screenings for alcohol misuse and depression, the Centers for Medicare and Medicaid Services (CMS) announced.

The new services will be added to other covered preventive services at no additional cost to beneficiaries.

“Preventive services bring relief to Medicare beneficiaries for whom preventive care means early identification of disease and greater opportunity for treatment and recovery,” CMS Administrator Donald Berwick, MD, said in a press release. “It’s just as important for our elderly beneficiaries to enjoy access to preventive services as it is for any American.”

In-office screening for alcohol misuse is covered on an annual basis by a primary care provider. If the screen is positive, Medicare will cover up to four “brief, face-to-face” behavioral counseling sessions per year.

Alcohol misuse is defined as risky and harmful drinking that places individuals at risk for future problems.

Risky or hazardous drinking, according to the United States Preventive Services Task Force is defined as more than seven drinks per week or three drinks per occasion for women and more than 14 drinks per week, or more than four drinks per occasion for men.

Misuse of alcohol is linked to cancer, liver disease, and cardiac disease, as well as mental and emotional problems, and contributes to societal problems such as economic losses from illness and injury, according to CMS.

CMS also issued a separate coverage determination on depression that covers Medicare beneficiaries for annual screenings in primary care settings that have resources to follow-up with appropriate treatment and referrals.

Depression affects one in six people over the age of 65 and carries an economic burden of more than $83 billion, according to CMS.

The new depression rule does not address treatment coverage.

For both alcohol misuse and depression, counseling must be performed by “qualified primary care physicians or other primary care practitioners in a primary care setting,” and not in emergency departments, inpatient hospital settings, ambulatory surgical centers, independent diagnostic testing facilities, skilled nursing facilities, inpatient rehabilitation facilities, or hospices.