In the first session of the 114th Congress, H.R. 826, Examining America’s Mental Health Services Act of 2015, was introduced. The bill is to provide for a study by the Institute of Medicine (IOM) on the gaps in mental health services and how these gaps might increase the risk of violent acts. The study would evaluate the gaps and barriers to receiving mental health services that includes treatment for both adults and children with severe and persistent mental illness.
Despite reforms, mental healthcare services are inadequate or nonexistent to large segments of our population. Additionally, due to the stigma and denial surrounding mental illness, patients who most need care don’t always seek it. And lastly, insurance policies create barriers to patient access and encourage clinicians to offer limited mental health services.
But, from a different perspective, the Department of Justice recently reported that 16 hospitals in seven states and their corporate parents have agreed to pay nearly $15.7 million to settle allegations they violated the False Claims Act for allegedly filing Medicare claims for psychiatric services that were not "medically reasonable or necessary."
"Hospitals that participate in the Medicare program must ensure that the services they provide and bill for are based on the medical needs of patients rather than the desire to maximize profits," said Principal Deputy Assistant Attorney General Benjamin C. Mizer of the Justice Department's Civil Division. "The Department of Justice is committed to ensuring that those who seek to abuse the Medicare program will be held accountable for their actions."
There is triple jeopardy here. We are providing these services to patients who allegedly do not require these services, while those who require these services are being neglected, and the government is the financial victim. I suspect there will be more to come on this issue. Stay tuned.