Medicare covers screening and counseling for alcohol misuse and screening for depression

DEPARTMENT OF HEALTH & HUMAN SERVICES
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MEDICARE NEWS

FOR IMMEDIATE RELEASE                       Contact: CMS Media Relations Group

October 14, 2011                                                                     (202) 690-6145

Medicare covers screening and counseling for alcohol misuse and screening for depression

The new coverage policies add new preventive services for Medicare beneficiaries

The Centers for Medicare & Medicaid Services (CMS) today announced two new national coverage determinations that cover alcohol misuse screening and behavioral counseling for Medicare beneficiaries as well as screening for depression. These new coverage policies add to the existing portfolio of covered preventive services, most of which are now available to people with Medicare at no additional cost.

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

Alcohol misuse puts individuals at risk for ill health as misuse is linked to diseases such as cancer, liver disease and cardiac disease, as well as mental and emotional problems.  For society at large, alcohol-related problems include economic losses from illness and injury, and disruption of family and social relationships. 

Annual alcohol misuse screening by primary care providers, such as a beneficiary’s family practice physician, internal medicine physician, or nurse practitioner, in settings such as physicians’ offices are covered under CMS’ new policies.  The benefit also includes four behavioral counseling sessions per year furnished by the primary care provider, if beneficiaries screen positive for alcohol misuse.

Depression is a medical disorder characterized by feeling sad, diminished interest in pleasurable activities, feelings of guilt, decreased ability to concentrate and other symptoms experienced nearly every day.  Depression may also include thoughts of suicide.  Among people 65 years and older one in six suffers from depression.

Annual screening for depression for Medicare beneficiaries is now covered in primary care settings that have staff resources to follow up with appropriate treatment and referrals.  The purpose of this screening is to assure accurate diagnosis, effective treatment and follow-up.

“These new coverage policies address important issues related to mental health and prevention of substance abuse,” said Patrick Conway, MD, CMS chief medical officer and director of  the agency’s Office of Clinical Standards and Quality. “We at CMS continue to carefully and systematically review the best available medical evidence to identify those preventive services that can keep Medicare beneficiaries as healthy as possible for as long as possible.” 

The coverage decision on alcohol misuse screening is online at http://www.cms.gov/medicare-coverage-database/details/nca-decision-memo.aspx?NCAId=249 and the decision on depression screening is online at http://www.cms.gov/medicare-coverage-database/details/nca-decision-memo.aspx?NCAId=251.