Mental Health Groups Raise Concerns About Dual-Eligible Demonstrations
In a letter to the Senate Special Committee on Aging submitted for today's hearing on "Examining Medicare and Medicaid Coordination for Dual- Eligibles," 44 national associations representing consumers, hospitals, and community services for individuals experiencing mental and addictive disorders raised concerns about the potential impact of new federal demonstration proposals intended to integrate care for beneficiaries that are concurrently eligible for both Medicare and Medicaid ("dual eligibles").
Mental disorders disproportionately affect the dual-eligible population, the Mental Health Liaison Group (MHLG) noted in a letter to the Senate Special Committee on Aging Ranking Member Sen. Bob Corker (R-TN). Dual eligibles are more likely to have cognitive impairment and mental disorders than non-dual eligibles.
A majority of the state proposals that the Centers for Medicare & Medicaid Services (CMS) is currently reviewing are planning to passively enroll beneficiaries into a managed care plan, giving beneficiaries no other plan in their area from which to choose. "Removing dual eligibles from their current health plans and prescription drug plans could cause disruption, particularly if they have established provider relationships or their new drug plan has a different formulary," the MHLG said. Even though an opt-out exists, "it would require this group to navigate a complex process to opt out."