Summary

GAO discussed the Department of Defense's (DOD) management of mental health care provided to its beneficiaries under its Civilian Health and Medical Program of the Uniformed Services (CHAMPUS) and how those benefits compared with those under private-sector and other governmental health plans. GAO noted that: (1) mental health care benefits and beneficiary cost-sharing requirements provided by CHAMPUS were more generous than those offered in private-sector or other government plans, despite legislative changes that imposed stricter limits on allowable mental health services; (2) further DOD attention was needed to improve its quality assurance program, reduce beneficiary incentives to use inpatient care, and design alternatives to costly inpatient care; and (3) the DOD utilization management contractor identified 11 CHAMPUS-approved facilities that had not met all CHAMPUS certification standards for the quality of care provided to children and adolescents in established residential treatment centers. GAO believes that DOD: (1) management initiatives and legislative changes will enhance the prospects for gaining control over increasing mental health care costs while ensuring the availability and affordability of necessary care; and (2) efforts to use its utilization review contractor to begin monitoring the quality of care, and its plans to contract for a continuing independent quality review of mental health care services, will better ensure the sufficient evaluation of quality of care.