The Medicare Improvments for Patients and Providers Act of 2008 amends "titles XVIII and XIX of the Social Security Act to extend expiring provisions under the Medicare Program, to improve beneficiary access to preventive and mental health services, to enhance low-income benefit programs, and to maintain access to care in rural areas, including pharmacy access, and for other purposes." Pertinent to mental health, Title I, Subtitle A, Part 1 specifies dates for the gradual elimination, by 2014, of differential copayment rates for outpatient Medicare psychiatric services. This section is not applicable to substance use services.

The legislation became law on 7/15/2008 as PL 110-275

Text of the legislation: The Medicare Improvments for Patients and Providers Act of 2008

From the Kaiser Family Foundation:

This issue brief examines coverage of the nearly 9 million "dual eligible" beneficiaries, the low-income elderly and persons with disabilities who are enrolled in both Medicare and Medicaid. It explores the national and state impacts of shifting the financing of selected services for dual eligibles from Medicaid to Medicare, including having the federal government pick up the full cost of Medicare premiums, cost-sharing and gaps in Medicare-covered services and long-term care services for this population.

Full Report: Rethinking Medicaid's Financing Role for Medicare Enrollees

This article presents trends and changes in health spending by age with a focus on children, middle aged adults, and the elderly for selected years between 1997 and 2004.  The authors also predict selected effects of the future age-mix on healthcare costs.  

Hartman, M., Catlin, A., Lassman, D., Cylus, J., & Heffler, S. (2008). U.S. Health spending by age, selected years through 2004. Health Affairs, 27(1), w1-w12. 6 Nov. 2007. DOI: 10.1377/hlthaff.27.1.w1. http://content.healthaffairs.org/cgi/content/abstract/hlthaff.27.1.w1 © 2008 by Project HOPE. 

Authors: Micah Hartman, Aaron Catlin, David Lassman, Jonathan Cylus, Stephen Heffler.

*Note: The New England Journal of Medicine (NEJM) policies preclude us from providing an article abstract or linking to the NEJM website; however, this article is available in full via the NEJM website. 

This 1995 article presents state-level health expenditure data based on personal healthcare expenditures for 1980 to 1993.  The article also highlights state-level differences in Medicare and Medicaid spending at over that period.    

Levit, K. R., Lazenby, H. C., Cowan, C. A., Won, D. K., Stiller, J. M., Sivarajan, L., et al. (1995). State health expenditure accounts: building blocks for state health spending analysis. Health Care Financing Review, 17(1), 201-54.  http://www.ncbi.nlm.nih.gov/pubmed/10153472

Authors: Katherine R. Levit, Helen Lazenby, Cathy A. Cowan, Darleen K. Won, Jean M. Stiller, Lekha Sivarajan, Madie W. Stewart. 

This article examines the detailed policy implications of the Medicare Part D program with special attention to the provision of psychotropic drugs for dually eligible mentally ill Medicaid and Medicare beneficiaries. 

Morden, N. E., & Garrison, L. P. Jr. (2006). Implications of Part D for mentally ill dual eligibles: A challenge for Medicare. Health Affairs, 25(2), 491-500. DOI: 10.1377/hlthaff.25.2.491. http://content.healthaffairs.org/cgi/content/abstract/25/2/491 © 2006 by Project HOPE. 

Authors: Nancy E. Morden, Louis P. Garrison, Jr.