Proposed CMS Rule on Behavioral Health Cost-Sharing: Opportunity for Plans and Providers to Comment

Medicare Advantage (“MA”) beneficiaries currently face higher out-of-pocket costs for behavioral health services than Traditional Medicare beneficiaries do. That may change soon under a rule recently proposed by the Centers for Medicare & Medicaid Services (“CMS”). This article summarizes how the Proposed Rule would change cost-sharing for behavioral health services and the potential implications for plans and behavioral healthcare providers. We suggest that comment is needed on a critical assumption of the Proposed Rule—that permitting beneficiaries to pay less for covered services will lead them to use those services more often, without causing significant losses to MA plans.

Go to the article.