Medicare Proposes Alcohol, Depression Screening Rules

Federal dollars should be used to screen Medicare beneficiaries for depression and for alcohol misuse under two rules proposed by the Centers for Medicare & Medicaid Services.

CMS cited findings by the U.S. Preventive Services Task Force that there is enough evidence that screening for alcohol misuse and depression are "reasonable and necessary for the prevention of early illness or disability."

The alcohol screening coverage would extend to four face-to-face, behavioral counseling interventions per year for beneficiaries:

• who misuse alcohol but whose levels or patterns of consumption do not meet criteria for impairment, who have a preoccupation with acquisition and/or use, a persistent desire to quit with unsuccessful efforts, or who sustain social, occupational or recreational disability.
• who are competent and alert at the time that counseling is provided
• whose counseling is counseling is furnished by qualified primary care physicians and other primary care practitioners in a primary care setting.

Under the other proposed rule, depression screening would be covered for Medicare beneficiaries in primary care settings. CMS points out that "Among persons older than 65 years, one in six suffers from depression," and the condition is higher in those with co-morbidities including cancer, arthritis, stroke, chronic lung disease and cardiovascular disease, and when stressful events are more frequent.

The decision to propose coverage for depression screening is designed to identify depressed patients in primary care settings to assure accurate diagnoses, effective treatment, and follow-up.