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Medicare Proposes Alcohol, Depression Screening Rules

Cheryl Clark, for HealthLeaders Media, August 16, 2011

The agency pointed to studies which have found that "the economic burden of depression is substantial and [it is] estimated that the combined U.S. direct and indirect costs of depression were $83.1 billion, including $31.5 billion in direct costs and the remainder in indirect, mostly workplace costs.

Nearly 300 comments posted on the Medicare website indicated support of coverage for alcohol screening.

"We believe that screening tests and questionnaires, education, and motivational interviewing should be included in this covered benefit," wrote Mollie Brooks of the Medicare Strategy Unit of the Mayo Clinic.

"Frequency of coverage should include an annual screening for all patients, and more frequent screening such as once every three months for those individuals at risk or those who display features that are alarming such as alcohol abuse. We believe that coverage rules should apply to several members of the medical team treating the patient to include registered nurses for obtaining questionnaires, mid level providers for education and follow-up, and coverage for MDs providing motivational interviewing and medical interventions."

But Cori Robin, a clinical social worker at Rush University Medical Center, said this rule should not just reimburse primary care providers, but social workers and psychologists as well, who are providing alcohol screening services at Rush "without compensation. Social workers and psychologists are also in a unique position to provide this screening in that they collaborate on a regular basis with client's primary care and specialty doctors for the purpose of continuity of care."

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