Member Article

As the American press focuses on the dismantling of the Affordable Care Act, the wheels have been set in motion to implement new health care legislation that enjoys strong bipartisan support. The 21st Century Cures Act (the “Act”), signed by President Obama on December 13, addresses a broad range of health care priorities, including drug innovation, biomedical research, and mental health reform. Among the myriad provisions in the Act are several that may prove beneficial over time for seniors and their care providers. They include:

• Increased funding for Alzheimer’s research and neurotechnology development. (Section 1001). The Act establishes a National Institutes of Health Innovation Account and appropriates $1.56 billion over the next decade to the Brain Research through Advancing Innovative Neurotechnologies (BRAIN) Initiative. The BRAIN Initiative seeks to accelerate the development and application of new technologies to treat brain disorders such as Alzheimer’s disease.
• Promoting access to mental health care and education for seniors. (Section 9012). The Act requires the Secretary of Health and Human Services to disseminate information and provide technical assistance regarding “evidence-based practices for the prevention and treatment of geriatric mental disorders and co-occurring mental health and substance use disorders among geriatric populations.” This requirement is part of a larger effort reflected in the Act to promote mental health parity and collaborative efforts to address mental health and substance use issues. 
• Taking steps to expand telehealth options in Medicare. (Section 4013). The Act directs the Centers for Medicare & Medicaid Services and Medicare Payment Advisory Commission to report on the existing and potential uses of telehealth in the Medicare program. Congress will then use the reports to assess how to expand Medicare-covered telehealth services.
• Expediting the process of bringing new drugs to market. (Sections 3001-3044). The Act requires the FDA to establish program efficiencies, such as expediting the review process for certain drugs, and to issue guidance related to patient-focused drug development, such as the use of patient experience data in regulatory decisions. 

Collectively, the above provisions are likely to have significant long-term impact on mental health for seniors.  Whether caused by disease or external factors, unattended and undiagnosed mental health issues can lead to physical health and behavioral challenges for seniors and operational challenges for providers. The 21st Century Cures Act holds out the promise of addressing such challenges through research, education, and the promotion of new drug therapies and care delivery.