National Coverage Analysis (NCA) View Public Comments

Screening and Behavioral Counseling Interventions in Primary Care to Reduce Alcohol Misuse

Public Comments

Commenter Comment Information
Bisgard, Eileen Title: Chair
Organization: Colorado Fetal Alcohol Spectrum Disorder Commission
Date: 08/18/2011
Comment:

I support the Centers for Medicaid and Medicare Services proposed decision memo for "Screening and Brief Counseling Intervention in Primary Care to Reduce Alcohol Misuse." It is well established alcohol misuse causes many social and health consequences, exacerbates health issues and makes an individual's health conditions more difficult to treat. In addition, screening and brief counseling of pregnant women may help prevent or minimize Fetal Alcohol Spectrum Disorders.

Thank you for

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Bocchino, Carmella Title: EVP, Clinical Affairs and Strategic Planning
Organization: America's Health Insurance Plans (AHIP)
Date: 08/18/2011
Comment:

August 16, 2011

Louis B. Jacques, MD
Director, Coverage and Analysis Group
Centers for Medicare and Medicaid Services
Mail Stop C1-09-06
7500 Security Boulevard
Baltimore, Maryland 21244-1850

Thank you for the opportunity to comment on the Centers for Medicare and Medicaid Services’ (CMS’s) proposed decision memo for Screening and Behavioral Counseling Interventions in Primary Care to Reduce Alcohol Misuse (CAG-00427N). America’s

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Belnap, Dan Date: 08/18/2011
Comment:

August 18, 2011

Dr. Don Berwick, Administrator
Centers for Medicare & Medicaid Services
Department of Health and Human Services
7500 Security Boulevard
Baltimore, MD 21244

Re: Proposed Decision Memos for Screening for Depression in Adults (CAG-00425N) and Screening and Behavioral Counseling Interventions in Primary Care to Reduce Alcohol Misuse (CAG-00427N)

Dear Dr. Berwick:

The Coalition for Whole Health is a broad coalition of

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Langendoerfer, MD, Sharon Organization: Denver Health
Date: 08/18/2011
Comment:
The costs are enormous to Medicare, Medicaid, Mental Health, Human Services and Legal/Judicial/Corrections by alcohol-abusing parents and their children! As a 35-yr pediatrician and member of Colorado Commission on FASD, I agree the evidence is convincing that Medicare funding for Screening and Brief Intervention as a critically important step in prevention.
King, Abby Title: President
Organization: Societyof Behavioral Medicine
Date: 08/18/2011
Comment:

The Society of Behavioral Medicine — the only professional organization devoted to the entire range of links between behavior and health — strongly endorses the CMS initiative for Screening and Behavioral Counseling Interventions in Primary Care to Reduce Alcohol Misuse (CAG-00427N). These approaches are evidence based and can reach and help many individuals struggling with alcohol misuse through the primary care system. The primary care system is a crucial venue for efforts to reach an

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Covall, Mark Title: President/CEO
Organization: National Association of Psychiatric Health Systems
Date: 08/18/2011
Comment:

The National Association of Psychiatric Health Systems (NAPHS) supports the action of the United States Preventive Services Task Force (USPSTF) in recommending screening and behavioral counseling interventions to reduce alcohol misuse by adults. We also support the conclusion that the evidence is sufficient to determine that screening and behavioral counseling interventions in primary care to reduce alcohol misuse are appropriate for Medicare beneficiaries.

We understand that

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Ross, Nurse Practitioner, Jennifer Date: 08/18/2011
Comment:
It is an excellent idea to screen all patients for alcohol abuse/misuse since alcohol has such a negative impact on one's personal health and society as a whole. I have misgivings about mandating it for only Medicaid/Medicare patients, as that is a slippery slope down to requiring sobriety in order to qualify for those public programs. However, keeping it firmly in mind that we do not want to require sobriety to qualify for social assistance programs, I think routine screening for alcohol

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Longtin, PMHCNS - BC, Brent Date: 08/18/2011
Comment:
To whom it may concern:
I submit that current screening practices for Substance Abuse as well as Depression in primary care overall is not comprehensive in the United States.
Even if screening is completed, there is documented evidence that there is lacking follow-up recommendations regarding determination of needed treatment, education and referral to available resources. This proposed standard also places for the first time a minimum competency standard and direction to help

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devaney, pat Date: 08/18/2011
Comment:
The future of truly integrating behaviroal health with primary care starts with this initiative. It is a critical foundation piece and may influence insurance comanies as well. Please approve this.
Nordal, Katherine Title: Executive Director for Professional Practice
Organization: American Psychological Association
Date: 08/18/2011
Comment:

The American Psychological Association (“APA” or “we”), the professional organization representing 154,000 members and affiliates engaged in the practice, research, teaching, and learning of psychology supports the Centers for Medicare and Medicaid Services (CMS) proposal to cover annual alcohol screening, and for those who screen positive, to cover up to four brief, face-to-face behavioral counseling interventions per year for Medicare beneficiaries, including for pregnant women meeting

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Rosenberg, Linda Title: President & CEO
Organization: National Council for Community Behavioral Healthcare
Date: 08/18/2011
Comment:

August 15, 2011

RE: Comments on Proposed Decision Memo for Screening and Behavioral Counseling Interventions in Primary Care to Reduce Alcohol Misuse (CAG-00427N)

The National Council for Community Behavioral Healthcare appreciates the opportunity to comment on the proposed Decision Memo for Screening and Behavioral Counseling Interventions in Primary Care to Reduce Alcohol Misuse. Together with our over 1,900 member organizations, we serve our nation’s most vulnerable

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Fitzpatrick, M.S.W., Michael J. Title: Executive Director
Organization: National Alliance on Mental Illness
Date: 08/17/2011
Comment:

August 18, 2011

Louis Jacques, MD
Director, Coverage and Analysis Group
Centers for Medicare & Medicaid Services
Attention: CAG-00425N
7500 Security Boulevard
Baltimore, MD 21244-1850

Re: Comments on Proposed CMS National Coverage Determination for Screening for Depression in Adults (CAG-00425N)

Dear Dr. Jacques:

On behalf of the National Alliance on Mental Illness (NAMI), I pleased to submit the following

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Foster, Susan Title: Vice President and Director
Organization: The National Center on Addiction and Substance Abuse at Columbia University
Date: 08/17/2011
Comment:

Dear Dr. Berwick:

The National Center on Addiction and Substance Abuse at Columbia University (CASA Columbia) is grateful for the opportunity to comment on the Centers for Medicare and Medicaid Services (CMS) proposal to cover alcohol screenings and brief interventions for adult Medicare beneficiaries, including pregnant women.

CASA Columbia strongly endorses this proposal. A strong body of research supports the provision of screenings and brief interventions to reduce

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Gitlow, MD, MBA, MPH, FAPA, Stuart Title: Acting President
Organization: American Society of Addiction Medicine
Date: 08/17/2011
Comment:

August 18, 2011

Donald Berwick, M.D.
Administrator
Centers for Medicare & Medicaid Services (CMS)
Department of Health and Human Services
7500 Security Boulevard
Baltimore, MD 21244

Re: Proposed Decision Memos for Screening for Depression in Adults (CAG-00425N) and Screening and Behavioral Counseling Interventions in Primary Care to Reduce Alcohol Misuse (CAG-00427N)

Dear Dr. Berwick:

The American Society of

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Heim, MD, FAAFP, Lori J. Title: Board Chair
Organization: American Academy of Family Physicians
Date: 08/17/2011
Comment:

August 18, 2011

Donald Berwick, MD
Administrator
Centers for Medicare & Medicaid Services
Department of Health & Human Services
P.O. Box 8013
Baltimore, MD 21244–8013
Submitted via email to CAGinquiries@cms.hhs.gov

Re: Proposed Decision Memo for Screening and Behavioral Counseling Interventions in Primary Care to Reduce Alcohol Misuse (CAG-00427N)

Dear Dr. Berwick:

On behalf of the American Academy of Family Physicians (AAFP),

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Lovelace, John Title: President
Organization: UPMC Health Plan
Date: 08/17/2011
Comment:

August 18, 2011

Lawrence Schott, MD, MS
Lead Medical Officer, Division of Medical and Surgical Services
The Centers for Medicare and Medicaid Services

Re: National Coverage Analysis (NCA) for Screening and Behavioral Counseling Interventions in Primary Care to Reduce Alcohol Misuse (CAG-00427N)

Dear Dr. Schott:

The UPMC Insurance Services Division (“UPMC”) is pleased to have the opportunity to comment on the proposed coverage

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lundin-martinez, john Date: 08/17/2011
Comment:
I support the Centers for Medicaid and Medicare Services proposed decision memo for "Screening and Brief Counseling Intervention in Primary Care to Reduce Alcohol Misuse." It is well established alcohol misuse causes many social and health consequences, exacerbates health issues and makes an individual's health conditions more difficult to treat.
Madara, MD, James L. Organization: American Medical Association
Date: 08/17/2011
Comment:

August 18, 2011

Louis Jacques, MD
Director, Coverage and Analysis Group
Jyme Schafer, MD, MPH
Director, Division of Medical and Surgical Services
Centers for Medicare and Medicaid Services
7500 Security Boulevard
Baltimore, MD 21244

Re:  Proposed Coverage Decision Memorandum for Screening and Behavioral Counseling Interventions in Primary Care to Reduce Alcohol Misuse; CAG-00427N
       Proposed

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Mays, Willard Date: 08/17/2011
Comment:

The proposed Medicare coverage for screening and behavioral counseling intervention in primary care to reduce alcohol misuse (CAG-00427N) is extremely important and will be of great benefit to older adults. Many studies have found that because of stigma and other factors the majority of older adults are reluctant to admit that the have an alcohol or mental health problem and don't seek services. The majority of those that do receive services access it through primary care. So covering

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montgomery, april Date: 08/17/2011
Comment:
NOFAS Colorado supports the Centers for Medicaid and Medicare Services proposed decision memo for "Screening and Brief Counseling Intervention in Primary Care to Reduce Alcohol Misuse." It will be a powerful tool to reduce the negative consequences of alcohol to pregnant women, their babies and their partners and families. It will result in cost savings downt he road to health care, education and social services.
Berkner, Dan Date: 08/17/2011
Comment:
I support the Centers for Medicaid and Medicare Services proposed decision memo for "Screening and Brief Counseling Intervention in Primary Care to Reduce Alcohol Misuse." It is well established alcohol misuse causes many social and health consequences, exacerbates health issues and makes an individual's health conditions more difficult to treat.
Graebert-Rodriquez, Gabriele Title: MS, CADCIII (Oregon)
Date: 08/17/2011
Comment:
25+ years experience in the field of addiction and mental health.
Physicians are usually the ones who see older adults the most, so it makes great sense to have the initial screening in the "doctor's office". But physicians do not have the education certified addictions counselors have. I suggest to let the addiction professional continue the consecutive sessions.
Jacobs, Ronnie Title: semi-retired parent advocate
Organization: none at this time
Date: 08/17/2011
Comment:
I support the Centers for Medicaid and Medicare Services proposed decision memo for "Screening and Brief Counseling Intervention in Primary Care to Reduce Alcohol Misuse". It is well established that alcohol misuse causes a myriad of social and medical ills, worsens existing health problems and makes it more complicated to treat patients whose symptoms/behaviors fall into this particular area of focus. Furthermore,Screening and Counseling Intervention services as described in this decision

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Purvis, Darcy Date: 08/17/2011
Comment:
I support the Medicaid/Medicare decision to propose "Screening and Brief Counseling Intervention in Primary Care to Reduce Alcohol Misuse." Alcohol abuse and misuse are related to many social problems and contributes to health problems. The Medical field has an opportunity to help their patients and reduce their own costs.
Woodard, Jade Date: 08/17/2011
Comment:
I support the Centers for Medicaid and Medicare Services proposed decision memo for "Screening and Brief Counseling Intervention in Primary Care to Reduce Alcohol Misuse." It is well established alcohol misuse causes many social and health consequences, exacerbates health issues and makes an individual's health conditions more difficult to treat. This is especially true for pregnant women due to the risk of Fetal Alcohol Spectrum Disorders for the unborn child.
Gaenicke, David Title: Retired, Certified Alcohol and Drug Counselor, Cal
Date: 08/17/2011
Comment:
Alcohol and Drug screening along with counseling Interventions are so essential in addressing Alcohol and Drug Addiction. Working in the field for 18 years has increased my awareness that denial of any disease or 'problem' with alcohol/drugs is such a large part of the disease, that most people do not get help. If Medicare would pay for that cost at least one time, would help break through the cycle of denial and lead to real health and sobriety.
Agosta, Christine Organization: Denver District Attorney
Date: 08/17/2011
Comment:
This testing is extremely important to health of our newborns and the care after birth. It is important to the mothere's health in that we may assist her with addiction needs during her pregnancy. I believe that early detection will, in the long run, also save money.
Certner, David Title: Legislative Counsel & Legislative Policy Director
Organization: AARP
Date: 08/17/2011
Comment:

August 17, 2011

Donald M. Berwick, M.D.
Administrator, Centers for Medicare & Medicaid Services
U.S. Department of Health and Human Services
200 Independence Avenue, S.W.
Washington, D.C. 20201

Re: National Coverage Analysis (NCA) for Screening and Behavioral Counseling Interventions in Primary Care to Reduce Alcohol Misuse (CAG-00427N)

Dear Dr. Berwick:

AARP strongly supported the Patient Protection and Affordable Care

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Zeipen, Jon Date: 08/17/2011
Comment:
I support the Centers for Medicaid and Medicare Services proposed decision memo for "Screening and Brief Counseling Intervention in Primary Care to Reduce Alcohol Misuse." It is well established alcohol misuse causes many social and health consequences, exacerbates health issues and makes an individual's health conditions more difficult to treat. The sooner we can address the condition, the higher the probability it will not progress into full-blown addiction.
Gingerich, Emily Title: Project Manager
Organization: HealthTeamWorks
Date: 08/17/2011
Comment:
We support the Centers for Medicaid and Medicare Services proposed decision memo for “Screening and Brief Counseling Intervention in Primary Care to Reduce Alcohol Misuse.” It is well established that alcohol misuse causes many social and health consequences, makes many health problems worse and makes an individual’s health conditions more difficult to treat.
Screening and brief counseling is an efficient and cost-effective approach to decreasing misuse and overuse of alcohol that can

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Jenkins, Frances Date: 08/17/2011
Comment:
: I support the Centers for Medicaid and Medicare Services proposed decision memo for "Screening and Brief Counseling Intervention in Primary Care to Reduce Alcohol Misuse." It is well established alcohol misuse causes many social and health consequences, exacerbates health issues and makes an individual's health conditions more difficult to treat.
Colby, Alison Date: 08/17/2011
Comment:
I know several people who have gone through the Brief screening and intervention. I have seen the results and those people have really been helped. It is a win/win situation for both the people and the government to implement this program. I see it as a "no brainer" solution because of the money it will save and the people it will help. I support the Centers for Medicaid and Medicare Services proposed decision memo for "Screening and Brief Counseling Intervention in Primary Care to Reduce

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O'Brien, Kevin Title: Therapist
Organization: Kaiser Permanente
Date: 08/17/2011
Comment:
I am supportive of the SBIRT screening model for alcohol misuse being a procedure that would be covered by Medicare. Since Primary Care is one of the main points of entry into our Health care system having this procedured as a covered benefit will go a long way in containing costs and reducing the suffering of Medicare members.
McNertney, Jennifer Title: Policy Analyst
Organization: Minnesota Hospital Association
Date: 08/17/2011
Comment:

August 16, 2011

Mr. Donald M. Berwick, M.D., M.P.P.
Administrator
Centers for Medicare & Medicaid Services
Hubert H. Humphrey Building
200 Independence Avenue, S.W., Room 445-G
Washington, DC 20201

Submitted electronically

RE: Proposed Decision Memo for Screening for Depression in Adults (CAG-00425N)

Dear Dr. Berwick:

On behalf of our 145 member hospitals and 17 member health systems, the Minnesota Hospital

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Bergstrom, Jennette Title: Director Acute Care
Organization: Parker Adventist Hosptial
Date: 08/17/2011
Comment:
Total support for this program
Karol, Meredith Date: 08/17/2011
Comment:
I support the CMS's proposed decision memo for "Screening and Brief Counseling Intervention in Primary Care to Reduce Alcohol Misuse." It is well known and studided that alcohol misuse causes many social and health consequences, exacerbates health issues and makes an individual's health conditions more difficult to treat.
Hall, Ryan Date: 08/17/2011
Comment:
I support the Centers for Medicaid and Medicare Services' proposed decision memo for "Screening and Brief Counseling Intervention in Primary Care to Reduce Alcohol Misuse." As an SBIRT health educator in an emergency room of a level II trauma center, I see daily evidence of how effective screening and brief counseling is when done universally. We are able to catch so many substance-related problems before they get worse, and, arguably, before they even happen. This is an invaluable service

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Reider, Linda Date: 08/17/2011
Comment:
I support the Centers for Medicaid and Medicare Services proposed decision memo for "Screening and Brief Counseling Intervention in Primary Care to Reduce Alcohol Misuse." It is well established alcohol misuse causes many social and health consequences, exacerbates health issues and makes an individual's health conditions more difficult to treat.
Kinkelaar, Barbara Kinkelaar Title: Barbara Kinkelaar
Organization: Associates in behavioral Counseling
Date: 08/17/2011
Comment:
I support screening and brief counseling interventions by medical professionals to help address and reduce alcohol misuse. This common problem has been ignored or glossed over for a long time. Alcohol habits have a huge impact on physical and mental health.
Maciejko, Karen Date: 08/17/2011
Comment:
I support the Centers for Medicaid and Medicare Services proposed decision memo for "Screening and Brief Counseling Intervention in Primary Care to Reduce Alcohol Misuse." It is well established alcohol misuse causes many social and health consequences, exacerbates health issues and makes an individual's health conditions more difficult to treat.
Mickow, Brenda Organization: Mayo Clinic
Date: 08/17/2011
Comment:

Mayo Clinic strongly supports Medicare coverage of alcohol screening and behavioral counseling.

The proposed decision memo outlines only primary care physicians, nurse practitioners, clinical nurse specialist, and physician assistant as providers of the alcohol screening and behavioral counseling. We urge CMS to consider coverage of screening and counseling services delivered by a wider range of providers (Aalto). We encourage CMS to consider allowing care managers (RNs

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Weiksnar, Melissa Date: 08/17/2011
Comment:
The US has over 12.5 million alcoholics. Most of them do not fit the typical stereotype of an alcohol: it is an equal opportunity disease. Such screening could also lead practitioners to see evidence of other substance abuse, which is a national epidemic and a threat to our nation's economic competitiveness and future viability.
Read, Stacee Title: Child Protection Safety Specialist
Organization: State of Colorado Department of Human Services
Date: 08/17/2011
Comment:
I support the Centers for Medicaid and Medicare Services proposed decision memo for "Screening and Brief Counseling Intervention in Primary Care to Reduce Alcohol Misuse." It is well established alcohol misuse causes many social and health consequences, exacerbates health issues and makes an individual's health conditions more difficult to treat. Lets support the early efforts to help people as well as to cut long term costs.
Ingram, Jordan Date: 08/17/2011
Comment:
I will admit that I am not extremely knowledgeable on the subject, but I don't think the people who really would need this would listen to someone telling them to stop. It seems like it would add another expense that we (america) can't afford already.
Pope, Vikki Title: Trauma Program Manager
Organization: Centura Health, Parker Adventist Hospital
Date: 08/17/2011
Comment:
I support the Centers for Medicaid and Medicare Services proposed decision memo for "Screening and Brief Counseling Intervention in Primary Care to Reduce Alcohol Misuse." It is well established alcohol misuse causes many social and health consequences, exacerbates health issues and makes an individual's health conditions more difficult to treat.
Markoff, Laurie Date: 08/17/2011
Comment:
The cost of alcohol misuse both economically and socially is huge. Screening and brief intervention could begin to prevent many of these costs and SHOULD without a doubt be reimbursed by Medicare.
Cassani-Beard, Connie Date: 08/17/2011
Comment:
I support the Centers for Medicaid and Medicare Services proposed decision memo for the payment of Annual Brief Counseling Intervention in Primary Care to reduce alcohol misuse.
Dahlen, Jeremiah Date: 08/17/2011
Comment:
I support the Centers for Medicaid and Medicare Services proposed decision memo for "Screening and Brief Counseling Intervention in Primary Care to Reduce Alcohol Misuse." It is well established alcohol misuse causes many social and health consequences, exacerbates health issues and makes an individual's health conditions more difficult to treat.
Baldwin, Jeffrey Date: 08/17/2011
Comment:
I am an addiction educator at a pharmacy college. Alcohol misuse has a huge societal impact in terms of disease, trauma, and criminal activity and related enforcement and incarceration. I wholeheartedly support the Centers for Medicaid and Medicare Services proposed decision memo for "Screening and Brief Counseling Intervention in Primary Care to Reduce Alcohol Misuse." It would be forward thinking to include pharmacists in the list of primary care providers since the pharmacist is often the

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Rothschild, Don Title: Substance Abuse Professional
Organization: Peak Paths
Date: 08/17/2011
Comment:

I can see no justification for CMS to pay for either screening or behavioral counseling because I do not believe this to be a matter for Medicare responsibility.

Therefore I cannot support this proposal.
Sinner, Laurie Date: 08/17/2011
Comment:
I support the Centers for Medicaid and Medicare Services proposed decision memo for "Screening and Brief Counseling Intervention in Primary Care to Reduce Alcohol Misuse." It is well established alcohol misuse causes many social and health consequences, exacerbates health issues and makes an individual's health conditions more difficult to treat.
Brodbelt, Shar Title: Neurosurgical Physician Assistant
Organization: St. Mary's Regional Hospital and Medical Center
Date: 08/16/2011
Comment:
Numerous comprehensive studies have established that alcohol misuse creates many social and health problems, complicates health issues, confounds an individual's overall health picture and exacerbates an individual's evaluation and treatment plan. SBIRT has proven itself over and over again in varied settings from emergency rooms to primary care clinics to be an efficacious and cost effective solution for identifying, addressing and treating patients with alcohol misuse and abuse. Published

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Scully, M.D., James H. Title: Medical Director & CEO
Organization: American Psychiatric Association
Date: 08/16/2011
Comment:

August 17, 2011

Donald Berwick, MD
Administrator
Centers for Medicare and Medicaid Services
Department of Health and Human Services
7500 Security Boulevard
Baltimore, MD 21244-1850

Re: Proposed Rules for Screening for Depression in Adults (CAG-00425N) and Screening and Behavioral Counseling Interventions in Primary Care to Reduce Alcohol Misuse (CAG-00427N)

Dear Dr. Berwick,

The American

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Hermeling, Laura Title: Employment Consultant
Organization: Midtown Community Mental Health Center
Date: 08/16/2011
Comment:
This is a critical link in providing integrated services - big SUPPORT!
Zayach, Jeff Title: Executive Director
Organization: Boulder County Public Health
Date: 08/16/2011
Comment:

I fully support the Centers for Medicaid and Medicare Services proposed decision memo for "Screening and Brief Counseling Intervention in Primary Care to Reduce Alcohol Misuse."

I am the Director of Boulder County Public Health. We just completed our community health assessment process, and alcohol abuse is one of the top three priorities for us as a community. One of the major opportunities we see is more intervention at the community health clinic and private provider level

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Saitz, Richard Date: 08/16/2011
Comment:

I support Medicare coverage of screening for unhealthy alcohol use (the spectrum from use that risks consequences to dependence). I have several substantive recommendations that may improve the decision.

1. This coverage recommendation presents an opportunity to modernize terminology to use an appropriate clinical designation for what should be identified by screening. That target is Unhealthy Alcohol Use which is the clearest and most inclusive term for the spectrum of interest,

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Wenzel, Kristina Title: Executive Director
Organization: Central CO AHEC
Date: 08/16/2011
Comment:
I support the Centers for Medicaid and Medicare Services proposed decision memo for "Screening and Brief Counseling Intervention in Primary Care to Reduce Alcohol Misuse." It is well established alcohol misuse causes many social and health consequences, exacerbates health issues and makes an individual's health conditions more difficult to treat.
As a Center Director for a CO AHEC center and as a nurse of more than 30 years- this movement will significantly support the implementation into

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Morse, Jennifer Date: 08/16/2011
Comment:
I support the Centers for Medicaid and Medicare Services proposed decision memo for "Screening and Brief Counseling Intervention in Primary Care to Reduce Alcohol Misuse." It is well established alcohol misuse causes many social and health consequences, exacerbates health issues and makes an individual's health conditions more difficult to treat.
Sutphin, Monette Date: 08/16/2011
Comment:
I support the Centers for Medicaid and Medicare Services proposed decision memo for "Screening and Brief Counseling Intervention in Primary Care to Reduce Alcohol Misuse." It is well established alcohol misuse causes many social and health consequences, exacerbates health issues and makes an individual's health conditions more difficult to treat.
colby, ger Date: 08/16/2011
Comment:
I'm in favor of the screening and brief intervention process. There are many people who experience negative consequences related to alcohol/drug use that are not "alcoholic/addicts". People who are in the non-dependent user categorie can certainly benefit from early intervention, and perhaps not procede toward further involvement with chemical use, and a more difficult,dangerous, and expensive problem. I have contact on a regular basis with people who tell me what a difference in their lives

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Kirk, Phyllis Title: Licensed Professional Counselor
Date: 08/16/2011
Comment:
I support the Centers for Medicaid and Medicare Services proposed decision memo for "Screening and Brief Counseling Intervention in Primary Care to Reduce Alcohol Misuse." It is well established that alcohol misuse causes many social and health consequences, exacerbates health issues and makes an individual's health conditions more difficult to treat. As a SA counselor working with our aging population I have personally witnesses the effectiveness of early SA interventions. Addressing these

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morgan, nan Title: Registered Nurse
Date: 08/16/2011
Comment:
I support the Centers for Medicaid and Medicare Services proposed decision memo for "Screening and Brief Counseling Intervention in Primary Care to Reduce Alcohol Misuse." It is well established alcohol misuse causes many social and health consequences, exacerbates health issues and makes an individual's health conditions more difficult to treat.Thank You
parks, cindy Date: 08/16/2011
Comment:
As a Certified Addictions Counselor for over 10 years, I support the Centers for Medicaid and Medicare Services proposed decision memo for "Screening and Brief Counseling Intervention in Primary Care to Reduce Alcohol Misuse." It is well established that alcohol misuse causes a host of social and medical ills, exacerbates existing health problems and makes patients more difficult to treat. Thankyou.
Scroggs, James Title: Director, Health Economics
Organization: American Congress of Obstetricians and Gynecologists
Date: 08/16/2011
Comment:

The American Congress of Obstetricians and Gynecologists (ACOG), representing more than 52,000 physicians and partners dedicated to improving women’s health, appreciates the opportunity to comment on the “Proposed Decision Memo for Screening and Behavioral Counseling Interventions in Primary Care to Reduce Alcohol Misuse (CAG-00427N)”. Our primary concern in reviewing any proposal for new reimbursement policies is the potential impact these policies may have on access to and quality of

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Rivera, Laura Title: Senior Researcher
Organization: OMNI Institute
Date: 08/16/2011
Comment:
I support the Centers for Medicaid and Medicare Services proposed decision memo for "Screening and Brief Counseling Intervention in Primary Care to Reduce Alcohol Misuse." It is well established alcohol misuse causes many social and health consequences, exacerbates health issues and makes an individual's health conditions more difficult to treat.
Goodman, Nelson Title: MD, FACP
Organization: Med Chi Public Health Committee
Date: 08/16/2011
Comment:
As a former chairman of the Maryland state medical society (Med Chi) Committee on Drugs and a current member of the Public Health Committee, I strongly support this important addition to Medicare's coverage.
Lisonbee, David Title: CEO
Organization: Twin Town Treatment Centers
Date: 08/16/2011
Comment:

I support the Centers for Medicaid and Medicare Services proposed decision memo for "Screening and Brief Counseling Intervention in Primary Care to Reduce Alcohol Misuse." It is also vital that Medicare become subject to the parity rules established in the private sector for covering the treatment of all substance use discorders.

It is irresponsible to leave Medicare beneficiaries who possess no secondary insurance without access to critical substance abuse treatment disorders!
Falcao, MD, MPH, Patricia Rose Title: Director of Continuing Medical Education
Organization: Preventive Medicine Associates, Inc. - Brookline, MA
Date: 08/16/2011
Comment:

ASK*ASSESS*ADVISE & ASSIST*ENGAGE in CONTINUING CARE

Patients are generally pleased when they experience clinician leadership to draw open the curtains of denial about alcohol & substance use, that cover the windows of hope, opportunity and resources for sustained recovery.

Cheng, Diana Title: Medical Director, Women's Health
Organization: Maryland Department of Health and Mental Hygiene
Date: 08/16/2011
Comment:
I wholeheartedly support primary care screening and counseling to reduce alcohol misuse. Being an obstetrician/gynecologist, I see the urgency in getting women to stop alcohol intake during pregnancy and, perhaps even more importantly, just before pregnancy. According to Maryland data, preconception binge drinking has been increasing steadily in recent years [from 13% of all women who delivered in 2001 up to 20% in 2007], especially among

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Morris, A Date: 08/16/2011
Comment:
Lets please start not only testing for alcohol use but for all illegal drug use before providing any resources to people. The only exception should be that needy children should get medicaid/care even if their parents are illegal drug addicts.
Osborn, Donald P. Title: MS, MA, MAC, NCP, ICAC, NCC, LMFT, LMHC; President
Organization: NAADAC, the Association for Addiction Professionals
Date: 08/15/2011
Comment:

August 16, 2011

Louis Jacques, MD
Director, Coverage and Analysis Group
Centers for Medicare & Medicaid Services
7500 Security Boulevard
Baltimore, MD 21244

Re: Proposed Decision Memo for Screening and Behavioral Counseling Interventions in Primary Care to Reduce Alcohol Misuse (CAG-00427N)

Dear Dr. Jacques:

On behalf of the 8,000 members of NAADAC, the Association for Addiction Professionals, I am writing to comment on

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Reason, Deb Date: 08/15/2011
Comment:
Please consider and vote "yes" to medicare Coverage for alcohol screening and brief interventions as a core medical care service. Identification and intervention for alcohol problems should be part of routine primary care. Screening and brief intervention have been proven to have a sustained impact on reduced alcohol use and will therefore have major benefits both for patients and for overall medical care costs. Thank you
Plank, Gene Title: Finance Officer
Organization: Above All Influences
Date: 08/15/2011
Comment:
[PHI Redacted], I know how beneficial early detection and treatment options can be.
Ives, Victoria Title: Counselor IV
Organization: Meridian Behavioral Health Care
Date: 08/15/2011
Comment:
I a substance abuse counselor and I believe it is important to start supporting services for those who have substance abuse and mental health problems. As I read about how the services of people who have these issues are being cut I wonder how much longer are you going to be putting money into the prison system and not care about the reasons people involved with this system. Look at the statistic on people who are in prison and how many of child abuse cases involve substance dependence. Thank

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Klisch, Shannon Date: 08/15/2011
Comment:
I support the Centers for Medicaid and Medicare Services proposed decision memo for "Screening and Brief Counseling Intervention in Primary Care to Reduce Alcohol Misuse."

In San Luis Obispo County (CA), only 40% of pregnant women are screened for alcohol or drug use during pregnancy. Prenatal alcohol use causes Fetal Alcohol Syndrome and a spectrum of related cognitive and behavioral disorders that fall under the term Fetal Alcohol Spectrum Disorders. These are 100% preventable.

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Jagim, Julie Date: 08/15/2011
Comment:
As a program supervisor for Superior Babies, a home visiting program for pregnant women who have substance abuse issues, I strongly support insurance coverage for alcohol screening and brief interventions in primary care settings. Addressing this issue is critical to prevent (Fetal Alcohol Spectrum Disorders (FASD) and substance exposed babies. We know the health effects of alcohol and drugs on the individual and the fetus and we know that screening does help identify when these issues need

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Brown, Jean Date: 08/15/2011
Comment:
I think that screening should be expanded to include children in the primary education grades. There is a growing trend that alcohol abuse starts at this lower age but is not studied or made public. In fact most grants want one to work with middle or high school age students.
Fleming, Robert Organization: DC Recovery Community Alliance
Date: 08/15/2011
Comment:
Screen and early intervention is critical because it is easier to treat alcohol and other drug disorders before they get well established in both the physical structure of the brain and the behaviors they induce. Further, it is easier to bring people to recovery while they still have the social, financial, and psycological support systems essential for sober living. Not only is it easier, it is cheaper.
Sheretz, Lisa Date: 08/15/2011
Comment:
Please cover alcohol screening in primary care visits especially for pregnant women and for adults so that this epidemic may be addressed and patients may be counseled and receive treatment.
Thank you.
Muehlbach, Britta Date: 08/15/2011
Comment:
I fully support the Centers for Medicaid and Medicare Services proposed decision memo for "Screening and Brief Counseling Intervention in Primary Care to Reduce Alcohol Misuse." It is well established that alcohol misuse causes a host of social and medical ills, exacerbates existing health problems and makes patients more difficult to treat. A funding mechanism for early detection and intervention is crucial; it will save lives and reduce future funding needs for the negative effects of

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Smith, Sandra Organization: www.erfrn.org
Date: 08/15/2011
Comment:
If it doesn't cost more Medicare shold include alcohol screening.
However, for those of us that don't drink, I don't want to be charged more by Medicare for this service.
Rocha, Adelia Title: Coalition Cordinator/Community Organizer
Organization: Dorchester Substance Abuse Coalition
Date: 08/15/2011
Comment:
support the Centers for Medicaid and Medicare Services proposed decision memo for "Screening and Brief Counseling Intervention in Primary Care to Reduce Alcohol Misuse." It is well established that alcohol misuse causes a host of social and medical ills, exacerbates existing health problems and makes patients more difficult to treat.
Williams, Jessica Date: 08/15/2011
Comment:

I strongly support the use of addiction screening and interventions in primary care, especially for pregnant women. I also believe that primary care settings should receive careful, comprehensive SBIRT training so that they may maximize the effectiveness of these evidence-based practices.

Coverage for alcohol screening and brief interventions as a core medical care service will send a powerful message that identification and intervention for alcohol problems should be part of

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Bjorke, Judy Date: 08/15/2011
Comment:
Please provide coverage of routine screening and brief intervention in primary care for pregnant women using alcohol. Addressing this issue is critical in preventing Fetal Alcohol Spectrum Disorders (FASD). Thank you!
Parsons, Elizabeth Date: 08/15/2011
Comment:
I support the Centers for Medicaid and Medicare Services proposed decision memo for "Screening and Brief Counseling Intervention in Primary Care to Reduce Alcohol Misuse." It is well established that alcohol misuse causes a host of social and medical ills, exacerbates existing health problems and makes patients more difficult to treat.
Gaspard, Craig Title: Staff Director
Organization: BOLD Coalition
Date: 08/15/2011
Comment:
Paying for alcohol screens and brief treatment makes a lot of snse and I am sure will pay for itself in savings if 1/10 folks actually follow up and follow suggestions from doctors and other medical setting professionals.
Navratil, Jody Date: 08/15/2011
Comment:
I feel that providing coverage of routine screening and brief intervention in primary care for pregnant women using alcohol, will help to address the issue of drinking and the effects it has on the unborn child. It is critical in preventing Fetal Alcohol Spectrum Disorders (FASD). Thanks so much! Jody Navratil ([PHI Redacted])
Hofer, Mary Jo Title: Diagnostic Specialist
Organization: Minnesota Organization on Fetal Alcohol Syndrome (MOFAS)
Date: 08/15/2011
Comment:
It is crucial to provide coverage of routine screening and brief intervention in primary care for pregnant women using alcohol. Addressing this issue is critical in preventing Fetal Alcohol Spectrum Disorders (FASD). Women need to get this message regarding alcohol use from their primary care physicians. Thank you.
Mary Jo Hofer
Martin, Michelle Heinert Date: 08/15/2011
Comment:
Please aid in reducing alcohol misuse and abuse. By intervening early we will potentially save money and lives.
Higgins-Biddle, John Title: Retired
Organization: University of Connecticut School of Medicine
Date: 08/15/2011
Comment:

I am a principal author of the WHO manuals on the AUDIT screening instrument and brief interventions, as well as other works on alcohol screening and brief intervention (which I abbreviated SBI nearly 20 years ago). I have also consulted to SAMHSA on its SBIRT program since before its initiation. I am currently consulting to CDC on its work in this area. I have devoted nearly 25 years to advancing alcohol screening and brief intervention.

Based upon the last 30 years of research, I

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Willert, Michele Date: 08/15/2011
Comment:
Please provide coverage of routine screening and brief intervention in primary care for pregnant women using alcohol. [PHI Redacted], I am hopeful that she will be afforded this same brief intervention if that is ever necessary.
kacalek, vicki Date: 08/15/2011
Comment:
[PHI Redacted] with FASD and know the terrible consequences of early alcohol exposure. Please provide coverage of routine screening and brief intervention in primary care for pregnant women using alcohol. Addressing this issue is critical in preventing Fetal Alcohol Spectrum Disorders (FASD). Thank you!
Locke, Deborah Date: 08/15/2011
Comment:
It is so important to address the issue of FAS! Screening of pregnant women (many of whom still believe it's OK to drink while pregnant) is so important. A little information could go a long way toward eradicating FAS. Please agree to cover screening and intervention for pregnant women who are using alcohol. Brain damage is forever, and completely preventable in these instances. Thanks for your attention to this urgent matter -- even as I write this, I wonder how many women in Minnesota are

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VanCamp, Toni Title: Victim Services Division
Date: 08/15/2011
Comment:
I support the Centers for Medicaid and Medicare Services proposed decision memo for "Screening and Brief Counseling Intervention in Primary Care to Reduce Alcohol Misuse." It is well known that abusing alcohol causes a plethera of social and medical ills, exacerbates existing health problems and makes patients more difficult to treat.
Terwey, Sue Title: Program Director
Organization: MN Organization on Fetal Alcohol Syndrome
Date: 08/15/2011
Comment:
Please provide coverage of routine screening and brief intervention in primary care for pregnant women using alcohol. Addressing this issue is critical in preventing Fetal Alcohol Spectrum Disorders (FASD). As the leading cause of cognitive disabilities, addressing this preventable disorder via screeing and treatment, when warranted, will be a giant step forward with prevention. Thank you!
Sullivan, Mary Date: 08/15/2011
Comment:
Seems like a great idea; however, if implemented poorly, it could have bad results for the substance abuse field.
henry, parks Title: Substance abuse program administrator
Organization: North Carolina Behaviorial Health Services
Date: 08/14/2011
Comment:
Thanks for the information, it has been very helpful
Ocampo, Ana Date: 08/14/2011
Comment:
I support this proposal.
Ana Ocampo, MA
Gast, Elita Date: 08/14/2011
Comment:
I would like to see insurance companies cover the cost of prescreenings for drugs and alcohol in ERs, hospitals, doctors office and walk-in clinics.
Bashian, Alicia Title: Coordinator, Child Evaluation Center
Organization: The Children's Hospital of Philadelphia
Date: 08/14/2011
Comment:
The Centers for Medicaid and Medicare Services proposed decision memo for "Screening and Brief Counseling Intervention in Primary Care to Reduce Alcohol Misuse" is an essential component of healthcare. It is well established that alcohol misuse causes a host of social and medical ills, exacerbates existing health problems and makes patients more difficult to treat due, particularly in the case of lifelong physical and social disabilites that occur with prenatal exposure to alcohol, as in Fetal

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Allsup, Vickie Title: Treasurer
Organization: Friends of Recovery of Delaware & Otsego Counties, Inc.
Date: 08/13/2011
Comment:
I support the Centers for Medicaid and Medicare Services proposed decision memo for "Screening and Brief Counseling Intervention in Primary Care to Reduce Alcohol Misuse." It is well established that alcohol misuse causes a host of social and medical ills, exacerbates existing health problems and makes patients more difficult to treat.
Baker, Janet D Date: 08/13/2011
Comment:
I support the Centers for Medicaid and Medicare Services proposed decision memo for "Screening and Brief Counseling Intervention in Primary Care to Reduce Alcohol Misuse." It is well established that alcohol misuse causes a host of social and medical ills, exacerbates existing health problems and makes patients more difficult to treat. I have personally witnessed the unchecked effects of alcohol use disorder in both the young, especially mothers, on Medicaid and the Medicare population. The

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Bugenhagen, Kathleen Date: 08/13/2011
Comment:
It is imperative that alcohol screening and counseling be included in every patient's primary care coverage. As a health educator, I am well aware of the implications of the misuse and abuse of alcohol, not only for the user, but his/her family, and society at large. [PHI Redacted]. By not including this important part of each individual's medical care, the problem worsens, and the medical implications become much more severe. Please stop stigmatizing alcohol addiction and

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savage, doug Date: 08/13/2011
Comment:
I support Medicare providing alcohol screening.
Schwartz, David Title: Licensed Clinical Psychologist
Organization: DC LIcense # 1712
Date: 08/12/2011
Comment:

This proposal is basic common sense: "an ounce of prevention (and early diagnosis) is worth a pound of cure."
With proper screening and evidence-based early intervention, the enormous costs (financial and quality of life/emotional) untreated abuse and addiction can be dramatically reduced.

Nowhere is this more true than for a pregnant woman and her very vulnerable fetus. And, it is true across the board for any abuser or addict. Do IT...it is the right thing on every

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Peterson, Flo Title: Social Work Care Manager
Organization: Salina Regional Health Center
Date: 08/12/2011
Comment:
Screening and education/therapy for alcohol abuse in the Primary Care health setting is a better way to reach many people, who may otherwise deny or refuse any help. It would also be cost effective to include drug use/misuse with the screening. Generally, patients have a closer relationship with their primary care treaters and may be more receptive to them. Treatment costs are sky high, and the majority of persons needing help, aren't getting it.
As an LMSW in a medical center, I

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Searle, Sarah Date: 08/12/2011
Comment:
I support this initiative
Chester, Julia Date: 08/12/2011
Comment:
It is crucial to implement alcohol misuse screenings for proper diagnosis and treatment of medical conditions that are complicated or caused by alcohol misuse. I believe that adoption of this practice will facilitate education of both the docot and patient and help to reduce health care costs overall and save lives.
Solorzano, Ellen Title: Clinician
Organization: UCSD Bridge to Recovery
Date: 08/12/2011
Comment:
I support the Centers for Medicaid and Medicare Services proposed decision memo for "Screening and Brief Counseling Intervention in Primary Care to Reduce Alcohol Misuse." It is well established that alcohol misuse causes a host of social and medical ills, exacerbates existing health problems and makes patients more difficult to treat.
Mobley MD, Derrick Date: 08/12/2011
Comment:
I support the necessity to fund screening and behavioral counseling interventions in Primary Care medical settings.
Petra, Megan Date: 08/12/2011
Comment:
I support the Centers for Medicaid and Medicare Services proposed decision memo for "Screening and Brief Counseling Intervention in Primary Care to Reduce Alcohol Misuse." Such brief interventions are effective in reducing alcohol misuse, which has a high cost to our society and to those aflicted with alcohol use disorders.
Boulley, Jennifer Date: 08/12/2011
Comment:
I support the Centers for Medicaid and Medicare Services proposed decision memo for "Screening and Brief Counseling Intervention in Primary Care to Reduce Alcohol Misuse." It is well established that alcohol misuse causes a host of social and medical ills, exacerbates existing health problems and makes patients more difficult to treat.
I work as a Community Based Doula on an Ojibwe Indian Reservation in Northern Wisconsin. Being a tribal member myself, I have seen my share of hardships

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Taylor, Kristy Date: 08/12/2011
Comment:
I support the Centers for Medicaid and Medicare Services proposed decision memo for "Screening and Brief Counseling Intervention in Primary Care to Reduce Alcohol Misuse." Alcohol misuse is a huge problem in our society and misdiagnosis decreases the ability for a person to be treated correctly.
Pepin, Amy Title: Policy Director
Organization: New Futures
Date: 08/12/2011
Comment:
New Futures has worked closely with the state of NH, primary care doctors, federally qualified health centers and others to support screening and brief intervention for alcohol and other drug problems in the state. We strongly support the Centers for Medicaid and Medicare Services proposed decision memo for "Screening and Brief Counseling Intervention in Primary Care to Reduce Alcohol Misuse." It is well established that alcohol misuse causes a host of social and medical ills, exacerbate

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Stamler, Rebecca Date: 08/12/2011
Comment:
Please consider covering alcohol screening with Medicare. There is such a high risk for alcohol abuse or dependence for many of the elderly adults in this country. They have to give up so much due loss of certain abilities, as well as watch a partner or themself become lost to a form of dementia.
Screening and brief intervention have been proven to have a sustained impact on reduced alcohol use and will therefore have major benefits both for patients and for overall medical care costs, as

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Genereux, Patricia Date: 08/12/2011
Comment:
Alcohol abuse and misuse is a public health problem. Without proper detection and intervention, it can lead to problems with growth, brain development, injurious and fatal accidents, and eventual addiction of the brain. Physicians, nurse practitioners and other primary care providers are in a position to see the public everyday and can readily ask a few additional questions and add a small counseling component to the activities in the clinic. It would save many dollars in other public

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Hutchison, Courtney Date: 08/12/2011
Comment:
This is a needed part of mental health care for those who are for whatever reason unable to pay for themselves. Please fund this!
Windish, Marylynn Date: 08/12/2011
Comment:
As a licensed professional in the field of behavioral health, I am totally in support of the effort to include screening and behavioral counseling interventions in Primary Care to reduce alcohol misuse. There is indisputable evidence that these measures will have an impact on the destructive effects of alcohol misuse, abuse and dependence on our society. It is time to bring primary care into the 21st century by requiring physician practices to take seriously their responsibility to screen for

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Rose, Ahniwake Date: 08/12/2011
Comment:

Dear Dr. Schott,

The National Congress of American Indians (NCAI) is the nation’s oldest, largest, most representative national tribal organization made up of American Indian and Alaska Native tribal governments. NCAI writes in strong support of the proposed coverage decision to provide screening and behavioral counseling to reduce alcohol misuse under Medicare Parts A and B. The proposed coverage decision memo addresses a serious need in Indian Country, as alcohol abuse and

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Comstock, Kathryn Title: Executive Director
Organization: Women & Children's Horizons, Inc.
Date: 08/12/2011
Comment:

I support the Centers for Medicaid and Medicare Services proposed decision memo for "Screening and Brief Counseling Intervention in Primary Care to Reduce Alcohol Misuse." It is well established that alcohol misuse causes a host of social and medical ills, exacerbates existing health problems and makes patients more difficult to treat.

I work for an agency which provides advocacy, shelter and help for victims of domestic violence and sexual assault. A huge percentage of the

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Rosario, Iván Title: Prof.
Organization: University of Puerto Rico at Carolina
Date: 08/12/2011
Comment:
support the Centers for Medicaid and Medicare Services proposed decision memo for "Screening and Brief Counseling Intervention in Primary Care to Reduce Alcohol Misuse." It is well established that alcohol misuse causes a host of social and medical ills, exacerbates existing health problems and makes patients more difficult to treat.
Mills, Ginny Title: Owner
Organization: Full Life Counseling & Recovery
Date: 08/11/2011
Comment:
Annual screening for those who have been identified as "risky drinkers" might allow individuals to self-identify and recognize trends in their own drinking and associated consequences without families having to intervention and with less overall suffering. I'd strongly support this venture in the interests of reducing both overall healthcare costs for alcohol-related medical problems and overall suffering of families and individuals.
Rigel, Julie Date: 08/11/2011
Comment:
should be mandatory
moore, betty Date: 08/11/2011
Comment:
I support doing yearly screenings and counseling if indicated. This would be an excellent preventive program and the costs to society and would more than pay for itself with savings from judicial and correction costs as well as the many costs to society in dealing with an alcoholic or addict and their family.
Uss, Veronica Title: retired
Organization: private citizen
Date: 08/11/2011
Comment:
Coverage for Alcoholuse screening and brief intervention needs to be included as an integral part of medical services. This will encourage health service providers to in clude such services as part of routine medical care. Failure to identify excessive alcohol use and intervene appropriately undermines the effectiveness of other medical treatments, worsening outcomes and driving up health care costs for all. Too many seniors suffer needlesly for lack of just such screening and intervention

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Cartwright, Janice S. Title: Certified Alcohol/Drug Couns/Certified Clinical Sp
Organization: McRae Probation
Date: 08/11/2011
Comment:
Save lives! We need insurance to cover alcohol screenings, especially for pregnant women and others who are at high risk.
Bercuvitz, Debra Date: 08/11/2011
Comment:
More than half of all pregnancies in this country are unplanned and drinking in pregnancy is the leading preventable cause of mental retardation. Screening and behavioral counseling interventions has been evaluated and proven to work for risky drinking. This is a basic health issue that has extraordinarily far-reaching financial implications in all systems of the country. It is way less expensive to prevent alcohol exposed births and to identify people when their substance use is just risky

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Kusterer, Hannah Organization: Kaiser Permanente
Date: 08/11/2011
Comment:
This is incredibly important! Untreated and undiagnosed alcohol abuse is linked to a huge number of costly societal problems: medical, legal, domestic violence, psychological. Alcohol abuse destroys families for generations, and hurts many more people than the alcohol abuser.
Olsen, Yngvild Title: Medical Director/VP of Clinical Affairs
Organization: Baltimore Substance Abuse Systems, Inc.
Date: 08/11/2011
Comment:

It is well established that alcohol misuse causes a host of social and medical ills, exacerbates existing health problems and complicates patient care. On the other hand, numerous studies have demonstrated the efficacy and effectiveness of early identification and intervention for alcohol misuse to mitigate these negative effects.

While the evidence for alcohol misuse screening exists, the uptake of such screening and counseling interventions in primary care has been slow. Some

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O'Connor, Mary Title: Professor
Organization: UCLA
Date: 08/11/2011
Comment:

Coverage for alcohol screening and brief interventions as a core medical care service will send a powerful message that identification and intervention for alcohol problems should be part of routine primary care. I have conducted and published in peer reviewed journals my own research on the positive effects of screening and brief intervention for pregnant women participating in WIC. Results indicated that this approach resulted in bettter newborn outcomes and lower mortality rates for

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Shrout, Duncan Title: Vice President for Public Policy
Organization: IMPACT Alcohol and other Drug Abuse Services, Inc.
Date: 08/11/2011
Comment:
The inclusion of Screening and Behavioral Counseling Interventions in Primary Care to Reduce Alcohol Misuse as compensated medicare and medicaid services makes great sense. The earlier people are screened and assisted to reduce their alcohol consumption the better.
Zahnd, Elaine Title: Sr. Research Scientist
Organization: Public Health Institute
Date: 08/11/2011
Comment:
I am in favor of the new policy. Are those covered by Medicaid also already allowed screening and behavioral counseling interventions on alcohol? If not, they should be added.
krolack, jan Date: 08/11/2011
Comment:

Screening for alcohol misuse is a necessary part of any primary care evaluation. Very often, substance abuse issues are at the heart of health issues and go undiagnosed, to the detriment of the patient and the ongoing cost of health care.

As a professional in the behavioral health field for over 30 years, I have no doubt regarding this necessity. It costs less in the long run to diagnose accurately and treat appropriately.

Doctor, Susan Title: Dr. Susan Doctor, FASD Specialist
Organization: University of NV, Reno
Date: 08/11/2011
Comment:
I urge you to follow through with the NCA named above. I commented on the next page but will restate that I think this is a much-needed response to alcoholism. I personally would like to see follow-up testing for those who indicate through their responses that counseling interventions are appropriate.
Neuschel, Fred Date: 08/11/2011
Comment:
I think this is a very worthwhile initiative. However, I question whether Primary Care Physicians are really able to do the counseling interventions. With all due respect, many have a very hard time talking about alcohol or drug use with their patients.
Andrews, Candace Title: Owner /Executive Director/ therapist
Organization: Alliance Counseling
Date: 08/11/2011
Comment:
I am for Medicare paying for quality addictions treatment. Many folks increase their substance use after retirement, a new illness, etc. Looking at end of life situations are difficult at best. Ageing can be a very fearful time. The elderly are valuable human beings.
Candace Andrews LADC 562-L
Reno NV
Cole, Joanne Date: 08/11/2011
Comment:
Great idea but should be done by an addictions nurse.
Rivelli, Sarah Date: 08/11/2011
Comment:
SBIRT is a high yeild evidence based intervention that will reduce morbidity and costs from chemical dependency.
Yes, it it should be reimbursed.
Schneider, William Organization: Catch A Rising Star
Date: 08/11/2011
Comment:
Please forward this opinion to the decision makers on this proposal. Thank yOu, Bill [PHI Redacted] I HOPE that Medicare will become inclusive of alcohol screening and the proposed treatment initiative.
Eager, Diane Date: 08/11/2011
Comment:
Please give utmost consideratin to agreeing to the proposed decision memo for "Screening and Brief Counseling Intervention in Primary Care to Reduce Alcohol Misuse." It is well established that alcohol misuse causes a host of social and medical ills, exacerbates existing health problems and makes patients more difficult to treat.
Baer, Alice Title: Substance Abuse Services Coordinator
Organization: Colorado Division of Youth Corrections
Date: 08/11/2011
Comment:
As a substance abuse and mental health licensed professional I support the initiative to have Medicaid screen and provide interventions as a routine medical service for substance abuse. In a society that has all the data on the cost/benefit of intervention and treatment for substance abuse, it is self-evident that this service should be accepted. In addition, pregnant women need to be told of its risks and intervened upon in a non-punitive or judgmental manner.
Page, Dorean Organization: HFM Prevention Council
Date: 08/11/2011
Comment:

This is an excellent move and has the potential to be very cost effective in the long run. Many people especially in the 50 - 70 year range fail to realize the dangers of alcohol consumption while taking medications. Some doctors fail to properly inform/warn their patients about alcohol use or try to keep them happy by saying "sure it is alright if you have a drink now and then". To some in this category that means several drinks every day. I say this from anecdotal observations made in

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Garbutt, James Title: Professor of Psychiatry
Organization: Department of Psychiatry, UNC-Chapel Hill
Date: 08/11/2011
Comment:
I am a physician who works with patients who have substance use disorders. Substance use disorders, and particularly unhealthy alcohol use, are some of the most common health problems in the United States and cause significant morbidity and mortality. I urge Medicare/Medicaid to provide reimbursement to physicians for screening and brief counseling for patients with risky drinking. Expansion of screening and brief intervention should be very cost effective for society and advance health for

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Hurley, Nell Date: 08/11/2011
Comment:
I support the Centers for Medicaid and Medicare Services proposed decision memo for "Screening and Brief Counseling Intervention in Primary Care to Reduce Alcohol Misuse." It is well established that alcohol misuse causes a host of social and medical ills, exacerbates existing health problems and makes patients more difficult to treat.
Teel, Nicole Title: DUI Prevention Coordinator
Organization: Poudre Valley Health System
Date: 08/11/2011
Comment:

To whom it may concern,

I am in full support of Medicare and Medicaid covering screening and brief counseling interventions in Primary Care. This would be a large step in the right direction of reducing the alarming trends regarding binge drinking and alcohol misuse and abuse. This is very important to me, especially in Colorado where I live and here the alcohol misuse and abuse rates are higher than the national average. This change would help set a standard in Primary Care

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Warden, Andrea Date: 08/11/2011
Comment:
I support the Centers for Medicaid and Medicare Services proposed decision memo for "Screening and Brief Counseling Intervention in Primary Care to Reduce Alcohol Misuse." It is well established that alcohol misuse causes a host of social and medical ills, exacerbates existing health problems and makes patients more difficult to treat.
Critel-Rathje, Dina Title: LIMHP
Date: 08/11/2011
Comment:
While alcohol treatment is important I don't believe this is an appropriate time to ask the Federal government to pay for any additional services. I don't believe the government should pay for alcohol screenings.
Drew, Shannon Date: 08/11/2011
Comment:
Identification and intervention for alcohol problems should be part of routine primary care. Coverage for alcohol screening and brief interventions as a core medical care service will help to convey this message. Screening and brief intervention have been found to have a sustained effect on reducing alcohol use and thus should have major benefits both for patients and for overall medical care costs, as excessive drinking often results in other longterm medical consequences.
Tomlinson, Judith Title: Substance Abuse Liaison Nurse
Date: 08/11/2011
Comment:
I support the Centers for Medicaid and Medicare Services proposed decision memo for "Screening and Brief Counseling Intervention in Primary Care to Reduce Alcohol Misuse". It is well established that alcohol misuse causes a host of social and medical ills,exacerbates existing health problems and makes patients more difficult to treat. As a Substance Abuse Liaison Nurse in a large inner city Level 1 Trauma Medical Center I daily see the devastating medical and social consequences of alcoho

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Lang, Marissa Title: Public Policy Manager
Organization: MN Organization on Fetal Alcohol Syndrome
Date: 08/11/2011
Comment:
Screening pregnant women, as well as providing a counselining messege regarding no safe amount of alcohol use during pregnancy, is critical in preventing alcohol exposed babies (FASD).
Thank you!
Marissa Lang- Public Policy Manager, MN Org on Fetal ALcohol Syndrome (MOFAS)
Cleavland, Lee Title: Head Case Worker
Organization: The Salvation Army
Date: 08/11/2011
Comment:
I would like to add my support for this necessary coverage. The misuse and abuse of alcohol has added to many physcial and socail problems for people of all ages and any assistance that can help identify and counsel those affected by this is necessary and a good use of these funds.
mcgovern, nicole Title: BCM
Date: 08/11/2011
Comment:
I believe it is importnat to provide these services to help prevent misuse and to dx.
Johnson, Lynn Title: Director, Pain Management Center
Organization: UHS Medical Center
Date: 08/11/2011
Comment:
I support the initiative wherein Medicare will begin to cover screening and brief intervention services for patients at high risk for alcohol abuse. This is a program that will pay for itself in the long run, and will at least partially address a major public health problem.
Solomon, Ph.D., Alan M. Date: 08/11/2011
Comment:
Abuse and/or misuse of alcohol has been shown to cause many health risks and therefore to increase health care costs. Therefore, Medicare should provide coverage for screening and brief help for people who are drinking alcohol in a way that increases their health risks, and our shared costs or providing Medicare help. Such primary prevention will be money well-spent.
Golinger, M.D., Ron Organization: Ronald C. Golinger, M.D.
Date: 08/10/2011
Comment:
I support the Centers for Medicaid and Medicare Services proposed decision memo for "Screening and Brief Counseling Intervention in Primary Care to Reduce Alcohol Misuse." It is well established that alcohol misuse causes a host of social and medical ills, exacerbates existing health problems and makes patients more difficult to treat.
This is especially important now because of the accelerating growth of the already massive advertising and public relations expenditures by the makers and

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Ralls, Anisa Date: 08/10/2011
Comment:
I support the Centers for Medicaid and Medicare Services proposed decision memo for "Screening and Brief Counseling Intervention in Primary Care to Reduce Alcohol Misuse." It is well established that alcohol misuse causes a host of social and medical ills, exacerbates existing health problems and makes patients more difficult to treat.
McCullough, MD, Daniel Date: 08/10/2011
Comment:
As a Family Doctor I think that compensating Primary Care Providers to screen for alcohol problems would increase screening and thereby reduce alcohol problems which would in turn improve the health of our society and decrease costs to the healthcare system.
Bernheim, Emily Date: 08/10/2011
Comment:

Please adopt the current proposal to provide coverage for alcohol screening and brief interventions as a core medical care service.

This is a wise investment that will pay back in many ways — better care for patients, lower overall medical costs through improved screening and providing at-risk patients with vitally important preventive care against.alcohol and substance abuse.

Emotional and physical illness, family violence, drunk driving incidents, fetal alcohol

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Hopkins, Y. Date: 08/10/2011
Comment:
I support the Centers for Medicaid and Medicare Services proposed decision memo for "Screening and Brief Counseling Intervention in Primary Care to Reduce Alcohol Misuse." It is well established that alcohol misuse causes a host of social and medical ills, exacerbates existing health problems and makes patients more difficult to treat. It is about time to assist those who cannot afford out of pocket expenses for a simple screening; an assessment ought to be covered as well as a brie

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Tenorio, Amber Date: 08/10/2011
Comment:
I think it is a good idea to screen for alcoholism or problem drinking and for Medicaire to pay for it. I personally have many many family and community members who are affected by alcohol and feel there is no one to turn to for help. Is this were offerred as a service and as a part of routine healthcare, then I believe a lot of the stigma of receiving treatment for alcoholism would go away.
Iskander, M.D., Elizabeth Date: 08/10/2011
Comment:

Physicians are not asking alcohol use questions and need to be told to do so and paid to do so. This will make them feel they are not being intrusive and IT IS their job to ask these questions.

If therapy is also given, this will help alcohol abusers know their problem is sooo serious, that we tax payers want to help them.

This will save many lives!

Joyner, Nancy Title: Outreach Technician
Organization: Amador County Public Health
Date: 08/10/2011
Comment:
I support the Centers for Medicaid and Medicare Services proposed decision memo for "Screening and Brief Counseling Intervention in Primary Care to Reduce Alcohol Misuse." It is well established that alcohol misuse causes a host of social and medical ills, exacerbates existing health problems and makes patients more difficult to treat. Early detection of alcohol misuse is essential to recovery.
relyea, marcia Date: 08/10/2011
Comment:
I stongly support Medicare paying for qualified screening, assessment and brief interventions for people with alcohol abuse difficulties. Research going back into the 1980's supports the positive effects of screening and brief interventions to reduce alcohol consumption and improved health--including fewer visits to the Emergency Depts.
Gabbert, Meredith Date: 08/10/2011
Comment:
Please recognize the critical importance of including screening and care for those suffering from the devastating effects of alcohol addiction and misuse. It is a matter of public health... for those who use and for everyone who affected by their alcohol abuse. Don't make the mistake of thinking it's not a problem- be part of the solution!
Andrews, Lewis Title: Community Resource Development C/D Specialist
Organization: Health and Welfare
Date: 08/10/2011
Comment:
As States cut funding for Chemical/Alcohol dependance it's imperative that the C/D problem be addressed by all means possible
McCormick, Amy Date: 08/10/2011
Comment:
I support the Centers for Medicaid and Medicare Services proposed decision memo for "Screening and Brief Counseling Intervention in Primary Care to Reduce Alcohol Misuse." It is well established that alcohol misuse causes a host of social and medical ills, exacerbates existing health problems and makes patients more difficult to treat.
Roberts, Stephenie Title: President
Organization: Change Your Life Enterprises, Inc.
Date: 08/10/2011
Comment:
Screening for alcohol and drug abuse will assist in bringing treatment services to those in need earlier than when they may begin seeking help on their own. Few recognize the problem at its onset, and it is only after multiple serious consequences that patients begin seeking help. Addiction affects all of our lives, let's treat sooner and avoid devastating consequences.
macdougall, peter Date: 08/10/2011
Comment:
I can think of few, if any, short-term interventions that have the potential to have a greater return on investment. The health benefits to the individual and potential cost return to the medicare system make providing for this medical intervention a necessity.
Lawrence, Richard Date: 08/10/2011
Comment:
screening and behavioral counseling intervention should be allowed under medicare allowable billing.
Sharp, James Title: Ph.D. (Clinical Psychologist
Date: 08/10/2011
Comment:
I strongly urge the coverage of alcohol screening and brief interventions by Medicare. This procedure is cost-effective and research-based. For too long addiction has been the poor stepchild of medicine and this is a step in the right direction.
Brown, S. Scott Title: Director of Diagnostic Imaging
Organization: Hanley Center, Inc.
Date: 08/10/2011
Comment:

I have been working at the Hanley Center in West Palm Beach, FL for close to a year now. I perform brain SPECT for our inpatients here. We look at the regional cerebral blood flow (rCBF) in alcohol and drug addiction. The most striking decreases in rCBF seem to occur in alcoholics. Opiates, cocaine, marijuana, benzodiazapines, amphetamines...none of these seem to affect the rCBF as much as alcohol.

"An ounce of prevention is worth a pound of cure."

I support the

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Hill, Melissa Date: 08/10/2011
Comment:
I support the Centers for Medicaid and Medicare services proposed decision memo for "Screening and Brief Counseling Intervention in Primary Care to Reduce Alcohol Misuse." It is well established that alcohol misuse causes a host of social and medical ills, exacerbates existing health problems and makes patients more difficult to treat.
Cairnes, Jan Date: 08/10/2011
Comment:
I support the Centers for Medicaid and Medicare Services proposed decision memo for "Screening and Brief Counseling Intervention in Primary Care to Reduce Alcohol Misuse." I have seen this brief process work first hand and believe it will reduce health care costs! It is well established that alcohol misuse causes a host of social and medical ills, exacerbates existing health problems and makes patients more difficult to treat.
elder, e. Date: 08/10/2011
Comment:

Coverage for alcohol screening and brief interventions as a core medical care service will send a powerful message that identification and intervention for alcohol problems should be part of routine primary care. Screening and brief intervention have been proven to have a sustained impact on reduced alcohol use and will therefore have major benefits both for patients and for overall medical care costs, as excessive drinking often makes other medical problems worse and harder to

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Soper, MD, Richard Title: Medical Director/CEO
Organization: Center for Behavioral Wellness
Date: 08/10/2011
Comment:
I support the Centers for Medicaid and Medicare Services proposed decision memo for "Screening and Brief Counseling Intervention in Primary Care to Reduce Alcohol Misuse." It is well established that alcohol misuse causes a host of social and medical ills, exacerbates existing health problems and makes patients more difficult to treat.
Wood, Sara Title: psychiatric nurse practitioner
Organization: UT M.D. Anderson Cancer Center
Date: 08/10/2011
Comment:
I support Medicare/Medicaid reimbursement for alcohol screening. Many lives are lost due to drinking and drunken driving. Many ER visits are alcohol related. It is a major public health concern, with effective treatments available.
Powers, Tom Date: 08/10/2011
Comment:

I have worked in the Addictions field for 25 years. I believe that it is a primary illness that frequently goes undiagnosed. The consequences get diagnosed. This action would go a long way toward assisting patients and families improve their quality of life. It could save untold amounts of money in that proper diagnosis and treatment of this primary disease would help avoid the necessity to treat the consequences of this illness.

Therefore:

I support the Centers for

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Moser, Doug Title: therapist
Organization: Munson Behavioral Health
Date: 08/10/2011
Comment:
As a Behavioral Health Specialist, I support the Centers for Medicaid and Medicare Services proposed decision memo for "Screening and Brief Counseling Intervention in Primary Care to Reduce Alcohol Misuse." It is well established that alcohol misuse causes a host of social and medical ills, exacerbates existing health problems and makes patients more difficult to treat -- and "brief interventions" are dollar-wise and time well spent. -- Doug Moser
Martell, Gwendolyn Title: Social Worker
Organization: Visions Counseling, Inc.
Date: 08/10/2011
Comment:
Please use screenings for alcohol use and abuse. There is research to prove the effectiveness of asking such questions to reduce consumption. Every drink is poison to the body.
Ruffino, Christina Date: 08/10/2011
Comment:
I support the Centers for Medicaid and Medicare Services proposed decision memo for "Screening and Brief Counseling Intervention in Primary Care to Reduce Alcohol Misuse." It is well established that alcohol misuse causes a host of social and medical ills, exacerbates existing health problems and makes patients more difficult to treat.
Kuck, Donni Date: 08/10/2011
Comment:
I strongly support Coverage for alcohol screening and brief interventions as a core medical care service. You will find financial benefit in offering this coverage.
Sherve, Stephanie Title: Co-Occurring Professional
Organization: Pend Oreille County Counseling Services
Date: 08/10/2011
Comment:
If implemented correctly, I believe follow up counseling will be beneficial to patients with positive alcohol abuse screens. I know some local physicians are already doing some screening, but I think the tools are underutilized and unless the patient meets criteria for admission into OP CD services, rarely follow up counseling happens for these patients.
Sobell, Mark Title: Professor
Organization: Nova Southeastern University
Date: 08/10/2011
Comment:
This would be a very important advance because research shows that the vast majority of persons with alcohol problems are not severely dependent and that brief interventions can be very helpful for that group. Moreover, because traditional treatments are very intense, most of those who have alcohol problems that are not severe will not access the treatment system.
Creadeur, Steve Date: 08/10/2011
Comment:
There is much research available that supports eliciting and enhancing an individual's motivation for beneficial change. Enlisting our health care professionals in this process would broaden the net to engage our most vunerable population. It make sense.
Solounias, Bernadette Date: 08/10/2011
Comment:
There is consistent evidence that brief interventions, in the medical setting, addressing problem alcohol use is effective in reducing drinking. Although there is a cost to conducting brief interventions, this is offset by the greater costs of medical care incurred by problem drinking.
Hillix-Di Santo, Richard Title: Consultant
Organization: FUSION Consulting
Date: 08/10/2011
Comment:
I strongly support the Screening & Behavioral Counseling Interventions in Primary Care to Reduce Alcohol Misuse. As a former school counselor, I see tremendous value in including this preventative medical service. Thank you for giving it your serious consideration.
Mroczek, Natasha Date: 08/10/2011
Comment:

I support the Centers for Medicaid and Medicare Services proposed decision memo for "Screening and Brief Counseling Intervention in Primary Care to Reduce Alcohol Misuse."

It is well established that alcohol misuse causes a host of social and medical ills, exacerbates existing health problems and makes patients more difficult to treat.

Ross, Julie Date: 08/10/2011
Comment:
Please support funding for alcohol screening.
Marion, Emily Date: 08/10/2011
Comment:
I support the Centers for Medicaid and Medicare Services proposed decision memo for "Screening and Brief Counseling Intervention in Primary Care to Reduce Alcohol Misuse." It is well established that alcohol misuse causes a host of social and medical ills, exacerbates existing health problems and makes patients more difficult to treat.
Greene, Paulette Title: Consultant
Date: 08/10/2011
Comment:
I've worked as a nurse for over 30 years. I go on record to support Medicare reimbursement coverage for alcohol screening and interventions visits. Access to services are significantly need in our communities. Screening and brief intervention have been proven to have a sustained impact on reduced alcohol use and will therefore have major benefits both for clients and for overall medical care costs.
Martinez, Chuck Title: Therapist II
Organization: HHS
Date: 08/10/2011
Comment:
Early intervention is the cornerstone in the prevention of any substance abuse issue. This proposal is heading in the right direction. But, what about illicit drugs use. These days there are secondary or primary illicit drug use along with alcohol abuse.
Blakeslee, Mark Date: 08/10/2011
Comment:
I support the Centers for Medicaid and Medicare Services proposed decision memo for "Screening and Brief Counseling Intervention in Primary Care to Reduce Alcohol Misuse." It is well established that alcohol misuse causes a host of social and medical ills, exacerbates existing health problems and makes patients more difficult to treat. In my daily practice I see seniors, most of them homeless that are in need of screening and treatment.
Krum, Laura Date: 08/10/2011
Comment:
I urge you to approve payment for alcohol screening and brief intervention in Primary Care. Undiagnosed/untreated alcoholism can be very expensive. Early treatment could actually save the government money.
Brown, Guida Title: Executive Director
Organization: Hope Council on Alcohol & Other Drug Abuse, Inc.
Date: 08/10/2011
Comment:

Screening and brief intervention have a sustained impact on reduced alcohol use and will therefore have major benefits for patients as well as for overall medical care costs, as excessive drinking often makes other medical problems worse and harder to treat.

In addition, Medicare coverage often sets the standard for other insurance benefits. In providing this coverage, it sends a message to other insurers who may follow Medicare's lead and provide the same coverage for people

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Brinkley, Deborah Date: 08/10/2011
Comment:
It is important to screen individuals for possible alcohol abuse as soon as possible. In the case of pregnant women, teenagers and other individuals with impairments, whether mental, emotional, or physical, there use of alcohol can be a danger to themselves and public safety. Please remember the mother driving the wrong way on the Taconic Parkway in NY under the influence killed herself, children and 3 men in another vehicle.
A brief screening couple with counseling can be a great

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Martinez, Chuck & Ane Marie Date: 08/10/2011
Comment:
Having worked in the field of the disease of alcoholism for many, many years, it is absolutely necessary that Medicare cover alcohol screening. There are so many people who are 65 and over who are in dire need of alcoholism treatment. But, first must be screened. Its truly amazing that so many organizations, individuals, etc.., think that once we reach 65 all of our diseases go away, i.e. alcoholism for example, does not disappear when we reach 65 and in many cases, becomes worse, as it is a

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Terp, Dianne Title: clinical social worker
Date: 08/10/2011
Comment:
This is a firm step toward treatment on demand. The faster we can get help to a person who is considering recovery, the better chance we have of achieving recovery.
Karam, Maher Title: Associate Medical Director, Addiction specialist
Organization: UT MDAnderson Cancer center, dept of Behavioral Science
Date: 08/10/2011
Comment:
It is imperative that all hospitals, clinics and health centers, including emergency rooms provide screening and brief intervention to people with alcohol abuse, dependence or addiciton. That maybe the only time someone will get a chance to be screened and referred for treatment or provided with brief education/feedback. CMS reimbursement of these services is a crucial step for hospital to be able to provide these services especially in the current economic strained environment.
Quigley-Allen, Heather Date: 08/10/2011
Comment:
[PHI Redacted] i believe this intervention could be extremely helpful in identifying potential alcoholics and bringing them to help. Unfortunately, many primary care physicians are not adequately trained or prepared to deal with this issue.
Harris, Beatrice Title: Director Disease Prevention
Organization: Public Heatlh-Dayton & Montgomery County
Date: 08/10/2011
Comment:
I support the Centers for Medicaid and Medicare Services proposed decision memo for "Screening and Brief Counseling Intervention in Primary Care to Reduce Alcohol Misuse." It is well established that alcohol misuse causes a host of social and medical ills, exacerbates existing health problems and makes patients more difficult to treat. I am thrilled that this is being considered. He focus of my work is wit h children who are affected by theirs mothers' consumption of aocohol during pregnancy

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Davis, Leslie Date: 08/10/2011
Comment:
As a Great Grandmother I approve of the Screening and Behavioral counseling Interventions in Primary Care to Reduce Alcohol Misuse and Illigel Drug Use. I would also support more laws that would protect unborn children, because of a mother that can't or won't protect her child.
Vos, Betty Organization: Prairie Ridge Addiction Treatment Services
Date: 08/10/2011
Comment:
I am an outpatient counselor at an addictions treatment center, and I have [PHI Redacted] who are currently in recovery from addiction. I believe that early screening and intervention would have helped them avoid enormous expense and trauma, and would have saved taxpayers considerable cost as well. I support the Centers for Medicaid and Medicare Services proposed decision memo for "Screening and Brief Counseling Intervention in Primary Care to Reduce Alcohol Misuse." It is

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Meyer, Janet Organization: HSA
Date: 08/10/2011
Comment:
It is important that people get services when they abuse or misuse alcohol, especially pregnant women. In the long run this will save the gov't money.
harper, cathy Title: coordinator
Date: 08/10/2011
Comment:
Addiction should be included as well.
Sanders, Brian Date: 08/10/2011
Comment:
I support the Centers for Medicaid and Medicare Services proposed decision memo for "Screening and Brief Counseling Intervention in Primary Care to Reduce Alcohol Misuse." It is well established that alcohol misuse causes a host of social and medical ills, exacerbates existing health problems and makes patients more difficult to treat.
Saxon, Andrew Date: 08/10/2011
Comment:
Many individuals seek medical attention for symptoms and diseases directly caused by excessive alcohol use. Many times health care providers treat the symptoms and disease without ever addressing the underlying cause. Alcohol screening would uncover the cause more quickly and allow health care providers to address this problem leading to poor overall health status. In the end alcohol screening would save money for unnecessary tests and interventions and would improve patients' lives.
Mirassou MD, Marlene Title: Campus Psychiatrist
Organization: University of California, Santa Cruz, Student Health - CAPS
Date: 08/10/2011
Comment:
I strongly back the inclusion of coverage for "Screening and Brief Counseling Intervention in Primary Care to Reduce Alcohol Misuse." Alcohol complicates health care by exacerbating a host of medical problems, making patients more difficult to treat and leads to many social and physical problems
Bissell, William Title: Clinical Consultant Army Substance Abuse Program
Organization: U. S. Army
Date: 08/10/2011
Comment:
I support the Centers for Medicaid and Medicare Services proposed decision memo for "Screening and Brief Counseling Intervention in Primary Care to Reduce Alcohol Misuse." It is well established that alcohol misuse causes a host of social and medical ills, exacerbates existing health problems and makes patients more difficult to treat.
Mathre, Mary Lynn Title: President and Co-founder
Organization: Patients Out of Time
Date: 08/10/2011
Comment:
I have worked at a major university hospital for years as an addictions consult nurse. All too often,the alcohol abuse is never addressed and the same patients return several months later with another alcohol-related illness or injury. Screening and brief interventions should be included in routine assessments.
Helgeson, Kari Title: RN, CADC, ICS
Organization: Impact Counseling Services, LLC
Date: 08/10/2011
Comment:
Screening and brief intervention for substance abuse problems should be routine in the primary care setting. Screening and brief interventions have been proven to have a sustained impact on reduced substance use and will therefore have major benefits both for patients and for overall medical care costs, as excessive substance use often makes other medical problems worse and harder to treat. I have seen many indivduals and families destroyed by this chronic disease. Education and screening is

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Nichols, Obie Title: Director Centralized Vocational Services
Organization: Palladia, Inc.
Date: 08/10/2011
Comment:
Research and numerous studies support the position that Screening and Behavioral Counseling interventions in primary care impact misuse of alcohol and other substances that can lead to chronic substance use disorder. Prevention has proven to as effective as treatment in reducing the incidence of substance use disorders.
Clubine, Larry Title: Certified Substance Abuse Counselor
Organization: Alternative Care Treatment Systems
Date: 08/10/2011
Comment:
As a substance abuse counselor with nine years in treating those with the disease of addiction, I support the Centers for Medicaid and Medicare Services proposed decision memo for "Screening and Brief Counseling Intervention in Primary Care to Reduce Alcohol Misuse." Evidence supports early interventions and as we know that alcohol misuse causes a host of social and medical ills, exacerbates existing health problems and makes patients more difficult to treat, this proposal, if implemented will

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Santos, Jacqueline Title: Registered Nurse
Organization: Association House of Chicago
Date: 08/10/2011
Comment:
Screenings are especially important for pregnant mothers to receive education and primary care to reduce fetal harm. Babies born with FES are also expensive to take care of long term causing more money for the state. Alcohol screenings for all adults will also promote more awareness such as BP screenings. This will allow more opportunity for treatment/prevention of high risk population.
Anderson, Ann L Title: medical (safety) officer
Organization: Div Pharmacotherapies & Med Conseq of Drug Abuse
Date: 08/10/2011
Comment:
It's about time. The common-ness and seriousness of the range of problems associated with alcohol misuse makes this a no-brainer. If it were hopeless, as with AIDS before AZT, we might have an excuse to not do this. But it is obviously not hopeless. Although compulsory inpatient tx may be more effective than outpt self-help (Walsh DC, et al, 1991), SOME kind of evidence-based tx is definitely worth our time and $.
Ann L. Anderson, MD, MPH
Pilon, Mark Date: 08/10/2011
Comment:
To whom it may concern,
I support the Centers for Medicaid and Medicare Services proposed decision memo for "Screening and Brief Counseling Intervention in Primary Care to Reduce Alcohol Misuse." It is well established that alcohol misuse causes a host of social and medical ills, exacerbates existing health problems and makes patients more difficult to treat. Coverage for alcohol screening and brief interventions as a core medical care service will send a powerful message that

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George, Brandon Date: 08/10/2011
Comment:
Should have been happening for some time. All diseases should be screened for. Early detection will help reduce misuse, abuse, and dependency. Name any other diseases that Medicare does not cover screening? Please help start treating this illness like others and give it the proper attention.
bradley, wendy Title: Improvment Advisor
Organization: Southcentral Foundation
Date: 08/10/2011
Comment:
We are in support of this policy. However with the move toward behavioral health integration into primary care it is imparative any behavioral health professional licensed by the state or authorized by the tribal health authority working under the auspices of a primary care physician be eligible for this reimbursement.
Ziolkowski, Bud Title: Sr. Project Specialist
Organization: North Country Behavioral Healthcare Network
Date: 08/10/2011
Comment:
I support the Centers for Medicaid and Medicare Services proposed decision memo for "Screening and Brief Counseling Intervention in Primary Care to Reduce Alcohol Misuse." It is well established that alcohol misuse, and alcohol-related disorders cause a host of costly social and medical ills, exacerbate existing health problems and make patients more difficlt to treat. A 2009 SAMHSA Fact Sheet entitled "Cost Offset of Treatment Services" cites numerous studies to illustrate societal cost

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shtasel, derri Date: 08/10/2011
Comment:

Coverage for alcohol screening and brief interventions as a core medical care service will send a powerful message that identification and intervention for alcohol problems should be part of routine primary care. Screening and brief intervention have been proven to have a sustained impact on reduced alcohol use and will therefore have major benefits both for patients and for overall medical care costs, as excessive drinking often makes other medical problems worse and harder to

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Matheny, jill Date: 08/10/2011
Comment:
I believe screening and brief intervention works - Just like prevention works, treatment is effective and recovery happens. SBIRT has got to be integrated into primary care. IT is long overdue. THerefore, I support the Centers for Medicaid and Medicare Services proposed decision memo for "Screening and Brief Counseling Intervention in Primary Care to Reduce Alcohol Misuse." It is well established that alcohol misuse causes a host of social and medical ills, exacerbates existing health

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Thompson, Patti Date: 08/10/2011
Comment:
Medicare covered patients often have a good relationship with their doctors office. Allowing this to be the setting for any alcohol intervention increases the chances of patients following through with help.
Brennan, Sarah Date: 08/10/2011
Comment:

PLEASE SUPPORT THE ALCOHOL SCREENING - I AM A PSYCHOLOGIST AND THE NUMBER OF PATIENTS THIS IMPACTS IS, UNFORTUNATELY, SIGNIFICANT.

THANK YOU.
SARAH BRENNAN, PHD
Price, Jeffrey Date: 08/10/2011
Comment:
I support the proposed screening for Alcohol misuse.I do believe that Prescription misuse/abuse should be screened for also. As a Chemical Dependency Professional Trainee I personally know of the importance of early detection and prevention. As with all diseases early detection and treatment have been proven to enhance the quality of life for those afflicted.
Clarke, Dianne Date: 08/10/2011
Comment:
I support this proposed decision. Alcohol screening and early intervention in alcohol misuse would reduce cost of future healthcare and help families live happier healthier lives.
Fields, Mary Alice Title: Substance Abuse Therapist
Organization: Scott County Behavioral Health
Date: 08/10/2011
Comment:
I am a Certified Substance Abuse Counselor in Rural Southwest Virginia. I provide screening and counseling services to substance abuse populations, and I support this proposal.
Kemp, Jack Organization: JBK Consult, Inc.
Date: 08/10/2011
Comment:
I fully support the Centers for Medicaid and Medicare Services proposed decision memo for "Screening and Brief Counseling Intervention in Primary Care to Reduce Alcohol Misuse." There is a rapidly growing body of scientific evidence that not only does screening and brief intervention often catch alcohol abuse problems well before they progress into full fledged alcoholism and the need for expensive treatment, but it also reduces the cost of health care for conditions related to alcoholism and

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McEwen, Sara Date: 08/10/2011
Comment:
I am writing in support of CMS providing alcohol screening and brief intervention in the primary care setting as a covered benefit. SBI has been shown repeatedly to be effective in preventing alcohol dependence and decreased hazardous use of alcohol. The direct and indirect costs of alcohol abuse are staggering and SBI coverage is a cost effective method to mitigate these costs to individuals, society, and government payers. treat.
Walker, Carol Title: Mrs.
Organization: Community Against Substance Abuse
Date: 08/10/2011
Comment:
I urge Medicare to cover annual alcohol screening services because identification and intervention done along with a person's primary doctor check-up has been proven to reduce alcohol use, often resulting in huge patient benefits. Then when the patient complies and avoids serious addiction, medical costs are kept much lower as there is a lot less problems to society.
Feely, Linda Date: 08/10/2011
Comment:
I am FOR testing medicaid recipients for alcohol misuse.
Newton, Terrance Title: Executive Director
Organization: Harbor Hall, Inc.
Date: 08/10/2011
Comment:
I support the Centers for Medicaid and Medicare Services proposed decision memo for "Screening and Brief Counseling Intervention in Primary Care to Reduce Alcohol Misuse." It is well established that alcohol misuse causes a host of social and medical ills, exacerbates existing health problems and makes patients more difficult to treat. Many physicians see active alcoholism and chemical dependency in the hospital settings yet are woefully not prepared for the diagnosis and treatment of these

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Lewis, Karen Title: Mother
Date: 08/10/2011
Comment:
I fully support the screening for alcholholism by Medicare. Prevention and early detection is our best defense against this horrible disease.
Moynihan, Rebecca Date: 08/10/2011
Comment:
I support the Centers for Medicaid and Medicare Services proposed decision memo for "Screening and Brief Counseling Intervention in Primary Care to Reduce Alcohol Misuse." It is obvious that alcohol misuse causes a variety of social and medical issues, escalates existing health problems and makes patients more difficult to treat.
Snyder, Kurt Title: Executive Director
Organization: Heartview Foundation
Date: 08/10/2011
Comment:
I urge CMS to fund screenings for alcohol and/or other drugs. The cost of alcohol misuse on society and healthcare in general is stagerring. This can make a difference! This will also further the cause to integrate behavioral health and primary care.
Bartz, Alicia Title: Assistant Director
Organization: Office of Behavioral Health, NYC Health & Hospitals Corp.
Date: 08/10/2011
Comment:
It is my strong belief that screening and brief intervention is a vital service that should be covered by Medicaire. Research shows that the substance abuse and dependence has risen in our senior population and with screening and brief intervention in the primary care setting, many of these people can receive the care they deserve and need. I urge you to include this coverage in Medicaire.
Hilliard, Lois Title: chairperson
Organization: Naranon
Date: 08/10/2011
Comment:
I support the Centers for Medicaid and Medicare I support the Centers for Medicaid and Medicare Services proposed decision memo for "Screening and Brief Counseling Intervention in Primary Care to Reduce Alcohol Misuse." It is well established that alcohol misuse causes a host of social and medical ills, exacerbates existing health problems and makes patients more difficult to treat.
Olmstead-Dean, Stephanie Date: 08/10/2011
Comment:
I support the screening if and only if it will not be used as a means of incarcerating or otherwise restricting the rights of expectant mothers. It should be a help, not a potential punishment.
Desrosiers, Cynthia Title: Grant Support Specialist
Organization: County of Cheshire
Date: 08/10/2011
Comment:
As a County, we see first hand the economic impact of substance use disorders and mental health challenges on our community. It impacts our judicial budget, our law enforcement budgets, our alternative sentencing budgets, and our community outside agency budgets. We have been continuing to see an increase in problems associated with the disease of alcoholism and behavioral health related issues while funding is continually being cut for interventions to treat these health challenges. Early

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Latessa, Heidi Date: 08/10/2011
Comment:
Im all for it and with working in the field its amazing to see the help people need and how easy it is to be looked passed. Please pass it...
Robinson, Susan Title: Probation Officer
Organization: Tompkins County Probation Department
Date: 08/10/2011
Comment:
I support the Centers for Medicaid and Medicare Services proposed decision memo for "Screening and Brief Counseling Intervention in Primary Care to Reduce Alcohol Misuse." It is well established that alcohol misuse causes a host of social and medical ills, exacerbates existing health problems and makes patients more difficult to treat.
Clippinger, Carrie Organization: Personal Solutions, Inc.
Date: 08/10/2011
Comment:
I support the Centers for Medicaid and Medicare Services proposed decision memo for "Screening and Brief Counseling Intervention in Primary Care to Reduce Alcohol Misuse." It is well established that alcohol misuse causes a host of social and medical ills, exacerbates existing health problems and makes patients more difficult to treat. As an individual employed in the substance abuse field, I urge you to make alcohol screenings available and affordable for as many people as possible. The

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Mahan, Richard Title: Substance Abuse Therapist
Organization: Tulsa Boys Home
Date: 08/10/2011
Comment:

Coverage for alcohol screening and brief interventions as a core medical care service will send a powerful message that identification and intervention for alcohol problems should be part of routine primary care. Screening and brief intervention have been proven to have a sustained impact on reduced alcohol use and will therefore have major benefits both for patients and for overall medical care costs, as excessive drinking often makes other medical problems worse and harder to

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Ottinger, Jeanmaire Title: LADAC
Organization: Drug and Alcohol Treatment Facility
Date: 08/10/2011
Comment:
Prevention and intervention will save lives and will save taxpayers, the government and individual money in the long run due to better outcomes for the individuals involved. Would like to be able to bill Medicaid part B as a LADAC, which would be cost saving to all involved.
Wert, RitaKaye Title: National President
Organization: Woman's Christian Temperance Union
Date: 08/10/2011
Comment:
It's about time our government recognizes the devastation alcohol has wrought in our country and does something serious about stopping this terrible drug addiction. Alcohol is the #1 drug in America. It kills brain cells and destroys lives not just of the user but all those around the user. I am in favor of this proposal.
KINN, HENRY Date: 08/10/2011
Comment:
I support the Centers for Medicaid and Medicare Services proposed decision memo for "Screening and Brief Counseling Intervention in Primary Care to Reduce Alcohol Misuse." It is well established that alcohol misuse causes a host of social and medical ills, exacerbates existing health problems and makes patients more difficult to treat.
Capps, Frederick Title: PhD, LPC-S, NCC, ICAADC
Organization: A NEW DIRECTION
Date: 08/10/2011
Comment:
As a Past President of the Texas Association of Addiction Professionals, I support the above proposal. It will save lives and money as is well documented in numerous studies and demonstrated daily by corporate Employee Assistance Programs and the USDOT Return-to-Duty Process (49CFR, Part 40). However, brief counseling should be provided by qualified substance abuse professionals as is required in 49CFR.
Pickener, Mary Date: 08/10/2011
Comment:
I support the Centers for Medicaid and Medicare Services proposed decision memo for "Screening and Brief Counseling Intervention in Primary Care to Reduce Alcohol Misuse." It is well established that alcohol misuse causes a host of social and medical ills, exacerbates existing health problems and makes patients more difficult to treat.
Beach, Marion Date: 08/09/2011
Comment:
I support the centers for Medicaid/Medicare Services decision memo for screening and brief counseling intervention in primary care to reduce alcohol misuse
It is well established that alcohol misuse causes a host of social and medical ills, exacerbates existing health problems and makes patients more difficult to treat.
Porter, Lane Title: Clinical Services Manager/Counselor
Organization: The First Step House
Date: 08/09/2011
Comment:
This service is absolutely necessary and needs to be provided by Mental Health, Social work, and Substance abuse professionals, or medical professionals but he latter only when properly trained!!!
Epling, John Organization: Lifechange
Date: 08/09/2011
Comment:
The orphan illness not diagnosed and not treated. Failure in education and failure to reimburse results in no screening and no intervention.
clendening, katherine Date: 08/09/2011
Comment:
I recommend screening for all clients with medicare to identify and reduce alcohol cunsumption. This is a gateway to treatment that can be done quickly and easily without any focus about having an alcohol problem. Client will come to primary care but not for alcohol treatment.
Carter, CAC, CPS, CCJS, MAC, Allen Date: 08/09/2011
Comment:
This email is a comment on the pending decision to screen Medicare and Medicaid patients for alcohol and drug abuse and provide intervention services including four Brief Counseling sessions when abuse is identified. I absolutly agree with this recommendation. Allen Carter, CAC, CPS, CCJS, MAC
Rogers, Mrs. Date: 08/09/2011
Comment:
I support the Centers for Medicaid and Medicare Services proposed decision memo for "Screening and Brief Counseling Intervention in Primary Care to Reduce Alcohol Misuse." It is well established that alcohol misuse causes a host of social and medical ills, exacerbates existing health problems and makes patients more difficult to treat.
Grossberg, Paul Title: Emeritus Clinical Professor of Pediatrics
Organization: University of Wisconsin School of Medicine and Public Health
Date: 08/09/2011
Comment:
As a co-investigator on NIAAA-funded grants showing positive outcomes for screening and brief intervention, I strongly support the Centers for Medicare and Medicaid Services proposed memo for "Screening and Brief Counseling Intervention in Primary Care to Reduce Alcohol Misuse". Physicians and other clinicians need reimbursement support in order to be motivated to do a better job with brief alcohol counseling. It is a critical intervention that will greatly reduce morbidity and mortality.
Brunker, Mary June Date: 08/09/2011
Comment:
This is an issue where no more heads can be in the sand. If there is screening for cancer, diabetes, and other diseases, there should be screening for the disease of alcoholism.
Sturgeon, Kourtnaye Date: 08/09/2011
Comment:
I think this propose for screening and counseling in primary care is an important and required step in helping to diminish the impact and growing rate of damage alcohol misuse has upon society and the effected individual. I support this and trust that the steps to see this a reality will be taken. Thank you, Kourtnaye
Molthen, Robert Date: 08/09/2011
Comment:
Support screening.
Stone, Jo-Anne Title: CAP,ICADC
Organization: A Stepping Stone to Success
Date: 08/09/2011
Comment:
Being a Substance abuse counselor myself I think that this is a great idea. We need help getting people to recognize they have a problem and sometimes the first person who can identify it is a primary care doctor. But only if he/she is educated about the symptoms, as people with the disease of addiction tend to minimize their problem with alcohol. Getting a referral from their doctor might make some people pay attention sooner.
Rossi, Beth Organization: Northwest Behavioral Healthcare
Date: 08/09/2011
Comment:
I have seen the effects of alcohol on the brain of children and teens. Prevention and treatment is the answer. Informing women on a personal level.
Jeffers, Jan Date: 08/09/2011
Comment:

The disease of addiction is one of the most rampant and out of control medical and psychological disease in our country today.

Without a doubt, a health screening needs to include blood tests, etc., to look at a person's conditions using "real numbers" to indicate to them that they are "playing with fire."

Our country is desperately in need for this screening.

Kelly, John Date: 08/09/2011
Comment:
Please support screening and behavioral counseling interventions in primary care to reduce alcohol misuse. Thank you.
Ely, Linda Date: 08/09/2011
Comment:
The medical community has long recognized substance abuse and addiction as a disease. We screen for other diseases in primary care settings, and yet this one is not coded or reimbursable. Is this omission related to "prevention" and "health maintenance" not fully recognized as a medical intervention? Or more plausible, is it considered too expensive for the insurance community and thereby the corporate community to absorb? Rather than approach those discussions, we are like the ostrich with

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devine, deborah Date: 08/09/2011
Comment:
I do agree completely with the proposal
Brown, Pamela Date: 08/09/2011
Comment:
I am in favor of the proposal that Medicare begin paying for annual alcohol screening for adults and pregnant women and up to four brief counseling sessions provided in a primary care setting for those who test positive for risky drinking.
Davis, Nan Date: 08/09/2011
Comment:
Please allow alcohol screens. [PHI Redacted] sober 35 years but could have had more productive years if the disease had been diagnosed sooner (and perhaps avoided re-activation of TB). Thanks
Mason, Joan Title: Owner
Organization: Joan S. Mason LCSW CAP PA
Date: 08/09/2011
Comment:
I understand how critical substance screening is for young pregnant girls and women as well as adults. This is a treatable disorder but without assessment we almost never find these individuals. A brief screening is easily done which will help prevent further much more serious medical issues in the future.
Please support this measure.
Ames, David Title: Medical Director
Organization: PORT Human Services
Date: 08/09/2011
Comment:
I have treated persons affected by alcohol addiction and abuse for 40 years of practice and am fully aware of the extent of suffering and injury caused by the abuse of alcohol. Therefore I strongly support your plan to include screening and brief intervention services as a service to be reimbursed by Medicare.
Blamasah, Julie Date: 08/09/2011
Comment:
I support the Centers for Medicaid and Medicare Services proposed decision memo for "Screening and Brief Counseling Intervention in Primary Care to Reduce Alcohol Misuse." It is well established that alcohol misuse causes a host of social and medical ills, exacerbates existing health problems and makes patients more difficult to treat.
robles-ortiz, rafael Date: 08/09/2011
Comment:
Necessary. Working in a large hospital I frequently see many adults with alcohol problems who have never been counseled. Many are not aware that alcoholism is a medical disesase and that treatment is helpful.
Hebbard, Jonathan Date: 08/09/2011
Comment:
As a drug educator of 16 years, I support the Centers for Medicaid and Medicare Services proposed decision memo for "Screening and Brief Counseling Intervention in Primary Care to Reduce Alcohol Misuse." Alcohol is widely misused, and that misuse costs untold billions in lost productivity and healthcare costs. Screening will save so much more money than it costs. Please note my support.
Solomon, Barbara Date: 08/09/2011
Comment:
alcohol screening should be part of all primary care treatment. Federal Government sets the standards.
mccarty-scheurer, sylvia Date: 08/09/2011
Comment:
As a mental health professional for the past 25 years, I strongly support this measure to do routine alcohol screening. About 80 % of my cases involve alcohol abuse, even though they present for marriage counseling. Our prisons are filled with people who have chemical addictions and we pay $50,000 / year incarceration when alcohol treatment would be so much cheaper (about $20,000) Alcohol screening must be done in front of a significant person in that patient's life such as spouse, parent,

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Howa, Dede Title: ADEP Counselor
Date: 08/09/2011
Comment:
Screening for Alcohol misuse in primary care settings is a critical tool for reducing alcohol related illnesses, injury, and addiction. I have provided screening and brief intervention on a college campus for the past 6 years and have seen first-hand the impact screening has on patients alcohol-related choices. When alcohol & drug use are screened routinely as blood pressure and weight, it removes the stigma and opens patient's ears and minds to changing their health behaviors. Billing for

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Driscoll, Shelby Title: Prevention Specialist
Organization: Our Family Services
Date: 08/09/2011
Comment:
As a Prevention Specialist who works with youth to prevent alcohol and substance abuse in their community, I strongly support the proposed screening and behavioral counseling to reduce alcohol misuse. These youth are at risk for using alcohol because of the social norm of family members who use and abuse alcohol. These screenings could help these family members become part of the recovery community, positively changing the norm and example for our youth. I enthusiastically urge you to

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Odo, Debbie Date: 08/09/2011
Comment:

I support the Centers for Medicaid and Medicare Services (CMMS) proposed decision memo for "Screening and Brief Counseling Intervention in Primary Care to Reduce Alcohol Misuse."

There are research-based screening instruments such as the CAGE (Ewing, 1984) and AUDIT (Babor et al., 1992) that have been tested and found effective in primary care settings. Moreover treatment services overwhelmingly support these brief assessment, screening type tools that establish targeted

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Bronson, Mo Title: Ph.D., pharmacology
Organization: retired university professor
Date: 08/09/2011
Comment:
This is a very important issue. Alcohol affects every organ in the body and causes a myriad of problems. Screening and counseling interventions should definitely be part of Medicare. It would save money and lives.
Watson, Argette Date: 08/09/2011
Comment:
I support the Centers for Medicaid and Medicare Services proposed decision memo for "Screening and Brief Counseling Intervention in Primary Care to Reduce Alcohol Misuse." It is well established that alcohol misuse causes a host of social and medical ills, exacerbates existing health problems and makes patients more difficult to treat.
Herndon, Charles Title: Medical Director
Organization: Providence Breakthrough
Date: 08/09/2011
Comment:
I support the Centers for Medicaid and Medicare Services proposed decision memo for "Screening and Brief Counseling Intervention in Primary Care to Reduce Alcohol Misuse." It is well established that alcohol misuse causes a host of social and medical ills, exacerbates existing health problems and makes patients more difficult to treat. It is also well documented that health care costs are much higher for those who drink alcohol in a hazardous manner.
Schimelfenig, Richard Date: 08/09/2011
Comment:

I can not possibly support the Centers for Medicaid and Medicare Services proposed decision memo for "Screening and Brief Counseling Intervention in Primary Care to Reduce Alcohol Misuse." Although it is well established that alcohol misuse causes a host of social and medical ills, exacerbates existing health problems and makes patients more difficult to treat, there is no evidence that such screening programs are anything more than intrusive.

Attempting to demand that Medicare be

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Fong, Jean Title: Payroll Specialist
Organization: Alcoholic Rehabilitation Services of Hawaii
Date: 08/09/2011
Comment:

I support the Centers for Medicaid and Medicare Services (CMMS) proposed decision memo for "Screening and Brief Counseling Intervention in Primary Care to Reduce Alcohol Misuse."

There are research-based screening instruments such as the CAGE (Ewing, 1984) and AUDIT (Babor et al., 1992) that have been tested and found effective in primary care settings. Moreover treatment services overwhelmingly support these brief assessment, screening type tools that establish targeted

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Carroll, John Title: President/Therapist
Organization: Evergreen Counseling Associates
Date: 08/09/2011
Comment:
I have worked with substance abusing clients for over 25 years. I firmly believe that any intervention by primary health care providers to help substance abusers is worth the investment. If even a fraction of those who need treatment were identified, I am convinced overall health care costs would decline.
Sparkman, Daunette Date: 08/09/2011
Comment:

I support the Centers for Medicare and Medicaid Services' proposed decision memo for "Screening and Behavioral Counseling Interventions in Primary Care to Reduce Alcohol Misuse." Providing coverage for alcohol screening and brief interventions as a core medical care service should be part of routine primary care. In addition, screening and brief intervention have been proven to have a sustained impact on reduced alcohol use and will therefore have major benefits both for patients and for

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Miskulin, Allison Date: 08/09/2011
Comment:
the amount of people that can use this kind of help is staggering. please allow for additional funding for addicts.
Kelley, Sharron Title: council member
Organization: FQHC Council, Lincoln County, Oregon
Date: 08/09/2011
Comment:
A brief A &D intervention in a primary care visit is a goal of our FQHC clinics. We know we can save lives and reduce health care costs through integrated health care.
Tisch, Rosemary Date: 08/09/2011
Comment:
I strongly support the federal government's proposal that Medicare begin paying for annual alcohol screening for adults and pregnant women and up to four brief counseling sessions provided in a primary care setting for those who test positive for risky drinking. This could led to great savings of lives and money!
burson, ernest Title: Partner
Organization: LDT, Corp.
Date: 08/09/2011
Comment:
There is an abundance of clinical evidence that such is called for, appropriate, medically responsible, and in the best interest of the individual person, the society at large, and is ethically and scientifically responsible so to do.
Boulton, Darcy Date: 08/09/2011
Comment:
I have worked for a drug and alcohol treatment center for twenty years. I support the Centers for Medicaid and Medicare Services proposed decision memo for "Screening and Brief Counseling Intervention in Primary Care to Reduce Alcohol Misuse." It is well established that alcohol misuse causes a host of social and medical ills, exacerbates existing health problems and makes patients more difficult to treat.
Martin, Gregory Title: Outpatient Counselor, CSAC
Organization: Hina Mauka
Date: 08/09/2011
Comment:
I support the Centers for Medicaid and Medicare Services proposed decision memo for "Screening and Brief Counseling Intervention in Primary Care to Reduce Alcohol Misuse." It is well established that alcohol misuse causes a host of social and medical ills, exacerbates existing health problems and makes patients more difficult to treat.
Moxley, Kathleen Title: PhD. Candidate, Special Education, Early Intervent
Organization: University of Oregon
Date: 08/09/2011
Comment:

I support the Centers for Medicaid and Medicare Services proposed decision memo for "Screening and Brief Counseling Intervention in Primary Care to Reduce Alcohol Misuse." It is well established that alcohol misuse causes a host of social and medical ills, exacerbates existing health problems and makes patients more difficult to treat.

Pregnancy is an especially vulnerable time and drinking during pregnancy can lead to a host of problems in the developing fetus as well as future

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Johnson, Alan Date: 08/09/2011
Comment:

There is no question that hundreds of millions of dollars if not billions will be saved by performing alcohol screenings. Early detection and intervention is key in preventing one persons issue into many peoples problems.

It is difficult to quantify the costs emotionally and fiscally by avoiding screening and behavioral counseling intervention. We all have had family and friends that have exponentially gone "down hill" since no one confronted them on their problem.

NZENWA, RICHARD Title: PROGRAM DIRECTOR
Organization: GORETTI HEALTH SERVICES INC
Date: 08/09/2011
Comment:

Coverage for alcohol screening and brief interventions as a core medical care service will send a powerful message that identification and intervention for alcohol problems should be part of routine primary care. Screening and brief intervention have been proven to have a sustained impact on reduced alcohol use and will therefore have major benefits both for patients and for overall medical care costs, as excessive drinking often makes other medical problems worse and harder to

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Freeman, Dr Rebekka Organization: Partners for Change Substance Abuse Agency
Date: 08/09/2011
Comment:
It's a Great Idea !!
Bakken, Marlene Title: Owner
Date: 08/09/2011
Comment:
Remember, the slippery slope started with the smoking ban on fraud perpetrated by Johnson & Johnson. One only has to look at the marketing strategies by Johnson & Johnson, makers of their own brand of nicotine in droplets stuck in a piece of gum and bariatric surgery that maims the demonized overweight people, and all of the deadly drugs they've put out lately that has resulted in recalls, and the fact that they were busted for bribery recently, to see that this is just more anti-freedom

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Bueno, cecilia Title: MFTI, CAADAC
Date: 08/09/2011
Comment:
Please require that adults and teens be screened for alcohol/drug abuse yearly as part of their yearly physical
Cripps, Rosalie Title: Clinical Psychologist
Date: 08/09/2011
Comment:
As a clinical psychologist who has worked with people with alcohol problems throughout my 38-year career, I support the proposal for Medicare coverage of "Screening and Brief Counseling Intervention in Primary Care for Alcohol Misuse." There are good protocols available for both screening and brief interventions that, if used more frequently, could help reduce the enormous social, medical and economic costs of alcohol misuse in the U.S.
WOODS, RUTH Title: PROJECT DIRECTOR
Organization: SACRED PATHWAYS INC
Date: 08/09/2011
Comment:
On behalf of the Board of Directors of Sacred Pathways, a 501 (c )3 organization whose mission is to respond to homelessness, addiction, poverty, ill health and hunger, we strongly support the screening and behavioral counseling interventions in primary care to reduce alcohol misuse and and other addictions.
Broadnax, Doris Title: DHH-Program Monitor
Organization: Stae of Lousisian Department of Health & Hospitals
Date: 08/09/2011
Comment:
I am an Addiction Counselor working in the Behavioral Helth field and I support the Centers for Medicaid and Medicare Services proposed decision memo for "Screening and Brief Counseling Intervention in Primary Care to Reduce Alcohol Misuse." It is well established that alcohol misuse causes a host of social and medical ills, exacerbates existing health problems and makes patients more difficult to treat.
Boyne, Patrick Date: 08/09/2011
Comment:
I support the Centers for Medicaid and Medicare Services proposed decision memo for "Screening and Brief Counseling Intervention in Primary Care to Reduce Alcohol Misuse." It is well established that alcohol misuse causes a host of social and medical ills, exacerbates existing health problems and makes patients more difficult to treat.
Tompkins, Dorothy Date: 08/09/2011
Comment:
Addiction treatment is one of the most cost effective medical measures there is. For every dollar spent on it more is saved than any other procedure except for immunizations. Economically it makes sense.
Lusk, Gregory Date: 08/09/2011
Comment:
support the Centers for Medicaid and Medicare Services proposed decision memo for "Screening and Brief Counseling Intervention in Primary Care to Reduce Alcohol Misuse." It is well established that alcohol misuse causes a host of social and medical ills, exacerbates existing health problems and makes patients more difficult to treat.
Yanushka, Thomas Date: 08/09/2011
Comment:
I support the Centers for Medicaid and Medicare Services proposed decision memo for "Screening and Brief Counseling Intervention in Primary Care to Reduce Alcohol Misuse." It is well established that alcohol misuse causes a host of social and medical ills, exacerbates existing health problems and makes patients more difficult to treat. As a holder of a Masters Degree in Addiction Psychology and a volunteer giving classes on addiction in a jail setting, I have seen what alcohol (and other

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Angulo, Ray Title: Voter
Organization: none
Date: 08/09/2011
Comment:
I support the Centers for Medicaid and Medicare Services proposed decision memo for "Screening and Brief Counseling Intervention in Primary Care to Reduce Alcohol Misuse." It is well established that alcohol misuse causes a host of social and medical ills, exacerbates existing health problems and makes patients more difficult to treat.
Kominars, Kathryn Title: Director
Organization: Office of Employee Assistance, Florida International University
Date: 08/09/2011
Comment:
Adding this component to Primary Care would be an excellent step to mainstream alcohol screening into what is 'customary' and result in earlier identification of problem drinking.
Wood, Becky Title: Youth Program Specialist
Organization: MADD
Date: 08/09/2011
Comment:
The is imperative in pregnant woman so that we can try and prevent alcohol syndrome babies. While I believe adults should are them with the budget cuts today I'm not sure they would be able to get the help that they need if they truly "wanted" to stop drinking. Prevention is always the best way to go but sometimes intervention is the only road available.
Seal, Gearl Title: Addictions & Domestic Violence Counselor
Organization: Lutheran Community Services Northwest
Date: 08/09/2011
Comment:
I think that a mandate WITHOUT FUNDING is grave mistake. Medicare is already underfunded and needs to be revised. I think it is a great idea to have the screening but people with risky drinking behavior would need far more than 4 brief therapy sessions to address their drinking behaviors. I believe that the government and insurance companies need to fund the idea but not from funds already paid to them.
Bushman, Brad Title: Owner
Organization: Snake Mountain Ranch
Date: 08/09/2011
Comment:
I, Brad Bushman, support the Centers for Medicaid and Medicare Services proposed decision memo for "Screening and Brief Counseling Intervention in Primary Care to Reduce Alcohol Misuse." It is well established that alcohol misuse causes a host of social and medical ills, exacerbates existing health problems and makes patients more difficult to
Cottam, Charles Date: 08/09/2011
Comment:
I support the Centers for Medicaid and Medicare Services proposed decision memo for "Screening and Brief Counseling Intervention in Primary Care to Reduce Alcohol Misuse."
Cooper, D Title: future substance abuse counselof
Date: 08/09/2011
Comment:
I do Not drink and I think this is an extreme invasion of privacy and person freedoms. Saying that I would also like to point out that I am a Human Services major for counseling & have a minor in Criminal Justice and one in Sociology. NO this should not be done unless requested by family and only with the consent of the client or patient.
Wilson, Jr., L. Levern Title: Real Estate Agent
Organization: Independent Contractor
Date: 08/09/2011
Comment:

Coverage for alcohol screening and brief interventions as a core medical care service will send a powerful message that identification and intervention for alcohol problems should be part of routine primary care. Screening and brief intervention have been proven to have a sustained impact on reduced alcohol use and will therefore have major benefits both for patients and for overall medical care costs, as excessive drinking often makes other medical problems worse and harder to

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Johnson, Alan Title: President and CEO
Organization: Hina Mauka Recovery Center
Date: 08/09/2011
Comment:

We support the Centers for Medicaid and Medicare Services (CMMS) proposed decision memo for "Screening and Brief Counseling Intervention in Primary Care to Reduce Alcohol Misuse."

There are research-based screening instruments such as the CAGE (Ewing, 1984) and AUDIT (Babor et al., 1992) that have been tested and found effective in primary care settings. Moreover treatment services overwhelmingly support these brief assessment, screening type tools that establish targeted

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O'Hara, Liz Date: 08/09/2011
Comment:
Denial, by the patient, of the existence of any alcohol abuse problem is a well known part of alcoholism. I support the Centers for Medicaid and Medicare Services proposed decision memo for "Screening and Behavioral Counseling Interventions in Primary Care to Reduce Alcohol Misuse."
O'Keefe, Patrick Date: 08/09/2011
Comment:
I support the Centers for Medicaid and Medicare Services proposed decision memo for "Screening and Brief Counseling Intervention in Primary Care to Reduce Alcohol Misuse." It is well established that alcohol misuse causes a host of social and medical ills, exacerbates existing health problems and makes patients more difficult to treat.
Kopera, tony Date: 08/09/2011
Comment:
This is critically important. Depression among the eldeerly often leads to alcohol abuse.
Maclaren, Sue Date: 08/09/2011
Comment:
I, Sue Maclaren am a substance abuse counselor and I have seen first hand how alcohol and drugs can ruin lives. I support the Centers for Medicaid and Medicare Services proposed decision memo for "Screening and Brief Counseling Intervention in Primary Care to Reduce Alcohol Misuse." It is well established that alcohol misuse causes a host of social and medical ills, exacerbates existing health problems and makes patients more difficult to treat.
Samuels, Lynn Title: CEO
Organization: Lifeline Connections
Date: 08/09/2011
Comment:
I think the experience and data from the SBIRT projects around the country confirm that this would be a cost effective intervention in primary care if implemented by appropriately trained and licensed clinicians using a validated tool.
McIlvaine, Amy Date: 08/09/2011
Comment:
I support the Centers for Medicaid and Medicare Services proposed decision memo for "Screening and Brief Counseling Intervention in Primary Care to Reduce Alcohol Misuse." It is well established that alcohol misuse causes a host of social and medical ills, exacerbates existing health problems and makes patients more difficult to treat.
In the long run unchecked alcohol misuse will result in increased spending for health care, criminal justice, nursing care and public health.
Ciarcia, Ann Marie Date: 08/09/2011
Comment:

I am writing to add my name to the list of Americans who support the use of Medicare & Medicaid funds for alcohol abuse screening and brief interventions.

The reduced incidence of fetal alchohol syndrome and fetal alchohol effect by treating pregnant women with alcohol use disorders will be not only cost-effective, in the sense that it will save the cost of caring for these disabled children; it is also just the right thing to do for the health of the child in utero.

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Scott-Haines, Erin Date: 08/09/2011
Comment:
Please pass this bill! I am a therapist in a chemical dependency intensive outpatient facility and my experience has shown that, unfortunately, people often wait until they have had legal or career consequences to seek the help they need. My belief is that if trusted physicians screened for alcohol misuse, more people would get the help they needed before it was too late.
Rocco, Susan Date: 08/09/2011
Comment:

I support the Centers for Medicaid and Medicare Services proposed decision memo for "Screening and Brief Counseling Intervention in Primary Care to Reduce Alcohol Misuse." It is well established that alcohol misuse causes a host of social and medical ills, exacerbates existing health problems and makes patients more difficult to treat.

"An ounce of prevention is worth a pound of cure."
The drain of monies and services for alcoholic related problems can be curbed with early

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kirk, deborah Title: prevention coordinator
Organization: pathways community behavioral healthcare
Date: 08/09/2011
Comment:
I work in the field of prevention and know how critical early intervention is for our communities. Alcohol is often a tragic and costly factor in families and in lives. I also know this from a personal point of view. For each day we can help a person avoid its deadly costs, we are doing a great service for our communities and our nation. Furthermore, alcohol screening is not complicated or expensive. From a purely financial standpoint, it makes terrific sense.
Redmond, Carol Date: 08/09/2011
Comment:
I support the Centers for Medicaid and Medicare Services proposed decision memo for "Screening and Brief Counseling Intervention in Primary Care to Reduce Alcohol and Prescription and Non-prescription Abuse and Misuse." It is well established that alcohol and substance misuse and abuse causes a host of social and medical ills, exacerbates existing health problems and makes patients more difficult to treat.
Connell, Ginny Title: Executive Director
Organization: PDAP of Ventura County, Inc.
Date: 08/09/2011
Comment:
I urge addition of Screening and Behavioral Counseling Interventions to primary care services as a valuable health service to reduce alcohol misuse by all patients served, and particularly to reduce and prevent this misuse by pregnant women in order to reduce serious risks for their fetus.
Rose, Meg Organization: Dorchester Substance Abuse Coalition
Date: 08/09/2011
Comment:
I support the Centers for Medicaid and Medicare Services proposed decision memo for "Screening and Brief Counseling Intervention in Primary Care to Reduce Alcohol Misuse." I work directly with youth in a community in Boston and this would make a great difference in their lives and the life of their families. Being able to feel comforable and supported when talking about alcohol in the primary care setting it crucial and knowing that they can get support right there will make a difference!
Gomes, Kate Date: 08/09/2011
Comment:
I has read the propsed policy, and strongly believe that it is an improtat step to take to improve the heatlh of our population. I also wonder why this step does not go further with supporting plancement of a Substance Abuse/ Behavioral Health Specialist in the primary care office.
Kate Gomes, LCAS/CCS, LMFT, LPCS
Crassweller, Nancy Title: AODA Prevention Coordinator
Organization: School District
Date: 08/09/2011
Comment:
This is fantastic proposal and absolutely necessary to the health of our kids and communities. I just finished a conversation about how we in schools/prevention work support kids who need AODA support....and it's usually because their parents are using abusively as well.
This could be the single most valuable medical coverage change we could ever get. PLEASE let this happen.
Larsson, Katherine Date: 08/09/2011
Comment:
Mental Health diagnoses and alcohol and drug addictions are diseases and should be teated as any other disease related to The Standards for Privacy of Individually Identifiable Health Information Privacy Rule. I urge you to do whatever it takes to protect our medical privacy, including behavioral interventions and primary car for mental health and addiction information.
Skochdopole, Richard Date: 08/09/2011
Comment:
I believe that screening for alcohol misuse is a very desirable addition to primary care.
Doran, Cathy Title: CEO
Organization: YFA Connections
Date: 08/09/2011
Comment:
I absolutely support this initiative. It makes fiscal sense to screen at the abuse level to reduce later, and more expensive, medical, legal and social consequences of misuse. It is also prudent to find ways to identify patients who are already in need of a treatment intervention. We can't rely on already over-worked social workers in the medicaid system to perform this function.
Kalensky, Susan Date: 08/09/2011
Comment:
I support the Centers for Medicaid and Medicare Services proposed decision memo for "Screening and Brief Counseling Intervention in Primary Care to Reduce Alcohol Misuse." It is well established that alcohol misuse causes a host of social and medical ills, exacerbates existing health problems and makes patients more difficult to treat.
Braun, Rose Date: 08/09/2011
Comment:
Covered alcohol screenings and counseling would be such a help to those who struggle with this problem. Please make this available to everyone as well as providing educational information and treatment options.
Schweit, Ronalda Date: 08/09/2011
Comment:
I think it would be a wonderful idea. As an alcohol counselor and social worker I have seen individuals, especially pregnant women abuse drugs throughout their pregnacy. There are people due to family environment who are not aware of the hazards of alcohol and think their use is "normal." It would benefit all who have been identified to receive education which would give them an opportunity to make better decisions for their future.
Martinson, Judy Date: 08/09/2011
Comment:
No, I do not approve that Medicare should cover alcohol treatment/counseling. Thanks to the government trying to make to many changes and cutting back in medicare services- it isn't right. Those government officials should slash their own wages/ retirement benefits etc before cutting medicare. they should also make sure they are in the healthcare reform justlike everyone else. The muslims should be included in the healthcare reform and not be excluded either.
Medicare and social Security

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Nichols, Don Organization: Private Citizen
Date: 08/09/2011
Comment:

I support the Centers for Medicaid and Medicare Services proposed decision memo for "Screening and Brief Counseling Intervention in Primary Care to Reduce Alcohol Misuse." It is well established that alcohol misuse causes a host of social and medical ills, exacerbates existing health problems and makes patients more difficult to treat. I also think it will save a tremendous amount of money if the screenings can identify problems before they manifest themselves in additional physical

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Alheim, Susanne Date: 08/09/2011
Comment:
Medicare need not be responsible for paying of alcohol screening or counseling of any kind!
Let all of those that profit from their sale of alcohol which is sold all over the place.
Alcohol is not a disease and is a learned life style!
Medicare is for those that have true physcial illness
and not for those that indulge and make themselves
sick!
Fockler, Lisa Date: 08/09/2011
Comment:
Action on this issue is long overdue!!!! I support the Centers for Medicaid and Medicare Services proposed decision memo for "Screening and Brief Counseling Intervention in Primary Care to Reduce Alcohol Misuse." It is well established that alcohol misuse causes a host of social and medical ills, exacerbates existing health problems and makes patients more difficult to treat.
Williams, Cathy Title: Evaluation Coordinator
Organization: Missouri Institute of Mental Health
Date: 08/09/2011
Comment:
I would like to encourage your support for the Centers for Medicaid and Medicare Services proposed decision memo for "Screening and Brief Counseling Intervention in Primary Care to Reduce Alcohol Misuse." It is well established that alcohol misuse causes many social and medical ills, making existing health problemsworse, and makes patients more difficult to treat.
Nanney, Douglas Date: 08/09/2011
Comment:
I do hereby urge Medicare to cover annual alcohol screening services, so that lives may be saved.
Snyder, Jennifer Date: 08/09/2011
Comment:
I support the Centers for Medicaid and Medicare Services proposed decision memo for "Screening and Brief Counseling Intervention in Primary Care to Reduce Alcohol Misuse." It is well established that alcohol misuse causes a host of social and medical ills, exacerbates existing health problems and makes patients more difficult to treat.
Hester, Ph.D., Reid Title: Director, Research Div.
Organization: Behavior Therapy Associates, LLP
Date: 08/09/2011
Comment:
I helped our NM Dept. of Health implement these procedures in a 5 year SAMSHA grant and saw how effective this protocol is in both reducing heavy drinking and health care costs.
Disney, Elizabeth Title: Associate Director, Broadway Center for Addictions
Organization: Johns Hopkins Hospital
Date: 08/09/2011
Comment:
I wanted to write and let you know that as a PhD psychologist specializing in addictions, I am glad to see, and fully support, the proposed Medicare coverage for "Screening and Brief Counseling Intervention in Primary Care to Reduce Alcohol Misuse."
Syphers, Bertha Title: Assessment Clinician -LADC
Organization: Stonington Institute
Date: 08/09/2011
Comment:
I believe that this would be a good service if done by qualified professionals as most people do not have clear knowledge of alcohol abuse. Most seem to think that being able to function at work or at home while using is not a problem. Many will acknowledge medical concerns but make no effort to change until they are given the proper advice. Doctors rely on self report of use and most users minimize their use.
Somers, Jessica Date: 08/09/2011
Comment:
I agree with this due to the large number of people that receive services and do not have access to treatment. I would hope that this can be a helping hand to the people that need treatment.
Solomon, Richard Title: PhD
Organization: retired
Date: 08/09/2011
Comment:

Coverage for alcohol screening and brief interventions as a core medical care service will send a powerful message that identification and intervention for alcohol problems should be part of routine primary care. Years of research has proven that screening and brief intervention have been proven to have a sustained impact on reduced alcohol use and will therefore have major benefits both for patients and for overall medical care costs, as excessive drinking often makes other medical

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cullinane, patrick Date: 08/09/2011
Comment:
Brief substance abuse screening is an affordable option for early intervention and prevention, in some instances, reduction in harmful drinking just by asking the questions with follow up standard consumption information. At a time of rising health costs, we need to engage such protocols more frequently. Such screenings are especially valuable for the Medicare population where there is misinformation and confusion about alcohol use and greater risk of alcohol, health adverse reactions.

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Warshaw, Glenn Date: 08/09/2011
Comment:
Please add alcohol screening and brief intervention to Medicare insurance policies. It is bital in order to reduce the amount of alcoholism in our society.
Brown, Kim Date: 08/09/2011
Comment:
I strongly support CMS' proposal to include "Screening and Brief Counseling Intervention in Primary Care to Reduce Alcohol Misuse." Research has proven that alcohol misuse leads to tremendous social and medical costs, exacerbates existing health problems, increasing medical costs and makes patients more difficult to treat. For these reasons and more we strongly support this provision.
French, John Date: 08/09/2011
Comment:
Instead of having Medicare pay for yet another unending situation-send them to AA-it works and is free-
Jacobs, Sharon Date: 08/09/2011
Comment:

I support the Centers for Medicaid and Medicare Services proposed decision memo for "Screening and Brief Counseling Intervention in Primary Care to Reduce Alcohol Misuse." It is well established that alcohol misuse causes a host of social and medical ills, exacerbates existing health problems and makes patients more difficult to treat.

Please support this bill!
Corbett, Julia Title: Director
Organization: Southwest Florida Employee Assistance Programs
Date: 08/09/2011
Comment:
I strongly support that screening and behavioral counseling interventions in primary care be paid for. It is always more cost effective to address a problem when it is identified, yet small enough to handle. Reaching out to vulnerable people at a time when they can change their behaviors and influence the course of both their own lives, and the lives of their children, is a smart way to spend my tax dollars.
Adams Marin, Barbara Title: Prevention Specialist
Date: 08/09/2011
Comment:
I support the Centers for Medicaid and Medicare Services proposed decision memo for "Screening and Brief Counseling Intervention in Primary Care to Reduce Alcohol Misuse." It is well established that alcohol misuse causes a host of social and medical ills, exacerbates existing health problems and makes patients more difficult to treat. It is well known that the body's ability to metabolize alcohol changes as a person ages, which may increase the risk of alcohol impairment in older patients.

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Dillon, Richard Title: Senior VP
Organization: Preferred Family Healthcare
Date: 08/09/2011
Comment:
I strongly support the payment for annual alcohol screening and brief follow up counseling. These measured, couple together, will support a strong early detection, intervention and treatment system and have the potential for saving billions of dollars over the next several years.
Serkin, Elizabeth Date: 08/09/2011
Comment:
Screening older adults for alcohol misuse will save many dollars treating associated medical problems.
Wilhelm, Liz Date: 08/09/2011
Comment:
Please support coverage for sccreen and behavioral counseling interventions in primary care to reduce alcohol misuse. Thank you. Liz
Davis, Kathy Date: 08/09/2011
Comment:
I work in the subtance abuse treatment field and I strongly support the Centers for Medicaid and Medicare Services proposed decision memo for "Screening and Brief Counseling Intervention in Primary Care to Reduce Alcohol Misuse." I believe that substance abuse is missed frequently because patients are not screened for substance use disorders, and many doctors are not trained to screen. It is well established that alcohol misuse causes a host of social and medical ills, exacerbates existing

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Hatlen, Merrill Date: 08/09/2011
Comment:
Despite the recommendation by USPSTF for regular screening for alcohol, many clinics still aren't on board. Thus, I hope that you support SBIRT in primary care settings. I note that Veteran's clinics have already implemented universal screening for all of their patients, so we can learn from their example. Thank you.
Stanger, Louise Title: Dr. Louise A. Stanger Ed.D, LCSW
Organization: AllAboutInterventions.com
Date: 08/09/2011
Comment:

This memo is in support of medicare coverage for alcohol screening and brief interventions. Screening and brief interventions have demonstrate a powerful impact on reducing alcohol use and hence reducing overall medical costs. With the increased incidence of older adult substance abuse including brief screening and intervention will go along way in reducing overall costs

Thank you
Warren, Bob Date: 08/09/2011
Comment:
Having a forum in primary medical care policy to empower those with alcohol/drug abuse/dependence issues will be a real asset in helping people maintain a healthy life-style.
williams, Anne Date: 08/09/2011
Comment:
I think that this is a great prevention tool to use to delay the onset of alcoholism or prevent alcohol use by pregnant women.Alcohol abuse and adddiction are related to so many problems with health and families.
LaFazia-Geraghty, Andrea Title: Project Manager
Organization: King County, DCHS, MHCADSD
Date: 08/09/2011
Comment:

Coverage for alcohol screening and brief interventions are a core medical care service and identification and intervention for alcohol problems should be part of routine primary care.

Screening and brief intervention have been proven to have a sustained impact on reduced alcohol use and will therefore have major benefits both for patients and for overall medical care costs, as excessive drinking often makes other medical problems worse and harder to treat.

In

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Ortega, Yolanda Title: Retired newspaper journalist
Organization: N/A
Date: 08/09/2011
Comment:

Alcoholism is a disease and my understanding is that people are genetically predisposed to it. In San Antonio, liver transplants are not granted to people who need one but drink. Is that treating it as a disease? My main concern is that in order to quit, insurance coverage is necessary. By the way, a major problem for Veterans is alcoholism as well as PTSD. If we are going to give our Veterans care for alcholism, then we should do the same for others. I had [PHI Redacted]

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Waite, Pam Title: Director Healthcare Workforce/NEONI Operations
Organization: The Center for Health Affairs
Date: 08/09/2011
Comment:
I understand the importance of this screening and would support this; however I would not support it being under Medicare. Why would it not be under Medicaid which is age appropriate. Medicare is not an entitlement like Medicaid - so this does not seem so appropriate.
Pogue, Elissa Date: 08/09/2011
Comment:
I support the Centers for Medicaid and Medicare Services proposed decision memo for "Screening and Brief Counseling Intervention in Primary Care to Reduce Alcohol Misuse." It is well established that alcohol misuse causes a host of social and medical ills, exacerbates existing health problems and makes patients more difficult to treat.
Mueller, Eric Date: 08/09/2011
Comment:
Please review
Tucker, Melvin Date: 08/09/2011
Comment:
let the war on drugs pick up the tab on this. Medicare is for seniors and disabled. Quit putting the load on the shoulders of seniors. Give us what we were promised.
Perfas, Fernando Title: Assistant Project Coordinator
Organization: Health Resources in Action
Date: 08/09/2011
Comment:

Coverage for alcohol screening and brief interventions as a core medical care service will send a powerful message that identification and intervention for alcohol problems should be part of routine primary care. Screening and brief intervention have been proven to have a sustained impact on reduced alcohol use and will therefore have major benefits both for patients and for overall medical care costs, as excessive drinking often makes other medical problems worse and harder to

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Conway, Stacey Title: Manager, Information/Intervention
Organization: The Council of Southeast Pennsylvania, Inc.
Date: 08/09/2011
Comment:
I am writing to support the proposal that Medicare cover screening and brief interventions for alcohol use. As a trainer on the SBIRT process and part of the Pennsylvania and now Bucks County SBIRT project, I have seen firsthand the positive impact that addressing risky alcohol use can have in healthcare settings. The proposed screening and intervention with pregnant women also has great potential to educate women about alcohol use during pregnancy and to reduce the incidence of

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Van Steinburgh, Tyler Date: 08/09/2011
Comment:
I support the Centers for Medicaid and Medicare Services proposed decision memo for "Screening and Brief Counseling Intervention in Primary Care to Reduce Alcohol Misuse." It is well established that alcohol misuse causes a host of social and medical ills, exacerbates existing health problems and makes patients more difficult to treat.
Rueter, Sean Date: 08/09/2011
Comment:
I support the Centers for Medicaid and Medicare Services proposed decision memo for "Screening and Brief Counseling Intervention in Primary Care to Reduce Alcohol Misuse." It is well established that alcohol misuse causes a host of social and medical ills, exacerbates existing health problems and makes patients more difficult to treat.
Speck, Kathryn Date: 08/09/2011
Comment:
I support screening, brief intervention and referral to treatment services especially with Medicare populations as well as for pregnant and parenting women in all healthcare settings. It will ensure that proven effective standards are in place nationally.
Wagner, Patricia Date: 08/09/2011
Comment:
I stongly support the Centers for Medicaid and Medicare Services proposed decision memo for "Screening and Brief Counseling Intervention in Primary Care to Reduce Alcohol Misuse." The primary care setting is an optimal environment to screen and intervene persons who are abusing alcohol.
Cerone Copeland, Edy Date: 08/09/2011
Comment:

I am very much in favor of providing this service. Addressing these issues prior to them getting out of hand would save lots of dollars for the individuals, health care, police/judicial systems, etc. My family has faced and is still facing a lot of challenges due to drug and alcohol addition of [PHI Redacted]. Education is of most importance also to every individual.

Boogaard, Shawn Date: 08/08/2011
Comment:
I am writing to encourage serious consideration of alcohol and substance abuse screening be a covered benefit of Medicare. I have personally witnessed and experienced the postitve outcomes of patients we have screened in our family medicine clinic. Thank you for your time and consideration.
Pollack, Rick Title: Executive Vice President
Organization: American Hospital Association
Date: 08/08/2011
Comment:

August 9, 2011

Donald M. Berwick, M.D., M.P.P.
Administrator
Centers for Medicare & Medicaid Services
Hubert H. Humphrey Building
200 Independence Avenue, S.W., Room 445-G
Washington, DC 20201

RE: Proposed Decision Memo for Screening for Depression in Adults (CAG-00425N)

Dear Dr. Berwick:

On behalf of our more than 5,000 member hospitals, health systems and other health care organizations, and our nearly 42,000

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Pata, Jacqueline Title: Executive Director
Organization: The National Congress of American Indians (NCAI)
Date: 08/04/2011
Comment:

August 5, 2011

Centers for Medicare and Medicaid Services
Attention: Dr. Lawrence Schott
7500 Security Boulevard
Baltimore, MD 21244

RE: Proposed Coverage Decision Memorandum for Screening and Behavioral Counseling Interventions in Primary Care to Reduce Alcohol Misuse (CAG-00427N)

Dear Dr. Schott,

The National Congress of American Indians (NCAI) is the nation’s oldest, largest, most representative national tribal organization

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Nickerson, Gail Title: Director, Clinic Services
Organization: Adventist Health
Date: 08/04/2011
Comment:
I work with hospital-based rural health clinics and am mystified as to why we are excluded from this program. Last year, the clinics I work with provided over 760,000 visits to about 140,000 individuals, some of whom would clearly benefit from screening and behavioral counseling to reduce alcohol misuse. If I can help you understand what "hospital outpatient" services actually are and how our patients should not be penalized for seeking care with us if they need this type of program, please

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Gaipa, LCSW, CAC III, Marilyn S. Organization: Care Solutions, LLC
Date: 08/02/2011
Comment:
I strongly support reimbursement for SBIRT screening and services be added as part of the comprehensive package of preventive services to be covered by Medicare. I work with integration of behavioral health services and primary care in diverse care delivery systems and am a member of the SBIRT Policy Steering Committee for the State of Colorado. The clinical and operational challenges of a truly integrated care system, along with the fiscal sustainability concerns, often create a conundrum

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Robin, Cori Title: Clinical Social Worker
Organization: Rush University Medical Center
Date: 08/02/2011
Comment:

We are writing on behalf of Rush University Medical Center Older Adult Programs. It is our professional opinion, that social workers and psychologists are in a position to provide quality screening and brief intervention services to clients. This type of screening is currently already part of a broader comprehensive service provision provided by social workers and psychologists. These behavioral health clinicians have the training and experience to assess, screen and provide treatment to a

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Muramoto, Kim Title: Director of Trauma
Organization: Littleton Adventist Hospital
Date: 08/02/2011
Comment:
I support SBIRT in all healthcare settings to ensure that it becomes a national standard. SBIRT it is an evidence based practice that takes little time with large yield. It is essential in patient care and all practicioners should be adept in having these conversations since they have such a profound effect on disease process, psychological issues, healing and trauma.
Botticelli, Michael Title: Director, Bureau of Substance Abuse Svcs
Organization: Massachusetts Department of Public Health
Date: 08/01/2011
Comment:

We are very pleased to support the CMS proposal to cover annual screening and, for those that screen positive, up to 4 face-to-face, behavioral counseling interventions per year, including pregnant women. We agree with the first 2 caveats under that proposal.

As to the third caveat: We recommend, in light of growing patient centered medical home use of health teams, that coverage for brief counseling be broadened to include other health team members. Allied health

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Robison, Cindy Title: LICSW, CDP Behavioral Health Supervisor
Organization: NATIVE Project/NATIVE Health of Spokane
Date: 07/29/2011
Comment:

I work at a FQHC Urban Indian Organization which is primary care to many. I agree with the proposal to pay for the screening. However, I do believe that if a clinic has chemical dependency professionals or licensed clinical social workers or therapists, that Medicare needs to also provide reimbursement for their services. Medical providers are not the only ones who need to be able to do this. Yes it does need done and will save money in the long run. Thank you.

Cindy Robison
Keefe, Alyssa Title: Vice President Federal Regulatory Affairs
Organization: California Hospital Association
Date: 07/29/2011
Comment:

Subject: Medicare Proposes Coverage for Screening and Counseling for Alcohol Misuse and Screening for Depression (00427N)

Dear Colleagues,

On behalf of the California Hospital Association (CHA) and our 400 member hospitals and health systems, we wish to express our support for the Centers for Medicare & Medicaid Services (CMS) proposal to add alcohol screening and behavioral counseling, and screening for depression to the package of preventive services for Medicare

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Valdez, Melissa Date: 07/28/2011
Comment:
I am the Director of Psychiatry Consultation Services at out local COunty hospital affiliated with BCM. I estimate that 1/2 to 1/3 of the patients that we see with suicide attempts has alcohol as a primary contributor to the act of self-harm. While admitted they improve due to lack of access and therefore lack of contribution of alcohol to their mental status. Said another way, without alcohol intheir system their risk for imminent self harm decreases to low such that they are safe for

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Keenan, Linda Title: Administrative Director Disease Management Program
Organization: Harris County Hospital District
Date: 07/27/2011
Comment:

As a mental health nurse and an administrative director it is welcoming to see the proposed decision to adopt an alcohol screening and 4 sessions for treatment as part of a preventive health visit. So many disease states are compounded by the patient's inability to self-manage due to mental health and substance abuse concerns that are often missed during the "physical" assessment of a provider's visit.

The focus on prevention today is noteworthy but only when it is holistic and

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Jones, Vivian Title: M.D.
Date: 07/25/2011
Comment:
I believe the proposed interventions will be a tremendous asset to primary care physicians.