This is a challenging time for our profession. We face challenges on a day-to-day basis with our clients, and recently we have found ourselves facing significant challenges with insurance companies. First came challenges with the transition of BCBSMN to Magellan. MPA has helped to address some of those concerns through the efforts of our Payer Committee, and those efforts will continue. Unfortunately, unannounced rate reductions began on July 1st, followed by an explanatory letter from BCBSMN, which led to even greater levels of confusion, anger, and fear for many providers. MPA participated in a community meeting sponsored by NAMI last week and helped to facilitate a meeting with BCBSMN executives on 9/11/17, which included representatives from NAMI and other organizations.
From that meeting, BCBSMN acknowledged they had not communicated effectively and had not taken the concerns and needs of providers into account in their recent decisions. The other participants expressed a great many concerns related to their planned changes and how those decisions would impact providers in the short, medium, and long term. In an hour long meeting, it became apparent the rate changes have been rolled back as stated in the letter sent to MPA members last week. The overpayment correction remains in place, as it was a clear departure above the rate in contracts. Be that as it may, BCBSMN indicated it is their intention to work with providers on how to collect the overpayment in a manner that will not be detrimental to the practices impacted. It is MPA’s intention to continue to advocate for no return of overpayments, as doing so would be too great a hardship for providers.
As a result of this issue, BCBSMN has committed to meeting with provider representatives, including MPA, on a monthly basis to work together to search for solutions to the immediate as well as less urgent issues in the provision of behavioral health services.
BCBSMN is not the only third party payer for which there are concerns. There have been recent changes in the administration of individual therapy codes, most notably the 90837 code, that MPA is seeking to address through its Payer Committee and organizational leadership. Addressing each of these concerns takes time. MPA is a volunteer organization and the people working for you at MPA typically have day jobs. Once again, I encourage you all to consider joining the process through participation in committees that serve as intervention agents in these times of crisis.
If you are interested in helping, please see the MPA website for relevant committee information.
Steve Girardeau, Psy.D., LP, is the Director of Clinical Services of Mental Health Systems, member of MPA Legislative Committee and Governing Council, and a member of APA, MPA, and ABCT. He provides psychological services in residential, community mental health centers, private practice, and intensive outpatient settings with a wide variety of at risk and underserved clients. He is the current president of MPA and training director of the APPIC internship training site.
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