My friend in Missouri sent this out. Apparently, it went out through the MoPA listserv
Hi everyone,
There is an exceptional amount of activity going on in the legislature that will greatly affect the future of psychology. It has the potential to affect your ability to have a private practice, to make a reasonable income given your education, experience, and skills, and to influence healthcare in Missouri at any time in the future.
It is the intention of the legislature with the agreement of the Democratic governor to turn the rest of the Medicaid fee-for-service system to managed care.
There are many places in the state where this is the primary means by which psychologists are allowed to earn an living and to conduct psychological evaluations easily. There is also talk that those with chronic mental illness should only receive their services through a primary care system, called patient homes. Psychologists are not even included providers in these homes. Rather, a two-tiered system where LPCs with supervision by LCSWs will be in place in these systems/medical homes will be the sole provides of mental health services!
More troubling is the fact that, in the private sector, compensation for Medicaid psychological evaluations will be reduced to $32-38 each. This is not economically feasible. Add to this the fact the only LCSWs and school neuropsychologists (both are master's level providers) will be given the authority to conduct psychological evaluations with and without testing. Other insurance providers, such as Blue Cross-Blue Shield are already in talks to expand these guidelines nationally within the next year to two years.
Many of us know already that managed care, particularly in mental health, operates less on creating efficiencies in the system than it does on reducing provider pay to reduce State costs and to earn a profit. I really don't believe that those in the legislature really understand this and at this point may not care.
Managed care is limited in its ability to create a less expensive system simply because mental health is already offered at rock bottom prices. There is little waste in the State's fee-for-service administration of mental health and even less waste in how we operate our own businesses. This bill will take the hard earned money of Missouri small business people and transfer to large insurance companies who are primarily located outside of Missouri. Medicaid fee-for-service Missouri jobs will inevitably be eliminated and given to people who live in other states where these insurance companies are located.
Fee-for-service Medicaid has been the standard in many ways for what managed care should pay and for what commercial insurance in our state should pay. With the elimination of fee-for-service Medicaid, the companies will only compare themselves to each other. Commericial insurance is seldom much higher than what Medicaid is paying. And a drop in Medicaid rates gives more fuel for the dropping of commercial rates which has been a problem here and across the country.
We are currently conducting a survey of Medicaid fee-for-service and managed care practices. We have been in contact with APA so that how we gather this information and for what purposes complies with Federal law. We absolutely need those who have done business with these insurance companies to share their experiences. We cannot go to the legislature and argue our position without accurate data. And for that we need you to take the necessary five minutes to help.
Check out the Medicaid transformation act, HB700: http://house.mo.gov/billsummary.aspx?bill=HB700&year=2013&code=R.
Also read material at http://www.BarnesforMissouri.com. It's easier to understand.
To my knowledge the provider pay benefits discussed in Barnes for Missouri are not currently included in HB700. However discussions with others in the government recommend that only master's level providers and physicians be allowed to provide services to the Medicaid system. This means that social workers will be conducting these psychological evaluations. Strangely enough, physician compensation, including psychiatrists, will actualy increase by 4-10 percent.
I will share more information about the bill as it is available if our membership is interested.
Hi everyone,
There is an exceptional amount of activity going on in the legislature that will greatly affect the future of psychology. It has the potential to affect your ability to have a private practice, to make a reasonable income given your education, experience, and skills, and to influence healthcare in Missouri at any time in the future.
It is the intention of the legislature with the agreement of the Democratic governor to turn the rest of the Medicaid fee-for-service system to managed care.
There are many places in the state where this is the primary means by which psychologists are allowed to earn an living and to conduct psychological evaluations easily. There is also talk that those with chronic mental illness should only receive their services through a primary care system, called patient homes. Psychologists are not even included providers in these homes. Rather, a two-tiered system where LPCs with supervision by LCSWs will be in place in these systems/medical homes will be the sole provides of mental health services!
More troubling is the fact that, in the private sector, compensation for Medicaid psychological evaluations will be reduced to $32-38 each. This is not economically feasible. Add to this the fact the only LCSWs and school neuropsychologists (both are master's level providers) will be given the authority to conduct psychological evaluations with and without testing. Other insurance providers, such as Blue Cross-Blue Shield are already in talks to expand these guidelines nationally within the next year to two years.
Many of us know already that managed care, particularly in mental health, operates less on creating efficiencies in the system than it does on reducing provider pay to reduce State costs and to earn a profit. I really don't believe that those in the legislature really understand this and at this point may not care.
Managed care is limited in its ability to create a less expensive system simply because mental health is already offered at rock bottom prices. There is little waste in the State's fee-for-service administration of mental health and even less waste in how we operate our own businesses. This bill will take the hard earned money of Missouri small business people and transfer to large insurance companies who are primarily located outside of Missouri. Medicaid fee-for-service Missouri jobs will inevitably be eliminated and given to people who live in other states where these insurance companies are located.
Fee-for-service Medicaid has been the standard in many ways for what managed care should pay and for what commercial insurance in our state should pay. With the elimination of fee-for-service Medicaid, the companies will only compare themselves to each other. Commericial insurance is seldom much higher than what Medicaid is paying. And a drop in Medicaid rates gives more fuel for the dropping of commercial rates which has been a problem here and across the country.
We are currently conducting a survey of Medicaid fee-for-service and managed care practices. We have been in contact with APA so that how we gather this information and for what purposes complies with Federal law. We absolutely need those who have done business with these insurance companies to share their experiences. We cannot go to the legislature and argue our position without accurate data. And for that we need you to take the necessary five minutes to help.
Check out the Medicaid transformation act, HB700: http://house.mo.gov/billsummary.aspx?bill=HB700&year=2013&code=R.
Also read material at http://www.BarnesforMissouri.com. It's easier to understand.
To my knowledge the provider pay benefits discussed in Barnes for Missouri are not currently included in HB700. However discussions with others in the government recommend that only master's level providers and physicians be allowed to provide services to the Medicaid system. This means that social workers will be conducting these psychological evaluations. Strangely enough, physician compensation, including psychiatrists, will actualy increase by 4-10 percent.
I will share more information about the bill as it is available if our membership is interested.
