Public Policy and Legislation
06/20/11: The Department of Health and Welfare has recently posted the new Medicaid reimbursement rates that go into effect on 7/1/11. There are drastic reductions in reimbursement rates for clinical services and according to IMHCA PP&L Chair and MHPAI President, Jeff Wright, these reductions “are not in line with what the department communicated to the provider community in good faith earlier this year.”
Jeff created a spreadsheet (click here to view) that shows the affected Medicaid codes, as well as the difference between the previous fee schedule and the fee schedule that goes into effect in July. From what we understand, some of these reductions place clinical services at a lower rate than PSR services. This is not acceptable. Even if your agency or private practice does not accept Medicaid, it is important that we stand together as licensed clinical professionals to address this issue.
We are asking that you contact your House and Senate representatives, Health and Welfare committee members as well as the Health and Welfare Department leadership. “Please share with them you opinion on how these rate reductions will negatively impact your agency's ability to serve Medicaid clients as well as retain quality staff.” Jeff will be contacting Health and Welfare in person in an attempt to get more answers regarding these rate cuts and we will keep you up to date regarding the outcome.
Below are the direct emails for H&W officials.
Richard Armstrong (armstrongr@dhw.idaho.gov)
Leslie Clement (clementl@dhw.idaho.gov)
Paul Leary (learyp@dhw.idaho.gov)
Pat Guidry (guidryp@dhw.idaho.gov)
Lourie Neal, Idaho Division of Medicaid Office of Reimbursement at (208) 287-1162
To contact your local representatives and the Governor, click on the red button above, left.
To go to the Department of Health and Welfare’s website, where the new fee schedule is posted, click here
Thank you in advance for supporting this cause, and thank you for being a member of IMHCA.
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IMHCA P.O. Box 1217, Meridian, Idaho 83680
7/1/2011: Thanks to your emails and calls in opposition to the recent proposed rate cuts for mental health providers, the Department of Health and Welfare has reinstated the previous rates for providers in their current fee schedule. According to Department of Health and Welfare official, Leslie Clement, the reinstated rates were posted to the DHW website on July, 1, 2011.
Public Policy and Legislative Report June 2011 - Eric Pettingill
• The transformation work group is developed and meeting. Its in the planning phase right now. The hope is that there will be a better system in place once it is fully implemented.
• LPC, LCPC, LMFT can now apply for jobs within the veterans health care system. A mailing went out trying to encourage LPC, LCPC and LMFT’s to get approved for Tri-Care.
• The substance abuse treatment funding has been carved into four pots of money: IDOC, JCC, Supreme Court and Health and Welfare. IDOC is going to do all assessments in house then refer out to private providers. It looks like JCC is going to do the same. The Supreme Court is funding drug courts throughout the State and the trend seems to be courts taking treatment services in house. Health and Welfare will continue to use BPA.
• The health care law was passed on the federal level. States are moving forward in implementing it, but that may stop depending on the political climate and court rulings. There is talk of making Medicare a voucher system where people will buy their own private insurance.
8/2011: In June 2011, Medicaid came out with a new fee schedule that cut mental health provider rates by 33%. As a result of this action, there was strong opposition demonstrated by members and organizations which resulted in the funds being reinstated. To see the current Medicaid fee schedule visit the Idaho Department of Health and Welfare website or visit IMHCA’s website at www.idahomentalhealthcounselor.org for more information and updates.
Agencies in Idaho will need to become nationally accredited by July 1, 2011, if they want to provide Medicaid services. National accreditation can cost up to several thousand dollars, the payment of which will be the sole responsibility of agencies themselves and not Medicaid. See HB 260 for more information on how this change might impact you.
Substance abuse dollars have been divided into four areas: Adult Corrections, Juvenile Corrections, Drug Courts and Department of Health and Welfare.
01/18/2012:
The Department of Defense issued regulations at the end of 2011 (online at http://www.gpo.gov/fdsys/pkg/FR-2011-12-27/pdf/2011-33109.pdf) which would let licensed professional counselors practice independently within TRICARE, the health care program providing services for an estimated 9.6 million active duty service members, retirees, and their families. For many years, all other master s level mental health professionals have been allowed to practice independently, while TRICARE beneficiaries can only see licensed professional counselors under physician referral and supervision.
Current Referral and Supervision Requirements Still In Effect
Although the rule stated that it was effective on December 27, 2011, it now appears that counselors will not be able to see TRICARE beneficiaries independently for a few months. According to staff with the TRICARE Management Activity (TMA, the agency charged with managing the program), the Department of Defense is maintaining existing requirements for physician referral and supervision of counselors services until it has reviewed comments on the regulation and made any final changes it deems necessary in light of the comments it receives. DoD staff indicate that TMA expects to finish this process and begin implementing the regulations later this year.
ACA encourages counselors interested in this issue to submit comments. Comments must be submitted by February 27th. You can do this through the website http://www.regulations.gov. In the drop-down box in the middle of the page entitled Select Document Type , select Rule , and in the box next to it entitled Enter Keyword or ID type in certified mental health counselors . Click Search , and the top result listed on the page that comes up should be entitled TRICARE: Certified Mental Health Counselors. You ll see a link for Submit a Comment on the right-hand side of the page.
ACA will be submitting comments as an organization, and we will be collaborating with both the National Board for Certified Counselors and the American Mental Health Counselors Association in developing our comments. ACA has worked closely with both NBCC and AMHCA over the years in advocating for independent practice authority for counselors within TRICARE.
ACA s comments are likely to include items such as the following:
An expression of strong support for DoD s proposed transition period, during which counselors with degrees from programs that have not yet become CACREP-accredited can apply for certification as independently-practicing mental health counselors; A request that TRICARE recognize all relevant counseling master s degree titles for practice as a mental health counselor; A request that TRICARE recognize all supervised experience obtained by counselors that meets the criteria used by the licensure board for the jurisdiction in which they practice; A request that TRICARE consider extending the transition period during which the agency will certify counselors with degrees from regionally-accredited institutions who have passed the NCMHCE, and counselors with degrees from CACREP-accredited programs who have passed the NCE through December 31, 2015. This would be especially helpful if the DoD regulations aren t implemented until the end of 2012.
For more information, or for a synopsis of TRICARE's proposed requirements for independent practice, contact Scott Barstow with ACA at sbarstow@counseling.org.
