Does anyone remember seeing the movie, "Stuart Little," where the alley cats said sarcastically to the house cat, "A pet cat for a mouse." "How can that be?" In the real animal world, it is usually the cat that have the "pet mouses" and not vice versa. How does this example apply to the mental health field for children?Mass Behavioral Health Partnership (MBHP) issued Alert # 55 (December 22nd 2008) stating new changes in how they will authorize Outpatient Mental Health Services for Adults and Children.
As a FYI, adults, 19 years of age and older will get 12 units authorized for a 180 day period (six months), while children and adolescents, 18 years old and under will get 14 units authorized for a 180 day period (six months). However, if a child or adult needs additional sessions within this time period for example, weekly visits due to the severity of a client's mental health symptoms, MBHP now requires the clinician to have a telephonic meeting with them to scrutinize the updated treatment plan that is submitted to them for review.
This new procedure is highly insulting for a clinician to "beg" for more services from not only from MBHP but also from other health insurance providers who will be following the same protocol as well. I am aware of the economic climate to control costs in a shaky economy in the healthcare arena. However, it is the clinicians training and expertise in children's mental law that needs to be respected and not undermined by insurers.
While the new children' mental health law will have services in place for mobile crisis interventions and at home therapy interventions for families, it fails to advocate for improved outpatient services for children. It is the clinicians that know how long it will take to treat their clients' symptoms and not the insurers. If a child does not receive additional sessions within the authorized time period, the child will be at risk for hospitalization or residential treatment that will cost the insurance companies more money to pay for. Last but not least..this stricter requirement to "beg" for more sessions from "the big mouse" will not help retain and/or recruit clinicians to service children with mental health needs.
Robbin MillerCitizen-Therapist
Facilitator
http://www.therapistsforchange.blogspot.com/.
2 comments:
Robin, the silence around these cuts has been "deafening". In addition to cutting sessions for children by 50%, the MBHP changes to the Authorization process have made it impossible to see children and teens who saw someone in the past on an Authorization. I just wrote to the NASW to ask them to ask MBHP the following questions:
1. Can there no longer be 2 Auths for the same child / teen under any circumstance?
2. So if a kid in therapy needs and gets FST, is the therapist no longer able to get an Auth when the previous one expires?
3. Will it be the same when CBHI related crisis services begin, that is, the child goes into crisis and the therapist who has been working with him / her gets the boot?
4. How can a therapist today get an Auth if HIPPA prevents MBHP from telling the therapist what other therapist currently has the Auth that is preventing the first therapist from getting one?
5. Will the President’s stimulus package result in MA getting enough Medicare money to get the cut sessions restored?
6. Are the cuts to sessions related to funds getting shifted to pay for CBHI? What is the cost of the CHBI program?
7. How do these cuts jibe with Parity? Would an insurance company tell an Oncologist to half the radiation treatments?
8. How do these cuts relate to the recently passed legislation to cover children of families making too much to qualify for Medicare – are these cuts to pay for that?
- Frank
Thank you Frank for your comments. Please let other people know you responded to this blogspot.
Robbin
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