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The first for-profit insurance company approved to offer government-subsidized coverage under Massachusetts’ health reform has dangerously restricted access to primary care, according to data reported in Thursday’s (Aug. 5) New England Journal of Medicine. Researchers say the findings raise troubling concerns about the Obama administration’s new health law, which is modeled after the Massachusetts plan.
As you know, the Centers for Medicare and Medicaid Services (CMS) has released its proposed rule on the 2011 Medicare fee schedule – and there is a lot at stake for practicing psychologists. As we [American Psychological Association Practice Organization - APAPO] have mentioned previously, in addition to reflecting an expected cut to all services as a result of the Sustainable Growth Rate (SGR) formula and changes to the Physician Quality Reporting Initiative (PQRI) payments, the rule would have a significantly negative impact on psychological and other mental health services due to revisions to the medical economic index (MEI).
A new fact sheet from the UCLA Center for Health Policy Research provides detailed county-by-county estimates of the number of California residents who have lost health insurance during the economic downturn. Check the end of this report for a link to the UCLA “California’s Uninsured by County” fact sheet..
Proposed cuts to community mental health centers in Illinois continues a disturbing trend in the state’s lack of commitment to helping families and individuals experiencing a mental illness, according to a University of Illinois expert on community-based mental health services. Christopher R. Larrison, a professor of social work at Illinois, says the state of Illinois has overseen a “decimation” of community mental health services thanks to decades of neglect.
As you know, the Centers for Medicare and Medicaid Services (CMS) recently published its proposed rule on the 2011 Medicare fee schedule, and our regulatory team has completed an analysis of the lengthy and complex regulation. In addition to reflecting an expected cut to all services as a result of the Sustainable Growth Rate (SGR) formula and changes to the Physician Quality Reporting Initiative (PQRI) payments, the rule would significantly negatively impact psychological and other mental health services due to revisions to the medical economic index (MEI).
In a comprehensive new study of mental health status and the use of mental health services by Californians, the UCLA Center for Health Policy Research found that nearly one in five adults in the state – about 4.9 million people – said they needed help for a mental or emotional health problem. In addition, approximately one in 25, or more than 1 million, reported symptoms associated with serious psychological distress (SPD), which includes the most serious kinds of diagnosable mental health disorders. Check the end of this report for a link to download the original UCLA research brief.
As you may recall, in 2007 the Centers for Medicare and Medicaid Services (CMS) implemented across-the-board cuts to provider reimbursements as a result of the five-year review regulatory process, which had a disproportionately negative impact on psychological services due to the way Medicare allocates value for services. Following the grassroots mobilization of practicing psychologists across the country, the APA Practice Organization was able to secure a legislative remedy by persuading Congress to restore 5% to Medicare psychotherapy services in 2008 and convincing both chambers to extend the provision again through the end of 2010.
As you know, a segment of practitioners have been randomly selected to participate in a critical survey of the psychotherapy codes as part of an important regulatory process of the Centers for Medicare and Medicaid Services (CMS), known as the Five-Year Review. For the first time in more than a decade, psychologists have an opportunity to participate in the process that determines how psychotherapy services will be valued and, ultimately, reimbursed by both Medicare and private insurance companies who view Medicare as a benchmark.
The Centers for Medicare and Medicaid Services (CMS) recently published its proposed rule on the 2011 Medicare fee schedule, and I wanted to draw your attention to three important aspects. First, CMS is projecting a 6.1% cut to all services in 2011 based on the Sustainable Growth Rate (SGR) formula. Since the regulation is based on current law, the proposed rule assumes no action by Congress to block the 23% cut currently scheduled for December 1, 2010, meaning the 2011 cut would be additional.
Medicare reimbursement has been front and center on Capitol Hill over the past several months. The involvement of practicing psychologists across the country in grassroots advocacy played a key role in ensuring the enactment of several laws extending the 5% payment restoration for Medicare psychotherapy services and preventing the 21.3% Sustainable Growth Rate (SGR) cut. [...]
I am pleased to report that Congress has finally sent legislation to the President to postpone the 21.3% Sustainable Growth Rate (SGR) cut retroactive to June 1 and through November 30, 2010. The House approved the stand-alone bill (HR 3962) by an overwhelming vote of 417-1. The roll call will be made available at http://clerk.house.gov/evs/2010/roll393.xml. [...]
Jeff Cook from the American Psychological Association Practice Organization is currently providing updates on the impending Congressional vote expected this evening related to the Sustainable Growth Rate (SGR). This is an extremely important event for healthcare providers who accept health insurance, especially Medicare/Medicaid. I will condense his hour-by-hour updates in this post, but will create [...]
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