Colorado mental health professionals angry at Medicaid forum

A virtual forum meant to identify “pain points” between exasperated mental health therapists and the state’s Medicaid department has left some healthcare providers screaming, shaking with anger and venting their rage in the meeting’s chat box.

The Colorado Department of Health Care Policy and Funding hired a group of consultants specializing in conflict resolution for the hour-long forum Wednesday, which left many of the 160 therapists, psychologists and social workers who attended more furious than when they connected.

“I’m kinda shaking with anger about this,” said Andrew Rose, psychotherapist and director of Boulder Emotional Wellness, his voice echoing through his microphone. “We are not going to get carried away by the companies. It was completely inappropriate. Suppliers quit!

The forum, intended to clear the air, comes after months, if not years, of intense frustration among mental health providers in private practice who wish to treat patients covered by Medicaid, the government insurance program for low-income or disabled people. The state division of Medicaid contracts with companies, called regional responsible entities, to qualify mental health professionals and reimburse them for providing therapy to Medicaid clients.

The system is riddled with administrative burdens, convoluted requirements, and — most frustrating for therapists — late payments and “clawbacks” in which a regional entity has asked mental health providers to repay the money they receive. have already been reimbursed for the services they have already provided.

Mental health professionals said they expected to be able to vent their frustrations and seek solutions during the forum. Instead, two mediators asked them to log into an instant poll website on their cell phones and answer questions, including whether they felt the process was “going in the right direction” and what was happening. was going well now. As the responses were displayed live on the screen in colorful words and graphics, mental health workers quickly became flustered.

We are not welcome to share our complaints and concerns today? We are here to watch your presentation?

Danielle Patterson, Licensed Clinical Social Worker in Colorado Springs

“If I could clarify,” interrupted Danielle Patterson, a licensed clinical social worker in Colorado Springs, “are we not welcome to share our complaints and concerns today? Are we here to watch your presentation?”

She then posted in the meeting’s chat box, saying the Medicaid division had not responded to their concerns for more than two years. “We’ve been trying to work with them for years with no response, no gas, worse policies, retaliation, etc.”

Mediators and staff from the state Department of Health Care Policy and Financing, which oversees the Medicaid division, tried to keep the presentation on track. They promised future meetings, breakout sessions and suggested people fill out “complaint forms”.

“Today is not the day that we’re just going to have 165 people talking at the same time because no one will be able to hear that,” said Allison Faeder of Arrow Performance Group, a Denver consulting firm.

When only half of those in the forum responded to a survey question, Faeder said, “I’m going to consider this a win considering how much heat there is in this conversation.” And later, his fellow mediator, Julie Auger, made a point of acknowledging the sentiment in the virtual room.

“You are not paid. Let’s call it what it is. It sucks. This is wrong,” Auger said. “If I had my magic pixie dust, we’d take care of it right away.”

Medicaid officials said they were committed to addressing the issues and were talking with regional entities to ensure mental health care providers would be paid. Melissa Eddleman, of the state Department of Health Care Policy and Financing, said the forum was not just an exercise, but a path to solutions. “It’s really about systemic change,” she said.

Throughout the hour-long meeting, the chat broadcast:

“Can you just log in as human beings? Don’t you see that trust is a major issue here? Listen to the providers,” wrote Doreen Hills, a therapist at Fort Morgan.

“We are tired of never finding solutions. Simply put: you get paid, we don’t,” wrote Fairplay and Bailey advisor Nola Knudsen. “This must be a priority solution.”

At the end of the meeting, Medicaid providers said they were tired of being told to cooperate with the mediation process and to be nice to the mediators and the Medicaid division.

I don’t appreciate being told that I’m not nice. I am a very nice person. I’m just pissed off.

Dr. Lisa Griffiths, Aurora Certified Psychologist

“I don’t appreciate being told I’m not nice,” said Dr. Lisa Griffiths, a licensed psychologist at Aurora. “I am a very nice person. I’m just pissed off.

Jeremy Rogers, a mental health counselor in Colorado Springs, added, “The kindness has gone out the window. Be very nice to me by paying the contracted rate and I will be super nice to you by providing the service to the member. There’s nothing good about the bills not being paid.

Someone shouted “Hallelujah!” As he spoke.

The turmoil comes as state leaders, including Governor Jared Polis, have made it a priority to increase the number of mental health care providers who will accept Medicaid. While the Medicaid division says the numbers have increased dramatically in recent years, some in private practice have stopped accepting Medicaid due to frustrations with licensing and billing.

Mental health providers who take Medicaid clients have faced reductions in reimbursement rates. They complain that it takes months, if not years, to get approval from the state Medicaid division and regional entities to take on clients. And in the fall, 199 of them received “recovery” notices from the regional entity for eight counties, including Boulder and El Paso, asking them to return the money they had already received due to an administrative problem. In some cases, the amounts totaled $17,000 or $18,000 for a single mental health therapist in private practice.

The entity that sent the recovery notices, the Colorado Community Health Alliance, is owned by private insurance giant Anthem. The alliance reversed course after coverage by The Colorado Sun and 9News.

Now, in the past two weeks, several mental health providers are again struggling to get paid after seeing Medicaid patients.

Among them is Faith Halverson-Ramos, who provides music therapy to tweens, teens and adults in a private practice in Longmont.

Halverson-Ramos, who opened her practice in 2015, began the application process to take Medicaid patients in August 2020. It took 11 months due to numerous administrative issues, including a missing date on a bank letter. Since then, she has had billing headaches.

Its regional entity, the Colorado Community Health Alliance, owes Halverson-Ramos about $1,000 for treating a Medicaid patient starting in the fall, she said. For another Medicaid patient, she was paid for two months with no hassle, but then began to receive denials from the regional entity because she did not have prior authorization to provide the treatment, which she says , is not necessary.

It’s sad, Halverson-Ramos said, that Colorado makes it so difficult to accept Medicaid clients. It’s important to her to keep trying, as she struggled with mental health issues at 18 and could only afford community mental health care.

“I just want to help create a better society, a healthier society, and have my efforts treated like this by a faceless insurance company that doesn’t care about people rather than their profits, which just ‘add insult to injury,” she said. said in an interview. “I really worry about children and teens growing up in poverty who don’t have access to mental health care.”

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