PROVIDENCE – A group of Rhode Island behavioral health providers met privately on Feb. 22 with representatives from Blue Cross & Blue Shield of Rhode Island and with R.I. Health Insurance Commissioner Christopher F. Koller.
One of the issues discussed was how to resolve any remaining problems caused by recent coding glitches that resulted in Blue Cross wrongly denying hundreds of claims and delaying payments for behavioral health providers in Rhode Island beginning on Jan. 1. The health insurer has apologized for for the problem,
A larger issue of parity in payment for behavioral health providers is still unresolved, according to Peter Oppenheimer, a psychologist with Feil & Oppenheimer Psychological Associates in Barrington, and a leader of the nonprofit organization known as the Coalition of Mental Health Professionals of Rhode Island. The group includes representatives from each of the professions licensed to provide mental health services in the state – social workers, nurses, mental health counselors, psychologists, psychiatrists and marriage and family therapists.
The issue regarding parity in pay was first raised in July of 2012 with Koller, according to Oppenheimer. A letter asking for a formal inquiry was sent to Koller in September of 2012, according to Oppenheimer.
The problem is that despite federal law guaranteeing parity for behavioral health providers, Oppenheimer explained, behavioral health professionals were being paid at a lower scale than other medical specialties by Blue Cross.
“The only response I got [from OHIC] was a letter implying that they were investigating, and that they did not want to talk about it while they were investigating,” Oppenheimer said. The result of the decreased payments, Oppenheimer continued, “is that it makes the economics of private outpatient psychotherapy nearly impossible to do.”
Further, Oppenheimer said that despite the calls for strengthening behavioral health services in the aftermath of the Newtown, Conn., murders, there has been a disconnect with the way that behavioral health fits within the framework of health care reform. “Everyone talks about the importance of behavioral health, but when it comes to implementation, it doesn’t always fit into the equation,” Oppenheimer said. “When it comes to implementing health care reform, behavioral health tends to get neglected.”
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