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Trump administration begins sweeping layoffs with probationary workers, warns of larger cuts to come; NYC music school teachers strike after union negotiations break down; Ohio advocates push for inclusive policies during Black History Month; Health experts recommend sunshine, socializing to cure 'winter blues.'

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Federal workers tasked with securing elections from foreign interference are placed on leave, parents' organizations reject dismantling Dept. of Education, and the Congressional Black Caucus presses discussions on slavery reparations.

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Rural America struggles with opioids and homelessness in unexpected ways, Colorado's Lariat Ditch could help spur local recreation, and book deliveries revive rural communities hit by Hurricane Helene.

In NE, reimbursement hang-up threatens mental health care access for some

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Thursday, November 21, 2024   

The mental healthcare landscape in Nebraska is being upended by policies for reimbursing providers who see patients covered by both Medicare and Medicaid. Systems say they're losing money, resulting in access gaps for older low-income clients.

Providers say the key concern has to do with serving patients considered dual-eligible, meaning they're enrolled in Medicare and Medicaid. This year, the federal government expanded the scope of professionals who can see Medicare patients for therapy and be reimbursed.

But Jon Day, executive director of Blue Valley Behavioral Health, said because of how Nebraska policy aligns with dual-eligible situations, practitioners are now seeing rates cut in half.

"More providers are coming out and saying, 'Oh my gosh, we can't see these people cause we're losing money.' So, we either refer them out, or they're not taking on people as well," he explained.

Day estimates a $200,000 revenue loss for his system and added that it's not easy to refer clients elsewhere because of provider "deserts" in some areas. Those working with the Nebraska Assocation of Behavioral Health Organizations have been meeting with state Medicaid leaders, noting the state can cover the difference without taking on extra costs. But progress on a final solution has been slow.

Providers say they understand the federal government's desire to bring more mental health professionals to the table in seeing patients. But they add unintended consequences at the state level almost defeat the purpose.

Chase Francl, CEO and president of the Mid-Plains Center for Behavioral Healthcare Services, said this is a heartbreaking situation.

"There's such a low margin on any behavioral health services, and any small disruption really can have catastrophic effects," he said.

Even though fixes offered by these providers are described as solutions without extra costs, they acknowledge the challenging environment given the appetite among elected officials to reduce the state's budget. As for the federal change that brought this situation to light, Licensed Independent Mental Health Practitioners can now be reimbursed under Medicare, and not just those with Masters or doctoral degrees in Social Work.

Disclosure: Nebraska Association of Behavioral Health Organizations contributes to our fund for reporting on Alcohol and Drug Abuse Prevention, Children's Issues, Health Issues, Mental Health. If you would like to help support news in the public interest, click here.


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