“When it’s delayed by two days on average it means some of those applications are being delayed by three weeks,” explained a state administrator. (Google street view image)
Nevada Medicaid will rescind plans to limit mental health services it put in place last month.
Facing a $56 million deficit this year, Nevada Medicaid officials say they would be scaling down services and cutting reimbursements as they intended last year.
One of these cuts was approved in August. It required mental health providers to receive prior approval for all neurotherapy and psychotherapy services after the first five sessions with a patient by submitting written documentation demonstrating medical necessity.
Medicaid previously accepted 18 sessions in a year for adults and 26 sessions in a year for those under the age of 18 without prior approval.
The policy was scheduled to go into effect on Oct. 1 before mental health providers raised concerns about the possibility of the change reducing access to much needed mental health services for Medicaid’s low-income clients.
At a hearing Thursday, Medicaid officials said they will not implement the five session limit on Oct. 1 as planned, and would officially revert the policy to its previous limits on Oct. 25, stating that an open meeting law requires the state to give a public 30 days notice before making any policy changes.
“I do want to emphasize that we are not going to implement the five session limit on Oct. 1. There are no changes going into effect Oct. 1. We will hear this item again,” said Cody Phinney, deputy administrator of the Nevada Department of Health and Human Services Division of Health Care Finance and Policy.
A Medicaid focus group worked with providers from the community and identified several alternative arrangements that would address the state’s concern over fraud and abuse within the system while maintaining the current limits on neurotherapy and psychotherapy services.
In coming months, the group will make recommendations to the Legislature regarding Medicaid costs overseen by Department of Health Care Financing and Policy related to psychotherapy and neurotherapy providers in the state.
Some of the alternative suggestions that came from health care providers include clarifying the certification that’s necessary to be qualified to provide the neurotherapy services, ensuring providers of neurotherapy services are required to enroll in the state program, and making additional fixes to the prior authorization process.
Health care providers were grateful for the reprieve.
“I just wanted to go on the record with my appreciation to Medicaid and all those who worked in the focus group and will continue to work in the focus group to revise this,” said Jer Roberson-Strange, a clinical therapist for Catch 22 at the hearing.
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