'So far, it's chaos': New changes in psychotherapy treatment codes puts population at risk
Delays, denials of payment could last for months putting mentally disturbed at peril
Codes used to describe and bill for mental health treatment in the United States underwent an overhaul at the beginning of the New Year. The codes, produced by the American Medical Association are updated each year, but changes to only 30 codes have drastically affected mental health services, putting the nation's mentally at risk.
The financial fallout for mental health services may force some providers to disrupt care, leaving mentally unstable patients on their own temporarily or longer, leading to a rush of new homeless people.
"So far, it's chaos," Deputy Executive Director for the American Psychological Association Randy Phelps says. "It's hard to evaluate how widespread this is."
The problem comes amid growing demands for better interventions with the mentally ill in the wake of shooting massacres in Colorado and Connecticut.
Sam Muszynski, director of the office of health care systems and financing for the American Psychiatric Association says that "compliance with treatment is a sketchy thing to begin with." Muszynski fears that financial fallout may force some providers to disrupt care, leaving mentally unstable patients on their own temporarily or longer, leading to a rush of new homeless people. "All it takes is one missed appointment," he added.
"There are some systems that aren't even ready to begin accepting claims," Nina Marshall, director of public policy for the National Council for Behavioral Health says. She's been inundated with calls and e-mails, not only from providers confused about how much to charge and when they'll get paid, but also from patients worried about care.
"I have heard from consumers saying that their providers can't provide the services," she said. "They're reaching out to me with real concerns."
"What has come out of managed care in mental health is they go in for three days, they're on meds, they're barely stabilized, and being treated by outpatient providers," Phelps said. "Nobody had reevaluated these codes for 30 years, but the world had changed tremendously."
Mental health providers say their insurance claims have been denied along with their payments withheld due to problems resulting from the changes.
Marc Milhander, a psychologist who co-owns a busy Niles, Mich., counseling center, is feeling the pressure.
"I've been paid for five hours of work for the month of January," Milhander says, who supports a staff of four and oversees 300 patients a month. "I just wrote a big, fat check out of my personal bank account to keep us afloat."
Federal estimates suggest that nearly 20 percent of the adult U.S. population has some form of mental illness.
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