Residents of the Sunshine State have it really tough these days. With a housing market on life-support, 46% of Florida mortgages underwater, and unemployment at a painful 10.6%, Floridians have an awful lot to worry about. So here’s one more. If your health insurance is provided by Blue Cross & Blue Shield of Florida (BCBSFL), and you just so happen to use Mental Health or Addiction Treatment services, November 30th of this year might be a very bad day for you.
Why? As of that date, all existing contracts between BCBSFL and mental health/addition treatment service providers will end, and a new group, New Directions Behavioral Health, will administer future Blue Cross’ mental health services agreements with providers. From this new entity, mental health providers can expect reimbursement rate cuts from 25-55% lower than their prior BCBSFL contracts.
Not surprisingly, this slash-and-burn approach to cost control will have the devastating effect of severly limiting patient access to quality mental health treatment, as providers who are already underpaid relative to other health professionals are forced to turn away New Directions policyholders because the reimbursement rates are too low to even cover the basic costs of running a practice!
This is most likely not what Congress had in mind when it passed the Mental Health Parity and Addiction Equity Act of 2008. Among other things, the Act,
…requires group health plans and health insurance issuers to ensure that financial requirements (such as co-pays, deductibles) and treatment limitations (such as visit limits) applicable to mental health or substance use disorder (MH/SUD) benefits are no more restrictive than the predominant requirements or limitations applied to substantially all medical/surgical benefits.
It would seem that the BCBSFL re-contracting move is nothing but an end-run around the Act’s financial parity requirements, targeting not copayments or deductibles, but provider reimbursement rates. Although a coalition of mental health advocates has formally requested Federal intervention into this matter, it will be the patients of Florida who will, in the meantime, bear the heavy emotional and financial burdens that this assault on mental health treatment will no doubt bring.
So much for the Sunshine State.
Copyright © 2011, Nelson A. Vega