YOUR CONTRIBUTION WILL HELP EFFORTS TO ACHIEVE REIMBURSEMENT PARITY!

GREAT NEWS FROM YOUR LEGISLATIVE COMMITTEE!

Tired of insurance companies paying you less than your services are worth?

Wish there was some way to protect your patients from having their treatment scrutinized unfairly, limited or denied?

Ready for some good political news??

February 2017: AMHA’s legislative committee is proud to announce that our bill has been formally introduced in the Oregon Senate.

 *Introducing Senate Bill 860   SB 860 declares that lack of parity for mental health reimbursement is a public health emergency.

 Current law says there must be parity, or equivalence, in the way insurers reimburse mental health providers and physical medical health providers, but we all know this does not happen in practice.

 This bill would compel the Department of Consumer and Business Services (DCBS) to study:

  1. historical reimbursement trends
  2. whether each plan imposes utilization management procedures for behavioral mental health providers that are more restrictive than for medical providers (routine denial of 90837)
  3. whether each plan pays equivalent reimbursement for time-based procedural codes
  4. whether the methodologies used by each plan to determine the plan’s reimbursement rate schedule are equivalent.
  5. DCBS must report the findings of this study to the Legislative Assembly no later than Sept. 1, 2018.

 DCBS shall adopt rules to ensure parity requirements are met by insurance plans offered to residents in this state.

This bill is the outcome of the hard work of the AMHA and WOMHA legislative committees under our coalition name: Oregon Independent Mental Health Professionals (OIMHP).  We work with our well-connected lobbyist in Salem, JL Wilson of Public Affairs Counsel.  JL has demonstrated a personal investment in ensuring parity in reimbursement for mental health providers as a way to protect our clients.  We have active partners in Salem advocating for the bill including NASW, COPACT and the psychologists.  We are really excited as we prepare to testify with a professional show of force in our state capitol.    We wanted to share the good news!  Thank you for your support of our efforts.


Link to: Complete text of Senate Bill 860 79th OREGON LEGISLATIVE ASSEMBLY--2017 Regular Session - Sponsored by COMMITTEE ON HEALTH CARE (at the request of Public Affairs Counsel)

 

September 2016

AMHA Legislative Committee aka Oregon Independent Mental Health Professionals (OIMHP):

This committee has been in existence since 2014 and current membership consists of Metro members (Anne Emmett, Tracy Bryce Farmer, Larry Venaska and Marc Andrews) and WOMHA members (Nick Dietlein, John Milnes and Pat Mooney). We represent members who have traditional practice, those in the IPA or a combination.  The committee works with the lobby firm Public Affairs Counsel.

What has been accomplished this past year: 

Collaborated in the design of the Oregon Insurance Divisions’ (OID) data call to gather 2007-2015 mental health reimbursement data in order to examine trends.

  • Proposed analytic methodology to help OID determine whether insurance companies’ reimbursement practices have complied with the intentions of the federal and state mental health parity laws.
  • Provided input to OID about how to determine the adequacy of an insurance company’s mental health provider panel in compliance with the new HB 2468 law. Tough rules on panel adequacy should yield better reimbursement.
  • Coordinated efforts with lobbyists for the psychologist, social workers and LPC/LMFT counselors in order to craft a unified approach to seeking better mental health reimbursement.
  • Met with eight influential Republican and Democratic members of the House and Senate health care committees during May Legislative Days, informing them of our work with OID and laying the groundwork for fair mental health reimbursement legislation.
  • Presented our IPA Connecting Care model to the Oregon Health Authority and discussed how to reduce bureaucratic roadblocks to attain high paying OHP contracts.     (Summary credit: WOMHA’s August 2016 newsletter)

Where do we go from here?

The 2017 legislative session starts in February and ends in July.   Because of our committee work and the guidance of our lobbyist we are poised to achieve results in our work towards tough insurance regulation and fair mental health reimbursement.  We also have been informing our legislators and policy makers about the Connecting Care Model.

Our lobbyist has been working in coalition with lobbyists from NASW, COPACT and OPA and reports a strong working relationship which will be helpful in this next legislative session, particularly if new legislation proposed. 

This committee is currently awaiting the results from a compliance review/formal market analysis of data from Oregon’s domestic health insurance carriers, consumer complaints and other related market analysis investigations that took place during the time period of 1-1-2007 through 12-31-2015.   We will be contacting interested legislators about this issue this month.

Funding continued work of this committee:

The Legislative Committee recommends continued involvement with PAC and have recently sent out a fundraising letter to the professional community to fund further work. See the letter on the AMHA-USA and Metro web sites.   The Metro Board has approved $7,500 in funds towards lobbying costs and will continue to look at ways to raise additional funds.  Please consider a generous contribution as an investment in your future as an independent private practitioner.

Sincerely,

Your Metro reps on the Legislative Committee:

Anne Emmett                        Larry Venaska

Tracy Bryce Farmer                Marc Andrews

September, 2016 Funding Appeal

 OIMHP LOBBIES FOR FAIR MENTAL HEALTH REIMBURSEMENT:  JOIN US

 Does it concern you that insurance companies now audit therapists for billing 60 minute sessions??

 Are you sick of not being compensated adequately for your professional services?

 Do you find it ironic that for all the talk about partnering physical and mental health care, insurance premiums go up, but mental health reimbursement stays stagnant or trends downward?

 The  Oregon Independent Mental Health Professionals organization (OIMHP) makes it easy for you to support  a targeted political  effort designed to deliver a long overdue increase in insurance payments to mental health professionals. OIMHP has  contracted with the Public Affairs  Counsel lobby firm to achieve this goal.   We need your financial support  to continue our work.

 OIMHP’s lobbyist, J.L. Wilson, has  a personal stake in advocating for financial parity for providers due to a loved  one’s  ongoing mental health challenges.  J.L. reports  there  are very promising signs on the horizon favoring the passage of insurance regulation and/or  new legislation that will increase mental health reimbursement:

 a collaborative relationship with the Oregon Insurance Division,

  • a State legislature receptive to supporting mental health parity issues, and
  • a strong working  coalition with mental health lobbyists for the psychologists, social workers and  LPC/LMFTs.

 Please make a donation at the link above. **2016-17 donations are partially deductible as a necessary business expense...Assure the growth of your income as a private practitioner!

Who are we?

Oregon Independent Mental Health Professionals

We are members of the American Mental Health Alliance (AMHA). We represent independent mental health practitioners in both traditional practice and in Independent Practice Associations (IPAs)*.  Our Legislative Committee, OIMHP, includes members from the Portland-based Metro Board (AMHA-OR) and the Salem-based Western Oregon Mental Health Alliance Board (WOMHA).

 Why have we built a legislative collaborative with the Public Affairs Counsel?

 The  Public  Affairs  Counsel has  lobbied mental health issues in Salem for more than three decades—first for the National Association of Social Workers and then for the Oregon Society of Clinical Social Workers. In 1981,  PAC was largely responsible for the passage of the mental health vendor-ship law for social  workers, allowing them  to bill insurance. The  Public  Affairs Counsel also  led the fight to pass  a mental health parity  law in Oregon.

 PAC has  a long list of corporate and association clients  including General Motors,  Allstate Insurance, 7-Eleven, Inc., Oregon Head Start  Association and the Oregon Housing Alliance. PAC’s J.L. Wilson  has  a 16-year history  in public  affairs  and  lobbying as past  Executive Director of NFIB/Oregon and  past Senior Vice  President of Government Affairs  at Associated Oregon Industries. Prior to that, he served as Legislative Director for two Speakers of the Oregon House.

 Why should you support us?

  •  We have been building a working  relationship with the Oregon Insurance Division (OID), giving  input on their data  call to Oregon insurers and  promoting an analytic methodology to make crystal  clear  the discrepancy between physical and  mental health reimbursement trends.  With this vetted data  in hand, we will lobby for needed OID regulatory activity  and/or  pursue reimbursement parity legislation with the support  of OID in the coming  2017 legislative session.
  •   AMHA’s OIMHP is the only Oregon professional group consisting of licensed multi- disciplinary private practitioners, focusing solely on the interest of mental health private practice.

 You  may be a member of a professional organization that also has  a lobbyist  you wish to support.  In that case, please give  to them generously. They are  our partners in this effort. However, if you are unaffiliated or wish to invest  in our efforts to bring about  better reimbursement on your behalf--please consider supporting our legislative efforts by donating to the Oregon Independent Mental Health Professionals.  It is a wise investment to promote the future  of your thriving  practice.

  PLEASE JOIN US!!

  *AMHA  Northwest (AMHA-NW) has  formed  an  Independent Practice Association (IPA) organizational structure with regional chapters and  bylaws designed to allow  therapists to join together and negotiate with insurers for better  reimbursement rates  based upon the ACA’s Triple Aim--better patient access and  experience of care, improved patient and group  health, and  cost- effective treatment.

AMHA-NW has  developed a “Connecting Care” treatment model  of providing empirically-based, physician-therapist coordinated care. By emphasizing quality  care  that provides added consumer value, individual AMHA members are  able  to negotiate better  reimbursement rates  as  a group while  preserving their  individual autonomy.   So  far,  we  have contracts with PacificSource and MODA. We seek others.

  OIMHP Legislative Committee:

 Patrick Mooney, Ph.D. Sam Stevens, LMFT

Anne Emmett, LCSW, Marc Andrews, LCSW John Milnes, LCSW,

Nick Dietlein, Psy.D., Judy Tuttle-Zollner, LPC, Tracy Bryce Farmer, LCSW