Shumlin Administration Will Restore Some Mental Health Cuts

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The Shumlin administration has agreed to restore some of the cuts it made to reimbursement rates for Medicaid mental health providers.

Rick Barnett is the head of the Vermont Psychological Association and has a private practice in Stowe.

He and other members of his organization were stunned, when the Shumlin administration on January first, implemented a 10 percent cut in reimbursement rates for outpatient Medicaid mental health services.

Barnett said the cut would likely cause a number of private providers to limit the number of Medicaid patients that they see.

He said this development could force other Medicaid patients to try to access community based mental health programs that have serious overcrowding issues.

"They’re already over stressed and have ridiculous waiting lists so they’re going to be left with less places to turn."

Mark Larson is the commissioner of the Department of Vermont Health Access.  He says the Medicaid reimbursement rate is based on a very complicated federal formula that tries to measure how specific procedures fit into the overall priorities of the Medicaid program.

He says the administration has decided to change several parts of the formula to restore about half of the cuts.

"It meant that we were skewing it from its intended purpose," said Larson.  "So what we have done is that we are holding psychologists and licensed social workers harmless to our change in the dollar figure."

Larson says the mental health providers will also benefit from an Administration proposal to implement a 3 % increase in most Medicaid reimbursement rates:

"That’s why we’re building that into the future so that we can preserve the access that we’ve maintained," said Larson. "And move toward reducing the amount that is shifted onto to private insurance when public insurance doesn’t keep up with the cost of services."

Barnett says the decision is a step in the right direction but he also thinks that the federal reimbursement formula needs to be changed.

"I think providers will be encouraged by the willingness to restore some of the cuts, they’ll be encouraged if it continues in that direction in getting for restoration," said Barnett. "But ultimately the Department of Vermont Health Access, they’re looking at the formula that is used and is handed down to them federally which is an antiquated system of figuring out the value of such services."

Larson says the restoration of these Medicaid funds will be made retroactive to the beginning of the year.

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