Provider group urges delay in Medicaid behavioral health plan

A group representing about 150 providers is asking the Ohio Department of Medicaid to delay its planned July 1 switch for mental-health coverage from a state-run system to managed care (Source: “Providers ask state to delay Medicaid behavioral health changes,” Akron Beacon Journal, May 28, 2018).

A previous change in January in the way providers are required to bill for services has led to months-long delays in payments from the state, forcing providers to tap into cash reserves and lines of credit and sell assets, said Lori Criss, chief executive of the Ohio Council of Behavioral Health & Family Services Providers.

A July switch, she said, will exacerbate the problem because managed-care plans reimburse providers about every two months, on average. The state’s standard is one or two weeks.

The state, noting that survey respondents represent about 25 percent of providers in Ohio, does not plan a delay in what is being referred to as “integration,” the final step in Gov. John Kasich’s plan to modernize and expand mental health care and substance abuse treatment services.

The state said it is moving to managed care to ensure that mental-health services are covered at the same level as physical health services, to encourage more providers to participate, and to expand services, including those for people with the most intense needs and for preschoolers.

Greg Moody, director of the Governor’s Office of Health Transformation, said that the state is keeping track of whether people are getting the care they need — not whether it’s easy for providers.

Managed care plans have conducted several tests to ensure they will be ready, and have been working with the state, providers and others for two years to ensure a seamless transition, said Miranda Motter, president and chief executive of the Ohio Association of Health Plans.