MaineCare Rate Study for Mental Health Services Leads to Proposals with Devastating Impact

MaineCare Rate Study for Mental Health Services Leads to Proposals with Devastating Impact

Created on: Monday, March 28, 2016
Author: Maine Medical Association

Mental Health agencies in the state and their health professionals are gearing up for a difficult fight over rate cuts proposed by DHHS based upon the results of a rate study for behavioral health and targeted case management services authorized in the state budget document passed last June.  The study was conducted by Burns & Associates out of Phoenix, Arizona.

Dated March 14, 2016, the study proposes some severe cuts to reimbursement for certain mental health services, including medical management, a service primarily performed by psychiatrists.  The Maine Association of Psychiatric Physicians (MAPP) is urging its members to communicate both with MaineCare officials and key legislators emphasizing the devastating impact that these reductions would have on the patients currently receiving these services and the impact as well on patients needing these critical services in the future.  

DHHS Commissioner Mary Mayhew is quoted in the media as stating that the rate study is part of an effort to make sure taxpayer-funded services cost what they should.  She told the Bangor Daily News, "This isn't a rate reduction tied to some budget cut that's got to happen because some budget has been reduced.  This is about what are the wages you pay staff, what is the overhead you pay for rent or other overhead costs that support the operation of the agency and what, therefore, is an appropriate cost." 

The rate study was added to the budget document as part of budget negotiations last year when the LePage Administration proposed to cut millions of dollars in MaineCare reimbursement for children's mental health services.  The budget document called for studies in two particular areas, Section 28, which includes services for children with cognitive impairments and Section 65, which includes behavioral health services.  The Department later added Sections 13 and 17 to the study.  Section 13 covers case management services and Section 17 covers community support services for adults with severe mental illness.

Interested parties have until April 8th to comment on the proposals which will then go to formal rule-making later in the year.   The proposals were subject to an information session before the HHS Committee of the legislature last Tuesday, March 22nd.   Concern was expressed by a number of clients and the Democrats on the Committee have expressed a need to slow the proposals done and have a legislative review.   Senator Tom Saviello, (R-Franklin) has prepared an after-deadline bill asking for a delay in implementation of any of the reductions in reimbursement until such time as they are reviewed by the Legislature.  The bill has not yet been considered for late introduction into the session.  At a meeting today between Senate HHS Chair Eric Brakey (R-Androscoggin) and MaineCare officials, a revised timeline for the effective date of any implementation was presented which may eliminate the need for the Saviello legislation.  It is hoped to have the results of that meeting confirmed in writing within the next day or so.  In the meantime, an appropriate strategy for those opposing the reductions is to communicate with their State Senator as the House leaders have already indicated support for the bill.

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