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Insurance cuts irk mental health professionals

Northwest Florida Daily News - 4/14/2018

April 14--OKALOOSA ISLAND -- Local mental health care providers believe they've been shafted by the titans of the insurance industry, and state Rep. Mel Ponder believes Okaloosa County got a raw deal last session when seeking funding to address its mental health needs.

The doctors and the lawmaker met Friday and decided to pressure the powers that be in Tallahassee to recognize the need for money to cover the costs of establishing psychiatric services and fairly reimburse the doctors that provide them.

"We've got to take this to the next level of activism," said Fort Walton Beach psychotherapist Joe Skelly, Northwest Florida's regional director Florida Mental Health Counselors Association and organizer of Friday's 2018 Behavioral Health Spring Gala at the Ramada Plaza Beach Resort.

The mental health professionals were impressed by Ponder's promise to work passionately next year to find money for Okaloosa County's mental health diversion program. Ponder told them much of that passion grew from being thwarted this year in two attempts to get money for a state-approved pilot program.

"You go over there and you swing and you miss, and you strike out twice, you get more passionate," he said.

Skelly and the other 30 or so mental health professionals brought their own fire to Friday's gala. They are outraged by insurance giants Humana and Blue Cross Blue Shield, which have slashed their reimbursement rates by 35 percent.

The rate cuts are forcing local doctors to raise fees to make a living, Skelly said, and threaten to limit them to offering services to only those who can pay -- primarily military retirees with TriCare or those affluent enough.

"One of the reasons we got in this business is to help. We want to make a living at it, but we got in it for diversity," Skelly said. "Any of us long standing in the business can go to all cash, basically, but your constituency will look like you and I do: older and Caucasian. ... That's what we face ethically."

Humana actually sent its three top eastern region staffers from Louisville, Kentrucky, to the event. Kevin Regenhold, the executive director of Network and Provider Solutions for Humana, said the rate cuts imposed by his company were believed necessary to prevent some providers from cheating the system.

The Humana group also offered to discuss rates with any mental health care provider and to work with providers to achieve a payment structure that will work.

"We're always open to discuss the terms of the contract," Regenhold said.

Humana's presentation appered to appease some of the mental health professionals.

"If I have a favorite managed care company, it's Humana," Skelly quipped.

There wasn't much competition Friday.

Blue Cross and Blue Shield, based in Florida, notified Skelly that it would not send anyone to the Spring Gala. Failing to do so didn't win the company any fans, and left it open to a rash of criticism.

Skelly pointed out that at the same time Blue Cross/Blue Shield was drastically cutting its reimbursements, the nonprofit's CEO was taking home $8.2 million in annual salary, "other compensation" and bonuses.

Skelly ripped away at the way Blue Cross/Blue Shield does business. He also skewered the state's Office of Insurance Regulation.

"The Florida Office of Insurance Regulation is aware of this change," Skelly said. "They've told us there's nothing they could do about it."

Skelly said he's planning an ad campaign and lobbying effort to bring attention to what the insurance companies are doing to the mental health profession. He turned over a petition bearing 651 signatures to Ponder and media representatives at Friday's event.

Ponder was asked if he could bring awareness of the insurance companies' treatment of the mental health profession to Tallahassee. He admitted he's not well versed on the topic, but offered to do what he could.

"We've got to get something going and that will start with a vision, a plan," he said. "The biggest thing I need is the blueprint so I can go over to Tallahassee and fight for Okaloosa. I don't want credit. I want a seat on the bus, to be part of the team."


(c)2018 the Northwest Florida Daily News (Fort Walton Beach, Fla.)

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