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Blue Cross tries to rectify mental health service cuts

Eagle-Tribune - 2/2/2024

Feb. 2—ANDOVER — Blue Cross Blue Shield of Massachusetts has reverted its rates for hour-long therapy session after many local mental health professionals decried the insurance company's cuts last fall.

"After research and conversations with network therapists, we made the decision to reinstate the previous reimbursement rate," said Amy McHugh in a statement for Blue Cross Blue Shield of Massachusetts. "At a time when mental health needs are high, we want to do everything we can to keep clinicians in our network and ensure our members can get the support they need, when they need it."

This past fall, Blue Cross Blue Shield of Massachusetts reduced its rates for key mental health services, which many said jeopardized coverage for patients.

Blue Cross had masked its reimbursements as an increase by 2% overall, according to Dr. David Rainen, a psychologist at Merrimack Valley Psychological Associates.

The reimbursement for face-to-face therapy with a patient for 38- to 52-minute sessions was part of that increase in September. At the same time, the therapy reimbursement for 53- to 90-minute sessions was decreased.

Blue Cross Blue Shield of Massachusetts claimed in its statement that therapy sessions are "traditionally" 50 minutes, so the increase to that reimbursement "has been well-received by the therapists in our network."

Yet, Rainen and other therapists in the area called the intake and one-hour sessions the two most common services therapists offer. They were both reduced by 2% in September.

"Providing our members with timely access to affordable and quality mental health care is a top priority at Blue Cross," a Jan. 17 email to therapists read. "We recognize the vital role you play in supporting that goal."

The reimbursement for the 60-minute therapy session has been reverted back to its level prior to Sept. 1, according to McHugh.

As of this week, Rainen and other therapists, however, have not been notified of the particulars in how much of an increase the reimbursement will be.

"It is my hope that Blue Cross recognizes the important contributions mental health clinicians provide to our communities, and that they will seek to compensate our providers fairly — both now, and in the future," said Rainen. "I am very pleased to hear that Blue Cross/Blue Shield of Massachusetts has reconsidered their stance on the previously reduced rate of reimbursement for mental health providers for 53-minute sessions."

While the payment returned to its previous amount, therapists in the area are still a bit disgruntled by the insurance company's practices.

"I recognize Blue Cross is a business and they're going to do everything to maximize profits," Rainen previously said. "But what I think what we'll see happening is pushing people toward (telehealth) companies and pushing people away from in-person therapy."

Online therapy has increased in popularity in recent years, particularly with the onset of the COVID-19 pandemic. Rainen said anyone who is trying to get into therapy now may be placed on waiting lists.

The sheer need of support is why the American Psychological Association called online therapy "here to stay." Online therapy often uses different reimbursement codes than in-person sessions, like the one re-adjusted on Feb. 1.

"Blue Cross Blue Shield of Massachusetts has been recognized as a local and national leader in ensuring access to quality mental health care for our members," the statement read. "We've consistently removed barriers and administrative burdens such as referrals and prior authorizations for all outpatient mental health care — we want our members to be able to get high-quality mental health care when they need it."

Follow Monica on Twitter at @MonicaSager3

Follow Monica on Twitter at @MonicaSager3

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