BCBS whacks pay for mental health

BCBS whacks pay for mental health

Some mental health providers say they will no longer treat Blue Cross & Blue Shield of Florida patients in light of a “surprising” letter they received from the company last week.

The letter announces that the insurer will terminate contracts with behavioral health providers by Nov. 30 and turn over management to a Kansas-based managed care company, New Directions Behavioral Health.

Treatment providers who want to continue seeing BCBS-FL patients must apply to New Directions and sign a contract within 15 days.

Under the contract, caregivers would be paid 25 to 55 percent less than they were before and would not be able to refer patients to providers outside the network, said Dr. Stephen Ragusea, a Key West psychologist.

“I'm not going to sign it, and I don't think other providers will either,” he said.

The change also applies to Blue Cross's Medicare Advantage plan.

Winter Park psychiatrist Dr. Louise Buhrmann said she's concerned about patients who are bound to have their mental health care interrupted as a result of the change.

Depressed patients who can't see their psychiatrists may not take their medications and may end up in the hospital, she said. Also, it could be difficult for a psychologist to find an in-network psychiatrist for a patient who needs medications, she said.

Blue Cross spokesman John Herbkersman said the switch could save money for the company, which it would then pass on to patients in the form of lower premiums and co-pays.

“A part of our mission is to make health care affordable for everybody,” he said.

He said he could not speculate on the potential loss of providers. New Directions did not respond to calls.

A June press release from BCBS-FL touts its partnership with New Directions, calling the company "one of the top thought leaders in the behavioral health field."

According to the New Directions website, the company also serves BCBS patients in Kansas and Arkansas.

BCBS-FL is a minority stockholder in New Directions, as are other Blues plans, Herbkersman said.

At least three providers who received the letter questioned the legality of the transition in light of the 1996 federal Mental Health Parity Act, which forbids insurance companies from financially limiting mental health services more than other types of medical care.

South Florida lawyer John Kelner said it's unlikely the company would lose a suit unless it could be demonstrated that the policy was implemented with the intent of not providing services.

By Brittany Alana Davis
Health News Florida