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NPO Taking Action on Insurance Reimbursement

NPO/ONA member Linda Morley, Psychiatric Mental Health Nurse Practitioner testified before the House Health Care Committee on January 13, 2010 regarding reimbursement rates for mental health providers. In Fall, 2009 two major health plans reduced payments to providers who are not physicians resulting in a 50% decrease in reimbursement rates. For some providers the patients covered by those plans is almost one half of their total patient population.

The legislative proposal being considered would require health insurance companies to report the basis for their reimbursement rates. Regence Blue Cross testified in opposition to this proposal citing the increased burden of reporting and claiming to be at the top end of reimbursement to mental health providers. Their data is not confirmed.

At the core of this first step is the issue of equal pay for equal work, which ONA and ANA have long supported. While this proposal will not change reimbursement policy, if passed it will give valuable information. Future legislation will be needed to insure that reimbursement is the same for services billed under the same diagnosis and treatment codes for all providers.

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