Saturday, May 14, 2011

NC DHHS : Please Do Your Work Re: the Medicaid Waiver Prior to Giving Everyone Else the Work To Do

In Mr. Cansler's 'Medicaid Waiver' presentation to state representatives in 2009, he mentioned, on page 4, that one thing that could be expected would be 'frequent billing and payment difficulties." Here is that information that Mr. Cansler gave out in 2009: www.ncdhhs.gov/dma/legis/071009MedicaidWaiverLME.pdf

Does the below lack of regard for provider's time come under that heading? And I really cabnot understand why is it acceptable to not anticipate these kinds of issues PARTICULARLY if one of the LME's, specifically, Piedmont Behavioral Health (pbH; their logo) 'has gone through' the Medicaid Waiver process since 2005.

Thus, I have written to the following representatives associated with these matters:

"Rep. Jeff Barnhart" ,
"Rep. Harold \"Bru\" Brubaker" ,
"Rep. Justin P. Burr" ,
"Rep. Nelson Dollar" ,
"Rep. Verla Insko" ,
"Rep. Darren Jackson" ,
"Rep. Beverly Earle" ,
"Rep. David Lewis" ,
"Rep. Bill Current" ,
"Rep. Fred Steen" ,
"Rep. Hugh Blackwell" ,
"Rep. Jean Farmer-Butterfield" ,
"Rep. Jennifer Weiss" ,
"Rep. Jim Crawford" ,
"Rep. Julia Howard" ,
"Rep. Mark Hollo" ,
"Rep. Pat Hurley" ,
"Rep. Rayne Brown" ,
"Rep. Shirley B. Randleman" ,
"Rep. Tom Murry" ,
"Rep. Tricia Cotham" ,
"Rep. William Brisson" ,
"Rep. William Wainwright" ,
"Rep. Garland Pierce" ,
David Gantt



Marsha V. Hammond, PhD
Clinical / Health Psychology
NC Licensed Psychologist
cell: 828 772 5197
e mail: chomskysright@gmail.com


May 16, 2011


Dear State Representatives and County Commissionersi:


I am in receipt of advocates' concerns re: the Medicaid Waiver . Providers have concerns also. I voiced these to Secretary Cansler as re: the Western Highlands Network (WHN) LME meeting last week during which they voted NO to the "Non-Disclosure Agreement" sent to them by Piedmont Behavioral Health (pbH; that's their logo). That means, that they are voting NO to the Medicaid Waiver . He wrote me back via his assistant 5.9.2011 and indicated that they were 'working on it.' That 'working on it' should precede the doing of the waiver. (you can see that letter at my blog: http://madame-defarge.blogspot.com/)


My concern, which I presented to the Executive board of WHN LME on 5.6.2011, was the 18+ pages of 're-certification' to render Medicaid Services. I am a licensed psychologist; I am a Medicaid provider; I am a Medicare Provider; I am a provider on most insurance panels. I have an NPI number (national provider number which was supposed to have taken the place of Medicare/ Medicaid numbers).


WHY can't NC DHHS work w/ CMS (Centers for Medicare/ Medicaid Services) to seguae this Medicaid Waiver thru the LME's if they are so intent on making it happen? Why leave it to the providers to do the work that NC DHHS should have done, this in addition to my work as a psychologist? Why am I having to ask the American Psychological Association's CMS liasons about what to do here? These are long processes, that of working with CMS and NC DHHS should have done this prior to hoisting this Medicaid Waiver which they have been doing since 2005 vis a vis pbH.


I would ask you to slow down this Medicaid Waiver matter until NC DHHS does its footwork and homework which has now become my work, unless I want to fill out 18+ page applications LME-by-LME. The concerns of the advocates and families of consumers has been exactly the same: please stop railroading this Medicaid Waiver prior to having done your work.


Sincerely,


Marsha V. Hammond, PhD, Licensed Psychologist

1 Comments:

Blogger Joseph said...

Hello Dr. Hammond, I have read your blog with great interest for some time now. As a MH professional in NC, and one who worked for years within NC's MH system, I am mystified by the changes that are taking place. I am now in private practice and although I left community mental health because of the reform changes, it seems I cannot escape them. I have 2 brief questions I would like to ask... First, where are the APA, ACA, AAMFT, NASW, and their State affiliates? Despite the fact that these associations exist to (hypothetically) to defend and advocate for our profession, there has been a palpable absence of input from them. Secondly, given that the DOJ launched an investigation into NC MH reform last year, are they investigating the fact that the State and LMEs have a monopsony on MH/DD/SAS services in areas where the waiver already exists? Soon, this will be statewide. As Medicaid is the largest payor of MH/DD/SAS services in the State, LME/State complete control of recipient's choice of providers, payment rates, and so on represents monopsony power. What are your thoughts? Thanks so much for all you're doing for our profession!

1:10 PM  

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