Wednesday, June 20, 2012

Big Shake-Up at NC Medicaid: (I Wondered Why No One Would Answer my Letters But Then Again That's What I Expect From These People)

I guess its Michael Watson that I need to ask the questions to re: the travesty regarding re-credentialing of already credentialed and licensed Medicaid Providers. 

So, here is my e mail to Michael Watson w/ a cc to DMA physician .nc.and the Secretary of NC DHHS.

FROM: Marsha V. Hammond, PhD
Clinical / Health Psychology  NC Licensed Psychologist
cell: 828 772 1127 e mail:

TO: Michael Watson, Chief Division of Medical Assistance

RE: Provider Re-credentialing Difficulties at WHN LME and SMC LME

Date: June 18, 2012

Dear Mr. Watson:

Congratulations on your new job. As the former CEO of Sandhills LME, perhaps you know something about how the LME's work.

As a Medicaid provider for over 10 years, working with the SPMI,Seriously Mentally Ill Population, as associated with both WHN LME and SMC LME, these are the difficulties I have (so far) encountered in trying to CONTINUE to see my seriously mentally ill patients for outpatient therapy-----something which keeps them out of the psychiatric hospital and saves the state of NC thousands of dollars every year.

WHN LME has asked for my 'Request' to be considered to continue to be a Medicaid provider twice now: once in January, 2012, and now again. They lost all my paperwork the first time and/ or they just want to ignore me. They asked for: tax return; attestation as to how I handle my emergency calls; an outline of the kind of people that I see (the SPMI population, including expertise w/ DID and personality disorders). I gave them all of that in January. Nothing has happened. I have been to the WHN LME Board meeting several months ago, complaining. I am getting ready to go again on Friday as the CEO and the Board's attorney are asking for a raise when WHN LME's own paperwork in March, 2012, indicated that they had served just 5% of the 80,000 Medicaid recipients under their catchment area. Why should they get a raise when most of the Medicaid providers have bailed and this one----a licensed psychologist----cannot even get her paperwork through?

SMC LME has asked for: CV; two letters of recommendation; A COLLEGE TRANSCRIPT (the NC Licensing Board saw this years ago). I have until July 1 to get this together. After that, their web page indicates that the provider network will be closed. How can that be when I was informed by a psychologist in DMA that the network, under Medicaid guidelines, must remain open for 'at least a year' as associated with this Medicaid waiver?

As per DMA notices posted, you have been considering using CAQH credentialing, which is online, paperless, and no a la carte menu of LME choices and providers have been using CAQH for years as associated with working w/ other insurance companies such as BCBSNC.

Can you PLEASE end this re-credentialing boondoggle so that I can continue to work with and be paid for working with my patients?

Marsha V. Hammond, PhD
Secretary Delia Announces Reorganization of State Medicaid, DHHS Leadership Team

State Medicaid office will now report directly to Secretary

Raleigh– North Carolina Department of Health and Human Services (DHHS) Secretary Al Delia today announced that he is reorganizing the leadership teams that oversee the state’s Medicaid division.

The changes come after careful evaluation of the Department’s management, said Delia, who was named acting secretary in February.

Michael Watson, DHHS chief deputy secretary, will become the new head of the state’s Medicaid office, the Division of Medical Assistance (DMA). That position will be elevated to serve on the Secretary’s executive leadership team. Watson joined the Department in 2009 as an assistant secretary. He is the former CEO for Sandhills Center for MH/DD/SAS, with more than 20 years of experience and leadership in developing and operating mental health, developmental disabilities and substance abuse services on a local and regional level. His salary remains $160,000.

Watson replaces Dr. Craigan Gray, who served as director of DMA since April 2009 at a salary of $270,000.

Beth Melcher, assistant secretary for mental health, developmental disabilities, and substance abuse services development since August 2010, will become chief deputy secretary. Melcher, a licensed psychologist, is the former president of Recovery Innovations North Carolina. She was clinical director of The Durham Center, and also worked with the National Alliance on Mental Illness North Carolina as its executive director and as public policy director. Her salary will be $141,797.

John Dervin, the secretary’s senior policy adviser since March 2012, will step into a newly created role as chief of staff. Dervin previously served as policy adviser for health and human services for Governor Perdue. His salary will remain $84,000.

“After nearly six months in this role, my first priority for strengthening our management team is to elevate the state Medicaid office to play a more prominent role in the Department’s decision-making process,” said Secretary Delia. “Medicaid is not a stand-alone division. It touches not only multiple DHHS divisions but also plays a huge part in shaping the state budget. We need better communications and stronger oversight of this $12 billion program. I believe these changes will accomplish that.”

These staff changes are effective immediately.


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