Why Did WHN LME Hand Out Paperwork at the June 22, 2012 Board Meeting Indicating that the NC Council of Community Programs Which Oversees the LME's Has Created a 'Central Repository' for Provider Re-Credentialing When It Does Not Exist?

FROM: Marsha V. Hammond, PhD, Licensed Psychologist, Asheville, NC e mail: chomskysright@gmail.com cell: 828 772 5197


TO: The Two Board Officers for the NC Council of Community Programs, overseeing the LME’s in NC:

1. Betty Taylor, Area Director President CenterPoint Human Services 4045 University Parkway Winston-Salem, NC 27106 (336)714-9118 btaylor@cphs.org

2. Ken Jones, Past President , Area Director Eastpointe 100 South James Street Goldsboro, NC 27530(919)731-1133 kjones@eastpointe.net

AND, Regional Representative for the Western part of NC:

3. Ed Tarleton Area Board Member Smoky Mountain Center PO Box 183 Glendale Springs, NC 28629 (336) 973-8618 etarleton@wilkes.net;

4. Arthur Carder Area Director Area Director Pathways Western Highlands Network 356 Biltmore Ave Asheville NC 28801;

5. Rhett Melton Gastonia, NC 28054 Asheville, NC 28801 (704) 884-2501 (828) 225-2785 rmelton@pathwayslme.org

DATE: June 28, 2012

RE: NC Council of Community Programs Handout at the June 22, 2012 WHN LME Board Meeting indicating there to be a ‘Statewide Issues Resolution’ re: Provider Credentialing

Dear Ms. Taylor, Mr. Jones, Mr. Tarleton, Mr. Carder, and Mr. Melton:

I am writing to inquire about the matter associated with a hand-out at the June 22, 2012 WHN LME Board meeting. It is on the NC Council of Community Programs letterhead. On page 2, it indicates that there has taken place a “Statewide Issues Resolution” as associated with the very pressing issue of “Need standardized application process for providers across all LME-MCO’s. ” Moreover, on page 2, in the same box, the memo states that there has been the creation of a “Central repository established for provider application.”

I am currently engaged in provider credentialing for SMC LME and WHN LME . The applications are completely different. Therefore, there is obviously no ‘Central Repository’ or even a similar application process.

For WHN LME, the provider re-credentialing takes place in poorly planned stages with the first stage being the submission of one’s tax return; statement of what will occur if there is a patient emergency; a declaration of what kind of expertise/ patients one has been seeing. Then one waits for months to hear an answer. I have been trying to be re-credentialed by WHN LME for over 6 months.

For SMC LME, there is one stage of re-credentialing which includes the following: 20 page form associated with items which one has already outlined in the demanded CV; copy of my psychologist license; copy of any other states’ psychologist license; my doctoral university transcript; CV; 2 letters of recommendation from ‘similar’ practitioners’; 2 page checklist which must be filled out; W-9 IRS form; face page of malpractice insurance.

Do you see any similarities between those two re-credentialing processes?

This is a massive hardship for providers. It is therefore an injustice as per NC citizens. If you need details on that, please see my blog which has been documenting this: http://madame-defarge.blogspot.com/

So, why does your paperwork indicate that this ‘Central Respository’ has been created----- when it has not? And moreover, why didn’t your organization consider the difficulties that providers would experience as associated with the a la carte method which has been utilized by the various LME’s in order to re-credential already Medicaid credentialed providers?

It appears that your organization is simply a lobbying mechanism (you state you have 2 lobbyists: http://www.nc-council.org/about/benefits-services/) for the LME’s. And, the LME’s appear to have massively failed regarding their No 1 mission which is to smoothly transition this Medicaid Waiver. Since 2002 the LME’s have simply been managing state-funded clients (those who cannot qualify for Medicaid and have no other health insurance). That is ALL the LME’s have been doing, to the tune of millions and millions of $$.

There is no standardization for the re-credentialing of providers and by your non-fulfillment of what you state you have done e.g., “creation of Central Repository”, your continued existence appears to be simply a mechanism to create work for the LME’s who continue to absorb most of the Medicaid money rather than it being employed for the treatment of NC citizens.

I am thanking you in advance for your response. I want to know why your letterheaded statement indicates that there is a ‘Central Repository’ when obviously there is not one. If there is a ‘Central Repository’ for re-credentialing, a matter which was suggested by NC DHHS as regarding the use of the CAQH credentialing process----which providers have been using for years----then someone needs to inform SMC LME and WHN LME that it’s there.

Sincerely,

Marsha V. Hammond, PhD, Licensed Psychologist, NC