ahem, tain't the size that counts...

us lil peoples need our say-so, too!  (she pipes up)

Medicare, nor Medicaid, will not reimburse licensed professional counselors (LPCs) who have private practices.  Those agencies will only reimburse clinics (those who worked inside the clinic are not paid as per insurance reimbursements, rather they are paid a flat salary/wage regardless).  The idea is that doctors (gasp) are involved and so the treatment must be superior to that which a person might receive if a doctor were not in the building and/or associated with said clinic (the doc is frequently elsewhere when clients are being counseled, sometimes in a different county even).  Actually, most LPCs especially in private practice, are supervised by a doctor.  So, THAT whole concept doesn't hold water as a justification.

This policy is extremely unfair to clients and counselors alike.  Clients do not have a choice of counselors as they must frequent the clinic and not any of the private practicioners.  In our area, there is one clinic, per county.  These clinics are all apart of the same organization (Community Counseling).  In some cases, recipients of Medicare/Medicaid have no place to go to receive services at all (as sometimes Community Counseling is not available for them, such as if a relative works within the system, then services for the entire system is closed to them, not just that particular office).  The counselors who work for the organization are way over-loaded and cannot devote the time, energy, and other resources for all of their cases because the demand surpasses the supply.  So burn-out and high turn-over results, and that is not good for the client who must start all over with a new counselor and it is not good for the incoming counselor who has to wade through the mess, often drowning and suffering severely before sinking and moving on.  Nor is it good for the outgoing counselor who is often more than a little soured on public-service positions, which leads to further shortages of qualified counselors who are willing to serve in those agencies.

Nor is it fair to the licensed professional counselor who practices in private practicioner settings.  They either cannot take clients who have Medicare/Medicaid or they have to accept a pittance for their services if they do take on a patient who has this type of insurance (as usually the client cannot afford even the self-pay rates, cuz ya know, their income level is sorta low, to make an understatement).  There are some LPCs who will make an exception to the rule, but that's just that, an exception.

Representative May Whittington (MS) has been the latest in a long-string of legislative folks to take this issue up as one of her causes.  She feels that we ought to pass an amendment which would allow a bill to be law, stating that Medicare/Medicaid must reimburse LPCs even if they don't practice in a clinic setting.  Hurray for May!!

Unfortunately, this bill has been floating around in the cesspool of congressional sessions for sometime.  It keeps getting sunk into the murky depths of rejection.  However, it bobs to the surface and someone swoops and scoops it up and carries it back in to the current session only to be bombed again.  sigh.

Please, write or call your representative about this matter.  I have the pertainnent info here in MS, but your state has a similar bill bouncing around too.  If anyone wants help in finding out specific information about the legislature in your state, let me know and I will help you find it!!!

For Mississippi:

"House Bill 447

AN ACT TO AMEND SECTION 43-13-117, MISSISSIPPI CODE OF 1972,
TO PROVIDE THAT MENTAL HEALTH COUNSELING SERVICES PROVIDED BY
A LICENSED PROFESSIONAL COUNSELOR (LPC) WILL BE REIMBURSABLE
UNDER THE MEDICAID PROGRAM; AND FOR RELATED PURPOSES."
Copy and paste:
http://billstatus.ls.state.ms.us/documents/2006/html/
HB/0400-0499/HB0447IN.htm