Background on Medicaid billing by Provisionals
BACKGROUND: In 2014, a bill was passed in the Wyoming legislature which allows LPC, LCSW, LMFT and LATs to bill Medicaid directly without the supervision of a licensed physician or psychologist. This went into effect July 1, 2014, so the Wyoming Dept. of Health Division of Healthcare Financing Medicaid has had more than 6 months to educate Licensed therapists on how to bill directly and work out any difficulties.
ISSUE: Currently, provisionally licensed therapists (PLs) still require supervision from a licensed physician or psychologist in order to bill for services provided to Medicaid clients. PLs, under supervision from their employer, may currently bill clients who pay through private insurance and personally.
Psychologists and psychiatrists charge the provisional licensee (or their small business employer) up to 40% of their gross income for therapy for said supervision. The cost is prohibitive. This reduces access to care for poor people and people with disabilities.
ADVOCACY: WCA members and other colleagues who are directors of small mental health agencies requested a change in the Medicaid rules to allow provisionally licensed therapists to bill for Medicaid services under the supervision of an LPC, LCSW, LMFT or LAT. This requires a change in the Wyoming statutes.
SENATE FILE NO. 102 “Medical billing-provisional providers” would allow provisionally licensed therapists to bill for Medicaid services under the supervision of an LPC, LCSW, LMFT or LAT.
According to the Wyoming Mental Health Professions Licensing Board rules, PLs would still need to be employed by an agency. They would not be allowed to work independently in a private practice. They must still complete clinical supervision in order to become licensed.
Previously, licensed and provisionally licensed therapists were not always able to receive quality supervision from medical doctors and psychologists due to time and distance constraints and the cost of Medicaid-specific supervision. This is an Access to Care issue.
SF No. 102 has the support of the Wyoming Dept. of Health Division of Healthcare Financing Medicaid.
The Wyoming Counseling Association is taking a proactive approach to encourage more training for clinical supervisors by including a 3 hours on Ethics and Supervision on Oct. 3, 2015, at its annual conference.
Tags: advocacy, legislature, medicaid billing, provisionals