Therapists For Soldiers Scarce

[DonaldN]

Monday, June 11, 2007 - Page updated at 02:01 AM

Therapists for soldiers scarce

The Associated Press

WASHINGTON — Soldiers returning from war are finding it more difficult to get mental-health treatment because military insurance is cutting payments to therapists, on top of already low reimbursement rates and a tangle of red tape. Wait lists extend for months to see a military doctor, and it can take weeks to find a private therapist willing to take on members of the military.

To avoid the hassles of Tricare, the military health-insurance program, one therapist opted to provide an hour of therapy time a week to Iraq and Afghanistan vets for free.

Barbara Romberg, a clinical psychologist in the Washington, D.C., area, has started a group that encourages other therapists to do the same. "They're not going to pay me much in terms of my regular rate anyway," Romberg said. "So I'm actually feeling positive that I've given, rather than feeling frustrated for what I'm going through to get payment."

Joyce Lindsey, 46, of Troutdale, Ore., sought grief counseling after her husband died in Afghanistan in September. The therapist recommended by her physician would not take Tricare. Lindsey eventually found one on a provider list, but it took two months. "It was kind of frustrating," Lindsey said. "I thought, 'Am I ever going to find someone to take this?' "

Tricare's psychological health benefit is "hindered by fragmented rules and policies, inadequate oversight and insufficient reimbursement," the Defense Department's mental-health task force said last month.

The Tricare office that serves Fort Campbell, Ky., and Fort Bragg, N.C. — Army posts with heavy war deployments — told the task force it routinely fields complaints about the difficulty in finding mental-health specialists who accept Tricare. "Unfortunately, in some of our communities ... we are maxed out on the available providers," said Lois Krysa, the office's quality manager.
"In other areas, the providers just are not willing to sign up to take Tricare assignment, and that is a problem."

Tricare's reimbursement rate is tied to Medicare's, which pays less than civilian employer insurance. The rate for mental-health services fell 6.4 percent this year as part of an adjustment in reimbursements to certain specialties.

Psychologists who treat active-duty troops are paid 66 percent of what Tricare views as the "customary" rate. So a psychologist eligible for a customary rate of $120 per hour would be paid $79.20 for the hour by Tricare, even if the psychologist's standard rate is $150 per hour.

John Class, a retired Navy health-care administrator who advocates on health issues for the Military Officers Association of America, said Tricare contractors say the lower reimbursement rates has made it tougher to maintain a network of providers.

In parts of Montana, some families drive two hours to see a health-care provider of any kind that will take Tricare, said Dorrie Hagan, state family program director for the Montana National Guard.

"When you get away from a city of any size then you start struggling for providers, and they'll tell you flat out it's because of the rate of pay."

[nurseflo]

And this is a shame!!

[TinCanMan]

Well, I'm certainly glad the Associated Press finally woke up. This is nothing new but I notice they're now attempting to tie it to "returning soldiers". I had a conversation along these very lines at least 5 years ago on USENET in the alt.military.retired newsgroup. At that time, retiree's were having a very tough time getting anyone to accept Tricare and the main reason wasn't so much the billing rate which is not all that much lower than OHI rates but the fact that if a provider agrees to bill Tricare directly they also agree to accept the Tricare rate as full payment. With OHI, after the provider bills the insurance co, and he finds it doesn't exactly cover his bill, he can go after the recipient of the service for the balance. Under Tricare and Medicare, they can't do that. They have to eat the outstanding balance.

Here where I'm at, doctors are bailing out of private practice in favor of the HMO's because they simply can't compete or pay off their student loans if they don't. The costs for medical liability insurance, medical education, diagnostic equipment and the pricey labs drive the prices up. Everyone thinks someone else ought to pay for it but the bottom line is "we" are the someone else.

I don't think this is really a problem for the returning soldiers who have the MTF if they are AD or the VA if they aren't. Unless I missed some new change, the only folks affected are retired and a handful of NG /RC with a LOD.