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."