This program is presented in partnership between The Chicago School of Professional Psychology, The Kennedy Forum of Illinois, and The Austen Riggs Center.
Presented by Joe Feldman, MBA, Eric Plakun, MD, Marie Casciari, JD, and the Honorable Patrick Kennedy.
When attended in its entirety, this course offers 1.0 CE for Psychologists or 1.0 BBS California CEUs for Social Workers, Counselors and LMFTs.
Insurance coverage for mental health and substance use treatment has long been a challenge compared to coverage for physical health. While federal and state laws have been implemented over the last several years to require parity treatment (i.e., mental health same as physical health), it remains far too common that claims are denied and coverage is out-of-reach for individuals requiring such care. More recently, federal lawsuits have been won in favor of patients where insurers improperly, that is illegally, denied claims. Step-by-step, the landscape may be shifting so that patients will be less likely to confront denied claims. But we’re not there yet.
Insurers have denied claims for “lack of medical necessity” where that determination has been made independently of the patient’s treating clinician. Such denials may be confounding to both patients and to their clinicians. After all, who should be making the determination about whether care is indeed “medically necessary”?
Authors of a recently published article will describe their recommendation for clinicians to provide a “letter of medical necessity” to their patients as a tool to improve the likelihood that insurers timely approve claims. Such letters have proven crucial in lawsuits and appeals; they represent an important tool that clinicians can provide their patients.
After attending this workshop participants will be able to:
1. Identify the key principals of the insurance parity laws regarding mental health and substance use treatment.
2. Describe the landmark Wit decision’s reinforcement of expectations for insurers’ compliance with parity.
3. Author medical necessity letters to help their patients with insurance coverage for mental health and addiction related treatment.
Program Standards and Goals:
This program meets APA’s continuing education Standard 1.2: Program content focuses on ethical, legal, statutory or regulatory policies, guidelines, and standards that influence psychological practice, education, or research.
This program meets APA’s continuing education Goal 2: Program will enable psychologists to keep pace with the most current scientific evidence regarding assessment, prevention, intervention, and/or education, as well as important relevant legal, statutory, leadership, or regulatory issues.
Appelbaum, P. S., & Parks, J. (2020). Holding insurers accountable for parity in coverage of Mental Health Treatment. Psychiatric Services, 71(2), 202–204. https://doi.org/10.1176/appi.ps.201900513
Feldman, J. (2019, September 11). 10 Steps to securing insurance coverage for mental health care. Retrieved from https://www.thekennedyforum.org/blog/10-steps-to-securing-insurance-coverage-for-mental-health-care/.
Feldman, J., DeBofsky, M., Plakun, E. M., & Potts, C. (2021). Providing a routine medical necessity letter to improve access to care for our patients. Journal of Psychiatric Practice, 27(4), 288–295. https://doi.org/10.1097/pra.0000000000000563
Davenport, S., Gray, T. J., & Meek, S. P. (2019). Addiction and mental health vs. physical health: widening disparities in network use and provider reimbursement. Milliman Report Commission by the Mental Health Treatment and Research Institute.
Target Audience: Healthcare and Mental healthcare professionals, Students welcome
Psychologists. This program, when attended in its entirety, is available for 1.0 continuing education credits. The Chicago School of Professional Psychology is committed to accessibility and non-discrimination in its continuing education activities. The Chicago School of Professional Psychology is also committed to conducting all activities in conformity with the American Psychological Association’s Ethical Principles for Psychologists. Participants are asked to be aware of the need for privacy and confidentiality throughout the program. If program content becomes stressful, participants are encouraged to process these feelings during discussion periods. If participants have special needs, we will attempt to accommodate them. Please address questions, concerns and any complaints to Danielle Bohrer at 312-467-2364. There is no commercial support for this program nor are there any relationships between the CE Sponsor, presenting organization, presenter, program content, research, grants, or other funding that could reasonably be construed as conflicts of interest.
MFTs, LPCCs, and LCSWs. Course meets the qualifications for 1.0 hours of continuing education credit for MFTs, LPCCs, and/or LCSWs as required by the California Board of Behavioral Sciences. If you are licensed outside of California please check with your local licensing agency to to determine if they will accept these CEUs. The Chicago School of Professional Psychology is approved by the California Board of Behavioral Sciences (BBS) to offer continuing education programming for MFTs, LPCCs, LEPs, and/or LCSWs. The Chicago School of Professional Psychology is an accredited or approved postsecondary institution that meets the requirements set forth in Sections 4980.54(f)(1), 4989.34, 4996.22(d)(1), or 4999.76(d) of the Code.
Participation Certificate. The Chicago School of Professional Psychology is able to provide students and other participants who simply wish to have documentation of their attendance at the program a participation certificate.
Non Psychologists. Most licensing boards accept Continuing Education Credits sponsored by the American Psychological Association but non-psychologists are recommended to consult with their specific state-licensing board to ensure that APA-sponsored CE is acceptable.*Participants must attend 100% of the program in order to obtain a Certificate of Attendance. The Chicago School of Professional Psychology is approved by the American Psychological Association to sponsor continuing education for psychologists. The Chicago School of Professional Psychology maintains responsibility for this program and its content.
*Participants must attend 100% of the program in order to obtain a Certificate of Attendance.
The Chicago School of Professional Psychology is approved by the American Psychological Association to sponsor continuing education for psychologists. The Chicago School of Professional Psychology maintains responsibility for this program and its content.