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BLUE CROSS BLUE SHIELD TERMINATES ALL FLORIDA PSYCHIATRISTS – One Year Later

By Ken Kramer
August 15, 2012

Psychiatrists are among the lowest-paid of all physicians because, unlike other doctors, they do not bill by the procedure and are reimbursed by time, this according to Bill Gallagher, of Gainesville, Florida who promotes himself as a “human rights advocate”.

So, it was especially hard for Florida psychiatrists when in August of last year, Blue Cross Blue Shield of Florida (BCBS) terminated the contracts of all psychiatrists, psychologists and mental health professionals in the State of Florida.

BCBS simply cancelled the contracts but offered new coverage from a company called New Directions of Kansas, at far reduced rates. BCBS notified ALL of their mental health professionals (licensed social workers, licensed mental health counselors, psychologists, and psychiatrists) that they would be terminated, without cause. That is, they would no longer be providers for BCBS. BCBS indicated that if the psychs chose to, they could sign up with a new company that BCBS partnered with, Kansas-based New Directions Behavior Health, which is 30 percent owned by BCBS.

BCBS spokesman Paul Kluding said his company turned over behavioral health to New Directions to cut costs. He acknowledged that some enrollees would have to find new mental health providers.

Psychiatric groups appealed to federal officials to investigate, on the grounds that Blue Cross singled out mental health – something they believe is barred by the Mental Health Parity Act of 2008. The act says insurers must handle “mental illness” benefits as they would medical benefits.

Despite protestations by the American Psychiatric Association, BCBS asserted that the company is “in compliance with all applicable parity laws and regulations.”

The Parity Implementation Coalition”; the American Psychiatric Association, Mental Health America, NAMI (National Alliance on Mental Illness) and TeenScreen beseeched Kathleen Sebelius, Secretary of the U.S. Department of Health and Human Services to intervene in the BCBS issue, complaining that it is violating the Mental Health Parity Act.

David Shern, (right) CEO of Mental Health America, who unsuccessfully tried to force TeenScreen into Pinellas County, Florida schools while he was the head of the Florida Mental Health Institute, complained to BCBS that their new policy was only directed at “one specialty provider group”; the entire mental health specialist network.

Connie Galietti, executive director of the Florida Psychological Association, had grave concerns Payments to some psychologists were reduced up to 54 percent. She protested to Florida’s Insurance Commissioner, Kevin McCarty, but received an unwelcome response “With respect to federal mental health parity issues, …I would note that the Office of Insurance Regulation has no jurisdiction with respect to enforcement of federal law”.

Mental Health America of Palm Beach urged its members to write to Florida’s Insurance Commissioner and to Blue Cross Blue Shield to express concern about the “unacceptable reduction in payments for mental health providers”.

The Florida Psychiatric Society, a membership branch of the American Psychiatric Society, carried an unknown message” for “members only” about the termination on their website.

“It really looks like a lose-lose type of proposition for the clinicians,” said Jim Akin, executive director of the National Association of Social Workers Florida Chapter.

A petition was drawn up by the American Psychiatric Association to protest the Blue Cross terminations which garnered a little over 5,000 signatures nationwide. Some of the petitioners expressed their reactions:

Susan Rae Helgeland, the Executive Director of Mental Health America of North Dakota said: “I am stunned/shocked that an organization such as Blue Cross Blue Shield would participate in activities against parity.”

Tampa Psychiatrist
Eric Weinstock

Eric Weinstock, a Tampa psychiatrist said that: “Since I began private practice in tampa florida in 2005 bluecross blueshield of florida has had a ‘closed’ panel, meaning that they were not accepting any applications for new psychiatrists to their network. It is now 7 years later and their panel has remained closed. Now on top of having no new psychiatrist added to their network in at least 7 years they have additionally fired a lot of their existing psychiatrists. I am beginning to wonder if they have any psychiatrist left at all.”

Judith Horowitz said: “When I found out that New Directions is a subsidiary of BCBS, all was illuminated. I believe this was a strategic move to lower mental health professionals fees.”

As for any lawsuits over the thorny issue, a representative of the APA said there were none “pending” at this time.

PsychSearch.net will keep you informed as more is uncovered.