Medicare Reimbursement Reductions

Dear Colleagues,

I hope all of you had a very happy Thanksgiving holiday.

Many thanks to Jon Rosenfeld for bringing the Medicare fee schedule cuts to our attention. I reviewed the reimbursement rates for the LA area and found decreases ranging from 6-13% for the services Jon referenced, similar to his findings for Manhattan. I echo Jon’s plea to all of us to immediately contact members of the Senate Finance Committee in an effort to reverse these cuts.

For now there are three points I’d like to make regarding this issue and I will be brief.

First, I think it goes without saying that we need to keep our seats at the appropriate third party reimbursement negotiating tables. We must remain vigorous in our advocacy efforts for the benefit of both psychodynamic psychotherapy and psychoanalysis as treatment modalities. Many of our colleagues work in these systems and these are pathways for many who need our assistance.

Second, we must also fight for parity of reimbursement among all psychoanalytic practitioners. After reading Lori Post’s note I looked again at the reimbursement rates in LA and discovered that Social Workers are reimbursed at a rate about 25% less than that of psychiatrists for the same services. This is not acceptable and we must attempt to correct this. Psychologists, at least in the Medicare system in LA, are reimbursed at rates similar to physicians.

Third, given the major secular changes occurring in the insurance industry, changes such as; ever declining treatment dollars, ever increasing and more stringent utilization review procedures, and ever fewer units of service provided, we must continue to look for other ways to support psychoanalytic treatment among potential analysands. One small example is that we need to direct the results of our efficacy studies not only towards potential third party reimbursers but also towards members of the public who need our services.

We also need to keep in mind that some of our members wish to work entirely outside of these third party systems and they need to be assured of appropriate confidentiality protections. We must support them as well.

My background has given me the skills to deal with issues such as these. I am a longstanding member of our Committee on Government Relations and Insurance (CGRI) as well as its former Chair (97-00). While Chair I participated in direct discussions with national level Medicare officials including the national Medical Director. As Treasurer for the past five years I have vigorously advocated that we provide CGRI with as much financial support as our budget allows.

You can count on me to put my energies and experience as well as our organizational resources behind efforts such as these.

Warren R. Procci, Candidate for President-Elect, APsaA