Medicaid billing currently unavailable for some professional counselors
UPDATE: The Louisiana Department of Health said Monday it received the requested guidance from the Centers for Medicare and Medicare Services that it was seeking. Based on the feedback of CMS, LDH says it's able to allow Federally Qualified Health Centers to bill for services provided by Licensed Professional Counselors. The state says it plans to notify the Medicaid health plans so they can resume working with LPC's in the FQHC's.
BATON ROUGE - There's been a change to Medicaid and it could be affecting your school-aged children.
Earlier this year, the Louisiana Department of Health says it was made aware of a change effective July 1, 2019, affecting Licensed Professional Counselors (LPC) working for a Federally Qualified Health Center (FQHC). The state is citing a federal requirement (42 CFR 405.2411(a)) from 2014 and says it's waiting on guidance about what to do next.
LPC's have been working in schools state-wide for years. They were brought in to help fill a need and assist counselors already in schools. Certain parishes do not employ guidance counselors and fully rely on non-profit agencies to provide behavioral health services. Some schools don't have enough counselors to fill the need.
LPC's working for FQHC's have been able to bill Medicaid and receive reimbursement for their services -- but not anymore. With this change, dozens of LPC's and thousands of students seeking counseling services at school are left wondering what's next.
Counseling has been a passion of Megan Lofland's for years. She's been working for an FQHC as an LPC in Louisiana public schools for the last four years.
"I see people hurting, and there's not a reason for continued hurt if you're able to have somebody to help walk you through it," Lofland said.
She's one of 14 LPC's working for an FQHC that counsel students directly within the school systems in East Feliciana, Livingston, Tangipahoa, and West Baton Rouge parishes. There are plenty more of these companies around the states and dozens of other Licensed Professional Counselors affected by this Medicaid change. Many are wondering what's next for them and feel uneasy about the entire situation.
"Panic, confusion, anxiety, because we don't know if we're going to be able to continue serving our children," Lofland said. "If this stands, we're not going to be able to continue our services."
Lofland and her coworkers fear this will create a large gap in mental health services for school children and are demanding answers from the state.
The Louisiana Department of Health says the state's Medicaid program values the work of Licensed Professional Counselors, but it's locked in its position because of federal law. Until it's received the guidance it asked for, the state says Medicaid can't make the reimbursements. The federal government allows Medicaid to pay for these services in schools, mental health clinics and in private practices but not in FQHC's.
The state says there is a way for FQHC's to get reimbursed for these professional counseling services. This can be done if the FQHC becomes licensed as a behavioral health services provider. This license will then allow the FQHC's to bill for services provided by a Licensed Professional Counselor.
Lofland says if FQHC's become a Licensed Behavioral Health Service Provider, it would only allow LPC's to bill for skill-building, not therapy, and the reimbursement isn't the same.
The state says the federal government has not said when the guidance it needs will be available, but Medicaid is working to get the issue resolved.
There isn't much time to waste. Lofland says right now, her company is not getting paid and they can only afford to continue working without reimbursement until October. Even so, Lofland and her coworkers continue to do their jobs.
"The kids that we serve is my concern, because when we leave there aren't enough social workers to cover the services. So that means children without services," Lofland said.
In email conversations with the Louisiana Department of Health, it did not address why it has let LPC's bill Medicaid for the last three years and the reason for the sudden change.
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