March 2002 • Volume 8 • Number 3 |
•Chapters lobby for change•
 |
You treat a patient for depression. But your diagnosis reads "fatigue," "back pain," "abdominal pain" or a combination of these symptoms. Your billing code goes nowhere near mental health.
Sound familiar? Exasperating?
"Family physicians want to be able to call it like it is," says Bradley Fedderly, M.D., of Fox Point, Wis. "We want to diagnose depression and bill it that way."
In Wisconsin, says Fedderly, the legislature minimally requires insurers to cover outpatient mental health care provided by psychiatrists, psychologists, hospitals and state-certified outpatient clinics. Not by family physicians.
Similar "carve-outs" apply in most states.
The Wisconsin AFP is taking steps now toward a legislative attack on the carve-out next year.
In written comments submitted Feb. 12, the chapter asked lawmakers to amend the Mental Health Parity bill, S.B. 157, to include FPs as reimbursable for mental health care.
"Wisconsin sets its budget biennially, and this is a budget year," says Fedderly, the chair of WAFP's Legislative Committee. The Sept. 11 terrorist attacks intensified the slump in the economy, causing tax revenue to plummet. "We thought we put the budget to bed last fall. After Sept. 11, lawmakers recalculated and came up with a $1.2 billion deficit," says Fedderly. "Our legislative session ends March 12, and all the legislators will get passed by then will be the budget."
The next session, though, starting this fall, won't wrestle with the budget. "We should be able to get the mental health bill moved in the next session," says Fedderly. "We'll have the same cast of characters this fall, with the newly elected lawmakers not taking office until January."
WAFP members are emphasizing cost-effectiveness in contacts with their legislators. "Family physicians can and do provide the lion's share of mental health care, at least at the gatekeeping level," says Fedderly. "We control costs by providing the care we're trained to offer instead of referring the patient to a subspecialist. We'd like to bill for what we do."
FP Report is published by the
AAFP News Department.
Copyright © 2002 by
American Academy of Family Physicians.