Blue Cross Blue Shield of Georgia Is Skimping on Mental Health Care, Says Georgia...

Blue Cross Blue Shield of Georgia Is Skimping on Mental Health Care, Says
Georgia Psychological Association

ATLANTA, April 7 /PRNewswire-USNewswire/ -- Late in 2007, Blue Cross Blue
Shield of Georgia (BCBSGa) announced that it was cutting its hourly therapy
reimbursement rate for clinical psychologists by approximately 19%. This new
rate is about the same as you pay your auto mechanic or home handyman per
hour.

However, unlike your mechanic, BCBSGa wants to pay licensed psychologists
about half of what they were paid 10 years ago by BCBSGa. In 1998 clinical
psychologists were reimbursed by BCBSGa nearly one and a half times today's
rate for the same therapy hour. Accounting for inflation, today's rate should
be nearly double in 2007 dollars (US Bureau of Labor Statistics based on the
Consumer Price Index). Unlike medical doctors and dentists, psychologists see
only one patient per hour.

As a result, GPA is hearing from its members that more and more licensed
psychologists, especially the most experienced, are finding they can no longer
see patients insured with BCBSGa insurance because they cannot run a practice,
much less make a living, on what BCBSGa, one of Georgia's largest insurers, is
willing to reimburse psychologists

Effective treatment requires highly specialized training and experience.
Clinical psychologists licensed in the state of Georgia have either a Ph.D. or
a Psy.D. including a bachelor's degree, 4-6 years post-graduate work, plus 1
year supervised internship, and at least one year post-doctoral supervision by
a licensed psychologist.

"Research has shown again and again that there is a connection between good
physical health and good mental health," said Georgia Psychological
Association past-president, Dr. Joni Prince. "And taking a pill alone is not
usually the most effective way of improving mental health; psychotropic drugs
work better when used in conjunction with psychotherapy," she continued.

But clinical psychologists feel pressured to defend themselves if they see
their BCBSGa patients for more than the "licensure type average" of 6.0
sessions, even though BCBSGa offers its PPO customers 50 therapy sessions per
calendar year. Major depression, can affect almost 9% of the American
population (Mann, New England Journal of Medicine, 10/27/05), and is a leading
cause of lost productivity and time off from work. "It seems that Blue Cross
is basing treatment decisions on statistics rather than clinical information,"
Prince said.

What else should you know?

In addition to psychotherapy, psychologists are the only mental health
professionals who are qualified to administer, score, and interpret
psychological testing instruments, including psycho-educational testing (for
IQs, learning disabilities, etc.) and neuropsychological testing, among
others.

Yet BCBSGa routinely denies coverage to its customers for psychological
evaluations. Evaluations and accompanying clinical interviews are the first
step in either diagnosing or ruling out learning disabilities, ADHD,
Depression, Anxiety, Bi-polar disorder and other psychopathology. Nearly half
(45%) of those with any mental disorder meet criteria for two or more
disorders (National Institute of Mental Health press release related to a
study published in September 2006 issue of the American Journal of
Psychiatry).

Without proper evaluation, mental disorders will go undiagnosed and therefore,
untreated. For instance, among adults who have an anxiety disorder about half
had symptoms of some type of diagnosable mental illness by age 15, an
NIMH-funded study showed. The results emphasize the importance of early
diagnosis and treatment of anxiety disorders (NIMH Science Update 2/7/07).
"In spite of these studies, many of which are publicized, patients are
neglecting their mental health in part due to poor coverage and limited access
to quality mental health care," Dr. Prince continued.

Once your child is diagnosed, for example, with Autism or Asperger's, his or
her treatment may not be covered by BCBSGa, depending on the type of policy.
This flies in the face of Georgia Law, which considers both Autism and
Asperger's to be neurological conditions, all of which are mandated by law to
be covered equally by insurers (GA Code 33-24-59.10).

Georgia Psychological Association
The Georgia Psychological Association (GPA), in Atlanta, GA, is the
professional organization representing psychology in the state of Georgia.
GPA's membership includes more than 1,100 researchers, educators, clinicians,
consultants and students. Through its regions and divisions, GPA works to
advance psychology as a science, as a profession and as a means of promoting
health, education and human welfare.

SOURCE Georgia Psychological Association

Cyd Preston Wise of the Georgia Psychological Association, +1-404-634-6272,
ext. 208, cydwise@gapsychology.org