Re: Re: Medicare enrollment

[Guest guest]

Drena and all,

I believe some of this changed recently following AATA's advocacy.

Since Medicare in National and Medicaid is State- they have different policies.

Ill do my best to get clarification.

Michele

Michele Amendolari MA, ATR-BC, LCAT Governmental Affairs Chair, New York Art Therapy Associationwww.nyarttherapy.org

To: NYCCAT Sent: Saturday, June 9, 2012 12:59 PMSubject: Re: Medicare enrollment

I can share my experience of applying to Medicare via the pecos system last year. I applied as an art therapist (choosing non-physician/other provider) options. After some back and forth, my application was rejected because "art therapy" is not a nationally licensed profession. I received a document saying just that. I reapplied with my LCSW license and was able to get our corporation (New York Creative Arts Therapists)to also be a covered entity. In short, my affiliation as an LCSW working for a licensed art therapy business allowed us to get the business itself (and all practitioners working for us) to be an approved provider for Medicare. Keep in mind, LCATs can be reimbursed by Medicare and Medicaid if you work for an OMH regulated agency in NYS. Unfortunately, we cannot apply as individual private practitioners. And it's not just LCATs --LMFTs, LPs, LPCs, and LMHCs are also ineligible to become Medicare (National program) or Medicaid

(NYS program) providers as private practitioners. Of note, LCSWs cannot see straight-Medicaid clients in private practice. They can only see Medicaid clients who also qualify for Medicare (QMBs they are called). On a related note (for those interested in becoming in-network providers for other insurances), most New York insurance plans are closed to all mental health providers at this time, unless you are located in a severely under-served geographic area (like far upstate NY). Several insurances only accept LCSW-R and Phd providers in-network. This means that LCATs are not the only professionals shut out of the plans. The requirements to join many networks is quite stringent. To receive an LCSW-R, a therapist must have a minimum of six (6) years post graduate supervision and approximately 4500 hours of direct client contact hours. And many plans are now requiring that practitioners show proof of additional professional training in their

declared area of expertise, i.e. trauma treatment, CBT, ABA, etc. All that said, I don't recall if I followed the exact steps that re-printed from AATA. So, if someone else is willing to try, it would be great to hear a different result. This is my understanding of the situation based on my personal experiences trying to expand our insurance coverage options. I am happy to hear of other outcomes.Drena Fagen, LCAT, LCSW, ATR-BCnycreativetherapists.comBrooklyn, NY