CareSource, an insurance organization, has reversed its plan to collect 15 percent of claims paid to some behavioral health caregivers, but the decision comes with significant new concerns for providers. The company initially demanded recoupment of large sums from mental health providers, prompting a rally of mental health professionals at CareSource’s headquarters in Dayton to advocate for change.
Sarah Papesh, co-owner of New Care Behavioral Health in Wellington, and Morgan Murray of Strive CLE Counseling in Westlake had expressed concerns about the potential tens of thousands of dollars CareSource was seeking. Papesh noted that for practices with large numbers of CareSource clients, the recoupments added up very quickly. The cancellation of clawbacks removes “that extra barrier” for caregivers and eliminates “that fear, that threat of these services being pulled away” for patients, according to Papesh.
However, CareSource simultaneously changed its reimbursement structure from 100 percent to 85 percent for some practitioners going forward. Both Papesh and Murray expressed concern about absorbing this long-term reduction. Murray stated, “Sure, the recoupments are done, but we’re also now getting paid less. So, that’s still a financial hit for many providers.” CareSource said behavioral health costs are rising but that it still wants to “ensure access to critical services for Ohioans.”
The women said lingering uncertainty requires them to stay vigilant on the issue. Murray stated, “The mental health community still intends to continue to push back and get answers that we still don’t have right now.” Both providers credited the rally and news stories about the original clawbacks with helping change CareSource leadership’s decision, though they continue to advocate for the mental health and substance abuse treatment support Ohio needs.
This article is an AI-assisted summary. All facts and figures are drawn from the original report: https://us.headtopics.com/news/now-no-clawbacks-on-mental-health-care-claims-but-83022084