Negotiating Higher Iowa Medicaid Reimbursement Rates
We are counting on your assistance in getting fair Medicaid reimbursement rates from Iowa Medicaid. In September 2022 IMHCA wrote to Iowa Medicaid to request a review of Iowa Medicaid Rates for behavioral health. IMHCA letter to IME
Here are two resources from Iowa Medicaid:
- A presentation by the Iowa Department of Health and Human Services:
https://hhs.iowa.gov/sites/default/files/BHDS-Final-Presentation-1-31.pdf
- Here is Liz Matney, Director of IME, presenting to the House HHS Budget 2-20-23
See pages 24-26 https://www.legis.iowa.gov/docs/publications/SD/1369457.pdf
September 12, 2022
To whom it may concern,
The Iowa Mental Health Counselors Association (IMHCA) is a membership organization that represents the Licensed Mental Health Counselors in the state. IMHCA is writing this letter for the purpose of requesting a full rate review and increase to reimbursement rates for mental health therapy services across the state of Iowa to bring us in alignment with our neighboring states. We are requesting a rate increase of 70% to achieve this goal. Services in this request include those provided by the following mental health practitioners: Licensed Mental Health Counselors (LMHC, tLMHC), Licensed Marriage and Family Therapists (LMFT, tLMFT), and Licensed Social workers (LISW, LMSW). These three licenses make up Iowa’s mental health therapists. Mental health therapists have not received adequate or timely rate increases.
IMHCA and our membership are aware that rates are set by Iowa Medicaid through the Department of Humans Services. According to research of the surrounding states (included below), Iowa is reimbursed at significantly lower rates than Nebraska, Minnesota, Illinois, South Dakota, North Dakota, Wisconsin, Kansas, and Missouri. We strongly urge you to consider increasing our rates particularly at a time when mental health is in crisis due to local, state, and world events. Some of the largest needs and concerns for rate increases are as follows:
1. All Iowans need access to mental health services, regardless of their insurance coverage. Increasing reimbursement rates will help increase access to care for all. Mental health providers frequently either opt out of accepting Medicaid at all or cap the number of Medicaid clients that they will see due to low reimbursement rates.
2. We need to attract and maintain talent to this profession in Iowa. Increasing reimbursement rates will help attract new professionals and retain the ones already serving Iowans. With the nationwide movement towards the Counseling Compact, providers may become more financially driven to provide services via telehealth across state lines in order to receive a reimbursement rate reflective of their services, resulting in less access for Iowans.
3. Rates have not increased significantly in almost 10 years. At the same time, cost of living and running a business have increased significantly.
4. Financial stability is important for mental health providers to ensure their ability to meet the increasing demand for their services across the state.
Thank you for this consideration. We look forward to working with you collaboratively to address this issue for Iowans.
Sincerely,
Board Members, Iowa Mental Health Counselors Association, 2022-2023
References:
Iowa: https://secureapp.dhs.state.ia.us/MedicaidFeeSched/X62.xml
Nebraska:
https://dhhs.ne.gov/Medicaid%20Practitioner%20Fee%20Schedules/Mental%20Health%20and%20Subst
ance%20Use%20July%201,%202022%20-%20Revised%207.5.2022.pdf
Minnesota: https://mn.gov/dhs/assets/mhcp-fee-schedule_tcm1053-294225.pdf
Illinois: https://www2.illinois.gov/hfs/MedicalProviders/MedicaidReimbursement/Pages/Practitioner.aspx
Wisconsin:
https://www.forwardhealth.wi.gov/WIPortal/Subsystem/Publications/MaxFeeDynamicSearch.aspx
South Dakota:
https://dss.sd.gov/docs/medicaid/providers/feeschedules/Behavioral_Health_Independent_Mental_Health
_latest.pdf
Missouri: https://apps.dss.mo.gov/fmsFeeSchedules/DLFiles.aspx
North Dakota:
https://www.nd.gov/dhs/services/medicalserv/medicaid/docs/fee-schedules/2022-professional-s
ervices-fee-schedule.pdf
Kansas:
https://portal.kmap-state-ks.us/PublicPage/ProviderPricing/FeeSchedules?searchBy=ScheduleLis