MAINE

STPA Legislative Needs and Concerns

Medicaid issues. In 2005, the state of Maine implemented a new computer system for processing of claims for Medicaid. This system was a DISASTER.. and it rejected everyone's claims (not just psychologists). Psychologists seem to be among the last whose claims processes were fixed. There remain other issues STILL with this... where some psychologists still don't have this resolved. In addition, a new managed care system (APS Healthcare) has come into the state.. this system was implemented HASTILY.. and psychologists learned about it last minute... the Quality Assurance person came to our Fall Conference.. in November.. to tell us it was being implemented DECEMBER 1st. He was surprised to learn that we knew nothing about it. Issus with this continue. So, this is clearly NUMBER ONE.

2. Business climate for psychologists in general. We have had significant issues with rate cuts for independent practitioners from private insurers... managed care is actually placing more limits on care.. we have full parity in our state.. but they are using "medical necessity" as the new point of leverage to reduce/deny care. We in MePA have a Reimbursement Oversight Committee that deals with the insurance industry.. and this committee has been very busy.

I would also like to add that we have had numerous discussions recently about being a CE provider through APA. We dropped this a few years ago as the paperwork was WAY TOO CUMBERSOME and as I understand, it still is. We have a HALF TIME Executive Director with no office staff. Hence, we do not have the capacity for this. I very much wish that APA would work with State Associations to make this easier and perhaps less expensive. We are a small state and do not have significant resources for this.