Deadline Missed for TRICARE LCPC Independent Practice Rule

Deadline Missed for TRICARE LMHC Independent Practice Rule
Washington, DC – June 24, 2011 – The National Defense Authorization Act for fiscal year 2011, signed in January 2011, directed the Department of Defense (DoD) to adopt regulations allowing licensed mental health counselors (LMHCs) to practice independently under the TRICARE program. The Act gave DoD until June 20th of this week to issue rules implementing the requirement, but DoD has now missed the deadline, making it impossible to implement the directive. Presently, we are hearing uncertain estimates of when the rule may be released, ranging from six to 18 months.

AMHCA has led LMHCs in encouraging the DoD to adopt regulations implementing the rule, which will make it easier for beneficiaries to gain access to needed care. However, we have also called on DoD to adopt more inclusive regulations that will recognize a wider array of qualified LMHCs than a recently adopted standard set in a separate VA administrative procedure.

AMHCA will continue to work with the DoD to ensure the regulations are more inclusive than the VA LMHC eligibility standard, and AMHCA is closely monitoring the agency's activity on this matter. For more information or if you have questions, contact James Finley, AMHCA's director of public policy, at jfinley@amhca.org.

Illinois Human services Budget

Dear Illinois Partners:

We have some important updates from the meeting this morning of the Human Services Commission.  Jerry Stermer from Governor Quinn's office assured us that the Governor intends to sign the FY12 budget that was passed by the Illinois General Assembly (HB3717) by June 30th.  In addition, Secretary Saddler of the Department of Human Services confirmed that new contracts will be sent to providers sometime next week.  Thanks to the advocacy of Illinois Partners, these contracts will be temporary, covering 4 months, to allow time for continued discussion and negotiation around any additional changes DHS intends to make for the remainder of FY12.  It is critical to note that the FY12 DHS budget has been reduced by $668 million from FY11, a 17.2% total reduction.  To review the reductions by specific line items, take a look at the information on our website.  Secretary Saddler stated this morning that the DHS contracts issued next week will be issued at 31.67% of the full FY12 appropriation.  There is an understanding that there is a disconnect between the statutory requirements facing state agencies and the corresponding appropriations levels passed by the General Assembly.  While there is hope for revenue to come in at a higher level than what the FY12 budget is based on, there is real uncertainty.  The Human Services Commission requested follow-up reports from the various state agencies once the FY12 budget has been signed by the Governor and decisions about implementing the FY12 budget have been made.

Please stay tuned, as we learn more details about the FY12 budget, we will contact you.  Thank you again for all that you do!    Judith Judith Gethner, Director Illinois Partners for Human Service Quality Services. Adequate Funding. Measurable Results. 312-906-2364 (p); 847-863-0040 (c) www.illinoispartners.org

Medicaid Rules 132 new definition of Medically Necessary

Medical Necessity or Medically Necessary − An LPHA has determined through assessment that a client has a diagnosis of mental illness or serious emotional disorder as defined in the ICD-9-CM or DSM-IV that has resulted in a significant impairment in the client's level of functioning in at least one major life functional area and needs one or more mental health services that are identified in the Mental Health Assessment and ITP to stabilize the client's functioning, or to restore or rehabilitate the client to a maximum level of life functioning.  For clients under the age of 21, medical necessity or medically necessary may additionally mean that the client has more than one documented criteria of a mental illness or serious emotional disorder as listed in the DSM-IV that is likely to impact the client's level of role functioning across critical life areas and needs a Medicaid reimbursable Part 132 mental health service recommended by the completion of an approved Healthy Kids screen by a physician or the completion of a Mental Health Assessment and included in an ITP that could not have been omitted without adversely affecting the client's level of functioning.
http://www.ilga.gov/commission/jcar/admincode/059/059001320A00250R.html