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State Medicaid payment of LPC's for seeing Medicare/Medicaid dual eligibles

  • 1.  State Medicaid payment of LPC's for seeing Medicare/Medicaid dual eligibles

    Posted 30 days ago
    I need some help.  I know it is one of the National Council's policy priorities to expand the list of authorized professional service providers in Medicare to include Licensed Professional Counselors.  For those Medicare beneficiaries who are also Medicaid eligible, prior 2018, Arkansas Medicaid would reimburse LPC's for seeing those clients when Medicare did not pay.  Arkansas no longer does this, and this limitation unnecessarily restricts the pool of eligible service providers, adversely affecting those parts of the state which can least afford to recruit LCSW's.

    In recent discussions with Arkansas legislators on this topic, I have have suggested that a policy change at the state level to allow LPC's to bill Medicaid for caring for Medicare/Medicaid duals would alleviate access issues in parts of our rural state where LCSW's are impossible to hire.  Our state Medicaid agency said that cannot be done, and the reason they gave is that federal limitations on using Medicaid as payor of last resort prevented this.  I need to know if this is true, because I do not believe that it is.  Otherwise, it wouldn't have been the practice here prior to 2018.

    Also, we have been notified by our state Medicaid Agency that after 7/1/22, they will no longer automatically process crossover claims from Medicare to Medicaid without and EOB from Medicare, which to my knowledge, does not exist.  

    I sure would appreciate knowing how these issues are handled in other states, and finding out if our state officials are simply using the feds as the bad cop, or if perhaps our state agency is viewed in low regard by CMS.  Many thanks in advance for your responses.

    --Joel Landreneau
      Executive Director, Arkansas Behavioral Health Council

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    Joel Landreneau
    Interim Executive Director
    Mental Health Council of Arkansas
    Little Rock AR
    501-372-7062
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