I have been a licensed practitioner for almost almost 30 years and remember 1994 when HMOs were just beginning their entrance into the therapeutic arena. Since then, therapists have been regulated and restricted from earning a reasonable income and the privacy and general mental health of their patients have been regulated to the detriment of clients' health and the disrespect of therapists devaluing their discretion, confidentiality and imposing exploitive monetary restrictions. UHC/UBH/Optum for instance refused to increase reimbursement for almost 20 years from $60 per session. I negotiated with them for 18 months before finally receiving an increase to $90 and eventually $115. They have done in person audits of records and office in my time. Magellan's practices imposed restrictions by constant regular reviews and if the client was not suicidal they imposed limits on sessions. Their interference crossed confidentiality boundaries and I left the network 6 years ago. This is not a new problem but it is worsening as now "claw backs" for sessions are more common and new regulations such as the "no surprise act" requiring therapists to predict a timeline to ascertain total cost of therapy is required regardless of diagnosis. Our membership organizations have not been able to help navigate these issues, provide a Union organization or work towards wage increases. I can cite numerous issues that have arisen over these many years, but the bottom line is that health care for profit serves only the health care corporations and harms both clients and therapists. I am appreciative that these issues are being brought to light at last.
Thank you for elaborating on this topic. Wouldn’t it be great if as consumers of insurance policies there would be a way to apply pressure on them ? It is criminal what they are doing to squeeze out therapists and people that require care.
I so appreciate your highlighting this issue. It has become more and more outlandishly difficult to get paid for my work as a therapist in private practice, due to the continual obfuscation by large insurance companies.
The issues go far beyond "insurers". Follow a sequence of evidentiary warrants that there is a highly concentrated vector of financial "ownership" at virtually every aspect of medicine as documented at https://academyanalyticarts.org/mcdowell-who-controls-quality-control. There find the World Trade Org's plan to sabotage national healthcare; there intellectual property rights committee overlaps the NCQA's pupet masters. Insurers still require DSM dx (albeit though ICD) though the NIMH disaffiliated from the DSM Dec 2013 citing the DSM's lack of scientific grounding. When I lost something, my mother taught me a few tricks: Look in your pockets. Translated for Jungians, look in the shadow of the professional persona where learned helplessness was a price of admission. You'll also find checks from insurers there. To fight one sided insurance rejections, form a committee of therapists (w/ a few PHDs who agree to gather and issue a their assessment of a case. In my opinion, it's fairy tale worthy of Jungian interpretation to think Harris and Biden will fix this: That highly concentrated financial interest winds through their backers at almost every level.
I have been a licensed practitioner for almost almost 30 years and remember 1994 when HMOs were just beginning their entrance into the therapeutic arena. Since then, therapists have been regulated and restricted from earning a reasonable income and the privacy and general mental health of their patients have been regulated to the detriment of clients' health and the disrespect of therapists devaluing their discretion, confidentiality and imposing exploitive monetary restrictions. UHC/UBH/Optum for instance refused to increase reimbursement for almost 20 years from $60 per session. I negotiated with them for 18 months before finally receiving an increase to $90 and eventually $115. They have done in person audits of records and office in my time. Magellan's practices imposed restrictions by constant regular reviews and if the client was not suicidal they imposed limits on sessions. Their interference crossed confidentiality boundaries and I left the network 6 years ago. This is not a new problem but it is worsening as now "claw backs" for sessions are more common and new regulations such as the "no surprise act" requiring therapists to predict a timeline to ascertain total cost of therapy is required regardless of diagnosis. Our membership organizations have not been able to help navigate these issues, provide a Union organization or work towards wage increases. I can cite numerous issues that have arisen over these many years, but the bottom line is that health care for profit serves only the health care corporations and harms both clients and therapists. I am appreciative that these issues are being brought to light at last.
Thank you for elaborating on this topic. Wouldn’t it be great if as consumers of insurance policies there would be a way to apply pressure on them ? It is criminal what they are doing to squeeze out therapists and people that require care.
Thank you for this informative piece. I had no idea this was going on. Let’s discuss on Monday!
I am so glad to hear that there is a plan for this because it is such a mess and this is an issue that needs fixing ASAP!
I so appreciate your highlighting this issue. It has become more and more outlandishly difficult to get paid for my work as a therapist in private practice, due to the continual obfuscation by large insurance companies.
The issues go far beyond "insurers". Follow a sequence of evidentiary warrants that there is a highly concentrated vector of financial "ownership" at virtually every aspect of medicine as documented at https://academyanalyticarts.org/mcdowell-who-controls-quality-control. There find the World Trade Org's plan to sabotage national healthcare; there intellectual property rights committee overlaps the NCQA's pupet masters. Insurers still require DSM dx (albeit though ICD) though the NIMH disaffiliated from the DSM Dec 2013 citing the DSM's lack of scientific grounding. When I lost something, my mother taught me a few tricks: Look in your pockets. Translated for Jungians, look in the shadow of the professional persona where learned helplessness was a price of admission. You'll also find checks from insurers there. To fight one sided insurance rejections, form a committee of therapists (w/ a few PHDs who agree to gather and issue a their assessment of a case. In my opinion, it's fairy tale worthy of Jungian interpretation to think Harris and Biden will fix this: That highly concentrated financial interest winds through their backers at almost every level.