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Providers tell Senate committee delays in psychological evaluations are stalling Medicaid payments
Summary
Providers told the Senate Health and Welfare Committee that psychological evaluations required for eligibility and payment are taking four to seven months in some cases, creating payment delays; providers said they sometimes pay psychologists directly to try to speed the process.
Multiple providers told the Senate Health and Welfare Committee that timelines for required psychological evaluations have lengthened and are delaying eligibility determinations and Medicaid payments.
Bridger Fly, CEO and administrator of Community Care Inc., said evaluations that once were completed within about 90 days are now taking "sometimes 4 to 6 and sometimes 7 months" on the calendar, even when providers contract with psychologists. "It can be a real complex, problem to solve," Fly said, adding that his facility sometimes pays psychologists directly using Medicaid funds to try to expedite assessments but that the delays persist and impede payment to providers.
Senator Wintrow raised the issue on stakeholders’ behalf and asked the department to work with providers to find solutions without holding up rule adoption. Jared Larson said the psychological-evaluation policy is unchanged in the present docket but the department is willing to discuss policy changes and work with stakeholders during the interim.
