Las Vegas Sun

May 4, 2015

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Letter to the editor:

State turns its back on mentally ill

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I am a mental health therapist who is a provider for Medicaid. I am concerned regarding our government’s lack of regard for the mentally ill of Nevada.

The mental health community has known for several months that the billing codes were changing for 2013 effective Jan. 1.

Nevada’s Department of Health Care and Financing Policy informed me last week that it has not implemented the changes, and mental health providers in Nevada will not receive payment for services rendered until April 2013.This leaves providers with few choices: Continue rendering services with hope of being paid in April or stop providing care for the mentally ill on Medicaid.

How many nonprofit agencies who service our mentally ill will be able to stay open without payment for services rendered for four months? This feels like a clear dismissal of mentally ill in Nevada.

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  1. Get use to it, doctor. It's the way to come under Obamacare. Medicare and Medicaid payments have always taken long. Obamacare will make the wait worse.


  2. The Governor has an agenda, made known in his State of the State address. To increase services for the mentally ill and children. Well, guess the seniors of this state will have to go the way of becoming mentally ill to get any better help. Medicaid expansion won't cover seniors, and the division is converging to now cover children cradle to grave. During this process, there will be changing codes and services, the delivery of information to agencies, them implementing what's new or different. The sad thing is, few seniors have shown up at public meetings to bring the voice of those aging and will be MORE reliant on the "system".

    Heaven help us all, when Nevada is a mecca for the older, retiring senior population, and their needs have been basically ignored. Amongst those needing mental health services are our seniors, by virtue of dementia, parkisons, or alheimers. It is morally wrong to turn our backs on anyone in our free society in regards to health care, especially upon those Americans whom have served our growing country throughout their lifetimes.

    Any change in a large organization takes a "turnaround" time. It is quite unfortunate for some who will be caught in this time, and hopefully the folks who deliver services, have some in the bank for such rainy days in the business.

    Blessings and Peace,

  3. "I am a mental health therapist who is a provider for Medicaid....."

    Sei -- so your paycheck depends on mental health being a priority with the state. How exactly does that give you credibility here?

    "Get use to it, doctor."

    CarmineD -- the letter writer is a therapist, not a doctor. Big difference.

    "Medicaid expansion won't cover seniors, and the division is converging to now cover children cradle to grave."

    star -- big contradiction there. Clarify, please

    "I think you all know that I've always felt the nine most terrifying words in the English language are 'I'm from the government and I'm here to help.'" -- the late President Ronald Reagan on YouTube @

  4. "CarmineD -- the letter writer is a therapist, not a doctor. Big difference." KillerB

    You're right. Thank you.


  5. It's time for a Single Payer Option Plan, From the President to the Seniors to the Teachers and ALL Federal/State and Municipal Government Workers including the VA and Medicaid Under the same Plan.
    That plan alone would include almost half of all Americans with up to a 50% savings on Health Care. The plan must be allowed to negotiate rates and include Mental Health Treatments.

    This is the Same Plan Mr. Romney praised in Israel and is used by Most Western Economies. It's the Plan President Obama supported until he became President and then he became attached to the Pharmaceutical lobby for Obamacare support.

    On The Obamacare Act (A Republican Policy Idea) - Republicans will run from it for fear of losing Major contributors and nothing from them will address Americans with Real Numbers as long as they follow the Factually incorrect Fox Noise Network and the Right wing nonsense machine keeps making up wild talking points.

    Just more Republican Right wing stuff like the NRA Gun Lobby, Women's Health Issues, Immigration Issues, Poverty and Jobs Issues, Education Issues, etc.. The sooner that the ridiculous party of Old Angry Uneducated White People is Gone, the sooner this country can move forward.
    Or we can Just let the Red States do all the cuts they want - since most Federal support monies go to these welfare states that pay far less then what they put back into the National Economy.

    Dean Heller Won the Election by Koch Brothers Money telling lies. This is Modern day Elections, however only if you have an educated electorate can this be stopped. The Highest Paid areas, With the Most Educated Populations, Extreme Wealth Concentrations, Highest Quality of Life Suroundings are ALL Democratic - can any of these Right Wingers on these Blogs Get a Clue?

  6. Blame all the special interests, ie. AMA, AHA, insurance companies, etc. for complicating the implementation of ICD-10 in the US, adding the AMA's CPT codes to the process.

    The WHO's ICD-10 was ready for implementation in 1992 and has been in effect in 25 countries, eventually with their own modifications, before the US.

    In the US, with it's complex non-universal healthcare system, all the providers have to get the most advantage they can for the highest payment possible.

    It is no surprise that it has taken 20 years for the US to implement it's particular complex take on the much simpler coding system.

    With all it's complexity and updates, it is no wonder that payment delays have occurred with each new implementation. It is not new, unless a provider is new to the realities of the system. It happened every year with updates during my career. A major ICD change was always much worse.

    There is alot of programming work required to update computer systems and often not alot of lead time given to perform it, especially in a major update as is currently being implemented. We are not talking small programs in limited use. It is a national, state, provider, and insurance programming event.

    The costs for all of this are enormous and that adds to what we all pay in healthcare dollars.

    It isn't related to political parties, or politicians interests. It is in the interest of providers and payment sources, which often involves private insurance companies who administer government programs.

    Benefits or services approved for a program are more related to the political side, but not the coding structure for payment.

    Unless the policy has changed, all providers eventually receive payment for the services provided but delayed during the complicated implementation period.

    Any changes in coverage of services is related to the plans or programs, not the coding. That is an issue that may be more related to budgetary issues and legislatures.

  7. Blame the States for the reason that the Feds turned the mental health matters and centers back over to them. States did a poor job measuring and managing mental health while the Feds fitted the bill for them. After mental health went back to the States, they have still fallen sorely short.