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News & Press: General

Anti-Clawback Legislation Needs Your Support!

Tuesday, January 23, 2018  
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Anti-Clawback Legislation Needs Your Support!
January 23, 2018

As you know, retroactive denials of service (often referred to as clawbacks) can occur at any point in time, and for reasons that may have nothing to do with the provider. The fact that clawbacks can occur even several years after a service was provided, and that they can occur with little to no warning, makes it impossible for providers to maintain financial stability for their business. These unfair business practices have led to fewer providers being willing to accept health insurance, which further reduces accessibility to care for citizens of the Commonwealth.

House Bill 2193 and Senate Bill 582, An Act to limit retroactive denials of health insurance claims for mental health and substance abuse services, would limit clawbacks to 6 months. They will not prevent health plans from retracting payment for fraudulent billing, nor will they prevent health plans from retracting claims by seeking judicial intervention if there is legal cause. These bills will simply set a 6 month limit on how long health plans have to retract payments made in good faith. You can read our legislative update on the anti-clawback bill on our website, including the written testimony provided by Director of Professional Affairs, Dr. Jennifer Warkentin, on behalf of MPA. While our last advocacy campaign on this issue led to the anti-clawback provision being successfully included in the Senate Health Care Bill, the anti-clawback bill will have a better prospect of becoming law if these two bills also advance favorably.

This is your opportunity to make a difference, by expressing support for these bills! We are asking you contact your legislators to ask them to express their support. Click here to find out who your state representative and senator is.

Phone calls have the most impact, so we urge members to use this option. Here are some scripts of what you could say. The bills are currently in the Joint Committee on Financial Services, so the advocacy here is based on asking your State Rep and Senator to ask the Chairs of that Committee to advance the bill favorably:

"Hi, my name is _________ and I am a constituent of Representative/Senator ______. I am also a psychologist who has been affected by clawbacks from insurance companies. This practice has cost me approximately ___ and I'm worried I won't be able to continue to see my patients or keep my practice open."

Feel free to edit this sentence with your own experience/frustrations regarding clawbacks. *If you haven't directly been affected, tell them you think this is a terrible practice that costs providers thousands of dollars.

 

THE ASK:

"It's really important to me that this bill be enacted this year, as a 6-month window would limit the amount of money they can claw back from clinicians, like me, who provide life-saving behavioral health and substance use services."

FOR REPS: "Will Representative ____ reach out to Chairman Michlewitz and ask him to report House Bill 2193 out favorably?"

FOR SENATORS: "Will Senator ____ reach out to Chairman Eldridge and ask him to report Senate Bill 582 out favorably?"

IF YOUR LEGISLATOR IS EITHER REP. MICHLEWITZ OR SEN. ELDRIDGE, YOUR ASK IS SIMPLE: "Please report this bill out favorably from your committee!"

If you prefer to send an email, you can copy and paste the two templates below and fill in your details.

 

Dear Representative (insert name here):

I am a psychologist and a constituent who lives at (insert your address here). I am very concerned about the practice of clawbacks, which is when health plans take back money that was paid in good faith at any point in time, even years later. This practice has cost me approximately ___ and I'm worried I won't be able to continue to see my patients or keep my practice open. It's really important to me that House Bill 2193 be enacted this year, as a 6-month window would limit the amount of money they can claw back from clinicians like me, who provide life-saving behavioral health and substance use services.

Will you reach out to Chairman Michlewitz and ask him to report House Bill 2193 out favorably?Without this bill the most in need remain least likely to be able to get help.

Thank you for your time.

(Your name)

(Your email address)

 

Dear Senator (insert name here):

I am a psychologist and a constituent who lives at (insert your address here). I am very concerned about the practice of clawbacks, which is when health plans take back money that was paid in good faith at any point in time, even years later. This practice has cost me approximately ___ and I'm worried I won't be able to continue to see my patients or keep my practice open. It's really important to me that House Bill 2193 be enacted this year, as a 6-month window would limit the amount of money they can claw back from clinicians like me, who provide life-saving behavioral health and substance use services.

Will you reach out to Chairman Eldridge and ask him to report Senate Bill 582 out favorably? Without this bill the most in need remain least likely to be able to get help.

Thank you for your time.

(Your name)

(Your email address)

 

Thank you for contacting your State Representative and Senator

to help limit clawbacks!

Massachusetts Psychological Association

195 Worcester Street

Wellesley, MA 02481
781.263-0080

www.masspsych.org

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