Advancing Access: Parity and Payment for Quality Mental Healthcare (Recorded)
The Austen Riggs Center presents the work of the Psychotherapy Action Network (PsiAN). This moderated panel discussion focuses on helping therapists address insurance denials, violations of parity, and other treatment limitations that impact providing optimal care for our patients. The landmark Wit v UBH class action lawsuit represented a huge win for patients, therapists, and depth therapy. However, that lawsuit is now in peril, and insurance companies continue to violate parity laws and essentially ration care, which particularly impacts the provision of depth therapy.
Panelists with a range of expertise in the areas of insurance law and mental health advocacy speak to issues including:
- A discussion of the insurance advocacy tool-kit that PsiAN and Austen Riggs have created, with information for therapists and tools such as templates for appeal letters and medical necessity evaluations.
- Strategies for responding to insurance company audits, denials, requests for records, and reviews.
- Short summaries of cases/situations that can turn into legal actions.
- "Ghost Panels” and their impact on access to care and therapist reimbursement rates
- Why the appeals process matters–for patients, therapists, and quality care.
- Status update on Wit v UBH, treatment guidelines for depth therapy, and discussion of impact and consequences.
- Opportunities for individual and collective advocacy.
This panel helps depth therapists gain the knowledge of the relevant issues, laws, and tools available to effectively advocate for our patients and our treatments.
Target Audience
_X_____ Introductory ______ Intermediate ______ Advanced
Learning Objectives
- Describe implications of Wit v UBH class action lawsuit
- Identify options and tools for appealing, or assisting in an appeal, of insurance company denials of care.
- Identify the appropriate ethical and legal responses to insurance decisions or pressures that impact treatment.
Moderator:
Bevin Campbell, PsyD, is a New York and New Jersey licensed psychologist treating couples and individuals in her Brooklyn based psychotherapy practice. Past professional roles include research and clinical coordinator for the Center for Complicated Grief, consultant trainer in the treatment of depression for the Veterans Administration, and clinician for a NIMH-funded research program for families with a member experiencing a first episode of psychosis. Dr. Campbell has a postgraduate certificate in Couple Therapy from Adelphi University and is an advanced candidate at the William Alanson White Institute for Psychiatry, Psychoanalysis, and Psychology. She teaches courses in couple and family therapy to graduate students at NYU and courses in advanced personality theory and systems of psychology to graduate students at Pace University. Dr. Campbell is a clinical supervisor for psychology doctoral candidates at Long Island University and Pace University. She is the creator and host of PsiAN Speaks Live, a quarterly forum on issues impacting contemporary mental healthcare, as part of her work with the advocacy organization the Psychotherapy Action Network. Dr. Campbell is a consultant with The Academy of Community Behavioral Health, a partnership between the Mayor’s Office of Community Mental Health and the CUNY School of Professional Studies, where she designs and facilitates coursework on responding to grief and loss
Panelists:
Linda Michaels, PsyD, MBA, is a psychologist in private practice in Chicago. She is chair and co-founder of the Psychotherapy Action Network (PsiAN), a non-profit that advocates for quality therapy. She is also consulting editor of Psychoanalytic Inquiry, clinical associate faculty at the Chicago Center for Psychoanalysis, and a fellow of the Lauder Institute Global MBA program. She has published, presented, and been interviewed by the New York Times, NPR and other national media on the value of psychotherapy, the therapeutic relationship and technology, and the public narrative about therapy.
D. Brian Hufford, JD, was described as “one of the leading ERISA litigators in the country and one of the sharpest legal minds in this area of law” by Chambers USA. He leads an innovative and nationally recognized practice representing patients and health care providers in high stakes disputes with health insurance companies. His efforts led to two of the largest recoveries ever obtained in ERISA-based health insurance class actions, and to a substantial collection of other precedent setting decisions that have transformed the rights of patients and providers, including with regard to behavioral health care and the Federal Parity Act. Brian’s work on reimbursement rate-related litigation against UnitedHealthcare and Health Net, for example, led to settlements worth over $600 million. Brian has served as co-lead counsel in other national health care litigation against UnitedHealthcare, Aetna, WellPoint, CIGNA, and various Blue Cross Blue Shield entities. Brian has successfully argued health care appeals before the U.S. Courts of Appeal for the Second, Third, Fourth, and Fifth Circuits, and was lead counsel in two trials against Blue Cross Blue Shield entities on behalf of providers and provider associations. Brian is one of only three attorneys recognized by Chambers USA in the ERISA Litigation: Mainly Plaintiffs category and is a Law360 "MVP" for Health Care (2015, 2016, and 2017) and Benefits (2019 and 2021). He was chosen as a Plaintiff’s Attorney “Trailblazer” in 2017 and 2021 by The National Law Journal, and has been recognized in industry rankings such as Benchmark Litigation and Super Lawyers. Under his leadership, the firm’s health care practice was named 2017 Health Group of the Year and Benefits Group of the Year in 2018 and 2019 by Law360. Brian was the recipient of the 2021 Rona and Ken Purdy Award to End Discrimination from the National Alliance on Mental Illness. He is a member of the Federal Bar Foundation and the Kennedy Forum Legal Workgroup and has published health law-related opinion pieces in The Washington Post, CNBC.com and many others.
Meiram Bendat, JD, PhD, served as co-counsel for the plaintiffs in Wit v. UBH. He played a critical role in uncovering the UBH guideline flaws and assembling the cutting-edge litigation team that led to plaintiffs’ victory at trial. Dr. Bendat is an attorney licensed by the State Bar of California as well as a psychotherapist licensed by the California Board of Behavioral Sciences. He is the founder of Psych-Appeal, the first private law firm in the United States exclusively dedicated to mental health insurance advocacy on behalf of patients and providers.
David Lloyd, MBA, is the chief policy officer at The Kennedy Forum. Mr. Lloyd is an expert on a range of behavioral health policy issues, including insurance coverage and the Mental Health Parity and Addiction Equity Act of 2008. He has led successful state and federal policy initiatives, including enactment of nation-leading insurance legislation in California, that have increased access to mental health and addiction care for millions of Americans. Mr. Lloyd also has expertise on budget and tax issues and previously served as a legislative assistant to U.S. Senator Debbie Stabenow. He has a bachelor's in History from Cornell University and an MBA from the Kellogg School of Management at Northwestern University.
Kathryn Gallagher, PhD, is a staff psychologist at the Austen Riggs Center. She earned her PhD in clinical psychology from Georgia State University and is a graduate of the Austen Riggs Center Adult Psychoanalytic Training Program and Fellowship in Hospital-Based Psychotherapy. Her graduate research primarily focused on understanding and preventing violence against women, a public health crisis rooted in gender inequality and issues of basic human rights. As a full-time practicing clinician, Dr. Gallagher has shifted her attention to another significant human rights and equity issue–inadequate access to affordable mental health care. Dr. Gallagher is especially committed to supporting efforts to appeal insurer denials of medically necessary mental health treatment.
Austen Riggs Center Inc. confirms that the presenters listed above, nor anyone involved in the planning of the CE/CME event, has disclosed a potential conflict of interest.
The views and opinions expressed in this presentation are those of the presenter(s) and do not necessarily represent the official policy or position of the Austen Riggs Center.
General CME/CE Information
Accommodations - The Austen Riggs Center follows all state and federal laws and regulations, including the Americans with Disabilities Act of 1990 (ADA). In accordance with the ADA, the Austen Riggs Center is committed to accessibility. If you need accommodations for your online course, please contact info@austenriggs.net.
Accreditation
(Physicians, Psychologists, Social Work and Nursing)
The Austen Riggs Center designates this online education webinar for a maximum of (see specific event) AMA PRA Category1 Credit(s) ™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
The Austen Riggs Center Inc. is accredited by the Massachusetts Medical Society to provide continuing medical education for physicians.
The Austen Riggs Center’s policy on disclosure, in keeping with requirements of the Massachusetts Medical Society, requires continuing education planners and speakers to disclose any relevant financial interest or other relationship with commercial entities that could pose a potential conflict of interest in the presentation of this educational activity. The Austen Riggs Center Continuing Medical Education Committee has established policies for identifying and resolving all conflicts of interest prior to this educational activity. The Austen Riggs Center accepts no commercial support of any kind to support our CME/CE activity.
The Austen Riggs Center Inc. also designates this online education webinar for (see specific event) continuing education credit(s) (CE) for psychology.
Austen Riggs Center, Inc. is recognized by the New York State Education Department’s State Board for Psychology as an approved provider of continuing education for licensed psychologists #PSY-0115.
The Austen Riggs Center Inc. is approved by the American Psychological Association to sponsor continuing education for psychologists. The Austen Riggs Center maintains responsibility for the program and its content. For additional information about this program, please call the Erikson Institute Education Coordinator, at 413.931.5230.
The Austen Riggs Center Inc., #1344, is approved to offer social work continuing education by the Association of Social Work Boards (ASWB) Approved Continuing Education (ACE) program. Organizations, not individual courses, are approved as ACE providers. State and provincial regulatory boards have the final authority to determine whether an individual course may be accepted for continuing education credit. Austen Riggs Center maintains responsibility for this course. ACE provider Approval Period: 02/02/2023-2/2/2026. Social workers completing this online education webinar will receive (see specific event) continuing education credits.
For a listing of jurisdictions that accept ACE, please visit www.aswb.org/ace/ace-jurisdiction-map/.
Attention NY and NJ Social Workers
The Austen Riggs Center Inc. is approved as a provider for social work continuing education by the Association of Social Work Boards (ASWB) www.aswb.org, through the Approved Continuing Education (ACE) program. As of January 2021, ACE is accepted in 48 jurisdictions. This does not include the states of New York and New Jersey. Check your state licensing board for further information. For a listing of jurisdictions that accept ACE, please visit www.aswb.org/ace/ace-jurisdiction-map/ or check with your state guild and licensing entities.
Available Credit
- 1.50 AMA PRA Category 1 Credit™
ACCME - As a Jointly Accredited Organization, The Austen Riggs Center, Inc. designates this learning activity for a maximum of 1.50 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
- 1.50 APA
As a Jointly Accredited Organization, The Austen Riggs Center, Inc. designates this learning activity for 1.50 continuing education credit(s) (CE) for psychology. Continuing Education (CE) credits for psychologists are provided through the co-sponsorship of the American Psychological Association (APA) Office of Continuing Education in Psychology (CEP). The APA CEP Office maintains responsibility for the content of the programs.
Austen Riggs Center, Inc. is recognized by the New York State Education Department’s State Board for Psychology as an approved provider of continuing education for licensed psychologists #PSY-0115.
- 1.50 ASWB-ACE
As a Jointly Accredited Organization, The Austen Riggs Center is approved to offer social work continuing education by the Association of Social Work Boards (ASWB) Approved Continuing Education (ACE) program. Organization, not individual courses, are approved under this program. State and provincial regulatory boards have the final authority to determine whether an individual course may be accepted for continuing education credit. Austen Riggs Center maintains responsibility for this. Social workers completing this Enduring course will receive 1.50 continuing education credit(s).
- 1.50 Contact Hours/ ParticipationA certificate of attendance for all Learners.
Requirements for course completion include: registering for the event, attending the entire session,
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