Medicaid Glitch Jeopardizes Pa. Drug, Mental Health Treatment

A glitch related to an expansion of Medicaid has led to Pa. not reimbursing many providers that offer drug and alcohol treatment and mental health services.

A glitch in Medicaid is imperiling drug and mental health treatment for Medicaid users in the state.

Currently, behavioral health providers — drug and alcohol, as well as mental health, treatment — are not being reimbursed by the state in certain instances. Medicaid is a federal program; it’s administered in Pennsylvania by a program called HealthChoices (which will soon be renamed Healthy PA).

“As far as I’m concerned this is a life-or-death issue,” State Rep. Gene DiGirolamo told The Patriot News. GiGirolamo, of Bensalem, has long been a vocal advocate of expanding drug and alcohol treatment.

The glitch appears to be due to the rollout of changes to Pennsylvania’s Medicaid program. In a move supported by Gov. Tom Corbett, Medicaid will expand next year. About 600,000 more Pennsylvanians are expected to become eligible. The state isn’t expanding Medicare as proposed in President Barack Obama’s health care law; instead, it’s doing its own implementation. Per The Patriot News:

But health care providers are reporting that thousands of Medicaid users who are currently getting help for drug addiction or mental health issues — or have a known history of drug addiction and mental health issues — have been sorted into the wrong plans. Many of those same Medicaid users, providers believe, are unaware of those plan changes and that they need to appeal them to the Department of Human Services.

Mike Harle, CEO of Gaudenzia, the largest drug addiction treatment provider in the state, said the net result is that providers fear a new round of reimbursement issues for existing and new Medicaid patients. “There will be a significant number of people who will not be able to get treatment because they aren’t in the right category,” he said.

The Department of Human Services says it is attempting to fix the glitch.

[Patriot News]