County adopts pilot program allowing private providers to bill Medicaid for mental health services

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ST. GEORGE — While state officials continue to figure out just how to implement Medicaid expansion in Utah, Washington County adopted the state-sponsored Utah Integrated Healthcare pilot program, which seeks to remove barriers connecting physical and mental health care funding.

Currently, mental and physical health care in relation to Medicaid is funded separately, Deputy Washington County Attorney Eric Clarke said in a County Commission meeting Tuesday.

“In our county we have the Southwest Behavioral Health Center and the Southwest Utah Public Health Department for mental health and physical health,” Clarke said. “They have very different duties and funding flowing in different directions.”

As it stands, individuals with mental health needs who are on Medicaid are limited to the Southwest Behavioral Health Center for care, instead of being able to go through a private provider.

This causes difficulties for patients who have to deal with separate agencies and results in dealing with physical and mental needs separately rather than together.

“Obviously, there’s some linkage they’re finding between (mental and physical health),” Commissioner Dean Cox said. “Treating the two separately doesn’t always provide the holistic or synergistic outcome we’re looking for.”

Commissioner Victor Iverson said the pilot program would take new funding provided through the state’s Medicaid expansion once it is implemented and allow private health care providers, such as Intermountain Healthcare, to bill Medicaid for a patient’s mental health treatment.

“Say they were treating (a patient) for a physical illness but also needed to get them counseling and mental health, they could also send (the patient) to a private provider and bill Medicaid,” Iverson said.

Activation of the program is contingent on new funding coming in with Medicaid expansion. Utahns initially voted for full expansion of the program last fall, but the Utah Legislature retooled the measure in March and sought to get a Medicaid waiver from the Trump administration allowing for enhanced federal funding for a partial expansion.

The waiver was denied late last month, and state leaders are considering what to do next. However, the denial of the waiver did not impact the partial Medicaid expansion that took place in April.

Utah’s partial expansion is expected to cover up to 90,000 people. The voter-approved law would have expanded coverage to some 150,000 people making less than about $17,200.

State legislators opposing the voter-approved measure claim it will be overly burdensome for Utah taxpayers and have sought to find a less-costly alternative.

The Utah Integrated Healthcare pilot program will be completely sponsored by the state and run at no cost to Washington County taxpayers, Clarke said.

Copyright St. George News, LLC, 2019, all rights reserved.

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