DPA - Delaware Psychological Association


State Advocacy

The State Advocacy Committee shall keep the Executive Council and Association members advised of state-level legislation and insurance issues impacted mental health and the profession of psychology.  As necessary, it shall establish and maintain relationships with state legislators, the Office of the Insurance Commissioner and major medical insurance providers within the state.  The Committee shall work at advancing the recognition of, and acceptance of qualified psychologists as independent providers of health services within the state.  The Committee may, as necessary and with the approval of the Executive Council, employ the services of a state lobbyist to assist with supporting or drafting appropriate state legislation, secure legislative sponsors, and organize any grassroots activity among the psychologists of the state in support of key legislation.

  • October 02, 2017 11:38 AM | Kelly Wetzel (Administrator)

    IMPORTANT UPDATES:

    House Joint Resolution 7 - Healthcare Spending Benchmark

    On Thursday, September 7th, Governor John Carney signed House Joint Resolution 7 granting the Department of Health and Social Services (DHSS) Cabinet Secretary, Dr. Kara Odom Walker authority to develop a health care spending benchmark for Delaware. A three month federal health spending analysis recently identified Delaware as the third highest for per capita health spending. The benchmark is proposed to provide a method of measuring the total cost of health care in Delaware, thereby supporting economic growth, and transitioning the state from a fee for service to a values based care model. See further details at http://news.delaware.gov/2017/09/07/benchmark/

    Recent Appointment

    Congratulations to Traci Bolander, PsyD, who was recently appointed by Governor Carney to the Behavioral and Mental Health Commission for a term of two years.

    ACTION ITEMS:

    Health Care Reform Special Interest Group (SIG)

    Are you interested in making a meaningful impact in health care reform for the state of DE?    

    Consider participating in the Health Care Reform SIG

    Health care reform meetings are held frequently throughout the state with several stakeholders present, although, psychologists are largely underrepresented. Your participation will entail attending relevant meetings, advocating on behalf of your state psychology colleagues, and reporting back to the SA committee on the outcome of the meeting.

    Critical Incident Reporting: Highmark Health Options Blue Cross Blue Shield (HHOBCBS) of Delaware

    The DPA State Advocacy and Executive Council remain committed to gaining clear and concise feedback from the Director of Clinical and Service Quality of HHOBCBS of DE, (hereafter referred to as “director”) regarding the behavioral health practitioners’ responsibility in notifying HHOBCBS of DE about critical incidents. Unfortunately, we have not received clear directives from HHOBCBS to date, and have proposed a plan to submit a follow-up letter per the approval of the DPA Executive Council requesting clear directives within a specified timeframe.

    State Advocacy Committee Chairs: Traci Bolander, Psy.D, and Danika Perry, Psy.D.

    Committee Members: Niki Serravalle, LPCMH, NCC

  • September 18, 2017 5:10 PM | Kelly Wetzel (Administrator)

    August 2017

    Below is a summary of ongoing updates in the state regarding insurance company collaborations and healthcare reform. If there are additional state advocacy concerns that you have, please reach out to us at: admin@depsych.org.

    ACTION ITEMS:

    Call for the Development of State Advocacy Special Interest Groups

    The Expanded Concussion Law

    • o   In September 2016, DE passed the Expanded Concussion Law regulating “return to play” requirements involving protection to all youth involved in any athletic program.
    • o   This law is more stringent and will ultimately result in the need for increased access to health professionals who make the “return to play,” determination.
    • o   The law is likely to go into effect the first week of September 2017.
    • o   Are you interested in contributing to the developing Expanded Concussion Law?
    • o   Consider participating in an Expanded Concussion Law Special Interest Group
    • o   The purpose of this Special Interest Group will involve researching existing laws in other states, and advocating at the level of the DE Department of Public Health to make recommendations on the type(s) of health professional(s) to be designated in the law as decision makers.

    Advocacy Event Attendance

    • o   There are various meetings held throughout the state which focus on health care reform.
    • o   Various members of the healthcare community, government officials, and business and legal representatives are present at these meetings in meaningful numbers.
    • o   Unfortunately, psychologists are largely underrepresented, despite the efforts of the existing SA committee members.
    • o   Are you interested in increasing the voice of psychologists at these meetings?
    • o   Consider participating in an Advocacy Event Special Interest Group.
    • o   Your participation in this Special Interest Group will entail attending relevant meetings, advocating on behalf of your state psychology colleagues, and reporting back to the SA committee on the outcome of the meeting.

    IMPORTANT UPDATES:

    Payment Reform Meeting in Delaware

    • -       The Delaware Center for Health Innovation (DCHI) cross-committee meeting was held on June 28th, 2017 at The Outlook Center, 500 West Loockerman St, Dover, DE 19904
    • -       Our very own Traci Bolander, PsyD, CEO/Licensed Psychologist, Mid-Atlantic Behavioral participated as a moderator for the second Panel on Research/National Perspectives on Payment Reform
    • -         You can review  the meeting at www.facebook.com/DEHealthInnovation for additional details

    Blue Cross and Change Healthcare (Billing and Coding) Educational Webinar

    The SA committee hosted an educational webinar focused on a general discussion about the auditors’ expectations for CPT psychotherapy coding and documentation. This webinar was facilitated by Joan Warner, RHIT,CCS,COS, Manager of Coding Compliance, of the Change Healthcare team, on June 23rd.  from 12 noon – 1 p.m.The Change Healthcare team is a Highmark contracted company which provides coding trending and education). Joan provided feedback about the following:

    • o   Redacted records are accepted from Highmark providers.
    • o   Health and Behavior Assessment codes 96160 and 96161 (which replaced code 99420):
    • o   Codes 96160 and 96161 are used when a patient risk-assessment instrument is administered to either the patient or the caregiver/parent in order to assess the risk of conditions, such as mental disorders
    • o   The instrument must be administered in conjunction with an E/M (a service provided by the physician or other qualified health care professional).
    • o   The separately reported E/M service includes interpreting the rating scale, discussing the results with the patient and/ or caregiver, documenting the patient/caregiver discussion in the patient’s medical record, and providing any referrals to the parent’s or caregiver’s primary care provider or mental health provider.
    • o   Codes 96160 and 96161 do not include physician work which may be reported for the patient encounter.
    • o   NOTE:  Additional alcohol and/ or substance abuse screening services cannot be reported in conjunction with either code 96160 or 96161.
    • o   Joan and her team are continuing to research use of the psychotherapy crisis code, as well as procedure codes 96127 and 99408.

    Proposed Behavioral Health Legislation in Delaware:

    DE Lt. Governor, Bethany Hall-Long presented legislation on June 8th announcing the development of the Behavioral Health Consortium. This consortium is designed to facilitate a coordinated behavioral health system (involving mental health and substance abuse concerns) within the state of Delaware. The committee is involved in these stakeholder meetings, and will notify the DPA body as these initiatives become public with the hope that others will offer their insight and participate in the committees that may be formed as a result of these initiatives. Please review DE House Bill (220) and Senate Bill (111), and review the link below about further details on the newly announced legislation.

    http://news.delaware.gov/2017/06/08/lt-governor-hall-long-announces-legislation-to-improve-behavioral-health-services-in-delaware/ 

    Please save the date for the bill signing of Senate Bill 111 and House Bill 220. Governor Carney will sign both pieces of legislation, which create the Behavioral Health Consortium and Addiction Action Committee. Preliminary details are below:

    When: Wednesday, August 16th, 2017

    Time: 3:00PM

    Where: SUN Behavioral Health

    21655 Biden Ave

    Georgetown, DE 19947

    Uniting our Efforts

    DPA Federal Advocacy coordinator, Barbara Giardina, PhD has agreed to provide listserv updates and Capwiz training to the SA committee in order to disseminate Federal Call to Action Alerts to the DPA membership.

    Critical Incident Reporting: Highmark Health Options Blue Cross Blue Shield (HHOBCBS) of Delaware

    The DPA State Advocacy and Executive Council remain committed to gaining clear and concise feedback from the Director of Clinical and Service Quality of HHOBCBS of DE, (hereafter referred to as “director”) regarding the behavioral health practitioners’ responsibility in notifying HHOBCBS of DE about critical incidents. Unfortunately, we have not received clear directives from HHOBCBS to date, and have proposed a plan to submit a follow-up letter per the approval of the DPA Executive Council requesting clear directives within a specified timeframe.


  • May 16, 2017 11:52 AM | Kelly Wetzel (Administrator)

    The State Advocacy Committee is dedicated to keeping you abreast of updates regarding changes in healthcare reform, collaboration with insurance companies, and the home health model. If you have any additional advocacy concerns please reach out to us at admin@depsych.org.

    TRICARE Rate Cuts Survey

    We recently developed a survey to gain your feedback about significant reimbursement rate cuts proposed by TRICARE through Humana. These data will be shared with the APA as they are closely monitoring the impact of these cuts and are developing a plan to respond to Humana. You will receive and email with a link for the survey, and it takes less than 3 minutes to complete. Please email admin@depsych.org or a member of the State Advocacy Committee if you have questions or concerns.

    Blue Cross and Change Healthcare (Billing and Coding) Educational Opportunity

    In response to the national and local trend of insurance company auditing resulting in the assessment of significant repayments by providers, the SA committee is encouraging proactive efforts to ensure that our members are not subject to take backs.

    To that end, the SA committee is planning an educational webinar proposed to occur in May 2017, focused on the auditors’ expectations for CPT psychotherapy coding and documentation. This webinar will be facilitated by the Change Healthcare team (a Highmark contracted company which provides coding trending and education). In order to be as responsive to your concerns in the development of this webinar, please submit questions/concerns to admin@depsych.org.

    Uniting our Efforts

    The SA and DPA Federal Advocacy committee led by Barbara Giardina, Ph.D., are in the process of developing a collaborative plan to comprehensively address advocacy concerns at a state and federal level.

    Critical Incident Reporting: Highmark Health Options Blue Cross Blue Shield (HHOBCBS) of Delaware

    DPA SA Chairperson, Traci Bolander, PsyD issued a written statement in January 2017, to the Director of Clinical and Services Quality of HHOBCBS of DE, (hereafter referred to as “director”), requesting concise directives regarding the behavioral health practitioners’ responsibility in notifying HHOBCBS of DE about critical incidents. Unfortunately, the concern appears to remain under internal review given that a formal response from the director has not been issued. As a result, the SA committee sought the support of the DPA Executive Committee (EC) to submit a formal letter to the director requesting a directed response.

    The DPA EC approved the formal letter, written on behalf DPA President, Cynthia Diefenback, PsyD, APRN, to be submitted to the director in April. We look forward to keeping you updated on this process.

    DE Behavioral Health Electronic Medical Record Incentive Program

    The availability of funding scheduled for February 2017 has not been released, and is pending the review of the new administration. We plan to keep you informed of any updates and encourage your continued monitoring of the Bid Solicitation Details website at http://bids.delaware.gov/bids_detail.asp?i=4124&DOT=N

    State Advocacy Committee Chairs: Traci Bolander, Psy.D, and Danika Perry, Psy.D.

    Committee Members: Niki Serravalle, LPCMH, NCC

  • April 04, 2017 9:45 AM | Kelly Wetzel (Administrator)

    March 2017

    The State Advocacy (SA) Committee has developed a summary of ongoing updates in the state regarding insurance company collaboration, and healthcare reform. As always, if there additional advocacy concerns that you have please reach out to us at admin@depsych.org.

    Critical Incident Reporting: Highmark Health Options Blue Cross Blue Shield (HHOBCBS) of Delaware

    DPA State SA Chairperson, Traci Bolander, PsyD issued a written statement in January 2017, to the Director of Clinical and Services Quality of HHOBCBS of DE, (hereafter referred to as “director”), requesting concise directives regarding the behavioral health practitioners’ responsibility in notifying HHOBCBS of DE about critical incidents. Unfortunately, the concern appears to remain under internal review given that a formal response from the director has not been issued. As a result, the SA committee sought the support of the DPA Executive Committee (EC) to submit a formal letter to the director requesting a directed response.

    During the March DPA EC meeting, the committee approved the development of a formal letter to be written by the State Advocacy committee. The letter will be submitted to the DPA President, Cynthia Diefenback, PsyD, ARNP in early April for final review.

    Blue Cross and Change Healthcare (Billing and Coding) Educational Opportunity

    In response to the national and local trend of insurance company auditing that are resulting in the assessment of significant repayments by providers because coding and documentation do not meet guidelines SA felt it was important to provide opportunities for our members to be proactive in ensuring they are not subject to takebacks.   To that end, SA is planning an educational webinar focused on what auditors are looking for in CPT psychotherapy coding and documentation which will likely be in May. This webinar will facilitated by the Change Healthcare team (a company contracted by Highmark to do coding trending and education). In order to be as responsive to your concerns in the development of this webinar, please submit questions/concerns that you would like to have addressed during the webinar to admin@depsych.org.

    DE Behavioral Health Electronic Medical Record Incentive Program

    The availability of funding scheduled for February 2017 has not been released. Our understanding is that funding will be released but the time frame is undetermined at this time. We recommend continued monitoring of the Bid Solicitation Details website at http://bids.delaware.gov/bids_detail.asp?i=4124&DOT=N

    The SA committee is dedicated to keeping you abreast of any updates. Please keep in mind that funding availability of this incentive program is contingent upon available federal funding provided through the Testing Cooperative Agreement Grant from the Center for Medicare and Medicaid Innovation (CMMI) State Innovation Model (SIM). You can find the original document outlining the incentive program at http://bidcondocs.delaware.gov/HSS/HSS_16037A_emrincent_rfp.pdf

  • February 24, 2017 2:58 PM | Kelly Wetzel (Administrator)

    The State Advocacy Committee is dedicated to keeping you abreast of updates regarding changes in healthcare reform, collaboration with insurance companies, and the home health model. If there are additional advocacy concerns that you have please reach out to us at admin@depsych.org.

    Critical Incident Reporting re: Highmark Health Options Blue Cross Blue Shield (BCBS) of Delaware

    State Advocacy Chairperson, Traci Bolander, PsyD issued a written statement in January 2017, to the Director of Clinical and Services Quality of Highmark Health Options, (hereafter referred to as “director”), requesting concise directives regarding the behavioral health practitioners’ responsibility in notifying Highmark Health Options about critical incidents as the email summary provided none of the details that were relayed by the director over the phone. Unfortunately, a formal response from the director has not been issued at this time. Inasmuch, the State Advocacy committee has proposed to submit a formal written letter from the DPA Executive Council requesting clarity from the director, as this matter is currently under internal review within Highmark Health Options BCBS of Delaware.

    Blue Cross Audit Letters (Billing and Coding) and Change Healthcare

    Traci remains involved in ongoing meetings with the Blue Cross Director of Provider Relationships specifically related to concerns that were raised related to notices received from Change Healthcare (a contracted company who reviews coding patterns and documentation for Blue Cross). Blue Cross and Change Healthcare have both indicated that the goal of these letters is to provide education related to billing and coding to providers.

    If you received notice from Change Healthcare regarding your use of the 90837 code, and you have concerns that you would like the State Advocacy committee to further explore, please reach out to the committee by emailing us at: admin@depsych.org

    Delaware Secretary of the Delaware Department of Health and Social Services (DHSS)

    Newly elected Health Secretary, Kara Odom Walker, MD, MPH, MSHS, was confirmed in her new role on 02/06/2017 and she met with the Joint Finance Committee (JFC) at Legislative Hall on 02/07/17 for the Fiscal Year 2018. The notes from her presentation can be found at http://www.dhss.delaware.gov/dhss/secretaryremarks.pdf

    Rita Landgraf, former Secretary of the DHSS has transitioned into her new role at the University of Delaware College of Health Sciences as professor of practice and distinguished health and social services administrator in residence. 

  • February 24, 2017 2:52 PM | Kelly Wetzel (Administrator)

    The State Advocacy Committee continues to work diligently in advocating for and addressing the needs of DE behavioral health providers and their patients. Please review the latest updates below to keep you informed. If you have questions or concerns that you would like to discuss, please feel free to reach out to either of the State Advocacy Committee members (contact information is below).

    Critical Incident Reporting re: Highmark Health Options Blue Cross Blue Shield (BCBS) of Delaware

    In an effort to gain clear, concise directives regarding critical incident reporting, State Advocacy Committee Chairperson Traci Bolander, PsyD, has been in ongoing communication with the Director of Clinical and Services Quality of Highmark Health Options, (hereafter referred to as “director”). A written statement was issued by the director indicating that behavioral health practitioners should maintain current ethical practice and licensing board requirements by reporting critical incidents to the appropriate state agency. The Advocacy Committee is awaiting a written response from the director regarding the behavioral health practitioners’ responsibility in notifying Highmark Health Options about critical incidents as well; this matter is currently under internal review within Highmark Health Options BCBS of Delaware.

    Blue Cross Audit Letters

    Approximately 2-3 months ago, various DPA members received notice from Change Healthcare (a contracted company who reviews coding documentation for Blue Cross) suggesting that the respective provider has billed high level codes (e.g. 90837) significantly more frequently than other providers within the same specialty. Traci is involved in ongoing meetings with the Blue Cross Director of Provider Relationships to determine the level of provider responsibility and potential consequences regarding the audit.

    DE Behavioral Health Electronic Medical Record (EMR) Incentive Program—New Updates

    The second call for proposals did not result in any new applicants. There were five respondents to the initial call for proposals, all of whom were granted EMR contracts to support their respective EMR integration plan.

    Seeking a Behavioral Health Integration (BHI) Program Manager

    DCHI will launch BHI projects throughout the state in February 2017, and a program manager is needed to help oversee successful implementation of the BHI project. If you are interested in this position, please reach out to Traci Bolander, PsyD at tbolander@midatlanticbh.com

    Changing of the Guards – Farewell to Rita Landgraf

    Rita Landgraf, former Delaware Health Secretary was a large proponent of Behavioral Health Integration (BHI) in the state of Delaware, and she will be sorely missed. The DPA Advocacy committee would like to publicly thank Rita for her tireless efforts in advocating for BHI and ultimately increased access to behavioral health care.

    Newly elected Health Secretary, Kara Odom Walker, MD, MPH, MSHS, a medical physician and public health specialist by trade, has contributed substantial efforts to the Patient-Centered Outcomes Research Institute in Washington, DC. Secretary Odom is highly respected, and will serve on the DCHI board to further support BHI.

    Stay Alert, Stay Aware

    Behavioral health providers are encouraged to be aware of governmental changes that could affect access to care and fees schedules for providers, given the current budget deficit in DE. Additionally, Aetna health insurance plan will represent a larger number of DE patients going forward.

    Stay Tuned

    Our Executive Director, Kelly Wetzel, MSW will be meeting with the committee on child welfare policy for the state of DE to discuss and clarify reporting responsibilities for DE psychologists.

    Traci Bolander, PsyD – Committee Chair

    tbolander@midatlanticbh.com

    Danika Perry, PsyD – Committee Co-Chair

    danikap@nemours.org

    Angela Nicole Serravalle - Member

    nikiserravalle@gmail.com 

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