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Budget Untangles WI Mental Health Care

July 29, 2009

MADISON, Wis. - The new budget signed into law by Governor Jim Doyle earlier this month is expected to end what had been a major roadblock for some people who need mental health treatment.

The new rules will allow mental health professionals to direct-bill insurance companies and Medical Assistance for the services they provide. The old rules mandated that, in order to be compensated, professional counselors and clinical social workers had to provide their services at a state-certified mental health clinic. Ruth Ann Berkholtz, a licensed clinical social worker, says that was a problem.

"The end result - certainly not the intention, but the end result, was - it blocked access to services for people on Medical Assistance."

As an example, Berkholtz says she had a client who lived one block from her private practice clinic, but would have to travel across the city, to another clinic at which she saw patients, in order to get coverage.

"Medical Assistance would not pay for my services when I operated out of that clinic. She could travel across town to my mental health clinic where I worked, a state-certified clinic - then, M.A. would pay."

The new measure makes it much more likely people will have an easier time getting the services they need right away, she adds.

"Then, it's already in effect and you should be able to go to any licensed mental health professional, whether they're in a state certified clinic or not."

She believes the change will be especially important for rural and central city areas, where clinics can be few and difficult to get to. When they take effect in January 2011, the new rules should make it easier for private practices to open in those underserved areas, as they will now be able to direct-bill insurance companies without a clinic's involvement.

Glen Gardner, Public News Service - WI