Provision of Mental Health Counseling Services Under TRICARE (2010) / Chapter Skim
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4 Independent and Supervised Practice of Counselors in Other Health-Care Systems
4 Independent and Supervised Practice of Counselors in Other Health-Care Systems
Pages 149-166
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From page 149... ...
. It was also asked to identify the states that had laws requiring private insurers to cover, or offer coverage of, the services of licensed mental health counselors.
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From page 150... ...
Medicare does not recognize licensed professional counselors as independent providers, so they are not directly reimbursed through the program. Provisions in several bills that have been introduced in the House of Representatives and the Senate would have added counselors and some other mental health professionals to those eligible to provide services (CRS, 2007)
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From page 151... ...
The new law allows VA to hire licensed mental health counselors at the same level as clinical social workers and allows counselors to apply for supervisory positions that are open to clinical social workers and marriage and family therapists. Rather than placing them in the same occupational category as other mental health professionals, the VA Under Secretary for Health approved, in February 2009, the creation of a new occupational category or categories for licensed professional counselors and marriage and family therapists to be hired by VA (ACA, 2009b)
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From page 152... ...
Mental health providers identified in IHS include psychiatrists, psychologists, psychiatric nurses, psychiatric social workers, other social scientists, and mental health technicians. IHS policies stipulate that all mental health staff working in IHS facilities must meet the minimum educational requirements set forth by the Civil Service or
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From page 153... ...
. Clinical privileges are recommended for mental health technicians, mental health counselors, and psychiatric nurses and allow them to provide clinical mental health services independently of physician supervision.
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From page 154... ...
. As of May 15, 2007, the Corps had 108 clinical social workers and 14 clinical psychologists in its health-services field (PHS-CC, 2007)
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From page 155... ...
. The FEHBP offers 10 FFS benefit plans that are available nationwide to all enrollees: the American Postal Workers Union "high," Blue Cross and Blue Shield "standard" and "basic," Government Employees Hospital Association "standard" and "high," Mail Handlers "standard" and "value," National Association of Letter Carriers "high," and Special Agents Mutual Benefit Association "standard" and "high." Each of those plans provides comprehensive coverage and has separate provider networks for which in-network providers have reduced costs.
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From page 156... ...
, FEHBP plans are not explicitly required to cover licensed professional counselors, although the law allows insurance plans to voluntarily cover other health professionals' (including counselors') services without physician supervision or referral, provided that the professionals are appropriately licensed or certified by state or federal law (5 USC § 8902(k)
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From page 157... ...
InDEPEnDEnT AnD SUPERVISED PRACTICE oF CoUnSELoRS TABLE 4.1 Coverage of Licensed Mental Health Counselors in FEHBP Nationwide and Selected State Insurance Plans Licensed Mental FEHBP Health 2010 Federal Plan Counselors Plan Details (Provider Definitions or Insurance Plans Codes Coverage Listed Benefits) NATIONWIDE FEE-FOR-SERVICE PLANS -- OPEN TO ALL Blue Cross and 10, 11 Yes Mental health or substance-abuse Blue Shield professional: a professional who is Service Benefit licensed by the state where the care is Plan provided to provide mental health or substance-abuse services within the scope of the license Benefits include professional services, including individual or group therapy, provided by licensed professional mental health practitioners and substance-abuse practitioners when acting within the scope of their licenses Government 31, 34 Yesa Benefits include individual or group Employees therapy by psychiatrists, psychologists, Hospital clinical social workers, licensed Association professional counselors, and marriage and Benefit and family therapists High Deductible Health Plans National 32 Noa Benefits include outpatient professional Association of services, including individual or Letter Carriers group therapy by such providers as psychiatrists, psychologists, and clinical social workers Mail Handlers 41, 45, Yes Benefits include outpatient professional Benefit Plan 48 services, including individual or group Value and therapy by providers approved by the Consumer managed in-network vendor; may Option include services by a licensed professional counselor or licensed marriage and family therapist continued
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From page 158... ...
MEnTAL HEALTH CoUnSELInG SERVICES UnDER TRICARE TABLE 4.1 Continued Licensed Mental FEHBP Health 2010 Federal Plan Counselors Plan Details (Provider Definitions or Insurance Plans Codes Coverage Listed Benefits) Special Agents 44 Yesa Benefits include outpatient professional Mutual Benefit services by such providers as Association psychiatrists, psychologists, and clinical social workers American Postal 47 Yes Benefits include professional services, Workers Union including individual or group therapy Health Plan by such providers as psychiatrists, psychologists, licensed social workers, and licensed intensive outpatient treatment centers NATIONWIDE FEE-FOR-SERVICE PLANS -- OPEN ONLY TO SPECIFIC GROUPS Rural Carrier 38 Yesa Qualified clinical psychologist: a person Benefit Plan who has earned a doctoral or master's Specific Areas clinical degree in psychology or an allied discipline and who is licensed or certified in the state where services are performed; this presumes that a licensed person has demonstrated to the satisfaction of state licensing officials that he or she, by virtue of academic and clinical experience, is qualified to provide psychological services in the state Foreign Service 40 Yes Qualified clinical psychologist: a Benefit Plan person who has earned a doctoral or Specific Areas master's clinical degree in psychology or an allied discipline and who is licensed or certified in the state where services are performed (such as licensed professional counselors)
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From page 159... ...
InDEPEnDEnT AnD SUPERVISED PRACTICE oF CoUnSELoRS TABLE 4.1 Continued Licensed Mental FEHBP Health 2010 Federal Plan Counselors Plan Details (Provider Definitions or Insurance Plans Codes Coverage Listed Benefits) Association 42 Yes Qualified clinical psychologist: a person Benefit Plan who has earned a doctoral or master's Specific Areas clinical degree in psychology or an allied discipline and who is licensed or certified in the state where services are performed; this presumes that a licensed person has demonstrated to the satisfaction of state licensing officials that he or she, by virtue of academic and clinical experience, is qualified to provide psychological services in the state Panama Canal 43 Noa Benefits include outpatient services, Area Benefit Plan including individual or group therapy Specific Areas by such providers as psychiatrists, psychologists, and clinical social workers SELECTED STATE-SPECIFIC INURANCE PLANS UnitedHealthcare E9 Yesa Benefits include professional services, Insurance including individual or group therapy Company, Inc., by such providers as psychiatrists, serving AR, AZ, psychologists, and clinical social CA, CO, DC, workers FL, GA, IA, IL, KS, LA, MD, MO, MS, NC, NM, NV, OH, OK, OR, RI, TN, TX, VA, WA, WI continued
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From page 160... ...
Publicly available sources did not specify whether the services of licensed mental a health counselors were covered. Listed information was obtained via telephone calls to company representatives.
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From page 161... ...
The Foreign Service Benefit Plan, for example, is an FFS FEHBP plan that includes state-licensed professional counselors among its covered providers (AFSPA, 2009, p.
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From page 162... ...
he use of specific methods, techniques, or modalities within the practice of a Licensed Professional Counselor is restricted to coun selors appropriately trained in the use of these methods, techniques, or modalities. A licensed professional counselor or associate licensed counselor shall not attempt to diagnose, prescribe for, treat, or advise a client with reference to problems or complaints falling outside the boundaries of counseling services.
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From page 163... ...
Notably, Maine licenses Professional Counselors and Clinical Professional Counselors: both are permitted to "engage in private/independent practice" (Maine Office of Licensing and Registration, 2009) , but only persons holding clinical licenses may "diagnose and treat mental health disorders" (Maine Revised Statues, Title 32, Chapter 119, § 13858)
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From page 164... ...
2009. Foreign service benefit plans.
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From page 165... ...
2009c. Federal Employees Health Benefits Program Handbook: Health Plans.
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