- Beginning March 1, those insured by Michigan’s largest insurance provider will no longer have access to limited-license mental health professionals in private practices.
- Blue Cross Blue Shield of Michigan claims this move is aimed at improving care quality and staying consistent with other offerings.
- Therapists have pointed out that Blue Cross is the primary insurer for many licensed therapists in the state.
Many residents in Michigan may find themselves without mental health support due to a recent policy change from Blue Cross Blue Shield of Michigan.
Starting March 1, this major insurer will stop covering limited-license therapists practicing in private settings. There are approximately 13,000 professionals in this category—like social workers and counselors—but it remains uncertain how many will be directly impacted by the discontinuation of these long-accepted benefits.
Some professionals have voiced concerns that Blue Cross is attempting to limit access as the demand for mental health assistance continues to rise.
Dr. Amy Milewski, the chief medical officer of the insurer, strongly disagrees. She stated that the change in billing policy will mandate new therapists to receive comprehensive training for full licensure through hospitals or accredited outpatient centers.
She emphasized that these facilities have built-in monitoring and quality standards to ensure effective care is provided.
“This decision was driven by quality, not cost,” Milewski clarified. “Our goal is to improve care.”
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According to Milewski, private practices needing reimbursement for limited-license staff could transition to becoming accredited outpatient psychiatric centers, though that would involve hiring additional professionals like psychiatrists.
Additionally, this policy aligns with existing practices of Blue’s HMO branch, Blue Care Network, which has historically not targeted limited-licensed mental health professionals. It also does not impact those insured under Blue’s Medicaid plans.
Milewski mentioned that there were concerns about the network fitting the needs of beneficiaries but believed ultimately that ensuring proper structures were in place for quality treatment was paramount.
How other insurance companies will manage limited-license therapists remains unclear.
Dominic Pallone, head of the Michigan Association of Health Plans, noted that coverage can differ significantly across insurers and contracts are typically confidential.
Still, several therapists indicated that Blue Cross remains the largest payor for limited-license therapists in Michigan, controlling nearly 70% of the state’s commercial market.
“This could silence numerous practices,” said Jacob Moon of the Relational Therapy Collective in Grand Rapids. Providers might struggle to support the services they currently offer, especially when trying to find staff with full licenses. Gina Merritt, who runs a counseling service, anticipates fees of at least $60 per session, sometimes exceeding $150.
Two of her limited-license staff work with students in local schools dealing with various challenges, from trauma to uncertainty about food or housing. She stressed that numerous children with Blue Cross insurance will struggle to find new therapists if this policy goes ahead, putting families in a tough spot.
Moon highlighted that this shift might lead to some providers shutting down altogether, as the shortage of limited-license reimbursements compounds their issues in hiring fully licensed professionals.
“I will need to let them go, but not just yet; it will happen in March,” he mentioned.
frustrated and concerned
Critics are worried this will place additional stress on healthcare providers and patients, especially as companies aim for profits in a challenging landscape with rising healthcare expenses.
“Removing individuals from the market increases profitability,” said Rob Cornoelier, who founded a care network in Grand Rapids. His center had around 75 therapists working across multiple locations, managing 36,000 appointments last year. He estimates that about 250 clients under 22 limited-license therapists will no longer have coverage after March 1.
“Limiting access does not lead to better care,” he said.
This change follows a recent public dispute between Blue Cross and Michigan Medicine regarding provider contracts, which raised alarms among many about potentially losing their doctors come July 1, although that has since been resolved.
In defending the change, Milewski maintained that enhancing quality of care was the primary focus behind this decision.
Furthermore, she mentioned that providers are being notified with a nine-month lead time to prepare.
With a significant shortage of mental health professionals in Michigan, finding alternative therapists can be quite challenging.
“We’re constantly busy,” Merritt remarked. “It’s tough to keep up.”
While initial reactions to the announcement of this policy were panic, they have since turned to anger, as she pointed out, “You’re jeopardizing the future of both this profession and those in need of mental health support.”
Transitioning to new healthcare providers can be fraught with challenges, particularly for those engaged in long-term treatments.
“The effectiveness of treatment is deeply tied to the client-provider relationship,” said Chris DeBoer of the Michigan Association of Mental Health Counselors, highlighting that about 13,000 limited-license providers work in the state. He added, “If I became depressed and suddenly lost my therapist, I’d be at a loss.”
DeBoer is also the clinical director at Spring Forest Counseling, where around 50 mental health professionals, including 16 with limited licenses, serve the community. He noted that stopping reimbursements for limited-license therapists could hinder Michigan’s role as a training ground for new professionals.
“This effectively cuts off the pipeline for future therapists,” he concluded.
