This is the place where we post relevant information about changes in our field or current issues that may affect practice.

Blue Cross/ Blue Shield of MN Recoupment

For those of you who haven’t heard, in October of this year BCBS of MN determined that they had been overpaying many clinics and solo providers for mental health services by about 23% based on their system set up error. They made the decision to recoup the overpayment amount from the providers for the past 10 months of services and the repayment is due or it will be taken from future checks by April 2018. Many providers and clinic are understandably upset by this determination and it is causing significant financial hardship for many clinics in the state who serve the lowest income clients (Blue plus/ medicaid clients).

Many organizations and solo providers have been hit with bills exceeding thousands of dollars which will likely lead to financial hardship, potential closing of practices, and a potential reduction in access to services for the lowest income clients across Minnesota. Several practices have opted to request an itemized accounting of all the overpayments and have found significant errors in the accounting of BCBS as well. Some practices have informed us that they are seeking private legal counsel in regard to this matter. Several providers have opted to reach out to the attorney general’s office, the department of commerce, NAMI, and the Minnesota mental health legislative network with their concerns. As of this point it is unclear whether any of these outside organizations will take action to rectify this issue.

Other organizations and the MACC have reached out to BCBS imploring them to reconsider their decision as it will financially negatively impact professionals who have already rendered services to their clients in good faith. Despite our requests, BCBS continues to hold firm to their decision. We encourage you to get involved; communicate your concerns to BCBS directly and to the other agencies referenced above as well. We will inform you of any updates we learn as this recoupment issue unfolds.

Blue Cross trying to recoup $4M in overpayments to therapists
Therapists say repaying Blue Cross for its error creates financial burden.
Star Tribune Article by Glenn Howatt

Blue Cross screws up, decides others should pay the bill — or else
City Pages Article by Susan Du

Contact Information for Attorney General, Lori Swanson
Contact Information for The Department of Commerce
Contact Information for NAMI (National Alliance on Mental Illness Minnesota)
Locate your Legislatures here.
Contact Information for Minnesota Department of Human Services