#IBELIEVE in Maternal Mental Health Access: Payer Guidance & Provider Talking Points to Hold Payer Accountable

#IBELIEVE in Maternal Mental Health Access and I will fight alongside you each and every step of the way.

Closing gaps in maternal mental health care seems like a no-brainer but, just like much of the healthcare industry, we’ve been slow to adapt and even slower in adoption.

  • Slow at adapting to a changing world and population needs.
  • Slow to adopt reasonably sound new technologies, interventions, and process innovations.

We cannot leave our mothers behind! As such, the following guidance is targeted towards payers and health insurance companies — and for us all (from community member to healthcare provider) to hold payers accountable.

2020 Mom believes change is possible in maternal mental health care. If you also believe change is possible, join us!

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Here are the steps health insurance companies can take to support maternal mental health (MMH)

HEALTH PLANS & PAYERS:

  1. Institute a case management/care coordination program, allowing obstetricians to refer moms immediately into the program who screen positive for depression, anxiety or bi-polar disorder. Medicaid plan case managers/care coordinators should also address social determinants of health, like food and housing insecurity and safety.
  2. Inform obstetricians how to bill for screening.
  3. Inform obstetricians how to bill for treatment (brief intervention/medication management).
  4. Provide telepsychiatry patient to provider services for all patients with bi-polar disorder, treatment resistant depression, or severe mental illness as a standard.
  5. Inform obstetricians that they should be treating basic depression and anxiety as prescribers when necessary, and how they can consult with a reproductive psychiatrist and bill for their time.
  6. Reimburse obstetrians and hospitals who staff LCSWs or other talk therapists in their offices.
  7. Cover digital therapuetics and explain to providers how to prescribe use of these tools.

MENTAL HEALTH INSURANCE COMPANIES

  1. Identify via an attestation, on the provider credentialing form and at a recredentialing for existing providers, which providers have taken at least 8 hours of a certificate based training in maternal mental health and have 20 practice hours treating MMH disorders.
  2. Pay providers who have earned a PMH designation (the board test provided by Postpartum Support International) higher rates.
  3. Monitor whether you have sufficient MMH providers based on child bearing age women and location of these women in the service area and recruit as needed.
  4. Be available to coordinate with case managers at medical insurers.
  5. Reimburse birth hospitals or medical clinics that provide support groups for maternal mental health disorders, NICU moms/parents that are clinician or certified peer specialist lead.
  6. Authorize services for MMH specific outpatient day treatment programs and inpatient programs. Work to recruit such programs in the provider network.

2020 Mom believes change is possible in maternal mental health care. If you also believe change is possible, join us.

http://www.mom2020.org

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