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Behavioral Healthcare Reimbursement Changes Research Paper


Stoil, M. (2006), “When Medicaid paid bills: behavioral healthcare have suffered as Medicaid has become the dominant public-sector payer.”

Medical executives from different US healthcare departments argue that government healthcare expenses are increasing. The argument arises from the fact that the federal administration spends too much on Medicaid, a US healthcare plan meant to assist persons who cannot afford healthcare (Stoil, 2006). It is noted that the government’s monetary contribution amounts to a huge percentage of total Medicaid expenditure.

In fact, it may increase in case the projected increase of Medicaid expenditure remains unchallenged. US government agendas on behavioral healthcare were habitually interpreted as state objective of influencing the healthcare; poor persons get (Stoil, 2006). This is because, in the past, major government expenditure on behavioral healthcare was directed to asylums and government healthcare entities (Stoil, 2006); however, this has changed over time with the government investing more in community progress institutions and other non-income generating entities.

HRSA. (2005), “Policy information notice 04-05: Medicaid reimbursement for behavioral health services.”

Healthcare institutions, including rural and federal establishments, have raised concerns that obtaining compensation from Medicaid has been a nightmare to them, thus risking patients’ health. The concerns were responded to by seeking statutory requirements of Medicaid, and was finally settled that it is Medicaid’s obligation to reimburse the rural and federal healthcare institutions. Persons to be compensated include doctors, nurses, and any other clinical social employee (HRSA, 2005).

Additionally, the refund must be strictly on expenses incurred on the line of duty, as stipulated by the constitution. This is because the concern of compensating certain duties on which were not within the scope of Medicaid strategies was raised. The worry was solved with reference to statutory boundaries that explain the extent to which practitioners are to be compensated. Recently, Medicaid reimbursement on behavioral healthcare entities has recently been restricted by the government. As a setback, Medicaid assistance to healthcare entities such as FQHC and HRC is threatened since it may fail to satisfy its legislative obligation (HRSA, 2005).

It is renowned that Medicaid does not define the services to be rendered by medical employees but instead, it recognizes the medical staff based on their medical qualification. In addition, reimbursement is done based on the work done within the scope of their profession as per stipulated in the statute law.

Main points from both articles

Medicaid fiscal service is outshining the rural grant bodies due to the support it gets from the government. In light of this fact, Medicaid reimbursement of healthcare services is projected to increase thus effectively satisfying its legislative requirements (Stoil, 2006). In addition, government reimbursement has recently shifted from state owned institutions to other healthcare bodies such as societal and non-income generating entities.

Congress has restricted Medicaid fiscal reimbursement to healthcare services consequently limiting its operations. This has raised concern among medical practitioners since they encounter tribulations in receiving compensations (HRSA, 2005). Additionally, concerns on the scope of work to be compensated have proven to be controversial. This is in reference to Medicaid limited mandate to rule over the matter.

Comparing and contrasting, including my point of view

The first article talks about the fiscal capacity of Medicaid with potential increase in future financial service; furthermore, it explains the shift of Medicaid operations from governmental to non-state healthcare institutions. Contrary to this, the second article dwells on the concerns raised by the practitioners with respect to their reimbursements. Concerns such as the scope of work to be compensated have proven to be controversial with Medicaid unable to solve the issue.

This is because of government restrictions of Medicaid compensations on behavioral healthcare services. Professionally, I would go by the second article, because it handles professionally raised concerns on the scope of reimbursements; furthermore, it talks about the reasons behind the concerns and points out persons who are responsible for the issues. In fact, it explains the changes that have affected reimbursement of professionals resulting from government restrictions, as opposed to, the first article which dwells on Medicaid current and future fiscal aspects.

References

Stoil, M. (2006). When Medicaid paid bills: behavioral healthcare have suffered as Medicaid has become the dominant public-sector payer. Behavioral healthcare management. Web.

HRSA. (2005). Policy information notice 04-05: Medicaid reimbursement for behavioral health services. Web.

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IvyPanda. (2021, January 1). Behavioral Healthcare Reimbursement Changes. Retrieved from https://ivypanda.com/essays/behavioral-healthcare-reimbursement-changes/

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1. IvyPanda. "Behavioral Healthcare Reimbursement Changes." January 1, 2021. https://ivypanda.com/essays/behavioral-healthcare-reimbursement-changes/.


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IvyPanda. "Behavioral Healthcare Reimbursement Changes." January 1, 2021. https://ivypanda.com/essays/behavioral-healthcare-reimbursement-changes/.

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IvyPanda. 2021. "Behavioral Healthcare Reimbursement Changes." January 1, 2021. https://ivypanda.com/essays/behavioral-healthcare-reimbursement-changes/.

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IvyPanda. (2021) 'Behavioral Healthcare Reimbursement Changes'. 1 January.

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