The Independent Practice and Managed Care Working Group is inviting Chapter members to join them. The group's focus is the effect of the managed care industry on clients and on practitioners. The group is urging documentation in writing of problematic experiences with managed care companies. This documentation is needed to impress upon State legislators that there are real problems with the unregulated managed care industry.

Practitioners are urged to keep in mind the following if they are doing business with a managed care organization:

1. There is an intense emphasis on brief, goal oriented treatment.

2. If you disagree with a managed care decision of no further medical necessity for mental health treatment, document that and appeal the decision by phone and in writing. A court case in California held physicians responsible for complications when they disagreed with, but did not appeal, a managed care decision about number of hospital days necessary post op.

3. Carefully read a contract a managed care company drafts for you to sign. There are often contradictions within a contract. Make copies of everything you sign.

4. You have an ethical obligation to your client to have a frank dialogue in the first session leading to a contract. Your client needs to know and understand that reports containing diagnosis and personal information will be submitted to the managed care organization to verify need for treatment. Clients should know specifically what information is transmitted. You need to discuss with a client her/his choices regarding treatment (with or without managed care involvement).

5. There is no recourse for those of you who are not panel providers when you are told that a panel is closed in the metropolitan New York area unless you can provide services to underserved populations (i.e., geographic, language, etc.).

This Working Group will continue to get information
out to the membership through Currents.
Call Dava Weinstein, (212) 799-0664, to Join the Group.