Insurance Committee (Formerly PAIC)

The Insurance Committee's (formerly Professional Affairs and Information Committee. PAIC) mission is to advocate for neuropsychologists and for accessible neuropsychological care for our patients in New York State, by working with members to remedy insurance problems encountered, as well as address other issues that affect the practice of clinical neuropsychology.

1. Achieving tangible improvements to the quality of professional life for New York neuropsychologists.
2. Addressing problems relating to network adequacy (for private insurance companies, No Fault, and Workers’ Compensation).
3. Working to maintain the practice boundaries between doctoral level psychology/neuropsychology and allied professions,
4. Working with other state and national organizations to:
   1. achieve parity for mental health treatment, and
   2. ensure that clinical neuropsychological services are paid as medical benefits rather than as behavioral health benefits.
5. Providing information to educate insurance companies, legislators, and the general public about the specialty of clinical neuropsychology.
6. Addressing the practices and policies of the NYS Workers' Compensation Board that impact the availability of neuropsychological services to injured workers. Further, monitors issues related to No Fault Insurance. Provides resources to assist NYSAN members with information and guidance on operating within the WC and NF systems.

Past Accomplishments:

• Worked with New York Medicaid to open neuropsychological testing codes to neuropsychologists, whereas prior to these discussions with NY Medicaid, CPT codes for neuropsychological testing had not been reimbursed by NY Medicaid to neuropsychologists and access of services to the poor had been greatly restricted.
• Advocated to the New York State Department of Education for the continued practice by neuropsychologists of making return-to-play decisions.
• Worked with various payers to bring outdated reimbursement rates and approaches in step with current standards. One example is work with the state office of vocational rehabilitation (formerly VESID; now ACCES-VR) to bring their reimbursement rates for neuropsychological evaluation up from a level that had fallen far out of step with standard rates, thereby increasing access to neuropsychological evaluation to many individuals who otherwise would not have viable access.
• Worked with CMS to increase transparency in reimbursement for neuropsychological services.
  
• Worked with representatives of GHI to bring their policies regarding the number of units reimbursed per neuropsychological evaluation in line with national normative data.
• Developed alliances for advocacy with other state and regional neuropsychology groups in: Arizona, California, Colorado, Florida, Maine, New Jersey, Pennsylvania, Texas, and Washington State.
• Worked with an insurance carrier to stop a practice of routine post hoc denials for neuropsychological assessment that had been resulting in both: a) significant unexpected bills to patients, and b) lack of access to services for patients due to many neuropsychologists refusing to accept that insurance.
• In the interest of improving patient outcomes and value of neuropsychological services, a resource list was developed for neuropsychologists and their patients. The list details contact information for and services provided by a range of healthcare-oriented organizations in New York, with a geographic breakdown.
• Worked with a large insurer to ensure that some neuropsychological services billing that had incorrectly been going to patients' mental health coverage was changed to payment under medical benefits.
• Worked closely with some major insurance carriers to eliminate prior authorization procedures, thereby expediting care to patients and reducing processing time and processing costs to insurers and neuropsychologists.
• Working to allow for reimbursement of graduate students and externs by insurance companies that are planning to disallow this practice.
• Developed position papers on appropriate qualifications for practitioners to provide peer reviews and independent medical evaluations (currently on the website).
• Developed a position paper describing the appropriate use of computerized assessments in neuropsychology and medical practices (currently on the website).
• Obtained NYS Senate support/sponsorship for Assignment of Benefits Legislation.
• Developed alliances with additional New York State Organizations (i.e., NYSMS, NYNG) to provide additional political advocacy and resources for educational activities.
• Addressed issue with BC Excellus's overly restrictive policy language which had resulted in denial of most requests for evaluations.
• Convinced Union 32 BJ to process neuropsychological evaluations under the medical portion of the benefit plan.
• Developed a Pediatric Affairs Committee to address issues specific to pediatric neuropsychologists in New York State.
• Continued to work to raise public awareness about the unique role of neuropsychology in patient care and clinical research.

Questions? Email drhenkell@linsllc.com