PROFESSIONAL AFFAIRS AND INFORMATION COMMITTEE (PAIC)
PAIC functions to advocate for neuropsychologists, to keep members abreast of practice-related changes, and to address insurance and reimbursement problems as they arise by directly communicating with the insurers, national neuropsychological/psychological organizations, and the attorney general and advocating for positive practice changes. In addition, PAIC has worked to develop a peer review committee to facilitate insurance appeals when claims are denied for no-fault and worker’s compensation cases, and continues to provide NYSAN members with important resources to help their practices grow.
Co-Chairs - Heather Henkell
Members - David McCabe (Secretary), Ed Barnoski, Cindy Breitman, Carolyn Certilman, Emily D'Antonio, Carole Filangieri, Steve Honor, Brian Lebowitz, Gianna Locascio, Rebecca Martin, Christina Palmese, Allan Yozawitz
- 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- Worked with various payers to bring outdated reimbursement rates and approaches in step with current standards.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.
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