Just Do It!

by Marc Herstand, MSW, CISW

Sometime last fall I received several emails from members complaining that Humana/Lifesynch had unilaterally cut their reimbursement rates below the current rate for Medicaid.  They also reported that they had been unable to reach a Humana/Lifesynch employee to discuss or renegotiate on these rates.

After receiving these inquires I sent a blast email to the NASW chapter executive directors around the country to learn how they might have handled this situation.  The Kansas Executive Director responded quickly urging me to “Fight Back!”.  She said the worse thing we could do was nothing at all.

When I first decided to try to set up a meeting with Humana/Lifesynch I had no idea if they would meet with us or address our concerns.  I only knew we needed to make the effort to stand up for our members and our profession.

As I have reported in newsletter articles and my executive director’s e-newsletter, our efforts with Humana/Lifesynch have been very successful.   We have developed a partnership relationship with them and a number of our members have successfully negotiated their reimbursement rates.

The lesson here is that we need to take risks and stand up for what we believe in and what is right even if we have no idea if we will succeed.   Obtaining support and good advice is obviously helpful in any endeavor.  With the Humana/Lifesynch situation, in addition to consulting with other NASW chapter executive directors, I also consulted with our national General Counsel to learn what I could and could not do in this situation.

With your support we are always looking for ways to stand up for you and our members in our public relations, legislative, monitoring and political work.   Sometimes we can be successful rather quickly as with Humana/Lifesynch. Other times it can take years of persistence to accomplish our goals as it was with our Vendorship bill, licensure bill and mental health parity bill.  There are always important issues on our “plate” so to speak.  Currently on the professional side we are trying to get the Department of Health Services to reimburse MSW graduates (CAPSW’s) for Medicaid services.   We are also monitoring the implementation of mental health parity by insurance companies.   On the legislative side we would like to see the cuts in support for the poor, our public schools, technical colleges and universities restored in the next state budget.  We would like to see the repeal of the Castle Doctrine, which could threaten the safety of social workers making home visits.  We would also like to see the Child Victims Act passed as well as a law that raises the age at which a child gets automatically referred to adult court from 17 to 18.

So the next time you have an opportunity to stand up for our profession, our clients or for NASW WI, remember that the worst thing is to do nothing at all.  Just Do It!