The Journal News from Hamilton, Ohio • B4

B4 COMPLETE. IN-DEPTH. DEPENDABLE. JOURNAL-NEWS THURSDAY, NOVEMBER 28, 2019 Reimbursement rates for mental health lag despite law By Laura Hancock The (Cleveland) Plain Dealer COLUMBUS Private insur- ance reimbursement rates to Ohio mental health pro- viders appear to be going down, according to a new report, and more state res- idents are seeking inpatient andoutpatientmentalhealth andaddiction treatmentout- side of network. The report byMilliman, a Seattle-based actuarialfirm, suggests that Ohio insurers may not be coveringmental health to the levels required by federal contracting with fewer providers and paying them relatively less.

Milliman looked at claims data for 37 million people nationwide between 2013 and 2017. That included claims data for policies cov- ering 2.8 million Ohioans. The report was commis- sioned by Mental Health Treatment and Research Institute LLC, a nonprofit subsidiary of The Bowman Family Foundation, which aims to improve the lives of people with mental ill- nesses. Ohioanswhowork inmen- tal health are concerned about the trend. In addition to affecting their bottom line, mental health providers are con- cernedaboutparitybetween medical and surgical health and behavioral health.

The federal Mental Health Par- ity and Addiction Equity Act of 2008 prevents health insurers from imposing less favorable benefit limitations on mental health and sub- stance use disorder as the limits they impose onmedi- cal and surgical health care. But the report suggests the opposite in Ohio. instance, in 2017, primary care doctors were reimbursed on average at 107.6%of theMedicareoffice visit rate, up from 102.1% in 2013. tal healthprofessionalswere reimbursed on average at 86.9% from82.7% in 2013. differences in reim- bursement rates, out-of-net- work utilization, and rela- tively low amount of spend- ing dedicated to mental health and addiction treat- ment for the2.7millionOhio- ans coveredbyprivate insur- ance should be alarming to regulators and policymak- said Teresa Lampl, CEO of the Ohio Council of BehavioralHealthProviders, which represents about 150 community nonprofits and addiction centers.

The organization plans to use the report to educate the public and policymak- ers about the trend, she said. The Ohio Department of Insurance is the state agency that takes calls and com- plaints about private insur- ance, referring some to fed- eral agencies and handling others themselves. Of the 15 complaints related tomental health coverage thus far in 2019, only one was related to providers being out of network, said Chris Brock, a department spokesman. In 2017, 3.8% of inpa- tient facility stays were out- of-network formedical and surgical treatment.That’sup from in 2013. year, it was 13.6% for mental health, up from 6.9% in 2013.

facilities, it was 5.5% in 2017 formedi- cal and surgical facilities, up from 5.2% in 2013. behavioral health outpatient facilities, it was 29.4% in2017, up from14.8% in 2013. Mental health paritywith medicalandsurgicalhealth is apriority forOhio insurance companies, said Miranda CrevistonMotter, president andCEOof theOhio Associ- ation of Health Plans. recognize the signifi- cant impact that behavioral health conditions have on individuals, families, soci- ety and the she said. the enactment of the Mental Health Par- ity and Addiction Equity Act of 2008, health plans have worked to make cov- erage available for compre- hensive mental health care and substance use disorder treatment an essential and equal component of an indi- overall health and Motter provided addi- tional research fromAmeri- Health Insurance Plans showing the complexity of complying with the law.

Plans are increasingly usingnewpaymentandcare models that integrate men- tal health chronic illness treatment plans. developing suchasnon-opi- oid therapies to treat pain that are being used by cov- eredphysicians, theresearch showed. Cleveland-area psychia- trist Megan Testa, the presi- dent-electof theOhioPsychi- atric PhysiciansAssociation, said thehassles of insurance coverage are one of the rea- toworkfor a communitymental health clinic, where she receives a salary and the clinic deals with health plans. Insurancecompaniesoften keep accurate lists of psychiatrists that are in-net- work, and people may be choosingplans basedon the outdated lists. This may be why Ohioans are going out- side network for some treat- ment, she said.

Forpsychiatristswho take insurance plans, there are disagreements over treat- ment reimbursement, Testa said. For instance, an insur- ance company may think the doctor should be billing for depression treatment. But the psychiatrist sees the depression is treatment-re- sistant andneeds to rule out othermedical issues, a per- sonality disorder or maybe the patient is admitting howmuch drinking or abusing drugs. psychiatrist is not being reimbursed for she said. PUBLIC HEALTH LOCAL STATE Cemetery Arboretum WOODSIDE CARE YOU CAN TRUST.

Save On Complete Burial Cremation Packages Community Mausoleum Vault Indoor Glass Front Niches Single, Double Family Niches 1401Woodside Blvd.Middletown, OH45044 513-422-3291 www.woodsidecemetery.org Single Grave Plan $3,150.00 Two-Grave Double $5,300.00 Labor Granite Monument Buy Direct ThroughWoodside 100 Acres of AwardWinning Grounds 35 More Acres for Future Use LEIGHTON Mary Jane 98 of Hamilton, passed away on Monday November 25, 2019 at Woodland Country Manor. She was born on April 5, 1921 in Cincinnati, the daughter of the late Max and Mary (Bildner) Hueblein. Mary Jane graduated from Hughes High School Class on 1939. She was a member of the Collinsville United Presbyterian Church and had retired from King Kwik convenience store as a manager after 25 years. She is survived by her four daughters, Sandy Lackey, Jo Ann (Ernie) Lenos, Mary Jo (Roy Lester) Robinson and Sharon (Paul Fields; numerous grand- children and great grandchildren; sister-in-law Nancy Hueblein and special friend Carolsue Sanders.

Mary Jane was also preceded in death by her husband, Harold Leighton; son, Joseph Michael Forch; grandson, Shane Lackey and siblings, Otto Hueblein and Louise Leiendecker. Celebration of Life Service will be held at 11am on Monday, December 2, 2019 at the Webb Noonan Kidd Funeral Home with Pastor Mike Gabbard officiating. Gathering for family and friends will be held prior to services from 10 to 11am. Condolences may be left for the family at www.Webb-Noonan.com LESHER, Gary D. Age 60, of Hamilton, passed away Nov.

24, 2019. Visitation Dec. 1, 1- 2 p.m. at Weigel Funeral Home, Hamilton, OH. SIMONS (Jeffrey), Joan Carol Age 82, of Franklin, Ohio passed away on Saturday November 23, 2019.

Joan was born December 24, 1936 in Middletown, OH. Joan is survived by; daughters Debbie (Steve) Lamb, Beth (Bob) Ward and Kelly Brown; sister Mary Anna Atkins and her loving children, of Mansfield, OH; five grandchildren; nine great-grandchildren; special friend Peggy Kidwell and numerous other wonderful friends. Joan lived in Florida for 14 years, and recently moved back to her home state of Ohio. She deeply loved the Lord and her family. Joan was preceded in death by her parents Lawrence and Virginia Jeffery; brother Bill Parker; and niece Laurie Atkins- Kanis.

Graveside memorial service to be held at 12 noon on Friday, November 29, 2019 at Woodside Cemetery and Arboretum in Middletown, OH, officiated by her nephew Dave Atkins. In lieu of flowers, memorial contributions may be made to Mission Ahava, a nonprofit world mission for at children, www.missionahava.com. Fond memories and expressions of sympathy may be shared at https://www.dignitymemorial.com for the Simons family. THOMPSON, Janet E. Age 74, of Franklin, OH; died Tuesday November 26, 2019 at Hospice of Butler Warren Counties.

Janet was born in Portsmouth, OH on April 20, 1945 to the late Omar and Laura (Jackson) Robertson. She was formerly employed by NCR and Hospice of Dayton. Janet was preceded in death by a brother, Byron Robertson and a sister, Ruth Hollifield. She is survived by her husband, Ronald Thompson; a daughter, Ronda (Scott) Barger; two grandsons, Jeremy and Kyle Barger; a sister, Wilma Jean Hacker; a nephew, Jimmy Hacker; and a niece, Jane Hime. Visitation will be Friday November29, 2019 from 6-8pm at Anderson Funeral Home 1357 E.

2nd St Franklin, OH. In, lieu of flowers, donations can be made to Hospice of Counties. Please visit www.anderson-fh.com to send an online condolence. VANDEVENTER, Curtis Gene 70, of Trenton, Ohio went to be with his Lord and Savior Jesus Christ on Saturday, November 23, 2019 at the home of his daughter in Hamilton, Ohio. Born on March 28, 1949, in Butler County Ohio.

Curtis was the son of Curt and Sadie (Lovins) Vandeventer. He dwelled with his friend Vickie Short in North Vernon, In, during the last few years of his life. He accepted Jesus as his personal Savior at 17 years of age. His working career consisted of a welder, an HVAC technician, iron worker and rigger. He ended his working career self employed using his many skills.

He is survived by his mother, Sadie Vandeventer of Middle- town, Ohio; daughter, Gena (Steve) Etson of Hamilton, Ohio; son, Brian (Regina) Vandeventer of Jasksonburg, Ohio; sisters, Sandra (Mike) Wonderly of Middletown, Ohio, and Ann (Offord) Burkhart of Ninevah, In; brother, Lowell (Pam) Vandeventer of Trafalgar, Indiana; grandchildren, Brandon Vandeventer, Aaron Combs, Julia Timberman, Adam Combs; great grandchildren, Gabriel and Gwen Combs. He is preceded in death by his father, Curtis Vandeventer; brother, Ernie Williams. A celebration of life service will be at 12:00 p.m. on Saturday, November 30, 2019 at Lindenwald Baptist church 460 Symmes Rd. Fairfield Ohio.

HAPPY BIRTHDAY KEN Ken, it was 55 years ago today that God blessed me with a wonderful baby boy. You grew in to an intelligent, handsome, kind, caring son. I have always been so proud of you. Death has left a heartache no one can heal, but love has left memory no one can steal. God has you in his arms, I have you in my heart.

I still miss you everyday. We only part to meet again in Heaven. so thankful you accepted Jesus as you Savior. They say it gets easier, but it I still love you and miss you more everyday, Mom. In Memory of Lisa Marie Ping Happy Birthday to our Angel! Loved ones may leave this world, but they never leave our hearts.

Love, Mom, Dad, Sam and Tigger. InMemoriam Online Obituaries and more. Search for obituaries Print maps and driving directions of local funeral homes and cemeteries Learn how to obtain a death certificate Locate bereavement support groups Place a death notice Click on Obituaries During the week of Thanksgiving, the Early times will be as follows: Date of Publication Nov. 27 Nov. 28 Nov.

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30 at 1:30 p.m. Nov. 30 at 2:30 p.m. Final hours on these days will be from 11-2 For more info call 937.225.2009 or email:.