Episode 35: Fighting Against Clawbacks

NASW Social Work Talks Podcast

Rebekah Gewirtz, MPA, Executive Director of NASW’s Massachusetts Chapter, speaks with us about how her chapter is fighting against clawbacks in her state.

Clawbacks are when an insurance company requires a provider to return money they’ve been paid in the past. Clawbacks can occur months, or even years, after the service has been provided.

Many social workers in private practice experience clawbacks, which make it difficult for them to know their true income. And they are leading some social workers to remove themselves from insurance panels, including state Medicaid programs. This in turn hurts patients, who need to use their insurance in order to afford mental health care.

Published July 9, 2019

Read a transcript of episode 35

Resources

Fact Sheet: Protect Mental Health & Addiction Treatment Providers from Insurance Clawback
This bill establishes fair parameters around the health insurance practice of reverting payments (clawbacks) for which providers of behavioral health services had received previous authorization and been paid by health insurers. The goal is to limit both MassHealth and commercial health insurers to a 12-month period for recovering payments to a behavioral health provider for behavioral health services completed.

Bill H.1078
An Act relative to limits on insurers’ retroactive clawbacks for mental health and substance use disorder services - General Court of the Commonwealth of Massachusetts

NASW-MA Legislative Agenda 2019-2020
Learn about the focus of the Massachusetts chapter's advocacy work in the coming year.

In the News

Social workers face twin threats in debt, clawbacks - Milford Daily News

It's time to elevate social workers and the important work they do - Sentinal & Enterprise

Clawbacks threaten mental health services - CommonWealth Magazine