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Soldiers struggle to find therapists who take insurance

By Kimberly Hefling
Associated Press Writer

WASHINGTON — Soldiers returning from war are finding it more difficult to get mental health treatment because military insurance is cutting payments to therapists, on top of already low reimbursement rates and a tangle of red tape.

Wait lists now extend for months to see a military doctor and it can takes weeks to find a private therapist willing to take on members of the military.

The challenge appears great in rural areas, where many National Guard and Reserve troops and their families live.

Not worth the hassle

To avoid the hassles of Tricare, the military health insurance program, one frustrated therapist opted to provide an hour of therapy time a week to Iraq and Afghanistan veterans for free.

Barbara Romberg, a clinical psychologist in the Washington, D.C., area, has started a group that encourages other therapists to do the same.

“They’re not going to pay me much in terms of my regular rate anyway,” Romberg said. “So I’m actually feeling positive that I’ve given, rather than feeling frustrated for what I’m going through to get payment.”

Joyce Lindsey, 46, of Troutdale, Ore., sought grief counseling after her husband died in Afghanistan last December. The therapist recommended by her physician would not take Tricare. Lindsey eventually found one on a provider list, but the process took two months.

“It was kind of frustrating,” Lindsey said. “I thought, ‘Am I ever going to find someone to take this?”’

Roughly one-third of returning soldiers seek out mental health counseling in their first year home.

They are among the 9.1 million people covered by Tricare, a number that grew by more than 1 million since 2001.

Tricare’s psychological health benefit is “hindered by fragmented rules and policies, inadequate oversight and insufficient reimbursement,” the Defense Department’s mental health task force said last month after reviewing the military’s psychological care system.

The Tricare office that serves Fort Campbell, Ky., and Fort Bragg, N.C. — Army posts with heavy war deployments — told task force members that it routinely fields complaints about the difficulty in locating mental health specialists who accept Tricare.

Maxed out

“Unfortunately, in some of our communities ... we are maxed out on the available providers,” said Lois Krysa, the office’s quality manager. “In other areas, the providers just are not willing to sign up to take Tricare assignment, and that is a problem.”

Tricare’s reimbursement rate is tied to Medicare’s, which pays less than civilian employer insurance. The rate for mental health care services fell by 6.4 percent this year as part of an adjustment in reimbursements to certain specialties.

Since 2004, Tricare has sped up payments to encourage more doctors to participate, said Austin Camacho, a Tricare spokesman. In some locations, such as Idaho and Alaska, the Defense Department has also raised rates to attract physicians, he said.

“We are working hard to overcome those challenges,” Camacho said.

Copyright 2005 Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

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