SALT LAKE CITY — Sarah Stroup is a supervisor at Monarch Family Counseling in Herriman, where her work never ends. Many of her clients have Select Health, but the insurance provider says it will no longer cover initial consultations with therapists who aren't fully credentialed.
Associate therapists, those who work under licensed therapists to earn hours for licensure, could only be covered for subsequent appointments.
“If I have an associate who all of a sudden has five openings and even three of those are filled with a Select Health client, I now have to decide: do I drop my own clients, which feels unethical, to now do these intakes so that those people can be seen or do I make them wait until I have an opening, which also feels unfair,” says Stroup.
On the flip side, she says it creates a workforce issue.
If those associates’ schedules aren’t filling up, they’re not earning those hours toward their license and graduation, creating two bottlenecks for clients seeking timely mental health care, and for those entering the workforce to get licensed.
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“The new rule requires that they meet with any new patients, all of them. Well, if they have to meet with every single new patient, how are they going to do that?” explained insurance broker and CEO of Ark Insurance Solutions Rebecca Yates.
Yates said they’ve confirmed with Select Health that it will grandfather in existing patient relationships.
“I think the biggest disruption is going to be for people that are new patients, so they either have to reestablish care with a new provider or, if they have not currently been receiving care, the ability to get into a provider is going to be greatly hindered,” Yates said.
The new enforcement will begin November 1.
According to Yates, customers could also try other payment options.
“You could pay cash, you can use your HSA funds or your FSA funds to continue to pay cash to see that provider, and sometimes you can negotiate a lower cash price,” said Yates.
Stroup is worried the price they’ll have to pay isn’t in currency, but in lives.
“We are putting people’s mental health on the line," said Stroup. "We can have clients who are in crisis. We can have clients that have just come out of a higher need of care, like a hospitalization after an attempt. If they’re waiting weeks to months, I don’t know what that’s going to look like for the state of Utah.”
FOX 13 News reached out to Select Health to ask why the change was happening in the first place, and the company replied in a statement, saying, "We administer benefits in accordance with established medical policies, regulatory requirements, and industry standards. Consistent application of these policies helps protect the integrity of the healthcare system, supports appropriate coverage decisions, and ensures responsible stewardship of healthcare resources.
"Our priority is to help members access high-quality, evidence-based care while supporting improved outcomes and maintaining sustainable healthcare coverage. We are currently meeting with providers and other stakeholders to answer questions and address concerns."
