In response to the Feb. 27 letter by Sasha Goss titled “Therapists out of touch,” there is a larger systemic problem with access to mental health counseling and services which includes MassHealth. Accessing care is designed to be hard for both the consumer and the provider. I am speaking from a place of privilege since I have had additional financial support in order to even go into private practice. Please do not discount my response because the information I am providing is based on experience not feelings.

MassHealth and commercial insurances as a whole make it extremely difficult for private practitioners to apply to be a provider. As of 2022 (per the MassHealth website) the non-refundable application fee is $631 to even apply to be a provider. I was fortunate enough to afford it with help. There are “some exceptions” but this is a long tedious process and there is a ton of red tape. With my level of licensure I am only allowed to apply and provide care for certain types of MassHealth products. (By products I am referring to BMC, Tufts Health Together, Be Healthy, Fallon, etc.)

I have been denied by certain MassHealth products along with other commercial insurances “because there are too many providers in the area.” Yes there are several MassHealth insurance products umbrellaed under the name “MassHealth” and the system is built so that insurances keep as much money as possible. It took me roughly six months to be approved/denied by different MassHealth products. I had to call several colleagues and ask them to call MassHealth on my behalf to even be reconsidered for one of them.

I continue to support clients with MassHealth even though I have experienced MassHealth “claw back” fees for sessions. They have taken back at least $2,000 worth of counseling sessions last year because the client “no longer qualified for MassHealth.” This is not unique to just MassHealth and also goes for commercial insurances. They have randomly audited me and have not paid for hours of work because my biller has made some clerical error.

I implore those looking for a therapist or mental health services to contact their state representatives and advocate for a better system that supports better access to mental health care. I wonder if the system looked at how to not only support the client but also the therapist, things might improve. Please go here to advocate: www.mass.gov/topics/legislative-branch.

Sarah Shube, LMHC, ATR

Agawam

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