    |
| Project FAIR History |
|
|
Project
Fair was created by OPA, and initially funded in large part by APA, in 1997
to address the mounting concerns psychologists had with managed care and
insurance company problems. Glenn Karr, an attorney in private practice who
had been volunteering with OPA because of his desire to make sure that
people got access to mental health care, was instrumental in putting the
Project Fair proposal together. He was then hired to head Project Fair for
two years and he actually continued in that role until 2003.
One of the first problems FAIR tackled was Anthem Insurance's failure to provide proper notification of a change in the rates it was paying to psychologists. Anthem denied any liability, but agreed to pay to psychologists and other mental health care workers over $400,000 in order to settle the dispute. Another major problem FAIR address was with QualChoice, an HMO operating in the Cleveland area. Their payments to psychologists were lagging months behind. Through extremely tough negotiations, and using the Prompt Pay law which requires payment within 24 days after receipt of a completed claim as a threat, OPA was able to negotiate a 6 month extension of existing rates to be paid to psychologists, which had been cut by every other carrier in the Cleveland area. QualChoice also agreed to add an OPA recommended psychologist to their Provider Relations Committee, and as a result OPA at least has some input to decisions when they are being formulated. FAIR, with funding from APA conducted an analysis of OPA member claims. The data was instrumental in the passage of SB4 in the 124th General Assembly (http://www.legislature.state.oh.us/bills.cfm?ID=124_SB_4). This law requires payment of clean claims in 30 days. It has proven to be a major improvement over the previous legislation governing payment to health care providers.
Other Project FAIR links
|
|
