clinical social work association

Dear CSWA Members,

There are several concerns about the potential risks of accepting the funds which many members have received as compensation for the potential loss of income due to COVID-19. There is no clear guidance on the meaning of the Relief Fund Payment Terms and Conditions, some of which are ambiguous, but the risk which accepting the funds causes seems less problematic than so have suggested. This is not legal advice, but my best guess about what the likely outcome of accepting the reimbursement will be and factors you may want to consider in making your decision.

Purpose of Funds – This statement in the Relief Fund Terms and Conditions is unclear when applied to psychotherapy: “The Recipient certifies that the Payment will only be used to prevent, prepare for, and respond to coronavirus, and shall reimburse the Recipient only for health care related expenses or lost revenues that are attributable to coronavirus.”  This can be interpreted in the broadest of terms, i.e., that there is anxiety and depression about the pandemic which almost all patient face even if that is not their primary reason for treatment, or in a narrower way, that the presenting problem is specifically emotional distress about being ill with COVID-19, having family members with COVID-19, or fears about this happening.  We must use our judgment about which way to interpret this section.

Meaning of UHC Involvement in Payments – this may be unusual in the way we are generally paid but this public/private partnership should not have any impact on our status as out-of-network providers, if we are. UHC is a pass through in this case, writing checks for HHS; Medicare does not accept out-of-network clinicians so there is no possibility of that option being limited for beneficiaries.

Out-of-Pocket Payments – finding LCSWs to provide services is challenging even without the additional burden of the emotional stress that has been created by the pandemic. Accepting the reimbursement requires us to agree that we have not charged anyone our out-of-network rates if we saw them outside of Medicare and that we will not do so going forward.

Consequences of Attestation – there may be some auditing of how the funds are used but it seems unlikely that the amount of money being distributed to LCSWs will be targeted. Signing the attestation that you have received the funds and intend to use them to treat Medicare beneficiaries with COVID-19 mental health problems seems like it is likely, to one degree or another. It is probably less risky if you affirmatively accept or reject the funds that you have received, after weighing all the factors involved.

Keeping the funds may be appealing and well-earned, but some members have decided to reject them because of the involvement with UHC, the ambiguity about whether the work we are doing meets the criteria for accepting the funds, and the possibility of being audited is not worth the risk.  Each of us will need to come to our own conclusions about this difficult decision.

Laura Groshong, LICSW, Director, Policy and Practice

www.clinicalsocialworkassociation.org

Clinical Social Work Association
The National Voice of Clinical Social Work
Strengthening IDENTITY | Preserving INTEGRITY | Advocating PARITY