The Legislature may force the state's Medicaid division to pay newly licensed mental health counselors and psychologists for counseling Medicaid clients, if the division doesn't change its payment policy on its own.

Sen. Annette Dubas, who raised the issue in debate Thursday, got a promise that senators will meet with Medicaid administrators before the session ends to talk about the problems created by the decision.

She also got support from a number of senators for introducing a bill next year that would require Medicaid reimbursement if nothing has changed.

A decision by the state's managed care company, Magellan, not to pay many of the provisionally licensed mental health counselors and psychologists is hurting care for low-income Nebraskans in rural areas, said Dubas of Fullerton.

The rule requires that new graduates work in accredited agencies before they can be paid for working with Medicaid clients.

A majority of the 900 newly licensed mental health professionals work with Medicaid clients, often in agencies that are not accredited, according to James Connelly, who teaches at Grace University in Omaha.

These agencies are cutting back on their use of provisionally licensed counselors because of the Magellan rule, he said. And new counseling graduates, who are required to have 3,000 hours of supervised practice, are finding it more difficult to find supervised positions.

"All the research shows that we need to be graduating larger numbers," but the HHS rule is going in the wrong direction, he said.

The HHS decision affects about 41 newly graduated psychologists and more than 900 newly graduated mental health professionals, according to a letter from the Nebraska Psychological Association to Gov. Dave Heineman.

State law requires new graduates to work between 1,000 to 3,000 hours under supervision before they are fully licensed. The Magellan ruling makes that more difficult, several senators said.

"They've done their job. They got their education. These provisional licensees need to work somewhere," said Speaker Mike Flood of Norfolk. "I do hope this bill can come back next year and get passed."

It is too late this year to introduce new bills.

"It's obvious, one way or another, the Legislature is gong to take some action," said Sen. Mike Gloor of Grand Island. "I don't see that this (rule) is very understandable … or even defensible."

The Magellan decision assures that the provisionally licensed professionals have adequate supervision, said Medicaid Division Director Vivianne Chaumont. It does not save money, according to an HHS spokeswoman.

Reach Nancy Hicks at 473-7250 or nhicks@journalstar.com.