STARs Network (State Advocates for Reimbursement)
Established May 2003 as an outgrowth of ASHA's initiative on Health Care Reimbursement.
Each state association is invited to provide a member to participate (44 states represented as of 01/04).
Each state representative(s) develops a network within the state.
State representative(s) nationally communicate via bi-monthly phone conference and via listserve.
STAR Network is facilitated by Maureen Thompson, M.A., CCC-A, ASHA Director of Private Health Plans Advocacy.
ASHA Focused Initiative Health Care Reimbursement Work Plan for 2004 involving STARs/MI
Outcome 1:
ASHA members will have access to information and tools to efficiently negotiate with private health plans to ensure appropriate coverage criteria and equitable criteria rates.
Health Care Economics and Advocacy Team (HEAT) will support STARs bi-monthly conference calls and interactive messages on the STARs forum and e-mail listserve.
HEAT will conduct 2 telephone seminars for up to 53 participants/lines with a replay option for up to 32 replays to provide further private payer reimbursement training for STARS.
Outcome 2:
Increase the number of employers that cover comprehensive speech-language pathology and audiology services in their health benefits package.
By October 31, 2004, the HEAT will advocate with the following BC/BS plans for more comprehensive coverage of audiology and speech-language pathology services: Florida, South Carolina, Highmark, Michigan, Texas and Illinois.
Outcome 3:
Increase the number of states introducing legislation that mandates appropriate coverage of audiology and speech-language pathology services.
By May 31, 2004, the State Advocacy unit will facilitate a meeting of state association leaders and lobbyists attending ASHA's State Policy Workshop in May to discuss their efforts and needs in obtaining insurance coverage of speech-language and audiology services through state legislation.
Outcomes 4:
ASHA members will have access to information and tools to help them effectively navigate state funded insurance programs (e.g., Medicaid, CHIPS) at the state and local level to ensure appropriate coverage criteria and equitable reimbursement rates.
By December 31, 2004, the School Services in Speech-Language Pathology unit and an ASHA member working group will have developed a technical report and position statement for school based certified speech-language pathologists in addressing the issue of what constitutes "under the direction of " when school-based certified speech-language pathologists supervise a Bachelor's level clinician.
By October 31, 2004 the HEAT will have created a new document for use by state associations in negotiating better outpatient rates and preserving or adding speech, language and hearing benefits in Medicaid programs. Medicare reimbursement rates, actuarial data, and selected state Medicaid rates will be included.
Michigan is looking for STARs Network Advocates to
Identify personal insurance coverage related to speech-language and audiology (S-L&A) benefits.
Survey other professionals/consumers for S-L&A insurance coverage.
Collect data regarding S-L&A coverage by payers in the state.
Network with other STAR advocates in MI and Nationally.
Share/develop education tools for consumer awareness and consumer advocacy of S-L&A benefits.
Advocate for S-L&A benefits via education.