Patient mental health at risk as county suspends payments to mental health provider 

Itasca County’s only public health insurance provider terminated its contract with one of the area’s largest behavioral health providers, leaving patients and their families searching for other options.

Lakeview Behavioral Health is a for-profit provider of individual and group therapy, addiction treatment and sober living houses based in Grand Rapids, a city of around 11,000 people three hours north of the Twin Cities. 

Itasca County is the only county in Minnesota that operates its own public health insurance program — IMCare — through a state program meant to improve health care access in rural Minnesota. 

But IMCare announced its plans to discontinue coverage of Lakeview Behavioral Health on Aug. 31. Coverage will end on Dec. 29, according to the termination letter, but IMCare suspended payments to Lakeview Behavioral Health shortly after the announcement, according to Lakeview Behavioral Health CEO Tom Johnson. 

IMCare isn’t currently reimbursing Lakeview Behavioral Health due to an ongoing legal dispute over IMCare’s access to patient records, Johnson said.

In a statement to the Reformer, IMCare CEO Sarah Anderson did not say why the county terminated coverage or temporarily suspended reimbursements.

“We are working hard to ensure that there are no gaps in care for enrollees,” Anderson said. “There are many other mental health care providers in the county, and we are working to get enrollees all the information they need to select new providers.”

The disruption comes amid a mental health and drug and alcohol crisis in rural America. Rural Americans suffer greater rates of depression and suicide than their urban counterparts but also have less access to mental health providers, according to the National Alliance on Mental Illness. 

Lakeview Behavioral Health is continuing to provide services to IMCare patients, but has stopped providing some medications — including esketamine, which is used for treatment-resistant depression —  because Lakeview’s contract with IMCare requires Lakeview to purchase the medication up front.

Lakeview Behavioral Health is the only provider of medication assisted treatment for addiction in the county, Johnson said.

Lakeview Behavioral Health’s relationship with IMCare had been rocky for a few years, Johnson said. IMCare would request pages of documents from Lakeview Behavioral Health, then use minor mistakes in paperwork to withhold reimbursement, Johnson said.

Kristina Gambill, a Grand Rapids resident, said she has a family member covered by IMCare receiving medication-assisted treatment and other services while living at a Lakeview Behavioral Health sober living facility.

“We’re not getting any answers,” Gambill said. She expressed frustration at the risk to patients arising from the county’s decision: “Lakeview has been incredibly supportive and encouraging, despite them not having any answers … What matters to me is that people’s mental health, recovery and sobriety is being disrupted by this decision.”

Pam Dowell contributed reporting from Grand Rapids.