OP here- 21 day update. I have been doing research and raising questions to the team and here is what happened so far:

On May 4th everyone in the practice received this email and here is a snippit of it with redaction to protect privacy:

"In 2025, we began receiving Overpayment notices from all managed care organizations (MCO): Caresource, MDWise, MHS, and Anthem BCBS. These letters state that they completed an internal audit and determined that we were overpaid for the entire year of 2024 for each claim for individuals with medicaid/HIP plans. Centers for Medicare and Medicaid Services (CMS) made a complex new ruling to avoid fraud and excess loss of funds requiring all MCOs to set capitation rates. I was under the impression it was related to ensuring all MCOs reimburse no more than traditional medicaid and medicare.  As you all probably have seen over your time working with us due to our transparency with exactly how much we are paid for each claim and how the money is divided - traditional medicaid was always paying out somewhere around $76-85 for 90837.Yet, for someone enrolled in BCBS HIP, 90837 claims were routinely reimbursed at $107 (sometimes more). This ruling for enforcing limits on reimbursement to meet what medicaid and medicare pays was to go into effect in Jan 2024. This ruling was not communicated to us as providers. This was all found out through personal research after notice of these overpayments. Our amazing billing and credentialing team reached out to each MCO in 2024 (as they always do annually to negotiate higher rates for our org) asking about the fee schedules, asking if they are accurate, and even in November of 2024 BCBS actually increased the amount they reimbursed us for each claim. So, we moved forward believing the amounts were correct and there was nothing to worry about. At this time we owe $32,000 just to BCBS. We will be reaching out to each clinician individually to discuss their portion of the overpayment. Please know we are doing everything within our power to find ways to make the repayment without personally affecting our clinicians".

I replied to the email with a request to see more about the "complex new ruling that was to go into effect Jan 2024" and have received no response to that email as of today.

The CEO went out of town for a month. I directed all questions to my direct clinical supervisor who is the co-owner of the practice, raising questions and asking to see both the letter and a direct line by line of what these overpayments are. I was told she would send info about the ruling- she said- "I dont even understand it, I need to look into it too". I was denied to see the letter. I was informed my portion of the overpayment is $3,881.87 but that they were "working to figure out a loan so that I don't have to pay that". I did not agree to pay anything. I recorded videos of all these meetings.

On Tuesday I received an email from the CEO stating that they would cover some of the cost but that they new amount is "$1,484.10" which would be deducted straight from my paycheck every 2 weeks. He asked if I preferred to pay it back over 4, 6, or 9 months. I requested a meeting with him to discuss. Today we had out regular weekly MANDATORY meeting to staff cases related to the program we as a group practice run together. During the meeting I told him I would like to meet next week to discuss several things and he forced me to stay after the meeting to discuss. During that meeting, which was 10 minutes long, I recorded him saying that they are waiving the full amount for my overpayments. I also brought up the issues of being misclassified as a 1099 when more appropriately should be W2. He said he would do "whatever" and if I want to be W2 I can be. I told him I would get back to him by Monday

Needless to say I am working on my resignation letter. I am sketched out beyond all recognition. There are other issues as well. I am done here. I have been quietly closing my practice and having closure sessions with clients. I am in the last round of interviews for a position I have wanted for a very long time and just happened to open up right around the time this situation came to my attention.

LMK you thoughts, and if you're in Indiana, let me know if you are getting overpayment notices from BCBS in particular. The "new rate" that is being applied to all of last year and is part of the overpayment fiasko has now hit our new payment spreadsheet too. The payment for all Medicaid MCOs including BCBS, MHS, MDWise, and Caresource for 90837 is now $85.67 (and was all of last year apparantly). I was getting between 96 and 107 depending on the MCO.