Health
3:01 pm
Mon December 12, 2011

State Looks to Cut Medicaid Payment to Therapists

The cuts could take effect on January 1st and would make Texas’ Medicaid spending on par with other states. But therapy providers worry it could leave many patients without services.

According to Stephanie Goodman, spokesperson with the Texas Health and Human Services Commission, the organization reviews its rates from time to time.

"Recently we looked at our therapy rates and found out that in Texas, for some reason, we’re paying substantially higher than other states.”

Physical, occupational, and speech therapy services would all be affected, including both out-patient and in-home care. Mary Hennigan with the Texas Occupational Therapy Association says it should come as no surprise that those types of treatment are expensive.

"Many of these services are provided for special needs children. And special needs children, by definition, have, in some cases, significant problems.  They are more expensive to treat to get the appropriate outcome. They’re very labor intense.”

She says because of the difference in patient profiles, comparing service costs of Medicare and Medicaid is like comparing apples and oranges. Hennigan worries that the cuts could mean Medicaid patients will be denied service.

 “There’s a tremendous labor shortage in the therapy world, and so when the reimbursement is decreased, there’s a potential that that labor will go where there’s greater reimbursement."

Hennigan says service providers as a whole should not be punished for the possible overspending of a few outliers. The Commission is currently working on a revised rate plan to address some of these concerns. They are expected to release it to state service providers in the next couple of weeks.

But since service providers need time to review the plan and give feedback, any proposed cuts would not take effect until late January at the earliest.