Thursday, October 1, 2015

From the Dallas Morning News: Texas Senate leaders: $350 million cut to Medicaid therapy is goal, not requirement

For 2306 students mulling over week 6's assignment. The state is trying to argued that the cuts will not limit access to care. Here they make their point.

- Click here for the article.

The Texas Senate’s GOP leaders have told state social services officials that a state budget provision requiring reductions in Medicaid spending on outpatient therapy services sets a dollar amount for a goal.
But that isn’t an absolute requirement, and disabled children’s access always was supposed to be considered, even if it keeps the savings from hitting the goal, Lt. Gov. Dan Patrick and Senate Finance Committee Chairwoman Jane Nelson said publicly on Wednesday.
“There has been a dramatic increase in the cost and utilization of acute care therapy services in the Texas Medicaid program,” the two Republican leaders said in a letter to Chris Traylor, head of the Health and Human Services Commission, which runs the state-federal health program for the poor.
“Costs have increased from roughly $436 million a year to an estimated $722 million from 2009 to 2014,” Patrick and Nelson wrote. “Speech therapists also represent a disproportionately high number of therapy investigations within your Medicaid Provider Integrity Unit. Overall, therapy providers represent 12 percent of the investigations caseload and 14 percent of the legal sanctions caseload.”
Then came the caveat: The provision, known as “Rider 50″ in the commission’s two-year budget, tells the commission to “reform” rate-making for outpatient therapy “to be in line with industry standards,” as well as change any policies that are allowing possible overuse of some services. Two-thirds of the projected two-year savings of $350 million in state and federal funds “should be achieved through rate reductions,” and the rest perhaps “may be achieved through various medical policy initiatives,” the provision says. But the commission should cut rates “while considering stakeholder input and access to care."