I received the following information from the Down Syndrome Association of Houston on proposed rate cuts for certain services and supplies provided by Home Health Agencies and Outpatient Rehabilitative Facilities provided by Medicaid.
The programs that are threatened with having funding cut are not ones that we currently use for Mara, but are ones we may need one day when she is no longer covered under our insurance. We've signed her up for the wait lists of a number of these Medicaid programs already, as the wait time on those lists ranges from approximately seven to twelve years. These programs may provide her with anything from housing in a residential/assisted living facility to covering various medical services and supplies, such as her glasses, orthopedics, speech, occupational, and physical therapies. I know there are so many people out there who rely on these programs to maintain their standard of living right now and I am frightened to think of what this would mean for us (and, particularly, Mara) if we were at that stage. I also think about the people being served by these programs now who didn't have as many opportunities or access to interventions that Mara has had, due to either our socio-economic status or the fact that she was born in 2011 and not twenty or even ten years earlier. I think of how these programs provide people with so many crucial and necessary services that enhance their lives. If you live in Texas and have the time and desire to send an email, please do so before Monday. I'm happy to forward along the missive I just sent out if you'd like me to send it to you. You can tinker with it to personalize it a bit and then send it out.
Thanks,
Catie
Oppose Proposed Rate Cuts!
Texas Medicaid Rate Cuts Will Have Devastating Affect on Persons with Disabilities
Rate Hearings are Scheduled for MONDAY (November 21st)
Submit Written Comments —Details Provided Below
WHAT?The Health and Human Services Commission (HHSC) is conducting rate hearings on November 21st regarding Proposed Payment Rates to be effective January 1, 2012. The Proposed Payment Rates slash rates for multiple, critical Medicaid services and supplies, including:
· therapies (speech, physical, occupational) provided by Home Health Agencies and Outpatient Rehabilitative Facilities.
To see the complete list of Medicaid services and supplies to be affected, go to: http://www.hhsc.state.tx.WHAT DOES IT MEAN FOR INDIVIDUALS/FAMILIES?
The proposed payment rates are significantly lower from current rates and there will be devastating outcomes for thousands of Texans. Consider the following:
· SERVICES PROVIDED BY HOME HEALTH AGENCIES & OUTPATIENT REHABILITATIVE FACILITIES—Payment rates for services provided by these entities are also being slashed (i.e. colleagues have calculated a 35% rate cut to Outpatient Rehabilitation Facilities and up to a 45% rate cut to speech therapy). The affected services include: therapies (speech, occupational, physical), psychology, dental, podiatry, durable medical equipment and many more. While the services and supplies will continue to be in the Medicaid “service array,” the severity of the rate cuts will translate into fewer providers being available and willing to provide the services and supplies to children and adults in Medicaid. Without the availability of these critical community based Medicaid services and supplies, thousands will be left with no other option that to seek care in emergency rooms and, even worse, institutions.
WHAT CAN YOU DO?
It is critical that you express your opposition to the proposed payment rates Monday (11/21). In addition to stating your opposition to the rate cuts, it is even more important that you share your story in order to describe to HHSC how the draconian rate cuts will negatively affect your life or the life of your loved one(s). Remember to include the following items in your letter:
· State your opposition to the proposed rate cuts for critical Medicaid services and supplies
· Describe the services and supplies your receive and that will be affected by the rate cuts
· Describe what would happen if the rate cuts go into effect on January 1st:
o Will your provider be unwilling/unable to see you or provide the services and supplies you need?
o How
will your health, safety and welfare in the community be negatively
affected? (Will you lose the skills you’ve acquired so far? )
o Will
you have to seek care from more expensive setting, such as an emergency
room, nursing home or other state institution (State Supported Living
Centers)?
SEND YOUR LETTERS TO: ESTHER.BROWN@HHSC.STATE.TX.US
Letters Regarding Rate Cuts to
SERVICES PROVIDED BY HOME HEALTH AGENCIES & OUTPATIENT
REHABILITATIVE FACILITIES MUST BE SUBMITTED TO HHSC BY MONDAY, NOVEMBER
21ST.
WHY IS THIS HAPPENING?
The Health and Human Services Commission (HHSC) is proposing the new, and much lower, payment rates in accordance with certain legislative mandates imposed via the state budget approved by Texas Legislators during the most recent legislative session (82nd Texas Legislature, May-June 2011). In the state budget, HHSC is directed via special instructions knows as “Riders,” to do the following:
· Implement
a budget cut of $88.3 million (state funds) in Durable Medical
Equipment. This includes rate cuts and additional cost containment
initiatives to durable medical equipment, and selective contracting for
incontinence supplies.
· Implement
rate cuts in the new biennium (2012-13) that are in addition to the
rate cuts implemented in fiscal year 2011. These rate cuts include a
10.5% rate cut to Medicaid durable medical equipment, as well as rate
cuts to multiple Medicaid program provided under the auspices of HHSC,
the Department of State Health Services and Department of Aging and
Disability Services.
· More
importantly, the health and human services agencies are directed to
implement certain Medicaid Cost Containment Initiatives totaling $705
million in state funds or $1.7 billion in state and federal funds.
These initiatives have led to reductions in service plans for
individuals in certain Medicaid Waiver Programs and include “Medicare
Equilization.” As it has been explained to us, Medicare Equilization
occurs annually and consists of lowering or increasing Medicaid rates to
match, as closely as possible, Medicare rates. It is important to note
that equalization efforts often result in the reduction of Medicaid
rates.
Thank you for taking action!
If you have any questions feel free to contact Tamara Ishee (governmentaffairs@dsah.org).
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