Therapy and Medicaid

[Guest guest]

Regarding the posts that reference Healthy Kids, CMS et al and Therapy services:

Starting in 2008 (approx in July, though the exact times are not specified as of yet), Medicaid will be converting a big part of the Therapy program (speech, OT, PT) for our children to a pre-paid capitation plan. Capitation basically means that providers would be paid a particular amount to give services to a particular child. This means that the fee-for-service model, which is how providers are compensated presently will be discontinued for these children. Obviously, the therapy provider community does not feel that they will be able to offer adequate services under this type of compensation model. To add to the issue, the company that is in charge of authorizing therapy visits to providers presently does not authorize services (in general, there are limited exceptions), to children with developmental disabilities. This means, that unless this company changes their present authorization policy, children with developmental disabilities will not be authorized to receive therapy services.

As you can expect, the organizations that govern therapy in this state are up in arms. Not only are they shocked that children all over the state will be losing their therapy services, but that their will be a huge amount of therapists out of work. They have issued statements and sent letters to the Secretary for Medicaid.

Information is sketchy at this point, so I am doing my best to convey information as it has been disseminated. Unfortunately, we do not have specifics at this time, nor do we know exactly how and when our kids will be affected. We only know that it is going to happen.See what's new at AOL.com and Make AOL Your Homepage.