After receiving public comments on the proposed policy to impose an annual therapy visit limit for adult Medicaid recipients, Medicaid has announced that it is delaying implementation of the policy. The following statement was released by Nora Poisella of the DMA Clinical Policy and Programs section:
“We will not be implementing the 30 visit limit at the present time so for the time being all you have to do is ensure that you are complying with policy 10A except for PA piece. Post payment validation can occur at any time. We will announce in the bulletin when new policy goes into effect.”
NCOTA, in conjunction with NCPTA and the Association for Home and Hospice, submitted comments which identified problems with the proposed policy. A letter jointly submitted by the three associations also suggested alternatives which would be fairer to providers and more appropriate to the needs of adult Medicaid recipients.
The Governor's budget proposes a 14% reduction in expenses associated with outpatient specialized therapy, to be implemented by October 1, 2009. It is likely that the therapy cap may be implemented in an effort to meet this goal. NCOTA will continue to monitor this issue as well as to seek ideas from members, providers and consumers that might achieve cost savings for the state without jeopardizing rehabilitation outcomes for adults receiving Medicaid services.
The current policy 10A (referred to in Ms. Poisella's message) can be downloaded from : http://www.ncdhhs.gov/dma/mp/8g.pdf
A copy of the letter submitted by NCOTA, NCPTA and AHHC is available for download below.