July 24, 2015 4:27 PM

Uncertain outcomes plague debate over big cuts to Medicaid therapy rates

“I don’t know why they think it’s necessary, in a budget surplus to do this. They’re cutting $150 million from one industry. I don’t know any industry that could withstand that reduction.”

A plan to slash what the state pays physical therapists who treat children with severe disabilities could devastate the industry and put Texas at risk of violating federal law, advocates and lawmakers say. Major stakeholders also claim they’ve been wrongly excluded from the rate-setting process, but state officials insist nothing is final yet and public comment remains welcome.

Those comments have been plentiful since the state Health and Human Services Commission published the new Medicaid reimbursement rates earlier this month. The proposed rates would slash payments for physical, occupational and speech therapy by 25 to 90 percent starting in September, a financial blow many therapy providers say they won’t survive.

On Monday, more than 180 stakeholders took advantage of their first and likely only chance to testify in front of the agency before the rates are finalized no later than August 10^th. For seven hours, parents, providers and patient advocates begged HHSC not to implement the plan, which would satisfy a cost-containment rider in the new state budget by cutting general revenue for the Texas Medicaid Acute Care Therapy Program by $150 million over the next two years. In doing so, the state would also surrender $200 million in federal money, reducing the total funds for Medicaid therapy by more than half.

Last year, the program provided medically necessary therapy for more than 440,000 people with severe disabilities. About 90,000 of those served were elderly Texans with progressive diseases like Alzheimer’s or Parkinson’s. But the vast majority—almost 350,000 patients—were children with birth defects or genetic disorders or infants who were born dangerously premature. Advocates estimate that if the rates are adopted, 60,000 to 70,000 children will lose access to treatment.

By Emily DePrang