Medicaid Issues – Suzie Rosser, President

In 2007 the STAR Committee prioritized the issues of concern with regard to speech language services billed under Medicaid.  The following were considered critical points to address in legislation.1)    Following physician orders for duration and frequency of treatment as prescribed in the doctors’ order or the doctors “prescription” for service.2)    Reimbursement for therapy provided in multiple settings, allowing treatment at school and with private therapist.3)    Equity in the appeal process.  The same procedure should be followed in the event of service denial and service reduction. 4)    Increased reimbursement rates.There was no resolution with any of our identified Medicaid issues.  After several years of trying to work in a cooperative effort within the Medicaid system we hired an additional lobbyist for the 2007 legislative session.  Initially, key legislators were responsive to the issues brought forward by our grassroots efforts that included speech language pathologists as service providers and parents of children with disabilities.  With the lobbyists direction we were able to meet with legislators to discuss the need for additional monitoring of Department of Medicaid practices and the need for statute that addressed services to children.  However, our efforts were derailed by a crisis at the administrative level in the state department of health shifting the focus of attention to a different area of public healthcare, and testimony of a previous Director of Medicaid suggesting an overall restructuring of the system.  In the current legislative session the codes of the Medicaid bill have been reintroduced.  We are currently monitoring recommendations made in committee


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