Medicaid Update

Mississippi Department of Medicaid (DOM) implemented new policy regarding outpatient speech-language pathology services on July 1, 2009, taking both service providers and parents by surprise.  As MSHA began to receive calls from members and non-members regarding the changes we investigated and found that DOM had posted a Proposed Rule Adoption to update the Provider Policy Manual on the Secretary of State website.  As a result of contacts made by service providers, parents, MSHA and other concerned organizations a hearing to gather facts was scheduled by Representative Steve Holland and other legislators on July 10, 2009.  Service providers, parents, DOM, concerned organizations, and MSHA, represented by Cindy Gibson, President, were present for the hearing.

Since the July hearing MSHA has been cooperating with MS Coalition for Citizens with Disabilities (MSCCD) to compile data on the number and types of denials, and decreased services to children resulting from this change in policy.  The American Speech Language Hearing Association (ASHA) state liaison, Janice Brannon, was instrumental in notifying all ASHA members of the state by email of the changes in policy and MSHA’s cooperative effort with MSCCD.  At MSHA’s request, ASHA reviewed MS DOM revised provider policy and responded with concerns in a letter to Dr. Robinson, Director of DOM, with copies of the letter forwarded to Governor Barbour, Lt. Governor Phil Bryant, Representative Steve Holland, and Senator Kirk Deadeaux.   

With members monitoring the Secretary of State Website, MSHA was alerted to the DOM filing a Notice of Proposed Rule Adoption with the Secretary of State on August 3, 2009.  This administrative policy amendment updates the sections of the Provider Policy Manual regarding outpatient speech-language pathology services.  Section 49.03 provides a listing of all the general coverage and clinical criteria for outpatient speech-language pathology services.  In Section 49.04 a list is provided for outpatient speech-language pathology services not covered/reimbursed by the Division of Medicaid.  This filing can be reviewed at https://www.medicaid.ms.gov/Amendments/Amendments.aspx. 

An oral proceeding will be held on August 25, 2009 at 9:00 a.m., at the War Memorial Building, 120 N. State St., Jackson, MS.  If you wish to be heard and present evidence at the oral proceeding, a written request should be sent via e-mail to exvkm@medicaid.state.ms.us,  via fax to 601-359-9153 (Attn:  Ginnie McCardle), or via mail to Division of Medicaid, Attn:  Ginnie McCardle, Walter Sillers Building, 550 High St., Jackson, MS  39201.  The request should be received at least 5 days prior to the proceeding and should include your name, address, and telephone number of the party or parties you represent.  Each speaker will be subject to a time limit for their presentation based on the number of requests submitted.

At the request of MSHA Executive Board, Christine Gibson, MSHA VP Healthcare Issues, formed a committee to review the current policy changes and develop a statement of concerns from MSHA private practice and healthcare service providers to be presented at the oral proceeding.  ASHA is again reviewing the revised policy and will issue a joint statement with MSHA to be presented at the oral proceeding by Suzie Rosser, MSHA Past President/President-Elect.     

You can help by enlisting the participation of parents at the oral proceedings on August 25th.  For more information contact MSHA President, Cindy Gibson, MSHA Past President/President-Elect, Suzie Rosser, or MSHA VP Healthcare Issues, Christine Gibson.

– – Suzie Rosser, MSHA 2009 President-Elect

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