Medicaid O&Ps on state chopping blocks

Tuesday, December 31, 2002

BOSTON – Red ink in many state budgets this year is causing a red alert for orthotics and prosthetics providers who serve Medicaid patients.

States across the country are facing budget deficits linked to the weak national economy and Medicaid coverage of O&P services is a prime target for cuts, the American Orthotic and Prosthetic Association reports. If state budgets drop O&P coverage, it’s the beneficiaries who will feel the brunt of the sting, said Walter Gorski, director of government affairs for AOPA .

“States should not balance their budgets on the backs of a vulnerable patient population,” he said. “These cuts are short sighted, particularly with regard to O&P, because it will force these recipients to use other public assistance programs due to their inability to keep or find jobs.”

O&P has already been trimmed from Medicaid coverage in Massachusetts. While other states are still mapping out cost-cutting strategies, Massachusetts instituted its final budget in November, which also jettisoned chiropractic services, eyeglasses and dentures from the coverage list.

Physical, occupational and speech therapy reportedly will need prior authorization for coverage, while minors under age 21, hospital inpatients and diabetics needing foot care will still be paid for in the revamped program.

State providers and a local advocacy group aren’t accepting the cuts lying down, however. The Massachusetts Society of Orthotics and Prosthetics, along with a group called Health Care For All, have been lobbying incoming GOP Governor Mitt Romney to rescind the program cuts.

Paula Rogerson, administrative manager for Boston-based Rogerson Orthopedic, said she spoke briefly with the incoming governor about the issue and that he seemed receptive.

“The feedback I’ve gotten is that he’s a friend,” she said.

At press time in early December, however, no official changes were planned.

The new policy is bound to take beneficiaries by surprise, said Keith Cornell, president of Salem, Mass.-based South Shore Orthopedic.

“Letters were sent to beneficiaries about the change, but I’m afraid they won’t understand until they need services,” said Cornell, AOPA president-elect.

O&P patients who use Medicaid as a secondary payer could also get caught in a cash pinch, he said, adding that “some may have to resort to begging in order to get the 20% they need.” HME