Providers stare down cut

Friday, July 31, 2009

ATLANTA--Just when rehab providers in Georgia thought they were making some progress, they could be delivered another setback.

The Department of Community Health, the state’s Medicaid program, has decided not to eliminate K0108, a miscellaneous code for wheelchair components and accessories. Furthermore, on July 1, the department “opened” several other codes for use.

But at press time, on July 9, its board was scheduled to vote on changing Medicaid’s allowables for HME, including complex wheelchairs, to 80% of Medicare’s allowables.

“It has been strongly implied that things are going to go through as they originally planned,” said Laura Cohen, co-coordinator of The Clinician Task Force, in late June.

The board scheduled the vote for July, after it received a flurry of comments from rehab providers, clinicians, consumers and state legislators. It originally planned the vote for June.

If Medicaid moves to 80% of Medicare’s allowables, access to equipment and services will be severely impacted, said Weesie Walker, manager of the National Seating & Mobility branch in Atlanta.

“Some of the allowables for equipment will be at or below cost,” she said.

Currently, Medicaid pays for equipment by review, using manufacturer quotes.

If the Medicaid allowables are changed, rehab providers have asked the department to put them into effect for only new prior authorization requests.