Texas: Providers stave off cut

Thursday, October 22, 2009

AUSTIN, Texas – Medicaid won’t be following in Medicare’s footsteps, at least not in Texas.

The Greater Texas Rehab Providers Council (TXRPC) reported in September that it has prevented Medicaid from implementing a 9.5% reimbursement cut for power wheelchairs. Medicare implemented the cut Jan. 1.

“Medicaid is under a mandate to implement Medicare’s fee schedule unless there’s an access to care issue,” said Chris Yule, one of the directors of the council, and president/COO of Travis Medical in Austin. “So that’s what we did: We proved there would be an access to care issue.”

Medicaid programs in other states like New York have already implemented the cut to wheelchairs (See “9.5% cut: Private payers, Medicaid dig in,” HME News, June 2009).

Medicaid proposed the cut and held hearings earlier this year, spurring dozens of rehab providers to provide public testimony.

The TXRPC continues to work with Medicaid to keep the lines of communication open.

“I really believe they want us to stay in business and make a profit,” Yule said. “But they’re always going to want to check to make sure reimbursement is fair and reasonable.”