Medicaid reimbursement: 'I've not seen it this bad'


There's a lot of talk about Medicare in the HME industry, but increasingly, when I'm on the phone with rehab providers, I'm hearing a lot about Medicaid. Here's the thing with Medicaid: It does what Medicare does then, usually, takes it up a notch. That's rarely ever good news for providers.

I came across this article in Topeka Capital Journal today about how Kansas Medicaid has changed reimbursement for wheelchairs and seating systems to 35% above cost or 20% below the manufacturer's suggested retail price. The cuts are taking their toll on end users like Brittany Ryan. Her seating system is on hold due to the cuts, forcing her to make do with a system that leaves her in pain.

The article hits all the bases—in addition to quoting end users, it quotes several rehab providers and representatives from several disability groups (Pat Terick of the Cerebral Palsy Research Foundation says: "I've been working in the field for nearly 30 years now. I've not seen it this bad").

It also quotes a spokesman for Kansas Medicaid. He hardly makes a case for the chaos the agency has created for providers and the patients they serve:

Peter Hancock, a spokesman for the Kansas Health Policy Authority, said the change in reimbursement systems shouldn't have been a surprise, although some providers say they were caught off guard. The reimbursement change was aggravated when plummeting state revenues led Gov. Mark Parkinson in November to order a 10 percent cut in Medicaid reimbursements. Those cuts began hitting providers in January.

"It was just a big wham all at once," Hancock said.

I know Medicaid-related issues are on the agenda of various rehab industry groups like NRRTS, but I have a feeling that once those groups are able to put a check mark next to creating a separate benefit for complex rehab, this will have to be their next major initiative.

Liz Beaulieu


[...] posted a blog last week about how just as many of you rehab providers complain about Medicaid reimbursement as [...]