Medicaid reimbursement changes prompt protest

Hundreds of people gathered on the Capitol steps Thursday to protest recent changes in Medicaid reimbursement, including cuts that took effect July 1, that organizers said have threatened to put some providers out of business.

“We’re very concerned about this,” Linda Short, an owner of Perspectives Behavioral Health Management of Fort Smith, said after the rally.

She predicted that the cuts will force the closure of her organization, which serves about 2,500 patients.

“We take it day by day,” she said.

The cuts were part of an overhaul of how the state’s Medicaid program pays for mental-health services that started last year.

Amy Webb, a spokesman for the state Department of Human Services, said the state equalized the rates paid for some services to mental-health agencies and individually licensed providers.

That resulted in the rates going up for individual providers and down for agencies such as Perspectives Behavioral Health Management.

“The old Medicaid behavioral health system required people to get assistance through a single provider type — behavioral health agencies — and there was a moratorium in place for new providers,” Webb said in an email.

The new system, she said,

“has expanded services, allowed for more providers to step up and offer care to beneficiaries, and now requires an independent assessment rather than having providers deciding what people need.”

She said the new system also pays for substance-abuse treatment “which is huge, particularly when you consider the growing opioid epidemic.”

On Sept. 1, the state also began requiring counseling for Medicaid recipients who are also enrolled in Medicare to be provided by licensed clinical social workers with master’s degrees, as required under the Medicare program, providers said.

Previously the Medicaid program would pay for counseling provided by employees with lesser licenses, after a claim for Medicare reimbursement was rejected, providers said.

As a result of that change, Short said her agency stopped accepting new patients who are eligible for both Medicare and Medicaid because she doesn’t have enough licensed clinical social workers on staff.

Carol Witham said the cuts have forced her to use $200,000 to $300,000 of her own money to pay the bills at Inspiration Day Treatment, which she founded in Little Rock about 10 years ago. She described herself as a philanthropist and said she doesn’t draw a salary from the organization.

“The state requests Cadillac services on a Yugo budget,” Witham said. “At some point your Cadillac gets repossessed.”

Witham also founded a group known as the Stakeholders in Treatment, Advocacy, Research and Recovery Coalition, which organized the rally.

Among the speakers at the rally was Patrick Kennedy, who served in Congress from Rhode Island and sponsored a federal law that sets requirements for health plans’ mental health and substance abuse coverage. He predicted that the cuts will have drastic consequences.

“It’s not hyperbole or a dramatization to say that when these vulnerable folks don’t have someone looking out for their basic needs, that many of them are going to die,” he said.