State panels oppose cut in fees for psychotherapy

A pair of legislative committees on Monday objected to a proposal to reduce the hourly rate that the state Medicaid program pays for group psychotherapy sessions.

Under the proposal by Medicaid Inspector General Elizabeth Smith, the reimbursement rate would drop from $55.20 per hour to $40 per hour, which she said would be more in line with the rate paid by nearby states.

Mental health care providers told legislators that the change, combined with limits that took effect Oct. 7 on the length and number of sessions Medicaid will pay for, would hurt them financially and cause them to cut back on services.

“This is a double whammy,” said Robin Raveendran, director of the Alliance for Health Improvement, which represents providers of mental health care.

If imposed, the rate cut would take effect in February, but Raveendran suggested that it be delayed until July 1. That’s when the state Medicaid program would begin providing a daily reimbursement rate for residential facilities as part of a proposed overhaul of its behavioral health reimbursement rules.

Smith said the proposed change is needed to ensure that state spending for the service isn’t excessive.

She has previously cited a report showing that, from 2013-15, Arkansas’ Medicaid program spent $147 million on group psychotherapy, more than six times the

amount spent on the service by the Medicaid programs in Alabama, Georgia, Louisiana, Mississippi, Tennessee and West Virginia combined.

About 10,000 Arkansans attend the group sessions.

“We’re an outlier,” she said, adding that the rate reduction would cut the state’s Medicaid spending by about $13 million each year.

In a divided voice vote, the Legislature’s Public Health, Welfare and Labor committees voted to “not review” the change, meaning it will go the Legislative Council’s Administrative Rules and Regulations Subcommittee with an unfavorable recommendation.

Changes that went into effect Oct. 7 shortened from 90 minutes to an hour the length

of a group therapy session and capped at 25 the number of sessions Medicaid will pay for a recipient.

Providers can ask for exceptions to the limits if more or longer sessions are medically necessary.

After the Legislative Council approved the limits Sept. 23 in a voice vote along with several other rules, some lawmakers complained that they didn’t realize the psychotherapy limits had been part of the vote.

One rule had been excluded from the list submitted for approval, but it dealt with substance abuse treatment and wasn’t related to the group psychotherapy limits.

At a special meeting Sept. 30, a motion to rescind the approval failed after it didn’t receive favorable votes from two-thirds of the council members from each chamber.