Lawmakers drop objection to cuts in Medicaid reimbursement
Earlier this year, the
On Friday, the committee reversed course, allowing the department to immediately move ahead with a 2.99 percent rate cut and shortened list of covered services. Five of the eight members said additional information from the department satisfied their concerns: Reps.
"I don't think there's a lot more room that the committee could have achieved in actual funding during the interim," he said. "I don't think it necessarily had the ability to raise case management rates. It didn't have the ability to raise Medicaid rates."
Recovery Center Missoula Executive Director
"It's still going to be a hardship," she said. "Not just for substance use disorder treatment, but for all the programs that are going to sustain cuts."
A single-digit reduction might seem small, but the impact could be significant because so many clients are covered by Medicaid. Providers said the program already did not cover the actual costs of care in many cases.
Kuntz said NAMI is still concerned the rate reductions could make it more difficult to connect patients to providers.
"I think there's always opportunity to alter and change the system, but these drastic rate cuts are forcing providers to make a lot of scary decisions about even shutting down offices," he said.
"A privately insured patient is double what we get from Medicaid," she said, so all the extra, little losses add up, especially when some critical services, like case management, are no longer eligible for reimbursement.
As a result, Nauts said the wait list for people covered by Medicaid will get longer because the drug treatment and mental health programs will need more privately insured clients to make their budget work. Currently, Medicaid clients must wait six months to a year to start care, she said.
Programs that once offered case management will lose that support entirely or, with the help of other funding sources, see that budget reduced. A few weeks ago, the
"Case managers are imperative to the success of those with chronic mental illness and helping them stay out of our local emergency rooms and
It's all those pieces of non-medical care that give patients a sure footing, providers said.
When contacted Friday afternoon,
Buck, the administrator, previously testified to the legislative committee in July and said he would have to reduce the number of Medicaid patients he accepts if the health department adopts the original proposal.
Buck said he didn't know the specific impact of the 2.99 percent rate reduction, but was more concerned that legislators were allowing any cuts to Medicaid providers.
"It's a crime," he said. These clients "have nowhere else to go, they have nothing else they can do. We're taking away the help we guarantee they have."
The health department has said delaying the rate reductions could trigger deeper cuts in the future, but Buck said it's not something providers can worry about when struggling to offer immediate services.
"What we feel here is the now," he said. "We're not legislators. We have to count on people in elected positions to advocate for the people they were elected to advocate for, and they don't seem to be doing that."
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