- Associated Press - Wednesday, September 21, 2016

LITTLE ROCK, Ark. (AP) - An Arkansas legislative committee has preliminarily approved placing a limit on a mental health benefit for Medicaid recipients, despite objections from some providers who say it would disrupt patient care.

The Arkansas Democrat-Gazette (https://bit.ly/2d1Ov86 ) reports that under the approved change, Medicaid reimbursement for group psychotherapy would be limited to an hour a day, instead of an hour and a half a day. The total number of hour-long sessions would also be limited to 25 per year, per person.

The changes were proposed by Medicaid Inspector General Elizabeth Smith after a company that monitors Medicaid and Medicare spending in several states found that Arkansas providers billed for group therapy services more often than their counterparts in the other states.

AdvanceMed also found if the state had capped the therapy sessions at one hour between 2013 and 2015, it would have saved Arkansas an estimated $31.5 million in state and federal Medicaid spending. Limiting the therapy sessions to 25 per year alone without capping the session length would save the state nearly $70 million over the same period of time.

Smith said she’s concerned improperly billing and that the federal government, which provides 70 percent of the funding, could seek reimbursement from the state.

“Arkansas is vulnerable for what we are doing with this billing code,” Smith said. “Not only are we vulnerable, we are spending money we don’t need to be spending.”

Robin Raveendran, director of the Alliance for Health Improvement, which represents mental health care providers, said other states may be reimbursing providers for the same services, but under different billing codes.

Executive director of Jonesboro-based Mid-South Health Systems Bonnie White said the cap would cause her organization to close down three 16-bed facilities it operates for people who have been acquitted of crimes because of mental illness.

She said her organization opened the facilities several years ago at the request of the state Department of Human Services.

The Medicaid program currently doesn’t limit the number of sessions a patient can receive. Currently a provider can earn up to $993.60 per session which can include up to 10 children or 12 adults.

The proposal will go Friday to the Legislative Council for final consideration.


Information from: Arkansas Democrat-Gazette, https://www.arkansasonline.com

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