Monday, November 23, 2015

Brain Injury Patients and Their Advocates Fighting New Reimbursement Rates

Why are brain injury patients up in arms about Kentucky’s plan to change reimbursement rates?

Brain injury patients, and those who support them, are fighting vigorously against Kentucky’s plan to change therapy reimbursement rates. They believe that such a change will result in increased bills for the ongoing therapy such patients require. Right now, state waivers for some intensive therapies exist, but the Cabinet for Health and Family Services has proposed eliminating such waivers. If this occurs, all patients will be moved to a state plan designed to comply with federal regulations, with a significant reduction in reimbursements. Those fighting this change argue that it would result in higher therapy costs for individuals. For most patients, this would mean a reduction in the number of patient therapy visits and might well necessitate moving to nursing homes.

How are officials and politicians responding to the foreseeable problem?

Mary Hass, advocacy director for the Brain Injury Alliance has said that without the therapies that enable individuals who have suffered brain damage to progress in the rehabilitation process, “…they’ll be lost.” She and other patient advocates have gotten the ear of politicians and legislators, like State Senator Julie Raque Adams (R) who has referred to the proposal as “troublesome.”

In October, 2014 and again in March of 2015, cabinet officials sent letters to providers informing them of the upcoming change to reimbursement rates. Several providers complained.

According to Gwenda Bond, a spokeswoman for the Cabinet, officials of the advocacy group are presently working with the federal Centers for Medicaid and Medicare Services to keep rehabilitative processes from being disrupted. Promising to communicate any additional information as soon as it becomes available, Bond states that, for the present, all providers should continue their usual billing practices.