State Budget Conflicted on Therapy Services Under Medicaid

The 2011-2012 State Budget contains two conflicting authorizations for how the Division of Medical Assistantce (DMA) is to address budget reductions to various therapy services under the Medicaid program. Previous budgets allowed Medicaid patients  a maximum of 30 physical, speech, occupational or other therapy visits per year. 

Section 10.37(a)(2) of the current budget allows DMA to eliminate or limit adult physical therapy, occupational therapy, and speech therapy visits to three visits per calendar year, while Section 10.37(a)(11)(c) allows DMA to reduce the maximum number of allowable services by one per year.  The NCMS is actively pursuing clarification of these conflicting budget provisions and are at the table advocating for standards that will allow for optimal patient care.

NCMS has received word from the NC Department of Health and Human Services (DHHS) that the drastic reduction to three visits will not be implemented.  Discussions are still underway inside the Department to ensure that they are interpreting the budget provisions as directed by the NC General Assembly while also meeting the budget savings target outlined for this reduction of services.  We will share any official decision as soon as possible.


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