Medicaid Rates
9:36 am
Wed May 29, 2013

Disability service providers protest change in Medicaid rate increases

DPHHS Director Richard Opper
DPHHS Director Richard Opper

Providers of general care for the developmentally disabled are asking the public to speak out against a plan from the state Department of Public Health and Human Services to alter an increase in Medicaid dollars for raises.

DPHHS is proposing to take two-percent of a total four-percent increase in rates for these providers and distribute that money in other ways than just an equal raise to all providers. DPHHS Director Richard Opper says this could include putting in place ‘performance measures’ to give higher raises to facilities operating more successfully.

“We are always looking for ways to deliver services more efficiently and effectively,” Opper said. ”So, if a provider were to come to us with a more creative way to distribute services…I think that kind of innovation needs to be rewarded.”

Opper said he does not have specifics as to what those performance measures may be, and says that’s important, because it’s something he thinks the Department should negotiate with some of the providers of services for the developmentally disabled.

“There has not been any outreach,” said Missoula Developmental Service Corporation CEO Fran Sadowski, who points out these new increased rates go into effect on July first. “So, if that’s his (Opper’s) intent, when is it gonna happen?”

The 2013 Legislature approved two-percent rate increases across the board for providers of Medicaid Services. However, lawmakers singled out providers of services for the developmentally disabled for the larger, four-percent, increases. Sadowski said it’s not unusual for one type of provider to receive a larger increase. She says providers of services for the developmentally disabled have not seen an increase in their rates since 2009.

“We’re not getting rich on this type of increase,” Sadowski said. “Some folks are just trying to stay afloat.”

Sadowski said the disabled patients of facilities like her’s are often under 24-hour care, and if those places shut down the patients may end up on the streets, in a nursing home, or at the state’s institution in Boulder, the Montana Developmental Center. She said MDC costs taxpayers more per patient than community-based centers.

Sen. Mary Caferro (D-Helena)
Sen. Mary Caferro (D-Helena)

  Sen. Mary Caferro, D-Helena, led the legislative effort to have higher rate increases for providers of services to the developmentally disabled. She does not at all approve of the idea to make any of the rate increases performance-based.

“There was nothing in the (bill’s) language about distribution options, there are no options,” she said. “It would be wonderful if the executive would respect the legislature and follow legislative intent.”

Opper said the Department wants to negotiate on the plan proposal, adding a straight four-percent increase is not off the table. The public comment period for the proposal ends May 30th