LITTLE ROCK, Ark. (KTHV) - The Department of Human Services is implementing new limits on therapy for Medicaid patients with developmental disabilities. This means that come July, some patients won’t receive as much therapy as they do currently.
Melissa Stone, Director of the Division of Developmental Disabilities, said that some patients receive hours of speech, physical, and occupational therapy each day through Medicaid. She explained that's rarely necessary, so DHS is setting a cap at 90 minutes per week per service.
One four-year-old, Lila Morrow, has down syndrome and receives about 120 minutes of speech, occupational, and physical therapy a week at the Allen School. Her mother, Lainey Morrow, is head of the “Medicaid Saves Lives” community.
“She didn’t say ‘Mama’ until probably the last three to four months and she’s four. So to be able to hear her say ‘Mama’ to me just makes me want to cry,” said Morrow.
But starting on the 1st of July, DHS will require Lila's therapist to get approval to bill more than 90 minutes of therapy for each service.
Stone claimed the therapy cap was created to help control costs and make sure the services aren't being "over-utilized."
“This recommendation was actually brought to me by a clinical work group because they were seeing cases where they felt the frequency and intensity was too much," said Stone.
Therapists at the Allen School say about half of their kids receive more than 90 minutes of therapy a week. This doesn't mean they won’t get that extra therapy, but they will have to get approval first.
"Some kids just have more challenges than others like Lila for instance, she has low muscle tone and strength and there’s just more areas to work on with her," said Lila’s occupational therapist, Ashley Howard.
Stone said for more time, the therapist will submit an online extension request. Clinicians with the Arkansas Foundation for Medical Care will look them over and determine if it's needed. Approval or denial will be granted within 3 days.
“We don’t want to set any kids or adults back in any way by implementing this rule change,” said Stone.