Complex rehab update: Medicaid worries, legislative hopes

BUFFALO, N.Y. - State Medicaid programs are keeping a close watch on the severity of the COVID-19 pandemic and the progress of relief-related packages in Congress as they make their budget plans for 2021, says Don Clayback.

That's the takeaway that Clayback, the executive director of NCART, had after attending the virtual meeting of the National Association of Medicaid Directors earlier this month.

“With all of the COVID-19 expenses going on, along with the drop in revenues at the state level, the risk of state Medicaid cuts is significant,” he said during a recent webcast.

NAMD represents the leaders of state Medicaid programs across the country. Its mission: to support directors in administering the program in cost-effective and efficient ways for more than 70 million Medicaid recipients.

Seth Johnson reported during the webcast that Congress has a goal of passing a relief package related to COVID-19 before members are set to adjourn on Dec. 11 - a development that would bode well for Medicaid programs.

“There is bi-partisan support to do something, but it looks like it will be significantly less than the $1.9 trillion package that (Steven Mnuchin, secretary of the treasury, and Rep. Nancy Pelosi, D-Calif., speaker of the U.S. House of Representatives), had walked away from the table with in late October,” said Johnson, senior vice president of government affairs for Pride Mobility Products.

In addition to relief-related packages, complex rehab stakeholders are tracking the progress of end-of-the-year spending packages and trying to include in them a provision giving CMS the authority to permanently authorize PTs and OTs as telehealth practitioners and to use related PT and OT codes as telehealth services.

“That's the primary vehicle that everyone's looking to attach their legislative priority to,” Johnson said. “That's a must-pass piece of legislation (before Dec. 11).”

When it comes to lobbying members of Congress, the recent election bodes mostly well for complex rehab stakeholders. A number of their champions in the House, including Reps. John Larson, D-Conn., and Lee Zeldin, were re-elected. They did, however, lose Rep. Jim Sensenbrenner, R-Wis., due to retirement.

“After 40 years in the House, he's probably due retirement,” Johnson said. “I know NCART is looking to recognize him in a special way.”