Alaska critics pan recommendation to cut Medicaid therapy

ANCHORAGE, Alaska — Alaskans lined up Wednesday to tell Gov. Sean Parnell’s advisory committee on Medicaid that it would be a bad idea to limit payments for therapy services.

More than 150 people attended the meeting that lasted more than five hours Wednesday at the Frontier Building, the Alaska Dispatch News reported.

Elann “Lennie” Moren, 62, testified that she was told she might not walk or talk again after she was slashed in 2007 by a machete wielded by her finance’s son. Seven years later, she walked to a microphone and told the Medicaid Reform Advisory Group that through occupational, physical and speech therapy, “much is possible.”

The advisory group has recommended trimming therapeutic service to cut Medicaid costs. “If this is an example of Parnell care … then it’s no care at all,” Moren said.

Parnell appointed the advisory group after refusing to expand Medicaid under the Affordable Care Act.

Medicaid is an entitlement program for low-income Alaskans. It cost about $1.4 billion in state and federal funds in 2013. Parnell asked for reform recommendations by Nov. 15.

One proposed recommendation is an across-the-board rate freeze for Medicaid services. Another would limit spending growth to no more than 4 percent annually. Historically, the cost grows by nearly 7 percent each year.

The group has proposed a six-hour annual outpatient limit for physical, occupational and speech therapy. Xerox, the state’s fiscal agent, could conduct a “medical necessity review” to authorize additional visits. Longer coverage approval “could occasionally be granted” for patients, according to the draft recommendation.

Some adults, the recommendation acknowledges, would no longer qualify for ongoing treatment. Treatment plans would have to include transitioning to self-directed care “when appropriate.”

Anchorage speech language pathologist Cheryl Campbell testified that the recommendation would burden providers with added paperwork and create a gap in care while patients wait for Xerox to authorize further treatment.