TX – Medicaid Proposes Reimbursement Cuts of at least 10% for Several Specialties

September 2017 ~

Texas Medicaid has proposed to reduce reimbursement rates by at least 10% for several specialties and services.

The newly proposed reimbursement rates would take effect on October 1, impacting such specialties as Ears, Nose, and Throat, Radiation Oncology, Nuclear Medicine, Physician Administered Drugs, Substance Use Disorder Services, Hospital Outpatient Imaging, and Rural Hospital Outpatient Imaging.

According to Modern Healthcare, dentists in Texas face an overall 11% pay cut compared to what they received this fiscal year, Ambulance providers collectively face a 10% cut, a 34% decrease for emergency care provided by ambulance staffers and 26% for non-emergency services.

To establish the proposed rates Texas Medicaid officials reviewed the median rates paid by other states for these services as part of their usual review to ensure they are spending healthcare funds wisely.

A spokeswoman for the Texas Health & Human Services Commission said the rates have not been finalized, and the department will continue to gather stakeholder feedback during the rate review process.

Source(s): Texas Health and Human Services; Texas Health and Human Services Commission Rate Analysis Department; HMA Weekly Roundup; Modern Healthcare;