(Radio Iowa) – State officials have changed the billing for some speech and physical therapy sessions covered by Medicaid that happen OUTSIDE of a hospital setting. The state’s Medicaid program has reimbursed some Iowa clinics, rehab agencies and individual providers for the duration of patient sessions, in 15 minute increments. Under a change implemented this month, bills are based on a daily rate instead. Iowa Medicaid Director Lee Grossman says it brings Iowa in line with the 2010 Affordable Care Act.

“Anytime we have a federal compliance issue, I think it’s best that we fix that expeditiously,” Grossman said. “…Trying to minimize the potential for any federal clawback, things like that is a big point of emphasis in terms of how we move forward on this.” Critics say for the past 15 years federal officials have never challenged the way Iowa Medicaid has paid for these services. Kelly Heysinger (HIGH-sing-er) of Unified Therapy Services in Dubuque says businesses like hers were just notified in mid-November that the billing change was taking effect December 1st.

“Reimbursement cuts like this will directly reduce access to children with developmental disabilities, infants born prematurely,” Heysinger said, “and adults with disabilities due to illness or injury.” Heysinger is considering stopping in-home visits or reducing the time of each patient’s appointment. “This new reimbursement that we will be receiving will be less than our cost per visit,” she said.

State officials estimate the billing change will save the state nearly half a million dollars a year. Legislators on the committee that reviews state agency regulations say they’ll examine the issue when the Department of Health and Human Services presents the rule outlining the billing change to the panel for review and approval next year.