Texans are being short changed by the proposed Medicaid cuts. Legislature has told the Texas Health and Human Services Commission (HHSC) that they must cut $350 million from the Medicaid funding over the next two years. In order to abide by the legislature’s demands, the HHSC has proposed cutting the reimbursement rates for pediatric physical and occupational therapists on average by 10 to 25 percent. And pediatric speech therapists would face cuts of 16 to 27 percent. Many feel that these cuts to the therapy payments have little to no effect on the services that children with disabilities receive. These individuals say that following the orders will assist in reducing the therapy rates and will reduce the practice of excess therapy. On the opposing side, it has been expressed that cutting therapy funds that the State of Texas provides has the potential to cause individuals within the pediatric population to lose crucial therapy services. The planned cuts have the risk to jeopardize the potential of our nation’s young. The cuts also make many agency’s that currently provide occupational, physical and speech therapy vulnerable to closures and lay-offs. The people that are promoting the cuts to the Medicaid funding for providers that offer occupational, physical and speech therapy feel that the reductions are necessary to curve-tale the surplus practice of various agencies. Many agencies have found multiple loop-holes that allow services to be rendered over what is
How legislation, policies and procedures relate to health, safety and security in a health and social care setting and how legislation, policies and procedures promote safety of individuals in a health and social care setting.
The Oregon Health Services Commission addressed budget cuts in 1990 by proposing services for Medicaid services in order of priority based on a cost-effectiveness analysis. Access to particular services became limited, but coverage was increased from 67% to 100% of the poverty line1. Much protest broke out in regards to how the treatments were prioritized on the list. Some of the notable results of the draft were prioritization of minor over serious services and the death of 7-year old Coby Howard following funding cuts for organ transplant . Coby was suffering from a form of leukemia and unable to procure enough money for a bone marrow transplant, formerly covered by Medicaid until the changes took affect1. His death became the face of
The purpose of this paper is to give an overview of two federally and/or state funded programs. The programs that will be discussed are Medicare and Medicaid. In this paper will be information about who receives Medicaid/Medicare, the services offered by these programs, and those long term services that are not.
The National Coalition on Health Care also known NCHC is an organization that helps healthcare system to achieve their goals and to improve health care in United States. They are the nonprofit company that represents more than 80 participating organizations like, medical societies, business, union healthcare providers, funds, insurer, etc. Besides, some of their current missions to improve the health care system are to increase resources for developing the culturally competent health and social services. Also, to change public and private sector policies to solve any issue, build and spread knowledge about health status and other health related information. In addition, they working on eliminating health disparities that occur based on
There are major challenges faced by policy makers such as trying to control the cost of Medicaid spending because Medicaid is the biggest payer of these services. Policy makers must ensure that they are also keeping the individual served front and foremost in their decisions. Ensuring that quality services are met is one piece of the puzzle. As stated, unfortunately it seems that those who have lesser insurance or who cannot afford these services are provided with less than
- Commission Directive 2003/63/EC (brought into UK law by inclusion in the Medicines for Human Use (Fees and Miscellaneous Amendments) Regulations 2003)
Rules and policies constantly change over time with all types of industries, companies, and organizations. The results of these changes can affect a drastic number of outcomes or solutions to current issues within those businesses. One type of profession in particular, occupational therapy, is also included in these categories. The impact of not just current policy issues, but the social, economic, political, geographic, and demographic factors can all play a role in occupational therapy. The following paper discusses how the Affordable Care Act is positively affecting clients who are involved with occupational therapy.
Throughout the early 1980’s and 1990’s the Federal Medicaid program was challenged by rapidly rising Medicaid program costs and an increasing number of uninsured population. One of the primary reasons for the overall increase in healthcare costs is the
The Health and Social Care Act 2012 came into force with crucial principles including new structures and arrangements in health care services to safeguard and strengthen the future of NHS and maintain the modernisation plan. In this Act, many new changes has been made to a number of existing Acts, National Health Services Act (NHS 2006), in order to enable health care system to tackle the existing challenges and also avoid any potential crisis in future. It has also introduced the proper allocation of NHS fund and budget, and improved the integrated care between NHS and social care services to promote patients’ choice in terms of delivering quality care.
As a practicing physical therapist in the state of Georgia, and over 35 years of clinical experience in this healthcare field, I am writing to you today to gain the support of your insurance company, Blue Cross Blue Shield of Georgia (BCBSGA) in the recent achievement of direct access for physical therapists in Georgia. Currently, patients in the state of Georgia now have direct access to physical therapists without the requirement of a physician referral; however under the current health care system physical therapists are still prevented from providing necessary medical treatment to patients, on the account of that services rendered under direct access are not reimbursed by BCBSGA. This extra step places a burden to the consumer by increasing
The problem with making cuts/reductions in this department was that it hurt a portion of the people it was meant to help. This program was intended to help those who could not afford the majority of the options out there for health insurance. So whichever way they decided to go, they knew that it was not going to be easy and it would still impact families who greatly need these services.
The NYC Health Department of health and mental hygiene, serves at New York City and covers all the five boroughs which are Manhattan, Staten Island, Brooklyn, Queens, Bronx. It is located at an urban center. This department functions about 8 million diverse populations with different cultural, ethnic and economic background. The major industries in NYC are Financial services, Health Care, Technical Services, Retail Trade and Food service, Manufacturing. The characteristics of this urban center is that it’s an international city with mixed groups of cross culture. This city has people from different backgrounds and is known as an immigrant land with broad-based. Also, New York City is known as the wealthiest city with growing job opportunities in all different fields. (New York City Population)
What is the agency you selected, and what is your rationale for choosing this particular agency? The center for health care services. I chose this agency because I like what it has to offer not only for its employees, but for the community.
If additional or unexpected treatment is needed, a patient must go through a substantial waiting period. According to the Official U.S. Government Site for Medicare, there are “therapy cap limits” that exist for recipients of the Medicare Part B medical insurance. These cap limits are $1960 for occupational therapy services--an amount that can be quickly exhausted, especially when the patient is a child with a developmental disability or delay and requires therapy twice a week, each week for many years to ensure healthy development. If a patient needed any additional financial assistance to continue therapy sessions, then they would have to apply to qualify for additional limits called “thresholds”, which cap off at $3,700 for occupational therapy. If they type or frequency of treatment a patient requires falls outside of the extent of services covered by Medicare, then a patient must pay for those service costs. In order to fully meet the rehabilitation needs of each patient, changes in policy actions and financing strategies must occur such as a reallocation or redistribution of financial resources and a re-evaluation of the current coverage of health insurance to include criteria that promote equitable access (WHO,
Throughout the past decade restrictions on eligibility for taxpayer-subsidized medical care has risen at both the state and national level. Some of these restrictions are based on laws and reform acts that have been produced by legal organizations as well as political federations. On a federal level, the Welfare Reform Act of 1996 (PRWORA)