LITTLE ROCK — The state Legislative Council on Friday approved limiting group therapy benefits for Medicaid recipients.
The council, which serves as the governing legislative body between legislative sessions, approved without discussion a proposal by Medicaid Inspector General Elizabeth Smith to cap Medicaid reimbursements for group therapy at one hour per day, in place of the current hour-and-a-half cap, and at 25 one-hour sessions per year.
The Medicaid program does not impose an annual limit on group therapy sessions.
The council approved the cap three days after its Administrative Rules and Regulations Subcommittee endorsed the plan. According to information provided to the subcommittee by the Office of Medicaid Inspector General, Smith offered the proposal after AdvanceMed, a Virginia-based company that monitors Medicaid spending in several states for the federal government, found that Arkansas’ spending on group therapy significantly exceeded that of surrounding states.
The cap will go into effect Oct. 1. It is estimated to save $8.2 million in state dollars and $18.9 million in federal dollars this fiscal year and $10.9 million in state dollars and $25.2 million in federal dollars in the next fiscal year.
During a public-comment period, the Office of Medicaid Inspector General received several comments charging that the proposal was driven by budgetary considerations without consideration of to the impact on patients, who would be likely to experience rapid deterioration and increased hospitalizations, incarcerations, and homelessness. Smith’s office disagreed.
“The current rate and benefit limit for (group therapy) allows for over-utilization and improper use of group psychotherapy services. OMIG believes aligning the limits with the other states in our region is not detrimental to patients but provides more appropriate care for the patients,” the office said in the materials it provided to lawmakers.