Medicaid stops payment for some child services

JACKSON — The Division of Medicaid has stopped automatic funding for some treatment services for children under age 6 diagnosed with severe emotional disturbances.

Richard Roberson, Medicaid’s assistant to the executive director, told The Clarion-Ledger that the action comes amid undisclosed audit results and a pending investigation by agency and law enforcement officials.

Providers said the funding change puts services for hundreds of children and some 300 jobs in jeopardy.

Eight community mental health centers and the Catholic Charities Diocese of Jackson received a fax from Medicaid shortly after 5 p.m. on July 29 saying there had been questions about reimbursement for the program.

They stopped receiving reimbursements as of Aug. 2, center directors said.

“Getting a one-day notice was definitely not the way I would have wanted to see it happen,” said Greg Patin, executive director of Catholic Charities, which operates three day-treatment programs for 27 children under 6 in Natchez. Patin said he will shut down his programs at month’s end.

Hinds Behavioral Health Services Executive Director Margaret Harris said staff began informing families late last week that the programs were shutting down Sept. 3.

Harris operates four programs that serve 36 children, 27 of whom are under age 6.

In its fax, Medicaid stated the program was “not appropriate” for children under 6, but little else information was provided.

“One thing Medicaid is definitely guilty of is not being thorough with explaining what they’re doing, or why they’re doing it,” said Sen. Lee Yancey, R- Brandon. “Because we’re having this investigation, all of a sudden all these kids don’t have any services? That doesn’t make any sense.”

In the fiscal year that ended June 30, Medicaid reimbursed $19.4 million for the programs serving 1,553 children under age 6.

Medicaid said two-thirds of that funding, about $12.9 million, went to reimburse Brandon-based Region 8 Mental Health Services, which covers Madison, Rankin, Copiah and Simpson counties.

Region 8 Executive Director Dave Van said the day programs are the only support system some of these children have. He called it one of his center’s most successful programs.

“These kids are thriving after completion and it is tremendously reducing the possibility they will be on Medicaid in the future,” he said.

Roberson said Medicaid has not changed guidelines for the program but decided to stop automatic payment “as the result of audit findings and pending investigations, and on the advice of other authorities.”

Roberson said Medicaid will follow up with providers this week to explain that Medicaid must pre-authorize any child under 6 based on medical need before funds are released.

Medicaid and its expert consultants will make a determination within days of receiving a child’s medical records, he said.

The Associated Press