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UPDATE: IDHW Delays Lowering of Medicaid Reimbursement After Critics Cry "Grinch"

The Idaho Disability Defense and Education Fund said there was "no legal reason to wait until a week before Christmas" for the announcement.

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UPDATE: December 23, 2015

In the shadow of sharp criticism of its announcement that it would lower Medicaid reimbursement rates to health care providers, the Idaho Department of Health and Welfare now says it will delay the rate adjustment from January 1, 2016 to early February "to allow Providers more time to adjust to the change and provide accurate information to participants about service options.

In its announcement, IDHW said it "realized more time would be necessary" for providers to adjust to the change.

IDHW officials also detailed how much the reimbursement rates will change in February. Health and Welfare says for the largest group of participants, a little over 600 Medicaid enrollees, providers are paid a dau rate. For the past three years, that rate has been $248 per day. But on Feb. 1, the rate will reduce to $225 per day. But for some, the change will be much more significant. IDHW says about 200 participants who support patients with intense needs - about 200 participants - the rate for the past three years has been $496 per day. But on Feb. 1, the rate will reduce to $269 per day.

IDHW officials reiterated that they'll monitor the situation and "the free market will help determine if rates need to be adjusted."

ORIGINAL STORY

Following a U.S. Supreme Court ruling in April, the state of Idaho has been cleared to lower Medicaid reimbursement rates to health care providers--reverting back to 2012 levels.

The high court said providers could not sue the state in order to raise reimbursement rates due to rising medical costs; and, on Dec. 18, the Idaho Department of Health and Welfare announced it had received approval from the Centers for Medicare and Medicaid Service to return the Medicaid reimbursement rates to the 2012 levels, effective Jan. 1, 2016.

Meanwhile, the advocacy group Idaho Disability Defense and Education Fund said the timing couldn't have been worse, accusing IDHW of being "the Grinch who stole Christmas," going on to state there was "no legal reason to wait until a week before Christmas" for the announcement.

"But we just got that approval [from CMS] just last week," said IDHW spokesman Tom Shanahan. "If we had approval to lower the rate last April, we would have changed it then. In fact, providers got eight months of higher payments while we were awaiting approval from CMS to lower the rates."

IDDEF President Bill Benkula insisted the lower rates may force service providers "to turn away the neediest patients" and some providers "might even have to lay off workers or go out of business entirely."

Shanahan said Health and Welfare always monitors Medicaid-funded services.

"We look at two things: access and quality," he said. "If we see a situation where there aren't enough providers or the quality of care declines, then we'll reevaluate the reimbursement rate. We're going to keep an eye on this very closely."

Benkula countered, "I cannot even imagine what led Health and Welfare to do this to these people, at this time of year."