May 31, 2007

Dearest Advocates:

As many of you may have already been aware- Governor Perdue VETOED HB 549 (regarding the therapy process, prior authorizations,etc).  This is VERY disappointing since I know many of you took time out of your busy day to write/call the Governor’s office last week in support of this bill.  We will continue to advocate for a change in the system…………………Medicaid needs to streamline the paperwork and make it easier for our therapist to provide the necessary services our children need!

Below is the explanation the Governor gave regarding his veto.  I do not necessarily agree with his statement but I wanted you to see first hand what he said:

HB 549         HB 549 seeks to amend prior authorization requirements for recipients of Medicaid funded services.  The proposed changes inadvertently conflict with federal mandates on Medicaid services.  Specifically, HB 549 would restrict the States ability to conduct appropriate prior authorization review as required by federal regulations (CFR 433.15(b)(7)).  Federal regulators have also indicated an objection to the establishment of different standards for recipients based on a general categorization of their condition rather than based on an individuals specific medical needs and likely rehabilitation and recovery (CFR 440.240).  For these reasons, federal approval of the changes mandated by HB 549 is not expected.  The timeliness of these services, particularly to this constituency is important.  I am, therefore, directing the Department of Community Healt h to continue its efforts to provide for a more streamlined preauthorization process so as not to unduly burden the practitioners and patients this bill seeks to assist. 

Please remember….United… WE WILL MAKE A DIFFERENCE.

We may have lost the battle..... but WE WILL WIN the WAR!

Sincerely,

Heidi