Monday, October 15, 2018

The Healthcare Committee of the Mississippi Speech-Language-Hearing Association took a stand against a policy of United Health Care. The result was a reversal of policy.

United Health Care, a managed care company administrating Medicaid funds in Mississippi, adopted a narrow definition of 
“medical necessity.” The result was denial of speech and hearing services to almost all children ages 0-21 seeking help.

The committee’s efforts included initiating an email thread to discuss talking points, studying the Medicaid Administrative code to determine what should be approved or denied, urging parents to contest denials, and setting up conferences with decision makers.

United Health Care officials provided guidance.  Policy makers at Division of Medicaid were attentive to our needs. The result of the collaboration was to postpone the prior authorization of services by UHC until 2019.

Speech-language pathologists spoke and policy makers listened, resulting in preservation of services for Mississippi children. 

Jeffalyn Trammell
MSHA VP of Healthcare

No comments:

Post a Comment

Barbara Jacobson, PhD, CCC-SLP is the ASHA Vice President for Standards & Ethics in Speech-Language Pathology. She will pr...