The Bush Administration has proposed language that would change definitions of targeted case management (TCM) and Medicaid rehabilitation. These changes would prevent the billing of Medicaid for any TCM or rehabilitation services that could be provided by other agencies, e.g., child welfare, education, juvenile justice, housing, job training, courts, or public guardianship programs using non-Medicaid funds. According to the Bazelon Center for Mental Health Law, state mental health systems rely on Medicaid to fund over half of the cost of community mental health services. If the ability to use Medicaid funds is limited, it is unlikely that the deficit would be replaced by state dollars. Furthermore, the administration has suggested that funding for TCM should be reduced to 50 percent, the administrative rate, instead of the usual Medicaid rate for services.
The National Council for Community Behavioral Healthcare (NCCBH) contacted PCPA August 19 and requested assistance in securing Pennsylvania-specific information for a letter to the US Senate Finance Committee. PCPA coordinated outreach from Mercy Behavioral Health in Pittsburgh, as NCCBH was seeking input from a member located in Senator Santorum’s home area. Additionally, advocacy is needed from many PCPA members to urge members of the Senate Finance Committee, of which Pennsylvania’s Senator Santorum (R) is a member, as well as the House Energy and Commerce Committee (which includes three Pennsylvania congressmen amongst its members) to retain the current definitions of TCM and rehabilitation and to oppose the cut in reimbursement levels for TCM. Contact information for pertinent Pennsylvania congressmen appears below:
The Honorable
Rick Santorum (R) 202-224-6324
The Honorable Joseph Pitts (R) 202-225-2411
The Honorable Timothy Murphy (R) 202-225-2301
The Honorable Mike Doyle (D) 202-225-2135
See the Action Alert from NCCBH (www.nccbh.org/POLICY/alert-EliminatesMedicaidCaseManagement.htm) for more information and a sample letter to members of Congress. Information on the effects of the changes can also be found on the Bazelon Center for Mental Health Law web site (www.bazelon.org/takeaction/2005/8-18-05medicaid.htm). PCPA members are urged to contact the congressional committee members listed above at their home offices by Labor Day as action is expected in the very near future.
