Please take action by August 4th!
The 2023 Montana state legislative session saw families, service providers, and lawmakers coming together to advocate for increasing DPHHS provider reimbursement rates. Guidehouse Inc. completed a rate study to determine the “benchmark” rates for what would be considered 100% funding for these services, and lawmakers debated which services should get this or that level of funding compared to the benchmark rate.
Everyone fought hard for the rate increases they eventually received, but there are problems developing for Autism/BCBA category services…
- There are inconsistencies and errors in the rate calculations [ Figure A ], and when we brought this to the attention of state officials, their responses did not make sense. They made some incorrect assumptions about the Guidehouse Rate Study’s scope and/or did not consider whether the numbers involved were factually plausible. We maintain that the Autism/BCBA category benchmark rate is most likely around 76% (as found in the Appropriations Subcommittee March 9th meeting materials), or at least NOT currently 96% of benchmark [ Figure B; Figure C ].
- There is no built-in inflationary adjustment for the rate increases. If inflation eats up all the gains we made for rate increases, then soon everyone will be back to where they started.
- Unless these problems are corrected, the rate increases are unlikely to meet the needs of providers or clients [ Figure H ], undermining the efforts of the lawmakers and community to make these services available and sustainable.
Clearly, state officials need to double-check these numbers to make sure the level of compensation in the category is appropriate and matches legislative intent. The DD Autism/BCBA category analysis by Guidehouse [ Figure D; Figure E; Figure F ], BCBA rate model cost analysis [ Figure G ], and data from the Resource-Based Relative Value Scale (RBRVS) can be used for comparison.
We are calling on all stakeholders—families, staff, service providers, and other interested parties—to submit public comment about this ASAP to:
FAX: (406) 444-9744
MT DPHHS, Office of Legal Affairs
P.O. Box 4210, Helena, Montana, 59604-4210
***Time is of the essence! The deadline for public comment is August 4th, 2023.***