Essential Benefits State Benchmark Plans (PDF 7.9 MB, members only)
View state by state summaries of comprehensive AOPA "members only" research into the four benchmark healthcare plans in each of the 50 states to the fullest extent available to our researchers. This information is critically important to O&P practitioners in each state because the Department of Health and Human Services has ceded to the states the final decisions as to which services are included in the essential benefits package. While stating generally that HHS believes all plans should include O&P services, your state gets to select one plan so O&P practitioners in each state will want to track what O&P services are and are not available in the plans from which your state can choose. If any of the benchmark plans in your state do not include O&P benefits, start now to encourage adO&Pion of a benchmark plan that does include O&P.
AOPA Supports Texas Members Amid State Medicaid Budget Threats
As reported in the June 14 and June 28 issues of AOPA In Advance, AOPA been alerted to another threat to cut Medicaid payments to O&P, this time in Texas. The Texas Health and Human Services Commission regarding the rate holds hearings July 12 to consider the issue of reimbursement a cut of 12.5% cut to O&P in the state's Medicaid budget over fiscal years 2011 and 2012. AOPA has submitted an official statement to the hearing. The statement emphasizes that this type of cut harms the near-term fiscal health of the state: "Anyone who understands the realities of health care in the U.S. realizes that states cannot simply "cost shift" budget dollars to providers without detrimental results, e.g., showing up in emergency rooms, adding to the uncompensated care burdens for hospitals and physicians."
AOPA has been providing support to the Texas Orthotic and Prosthetic Association (TOPA), crafting an ad for placement in newspapers and is distributing a letter to O&P patient care providers in the state to alert them to the Medicaid cuts and how to register their opposition to the cuts with their state representatives.
AOPA will continue to update members about the status of the O&P cuts in Texas.