Medicaid Reimbursement of Hearing Services for Infants and Young Children
Medicaid Reimbursement of Hearing Services for Infants and Young Children
复制标题
DOI：
10.1542/peds.2010-0354h
复制
发表时间：
2010-08-01
期刊：
影响因子：
8
通讯作者：
Thompson, Maureen
中科院分区：
文献类型：
--
作者：
McManus, Margaret A.;Levtov, Ruti;Thompson, Maureen
随着新生儿听力筛查项目的扩大，越来越多的婴幼儿需要听力服务。医疗补助是这些服务的主要资金来源之一，根据法律，必须建立足以招募足够提供者提供服务的支付率。在这项研究中，我们比较了2005年15个州的婴幼儿听力服务的医疗补助报销率与医疗保险和商业健康保险对相同服务的支付率。平均而言，相同服务的医疗补助费率仅为医疗保险的67%，仅为商业费用的38%。此外，从2000年到2005年，大多数医疗补助费率下降，许多州没有婴儿和幼儿所需的大量听力服务的计费代码。这些因素可能导致听力损失的婴幼儿无法获得他们需要的听力服务，从而无法从早期识别听力损失中受益。这些数据还提出了一个问题，即各州在多大程度上满足了联邦的要求，即医疗补助支付足以招募足够的提供者，以便该地理区域的普通民众能够充分获得护理和服务。儿科2010;126：S34-S42
As newborn hearing-screening programs have expanded, more and more infants and young children need hearing services. Medicaid is one of the primary sources of funding for such services and, by law, must establish payment rates that are sufficient to enlist enough providers to provide services. In this study we compared 2005 Medicaid reimbursement rates for hearing services for infants and young children in 15 states with the payment rates for the same services by Medicare and commercially available health insurance. On average, Medicaid rates for the same services were only 67% as high as Medicare and only 38% as high as commercial fees. Furthermore, most Medicaid rates declined from 2000 to 2005, and many states did not have billing codes for a significant number of the hearing services needed by infants and young children. These factors likely contribute to infants and young children with hearing loss not being able to get the hearing services they need to benefit from early identification of hearing loss. These data also raise questions about the extent to which states are meeting the federal requirement that Medicaid payments be sufficient to enlist enough providers so that care and services are adequately available to the general population in the geographic area. Pediatrics 2010;126:S34-S42