Lawmakers want changes to Early Intervention payment system

09 October 2013, 10:49 am by Jon Campbell

A change in the payment system for Early Intervention programs has drawn ire from state lawmakers, who say it has led to lengthy delays in getting payments to providers.

Sen. Cecilia Tkaczyk, D-Duanesburg, Schenectady County, held a news conference Tuesday to push for changes to the system, which was changed April 1 to remove counties’ administrative responsibilities to seek repayment from insurance companies as a form of mandate relief. She was joined by several other lawmakers, including Sen. George Latimer, D-Rye, Westchester County.

Last month, three lower Hudson Valley lawmakers—Sen. David Carlucci, D-Clarkstown, Rockland County; Assemblyman Tom Abinanti, D-Mt. Pleasant, Westchester County; and Assemblyman Ken Zebrowski, D-New City, Rockland County—held a similar news conference calling for changes.

The issue, Tkaczyk said, is tied to a change requiring providers to first attempt to receive payment from insurance companies or other third parties. Early Intervention therapists provide services, such as speech pathology, to infants or toddlers with developmental disabilities.

“Thousands of infants and toddlers with disabilities and their families rely on services from Early Intervention providers,” Tkaczyk said. “But those services are now jeopardized by a convoluted and onerous billing process.”

Tkaczyk’s bill would make the state, or it’s “designated fiscal agent,” first attempt to get payment from third parties. Municipalities and the state, meanwhile, would be required to issue payment to the providers within 30 days.

The state Department of Health in August announced it would make available one-time “safety net” payments for 75 percent of unpaid claims. At that time, DOH said it had issued about $133 million in payments to providers through its fiscal agent since April 1.