Lawsuit temporarily halts North Carolina Medicaid cuts to autism care
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North Carolina's Department of Health and Human Services says it will comply with a judge's order to temporarily reverse Medicaid cuts affecting children diagnosed with autism.
Why it matters: DHHS made reimbursement cuts to its Medicaid program in October, potentially affecting care for the millions of residents in the state who rely on it.
- The cuts came after the N.C. General Assembly couldn't come to an agreement on a state budget that would include enough funding for Medicaid.
Driving the news: Twenty-one families filed a lawsuit in October against DHHS in an effort to halt the cuts for applied behavior analysis (ABA) therapy.
- A judge granted a temporary restraining order until the next hearing in the case on Nov. 10.
By the numbers: About 2.5% of eight-year-old children in North Carolina were identified as having autism spectrum disorder as of 2020, according to CDC data.
- Those who rely on ABA therapy were unfairly targeted, the lawsuit claims, given that reimbursement rates for other programs were only cut by 3%.
Zoom in: DHHS specifically had reduced reimbursement rates by 10% for behavioral therapy and analysis for patients with autism, NC Newsline reported.
What they're saying: "These families were left with no choice but to take the state to court," a spokesperson for Health Over Politics, a group supporting the lawsuit, said in a statement. "Children are losing medically necessary ABA therapy today because of bureaucratic gridlock and reckless rate cuts."
The other side: A spokesperson for DHHS said it would comply with the order, though it is still waiting for a written order issued by the court.
- DHHS added that the order adds more evidence that the state legislature needs to provide more funding for Medicaid, and said that without more funding, N.C. Medicaid could run out of money by April.
- "We understand these provider rate cuts are devastating to people, providers and communities that rely on NC Medicaid," DHHS said in the statement. "DHHS did not want to take this extremely difficult step of making these significant reductions for NC Medicaid services, however, without additional funding from the General Assembly, it was unavoidable."