Ask Mike - Does the government pay providers for respite and habilitation care for children?

Dear Probing for Pay,

Thanks for writing. You provide respite and habilitation services to children with autism in Tucson, Arizona and want to know how much the agency providers are paid for doing same.

The amounts paid to various types of agencies, and mechanisms utilized to do so, vary widely from state to state and program to program. For example, within the same state, an aging program may pay one rate for respite while a working age physical disability program pays an entirely different rate, while a developmental disability program pays yet another rate. Again, all of this varies widely between states, from one state to the next.

The mechanisms used to pay providers also vary. Most don't so much pay providers as reimburse expenditures. Others pay a capitated rate, that is, a set, flat fee per person without regard to the types and amounts of services the person may actually utilize. The differences in payment rates and structures, and the differences in programs, can result in variations of hundreds of dollars.

I don't believe that the reimbursement rates paid to agencies are confidential so you should be able to find out what they are by either making a formal request, in writing, to the agency, or else asking the state Medicaid agency. Go to " Arizona Agencies Related to PAS" and click on "Medicaid Agency". The contact information and website address for "Health Care Cost Containment of Arizona" can be used to pursue your question if a direct request to the agency does not pan out.

I hope this helps.

Mike Oxford