Rio Grande Valley outbills big cities in Medicaid speech therapy

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by BYRON HARRIS / WFAA

WFAA

Posted on November 19, 2013 at 9:32 AM

BROWNSVILLE, Texas –– Texas spent $400 million on speech therapy for children under Medicaid last year, up 30 percent from three years ago.

Speech therapists along a 76-mile stretch of Texas Highway 83, from Brownsville to Mission, collect more money for Medicaid speech therapy than nearly anywhere else in the state on a per capita basis. 

Last year Medicaid paid out $714 per child in Hidalgo County for speech therapy compared to $105 per child in Dallas County.

Medicaid Speech Therapy by Child

 

Speech therapy has been a growing business in Hidalgo and Cameron counties.  Clinics accepting Medicaid have billboards along Highway 83. One chain of clinics, Dynamic Children Therapy, has made commercials advertising its services.

Dynamic has grown from virtually nothing three years ago to billing the state $4.1 million last year for the most common type of Medicaid speech therapy, according to records obtained by News 8 from the Texas Department of Health and Human Services.    

Texas Medicaid Speech and Related Treatments FY12

Editor's note: Data via Texas Department of Health and Human Services. Dynamic Children Therapy also bills under ABC Pediatric Rehabilitation and Autism.

With four clinics, Dynamic covers speech therapy for the Rio Grande Valley. Other clinics have also grown rapidly, and Dynamic is not the largest biller in Hidalgo county. Of the top 200 billers for the most common speech therapy procedure last year, at least 95 were from the Valley, records show.

Based on what Texas pays out in Medicaid money, there could be an epidemic of speech problems among children in the Valley. Or it could be something else.

"The kinds of complaints that we're getting and the investigations we're opening," said Doug Wilson, the inspector general of the Texas Department of Health and Human Services. "There's definitely fraud, waste and abuse going on in the system."  

Wilson spoke about industry trends rather than any specific provider.

There are poor children all over Texas. Statewide, there are about 2.6 million kids on Medicaid.

Dallas County has 303,000 children on Medicaid. Hidalgo County has 168,000. But while Dallas County speech therapists collected $41 million from Medicaid last year, those in Hidalgo County collected $91 million, more than twice as much.  

Children in Hidalgo and Cameron counties also received 25 percent to 40 percent more treatments than kids in Dallas and Harris counties. And the state spent significantly more per child in the Valley: $5,308 in Hidalgo County compared with $4,423 in Dallas county.

Could poor children in the Valley have more speech problems than poor children in Dallas? Probably not, says Lisa Famiglietti, who's been a speech therapist for more than twenty years. 

"They should not deviate by any significant percentage points," Famiglietti says.

Speaking generally, Inspector General Wilson told News 8, "The numbers just don't appear to look right. "

The Office of the Inspector General now has more than 200 open investigations on Medicaid speech therapy in the Rio Grande Valley, Wilson said. No charges have been filed against anyone, and no wrongdoing has been alleged.

Email bharris@wfaa.com

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