Therapies for hundreds of Oklahoma kids on SoonerCare are on hold Thursday night. According to some speech therapists, families have waited weeks for approval.
“It's taking literally 10 times longer than it used to,” said speech pathologist Chelsie Wall.
Wall works at Little Hands Little Voices in South OKC. The clinic just opened its doors, but they're not sure for how long.
“We're seeing children all day long back to back and we have no idea if we're going to get paid or not,” she said.
The clinic provides speech and occupational therapies for children, but for more than 100 of the patients here on SoonerCare, those therapies are not approved yet.
“Before we would find out if they were approved for therapy or denied for therapy within 48 hours,” Wall said.
Now, Wall says it's taking weeks, ever since the Oklahoma Health Care Authority began processing prior authorizations for speech therapy in-house instead of using a third party vendor.
“It's kind of devastating because, what are we going to do,” said Johnathan Williams.
Williams’ has three kids in need of these services and for the past month, they haven't received approval.
“My youngest son he's really far on the spectrum and he didn't even know how to talk and he actually learned to talk through speech therapy,” he said. “That's going to be a push back on the learning experience we've built with them so far, to have it cut short it feels a bit unfair.”
Therapists agree a delay in treatment could cause a regression in some children.
“If they've learned a skill, if they go without therapy even a couple of weeks sometimes they lose that skill completely,” said Wall. “It’s just unacceptable that children are going without therapy for weeks and weeks.”
OHCA released this statement in response to the concerns:
“The Oklahoma Health Care Authority (OHCA) recently began processing prior authorizations for speech therapy services in-house instead of continuing to contract with a third party vendor. We are aware of provider and member concerns during this transition and we are reviewing requests as quickly as possible while we ensure that the taxpayer money is spent on those services that are truly medically necessary. We feel confident that working with our providers as we move forward will result in a better solution for both the state and the provider network.” – Yasmine Barve, Director of Medical Authorization, Oklahoma Health Care Authority.
However, a solution can't come soon enough for the families who need it most.
“There's a possibility that we might have to close the doors but we don't want to give up on the kids because we feel like a lot of other people do,” Wall said.
While the OHCA says it will continue to work with providers to come up with a better solution, it didn't have a time frame on how long that would take.
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