Over the past several years, we have witnessed how the American Therapy Administrators of Florida, Inc./Health Network One (ATA/HN1) have expanded its reach by contracting with an ever-increasing number of Managed Medical Assistance (MMA) plans such as Molina Healthcare, Simply Health Care, Humana Healthy Horizons, Sunshine Health, Community Health Plan and Aetna Better Health of Florida. This process has been drastically reducing healthcare access to children from low income working families by functionally limiting their ability to obtain speech, occupational and/or physical therapies. These rehabilitation services are medically necessary and essential if we are to enable our children with special needs with a productive and independent life. Children Medical Services (CMS) and United Health Care are two of a handful of Medicaid Administrators that remain independent.

Medicaid contracts MMA plans to manage the healthcare of children from low-income families. ATA/HN1 in turn contracts with the MMA’s to manage therapy services such as Occupational, Physical and Speech therapies. ATA/HN1 is paid by each MMA plan a dollar amount per recipient covered under that plan. ATA/HN1 is responsible for administering therapy services out of those funds. Since provider claims are paid by ATA/HN1, this creates a situation where there could be a monetary benefit for ATA/HN1 to deny, limit or discontinue services. Therapy providers are forced to either drastically limit services or provide services for an extremely low rate or even for free. A model that places all the onus on providers to render services at significantly reduced rates and/or for free, disincentivizes participation of therapy providers, leaving families enrolled in these plans with increasingly fewer providers that accept their health insurance. Parents have been left to bear the burden of seeking therapy providers from an ever-shrinking pool, that accept their health insurance to secure treatment for their children. The ATA/HN1 model is totally divorced from the reality these children and their families face daily, a reality that only consistent and continued therapy (Occupational, Physical and Speech/Language therapies) can help overcome in time. Help us stop this practice that ATA/HN1 has imposed in our state and save our children – Federal Medicaid Law (EPSDT) grants that right.    Please click here for more information.