Bill to offer Medicaid reimbursement for equine movement therapy passes state House

More Coloradans may be able to access therapy that uses horses after legislation to offer Medicaid reimbursement for the therapy passed the state House of Representatives.

The Medicaid Reimbursement for Therapy Using Equines bill would make Medicaid reimbursement available for equine-movement therapy, when the therapy is provided by a physical or occupational therapist, or a speech-language pathologist.

Equine therapy uses a horse’s movement to help people with movement dysfunction, according to the bill’s fiscal note. The treatment is used in physical therapy, occupational therapy and speech-language pathology.

House Bill 22-1068 was sponsored by state Reps. Karen McCormick, a Longmont Democrat, Mike Lynch, a Wellington Republican and state Sen. Sonya Jaquez Lewis, a Boulder County Democrat. 

The bill covers all equine assisted therapy, including hippotherapy, when the therapy is done by a physical or occupational therapist or a speech-language pathologist. 

Hippotherapy is physical, occupational and speech-language work that is done on horseback by licensed therapists, such as speech pathologists and occupational or physical therapists, said Jay Muller, the president of Grand Valley Equine Assisted Learning Center, which he co-founded with his wife.

Hippotherapy can help to maximize a client’s time, because whereas a client may run out of steam or energy, or may not be able to do some of the physical work in the clinic setting, a horse can allow the movement naturally.

“The other thing is, clients don’t see it as therapy, so you are able to go much longer in terms of providing services,” Muller said. 

Hippotherapy can be used for both physical and intellectual or developmental disabilities, Muller said. The Grand Valley Equine Assisted Learning Center works with both children and adults. 

Currently, the only way a patient can have equine assisted therapy covered under Medicaid is if they apply for a waiver through the federal system, McCormick wrote in an email to Newsline. This is because Medicaid is a federal program.

Occupational, physical and speech therapists have been using equine assisted therapy as a tool for over 40 years and have argued that it has been miscategorized in the Colorado Medicaid billing manual for too long, McCormick wrote. HB-1068 would put equine assisted therapy under the existing codes that these therapists use for various tools to address various issues with their clients, McCormick wrote. 

If passed, the bill would put this therapy where it should have been from the beginning, McCormick wrote. That is, not as a separate therapy, but as a tool that can be used at the therapists’ discretion, just as therapists may choose a therapy ball, a special swing or any other tool they may use for specific outcomes for their clients. 

“It is a common sense, logical fix to a problem that should have been corrected long ago,” McCormick wrote. 

The bill passed the state House of Representatives earlier this month, with 58 members voting in favor of the legislation and five voting against it. State Reps. Ron Hanks, a Cañon City Republican, and David Ortiz, a Littleton Democrat, were excused from the vote. 

Republican state Reps. Stephanie Luck of Penrose, Dave Williams of Colorado Springs, Tonya Van Beber of Weld County, Shane Sandridge of Colorado Springs and Patrick Neville of Castle Rock voted against the bill.

McCormick decided to co-sponsor the bill partly due to the fact that Colorado State University has built a new facility at the National Western Stock Show campus, CSU Spur, which houses a new arena for equine assisted therapy to take place, she wrote.

McCormick, who works as a veterinarian, said her profession helped her understand that the health care professionals were just asking to be able to decide the tools that they use for their clients. 

The bill would not require new codes in the billing manual and shouldn’t increase overall costs to the system significantly, McCormick wrote. 

The legislation is subject to federal authorization and federal financial participation, but if passed, it would go into effect on or after July 1, 2024, according to the fiscal note. 

The bill was assigned to the Senate Health & Human Services Committee last week and a hearing on the legislation had been scheduled for Wednesday.