Providers Ask Judge To Stop Medicaid Cuts

The state has slashed any Medicaid rate that was higher than 145 percent of the commercial rate. While some rates wouldn’t change, others could be cut anywhere from roughly 30 to 90 percent……….

By EMILY SIDES STAFF WRITER | Posted Yesterday

Pediatric home health care providers and family members of disabled children filed a lawsuit Tuesday in Travis County requesting the court order the state to not cut Medicaid reimbursement rates for occupational, speech and physical therapy.

District Judge Suzanne Covington set the injunction hearing for Monday, Aug. 24. Four family members of children ages 2, 4, 9 and 15, along with four home health care agencies from around the state sued the Texas Health and Human Services Commission and its Executive Commissioner Chris Traylor because they oppose the rates, which are slated to go into effect Sept. 1.

State legislators ordered the commission to cut $350 million over the next two years for these kinds of therapies which assist children to breath, eat, engage and walk, among other goals.

Richards Rodriguez & Skeith lawfirm is representing the providers and families. State law requires any lawsuit against a state agency be filed in Travis County, the lawfirm’s lawyer Ben Hathaway said Wednesday.

Hathaway said the judge can grant or deny the injunction hearing where parents and providers are expected to testify, adding that he did not want to discuss the merits of the case.

Providers and more than 25 legislators, including Rep. Bobby Guerra, D-McAllen, said the cuts will drastically reduce access to treatment for struggling families and would lead to children requiring costly medical needs down the line.

The commission proposed to cut the rates by comparing them to what companies charge for these services, according to an email last week from commission spokesman Bryan Black. Texas A&M researchers provided the commission with commercial rates after analyzing 50 million therapeutic services in 11 states, according to an email from Black.

The commission slashed any rate that was higher than 145 percent of the commercial rate. While some rates wouldn’t change, others could be cut anywhere from roughly 30 to 90 percent, according to the rates provided in the report.

The proposed rates need to be finalized at least 10 days before Sept. 1. Black wrote in an email that the rates will be posted online as soon as they are finalized.

“It is my understanding from the team working on the project, the new rates might be posted prior to the 10-day mark,” Black wrote in an email Wednesday.

Black also wrote in an email that the commission will not comment on pending litigation.

 

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