On Friday, the Texas Health and Human Services Commission renewed its effort to change Medicaid therapy reimbursement rates for specialists who treat more than a quarter of a million disabled children and seniors.
It was the latest action in what has been a messy saga for the Legislature.
The proposal was approved last year by lawmakers eager to shave some $100 million from the publicly funded therapy.
The proposed cuts left many lawmakers squeamish and prompted legislators to direct Health and Human Services Commissioner Chris Traylor not to take any action that would harm children.
That’s ironic, since Rider 50, legislation attached to the commission’s budget, was their own creation.
In response, Traylor reduced the severity of the reimbursement rates, telling Texas Senate leadership his agency would work to “preserve access to care” even if this meant the full budget cuts “cannot be achieved.”
But the reduced cuts were still too much for a group of therapy providers and advocates. They sued and convinced a Travis County judge that such reductions could still irreparably harm children.
In late April, the Texas 3rd Court of Appeals overruled that opinion, saying the courts lack the jurisdiction to continue blocking the cuts, thus freeing the agency to pursue the reductions.
With the cuts now set to take effect on July 15, real concerns remain about their impact on vulnerable Texans, and real questions remain about the Legislature’s ability to prevent loss of services.
Rachel Hammon, executive director of the Texas Association for Home Care & Hospice, warned in a news release that the commission used flawed methodology to calculate the new rates.
As a result, some service providers could see cuts they are unable to absorb, driving them out of business and leaving thousands of children and elderly people without critical services and care — exactly what legislators directed the commission to avoid.
Some lawmakers, including Sen. Jane Nelson, R-Flower Mound, have insisted that the rates currently paid in Texas are well above those in other states and above in-state commercial rates.
And the state has argued that children and the elderly will still be able to find providers, even with the reduced rates.
That might be true.
But if Hammon is right, it will be too late for the children and the elderly forced to go without services and too late for the Legislature to clean up its mess.