AUSTIN — Texas quietly violated a court order that prohibits it from reducing the rates it pays to therapists serving Medicaid recipients, a group of providers and parents of disabled children said Tuesday.

The group told Judge Tim Sulak that Superior Health Plan Inc. notified its providers April 1 that the state would be changing reimbursement rates starting at the beginning of next month. Rates for some services could be reduced up to 30 percent, the letter said.

That rate reduction, the group said, would be in violation of a court order that Sulak issued last fall, temporarily blocking $350 million in Medicaid cuts enacted by the state Legislature.

“When one of the state’s contractors took upon themselves to make cuts even though there was court order prohibiting that, it gave us opportunity to know the state is not following its own protocols,” said Chuck McDonald, a spokesman for the group.

Bryan Black, a spokesman for the state Health and Human Services Commission, which is in charge of the Medicaid program, declined comment, saying he could not discuss pending litigation.

Tuesday’s hearing, spurred by a complaint filed by the group of providers and parents, was the latest in a months-long struggle over the proposed cuts.

Critics last year filed a lawsuit against the cuts, arguing it was based on a flawed study and would reduce the number of providers, hurting an estimated 60,000 mentally ill and disabled Texas children who rely on Medicaid coverage.

The state has argued that Texas Medicaid reimbursement rates are higher than in many other states and that the the number of Medicaid therapy providers grew 30 percent between 2009 and 2014. It also is arguing that the judge has no jurisdiction over the case because Medicaid is a federal program.

A trial regarding the group’s lawsuit is scheduled to start April 25.

According to McDonald, Superior should be added to the lawsuit since it is implementing policy changes on its own, but under the name of the state.

Superior’s health care plan covers all of the children in foster care who need health care coverage, meaning that population could be disproportionately harmed by the rate reduction, advocates say.

In its complaint, the group argued the reductions would dramatically decrease the number of providers. Lawyers made the same argument before Sulak on Tuesday.

“In court, where rhetoric is not good enough and facts are required, they have nothing,” McDonald said in an interview. “The state has to do a study and determine how the rates will not harm access to care.”

This story was published in the Houston Chronicle on April 12, 2016. 

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s