Texas Plans to Cut Medicaid for CRT Up to 20%

Tuesday, July 12 at 9am HHSC held a public rate hearing in Austin.  This rate hearing was to discuss proposed rate reductions for DMEPOS items – across the board!  The smallest percentage cut taking place is 6%, with some as large as 20% and one (E0265 Full Electric Hospital bed) being eliminated as a benefit with a 100% rate reduction.

 TXRPC Membership pulled together with a show of force at this meeting.  For almost two hours, testimonies were given with the goal of tabling or postponing until further review the proposed rate reductions.  The rata analysts who were taking testimony understood the information presented, however they cannot overturn this current proposal as it is a mandate from the Texas Legislature.  The only way to get these rate cuts rescinded or reduced is to make some noise.  There are HHSC staff members who can help achieve this goal if they are informed of the access to care issues that these reimbursement reductions will cause.

 The TXRPC board is compiling a position letter in opposition to the proposed rates.  This alone will not be enough.  Everyone who presented testimony at Tuesday’s hearing is urged to send electronic copies of it to the below listed HHSC staff members.  Anyone who did not is urged to create a letter to send to these people.  Share this request with any Complex Rehab companies who may not be TXRPC members.  Share this request with Manufacturers, who are also important to this process – they, too are encouraged to create and send letters opposing this.  Consumer groups are ESSENTIAL to this process.  Please discuss this matter TODAY with any individual consumer advocates or consumer groups who can submit testimonies imploring the state to look elsewhere for their cost savings.  Since the plan is to get as many testimonies to these people as possible, it is of extreme importance to touch on the subjects that will have the greatest possibility to delay the implementation of these rate reductions.  Some of these subjects are listed below:

 1.    General Access to Care – be sure to describe how the lower rates would prevent Medicaid beneficiaries from receiving (appropriate) products represented by the codes being cut

2.    Cost savings in other areas – are there codes which may be able to take more of a cut and some that MUST keep their current level of funding

3.    Cost savings through other means – are there policies that could be reworked to create a cost savings

a.    Quantity limits

b.    Timeframe increases

c.    Forms that currently create more work, therefore more cost for the state (issues with the Title XIX for example) 

In your letter, urge the HHSC to suspend this action until further input can be gathered for other areas that could help achieve the cost savings.  Not all HCPCs have to be cut the same, but HHSC has been mandated to save 10.5% from DME overall.  Providers, Consumers, and Political affiliates need to tell them that Complex Rehab must maintain its current level of funding to prevent access to care issues!!!

Thomas.Suehs@hhsc.state.tx.us             HHSC Executive Commissioner

Jose.Gonzalez5@hhsc.state.tx.us           HHSC Medical Director

Rhonda.Alexander@hhsc.state.tx.us      Works for Medical Director Gonzalez

Donna.Claeys@hhsc.state.tx.us              Nurse for MD Gonzalez

Jennifer.Stansbury@hhsc.state.tx.us      Senior Policy Analyst

Dan.Huggins@hhsc.state.tx.us                Rate Analysis Department