TMA testifies against additional Medicaid, CHIP budget cuts
As the Texas Health and Human Ser- vices Commission (HHSC) prepares its 2014–15 budget request for the upcom- ing legislative session, the Texas Medi- cal Association and other state physician organizations voiced their concerns that piling on even the slightest of additional payment cuts will only exacerbate exist- ing access-to-care shortages. In the last biennium, the state re- duced by 2 percent “already meager payment rates” to certain physicians participating in Medicaid and the Chil- dren’s Health Insurance Program (CHIP), said a September joint letter by TMA, the Texas Pediatric Society, the Texas Academy of Family Physicians, and the
American Congress of Obstetricians and Gynecologists/Texas District. That hit came on top of what physi- cians called a “draconian” payment re- duction for doctors treating dual-eligible patients, those eligible for both Medi- care and Medicaid. The cut, which sig- nificantly reduced Medicaid’s payment of the Medicare Part B coinsurance and deductible, took effect in January. The physician organizations asked HHSC to restore those dual-eligible pay- ments. They also rejected a proposed 1-percent across-the-board rate cut in Medicaid and CHIP payments to doctors and other health care professionals, as part of an overall 10-percent HHSC bud- get cut. Already, Medicaid and CHIP pay on average 73 percent of Medicare and 50 percent of commercial health insurance rates. The low rates and recent cuts com- bined are a top reason the proportion of Texas physicians willing to accept new Medicaid patients plummeted from 42
percent to 31 percent between 2010 and 2012, according to a TMA survey. “Inadequate payments, combined with rising practice costs, mean more and more physicians simply cannot afford to continue taking a loss for their services,” TMA and the other groups said. Instead of cutting further, physicians
asked that HHSC put patients’ access to care first and take action to at least maintain, if not improve, current Medic- aid and CHIP services. A provision of the Patient Protection and Affordable Care Act (PPACA), for example, allows states to implement a two-year increase in Medicaid payment rates for preventive office visits provided by pediatricians, family physicians, and general internists. The physician orga- nizations asked HHSC to extend that rate hike — which would raise Medic- aid rates to 100 percent of Medicare and run from Jan. 1, 2013, to Dec. 31, 2014 — through the end of the 2014–15 bien- nium and to broaden it to include other
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December 2012 TEXAS MEDICINE 45
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