AUSTIN – Lieutenant Governor Dan Patrick and Senate Finance Committee Chair Jane Nelson sent a letter to Health and Human Services Commission (HHSC) Executive Commissioner Chris Traylor, affirming the need for Medicaid therapy rate reductions and the importance of preserving access to care. The Lt. Governor issued the following statement about that letter:
“Anyone claiming the legislature arbitrarily instructed HHSC to save taxpayers $100 million by eliminating waste, fraud and abuse without consideration of the potential impact on Texas’ most vulnerable citizens – is just flat wrong.
“The 84th Legislature overwhelmingly passed a budget with bipartisan support that included Rider 50. Rider 50 charged HHSC with saving Medicaid dollars by addressing waste, fraud and abuse for therapy services, while preserving access to those in need.
“Unfortunately, this is not a unique problem in Texas. In our nation’s Capitol, the Health and Human Services Inspector General is also calling for a crackdown on excessive Medicare therapy services.
“Many people know my long record of fighting for children with disabilities. I have served on the Board of “Be An Angel” for 27 years, a charity solely focused on children with disabilities. According to leaders at the charity, I have helped raise over $16 million for the organization. This session we were finally successful in passing my priority legislation to protect children with disabilities in the classroom by installing cameras to protect both the children and teachers from abuse or false charges.
“I will continue to hold the line on waste, fraud and abuse in Medicaid to protect those who need those resources most and provide access. At the same time, we will make sure no provider or anyone else takes advantage of the families they serve or the taxpayers.”
Letter sent to Executive Commissioner Chris Traylor by myself and Chair Jane Nelson, Sept. 30, 2015
We are writing to urge the Health and Human Services Commission (HHSC) to follow our clear legislative direction as you implement Medicaid rate reductions in accordance with Rider 50. As previously communicated, our offices agree that Rider 50 gives you the flexibility to strive for achieving $100 million savings in Medicaid therapy services while preserving access to services.
The Legislature included Rider 50 recognizing that Texas taxpayers are paying significantly higher rates for therapy services compared to Medicaid rates in other states and commercial rates in Texas. In fact, one of the most commonly used therapy codes costs the state 204% of commercial rates for certain providers. As a result, both the House of Representatives (by a vote of 115-33) and Senate (by a vote of 30-1) included therapy rate reduction riders in the final budget that passed their respective chambers.
There has been a dramatic increase in the cost and utilization of acute care therapy services in the Texas Medicaid program. Costs have increased from roughly $436 million a year to an estimated $722 million from 2009 to 2014. Speech therapists also represent a disproportionately high number of therapy investigations within your Medicaid Provider Integrity Unit. Overall, therapy providers represent 12 percent of the investigations caseload and 14 percent of the legal sanctions caseload.
We also recognize the need to proceed with the reductions in a responsible manner. Rider 50 explicitly states that you should consider access to care when implementing these rate reductions. Federal law also requires this consideration. With that in mind, our offices agreed to the plan you suggested to bring rates down in a gradual manner.
Rider 50 gives you the ability to pursue a savings of $100 million dollars from Medicaid acute care therapy rates, while also making sure that eligible children all over this state can continue to receive these important services. Rider 50 was purposefully written so that you can do both. If there are vulnerable citizens in need of services we expect you to assess and address them as vigorously as pursuing cuts in waste, abuse and fraud.
Please feel free to discuss this with our offices further as you work toward a resolution of this important effort.
Lt. Governor Dan Patrick Senator Jane Nelson