Dallas Morning News
Cuts to disabled Texas children’s therapy providers take hold despite court action, advocates say
Published: 15 September 2016 12:36 PM
Updated: 15 September 2016 07:07 PM
AUSTIN — Despite appearances that court decisions have stopped them, sweeping budget cuts to state-funded therapies for tens of thousands of disabled children are taking place anyway, Democratic lawmakers and service providers complained Thursday.
The cuts are being administered through managed care organizations that serve about half of Texas children on Medicaid, said Sen. Jose Rodriguez, D-El Paso.
At a Capitol news conference, Rodriguez said the managed care insurers cut Medicaid payments for children’s outpatient therapy by 10 percent to 30 percent.
The rates for therapy assistants were slashed even more deeply, by as much as 60 percent.
“Needless to say, this would dramatically affect the ability of providers to continue providing services when the rates are cut to that extent,” he said.
Families of children with Down syndrome, hydrocephalus and scoliosis, as well as parents of foster children still recovering from shaken baby syndrome, appeared at the Capitol and scolded Senate budget writers for approving $350 million in therapy cuts last year.
Some Senate Finance Committee members, though, said a surge in use of therapy services justified placing some restraints on the program.
But families of disabled children testified that the state is making an already difficult care-giving task even harder.
“We will fight to the bitter end for this. We are not going away,” adoptive mother Dena Dupuie of Driftwood said at the news conference.
Dupuie described interruptions in her adopted daughter Brianna’s speech and physical therapy, which she said were caused by new hassles in verification of need and prior authorization of services.
The parents said they know of no abuses and believe they are victims of lawmakers’ relying on flawed studies and innuendo.
“I just want to tell all the legislators, really think about how you’re going to hurt all these kids,” said Mayra Reyes of Austin, whose 2-year-old son, Gerardo, was helped by an early childhood intervention program run by Austin nonprofit Any Baby Can.
Health and Human Services Commission spokeswoman Carrie Williams blamed prior authorization vendor Accenture’s “failure to properly estimate workload demands.” The miscalculation has created a backlog of requests to authorize therapy, she said.
“We are aware of the challenges that families have faced and are happy to work with individual families to resolve outstanding concerns,” Williams said.
According to Rachel Hammon of the Texas Association for Home Care & Hospice, a home health care trade group that has fought the cuts, the only Medicaid managed care organizations serving rural areas of the state — Superior and Amerigroup — have cut therapy reimbursements.
That’s despite a Texas Supreme Court preliminary ruling in July that reinstated a lower court’s order stopping cuts in fee-for-service reimbursements, she said.
In the original lawsuit by opponents of the cuts, plaintiffs were unable to persuade District Judge Tim Sulak to stop Superior’s cuts in the managed care reimbursements, Hammon said, so those were unaffected by the high court’s action.
She said a new threat looms.
In 2013, the Legislature ordered that about 180,000 children and young adults under age 21 who have disabilities move into a Medicaid managed care program called STAR Kids.
The shift is scheduled for Nov. 1, and those patients also will be at risk of losing access to therapy because of rate cuts, Hammon said.
Many in-home therapy providers have said the payment reductions would force them out of business. Several have pulled out of the Medicaid program, Hammon said.