Texas Medicaid Reform Group Sees Positive Developments for Medicaid Providers in Increasing Legislative Support for Bills

Share Article

With more Texas Legislators signing onto due process bills, Austin-based Texas Dentists for Medicaid Reform also gets more interest

Thank God for your guys! I finally feel like I can have some hope again! This is exactly what we need.

Fourteen State Representatives are now signed onto HB 1536 and two State Senators have sponsored an identical Senate bill, SB 785. The legislation guarantees the right of a Medicaid provider accused of overbilling the program by the Office of Inspector General / Health and Human Services Commission ("OIG") to obtain a hearing before the State Office of Administrative Hearings. It also enables the provider to file for a judicial review should they contest the SOAH judge's ruling when the amount of overpayment is greater than $50,000.

"We've been increasingly effective in getting the message to the legislature about the need for Medicaid provider rights in Texas," comments Chuck Young, spokesperson for TDMR. "This has brought about a cascade of interest in our organization and a ray of hope for the future of Medicaid in this state."

House Bill 1536 was introduced last month by Rep. Bobby Guerra, Rep. J.D. Sheffield, Rep. Sergio Muñoz, Jr., Rep. Philip Cortez and Rep. Cecil Bell. The bill was co-authored by Rep. Nicole Collier, Rep. Pancho Nevárez, Rep. John Raney, Rep. Oscar Longoria, Rep. Justin Rodriguez, Rep. Terry Canales, Rep. Roberto R. Alonzo and Rep. René O. Oliveira. Rep. Susan King has now joined them.

The corresponding Senate Bill, SB 785, was filed by Sen. Juan "Chuy" Hinojosa and is now co-authored by Senator Eddie Lucio Jr.

Further, Sen. Hinojosa filed SB 1150 on Tuesday-- a bill "relating to a provider protection plan that ensures efficiency and reduces administrative burdens on providers participating in a Medicaid managed care model or arrangement."

The legislative action has spurred increased visitor traffic to the TDMR website. The website is now getting an average of 2,000 visitors monthly, up more than 250% from just a month ago.

Not only has web traffic increased but TDMR has elicited strong statements of support from individuals contacting the organization through its website.

One provider wrote in "I am very happy to hear of the existence of this organization. This is necessary to deal with the oppressive and abusive tactics of the Medicaid insurance companies and their setting of standards of care. I hope to become a part of this effort and organization."

Another relayed, "Am so glad that this group has formed, as a pediatric dentist, I have been very concerned about what is happening with Medicaid because our patients do not have a voice. All the changes of the past year have resulted in limited access to care for many of our patients. Patients have been moved to different providers even though they kept saying they wanted to stay with their same provider. A great injustice has been done to the patients that were undergoing ortho treatment and then their providers were not allowed to complete treatment, these patients have not had their wires adjusted in months and the administrators managing the new plans simply do not care. I have been a dentist since 1986 and have by choice limited my practice to Medicaid patients because I enjoyed providing my service to those patients that often do not have access to care, with all the changes of the past year the focus now seems to be on billing and appeals instead of just trying to provide the best care to our patients. I feel like the new system is really failing our kids in Texas, feels like we have gone back in time.”

Others expressed relief that TDMR exists:

"I'm so glad you guys exist. I think what you're doing is really, really needed."

"Thank God for your guys! I finally feel like I can have some hope again! This is exactly what we need."

"Our board and staff are redoubling our efforts to reform Medicaid for the benefit of patients and providers," concluded Young. "In the next few months we'll keep educating both legislators and the public on this issue. We are now definitely seeing positive developments which must be fulfilled."

Share article on social media or email:

View article via:

Pdf Print