Doctors Restricting Texas Medicaid Patients Due to Cuts

by Denise Reynolds RD on 2010-07-12


A 1% cut to Medicaid reimbursement that is scheduled to take effect September 1, 2010 has doctors in Texas considering dropping Medicaid patients or severely limiting those they serve, according to a report by The Dallas Morning News. The cuts are the first in a series expected to take place over the next two years to help cover an expected $18 billion revenue shortfall.

About 3.3 million poor and disabled Texans depend on Medicaid for health care.

According to Texas Health and Human Services Commission, less than a third of the state’s 48,700 practicing physicians are currently accepting Medicaid patients. A survey by the Texas Medical Association found that 45% of its members would limit how many patients they could treat if Medicaid fees were cut by 1 or 2%, while another 24% said they would stop accepting patients altogether.

Medicaid reimburses physicians only 70% of what Medicare pays for the same service.

In testimony before the Health and Human Services Commission (HHSC), Tom Plowman, Director of Rate and Financial Analysis for the Texas Health Care Association, warned that the 1% decrease in Medicaid rates will also undermine senior care in the state of Texas. About 80-85% of Texas nursing home residents depend upon a combination of Medicare and Medicaid for funding.

“As proposed, the FY 2011 rates represent a one percent reduction in a reimbursement rate that already holds the unenviable rank of 49th lowest in the country,” Plowman testified. “For more than ten years now, the Texas nursing facility Medicaid reimbursement rates have been set at levels that have not even covered the operating costs of well more than half of Medicaid contracted nursing operators.”

Plowman also testified that reductions in Medicaid reimbursement will not actually save the state money. "For every dollar that the state attempts to save through reductions in Medicaid reimbursement rates, the state's general revenue fund only saves less than 40 cents -- even less if the enhanced Federal Matching Assistance Percentage is extended as is currently being considered by Congress. Medicaid providers have to absorb the full $1.00 hit for the state to save that 40 cents."