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Parents rebuke lawmakers for cutting Medicaid money for therapy


Families of disabled children packed a Capitol hearing room Thursday to rebuke lawmakers for cutting money for therapy services to some of the poorest and most vulnerable Texas children.

Last year, the Legislature approved $350 million in Medicaid payment cuts spread over two years to therapy providers, primarily those that serve children. A week before the cuts were to go into effect in July, the Texas Supreme Court temporarily blocked the cuts.

The case is still pending, but the temporary injunction didn’t apply to managed care organizations. They’ve passed the cuts on to providers, who have had to drop patients or shut their doors, according to child advocacy groups.

Tearful parents who lauded the benefits of therapy asked the Senate Finance Committee on Thursday to restore the money next legislative session.

Thursday was the first time parents and advocacy groups had the opportunity to provide comments on the cuts to lawmakers during a Capitol hearing since public testimony was never taken during the last legislative session.

“Look at the kids here who need all the therapy that they can get. They’re here because of the therapies that help us too, even though we are the parent,” said Austin resident Mayra Reyes, whose 3-year-old son was born with multiple health problems, including hydrocephaly, scoliosis and hyperthyroidism. He lost therapy services about a month ago.

Charles Smith, the state’s health and human services commissioner, told lawmakers that despite the temporary injunction, his agency — which is $1.3 billion in the hole — has already cut costs to Medicaid by $137 million. He promised that the agency will find more savings.

State Sen. Jane Nelson, R-Flower Mound, head of the finance committee, has justified the payment cuts to physical, occupational and speech therapists based on a study that showed that Texas reimbursed then at a higher rate than other states and commercial insurance programs.

“I’m trying to make sure … that we’re going to still take care of these children. On the other hand, I want to make sure we have the resources to take care of everybody … that we’re not paying more,” Nelson said Thursday.

Opponents of the cuts argued that the reduced rates would cut revenue by 18 percent to 28 percent and force physical, occupational and speech therapists to close their doors, interrupting vital services to an estimated 60,000 disabled Texas children.

The federal Centers for Medicaid and Medicare Services is also reviewing the state’s proposed rates. If it determines the cuts would reduce access to care, the agency can reject the state’s proposal.

Gary Jessee, who oversees Medicaid for the state’s health agency, said there hasn’t been a “mass exodus” of providers.

At least three home therapy provider groups in the Houston, Panhandle and Wichita Falls areas have stopped some or all services for Medicaid patients, according to the Texas Association for Home Care and Hospice.

Another three provider groups that provide therapy for children younger than 3 years old through early childhood intervention programs have stopped their programs altogether, according to Austin-based Any Baby Can, a nonprofit that provides parenting and child development resources.

Brian Schick, who said he is the only pediatric therapy provider in Comal County, told lawmakers that he plans to close in 60 days.

Kathy Clapsaddle, a Goliad-based therapist whose company also serves the Austin area, told lawmakers that the state can save money by ensuring high quality service, not by cutting payment rates.

“When we look at the health care research, rates account for 5 percent of waste while poor quality services account for 14 percent,” Clapsaddle said. “So we’re leaving a lot of money on the table.”


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