MISSION — District 36 State Rep. Sergio Muñoz said the state’s interpretation of the medical transportation program (MTP) law has halted the access to medical treatment for a lot of Rio Grande Valley children.
Recent changes in health care have caused disturbances in the Valley that are unique to other areas of Texas and the United States, said Muñoz in a news conference to explain the changes. The adjustments have caused treatment clinics to curtail their services, pharmacies to close, and has created an access to care issue leaving thousands of Medicaid patients without healthcare.
The first change was the cuts in reimbursements for physicians who serve Medicaid and Medicare patients. The next change that rolled out on March 1 was a new health care delivery system for Medicaid patients where a set of managed care organizations were named to administer the Medicaid program. According to Muñoz, an estimated 400,000 residents have been impacted by the new managed care system.
After the transition to managed care, the reduction of reimbursement rates for pharmacists was put in place. Many pharmacies were forced to close.
The most current changes are Health and Human Services Commission (HHSC) policy changes to their MTP. The first change does not allow transportation to therapy clinics for children less than 15 years of age unless accompanied by a parent or guardian. The second change only allows therapy care to a patient if a parent, guardian, or eligible consented adult is present.
This change has created a devastating effect on patients and providers alike, said Muñoz.
“With the stroke of a pen the agency has sent therapy providers into a crisis mode to find a way to restore the access to this type of care for the children who need it most,” he said. “The policy was changed from one day to the next without any prior notice and without any regard to our unique set of dynamics here in the Rio Grande Valley.”
Muñoz said he’s met with the commission to find solutions. For now, Muñoz encourages providers to abide by the current policy changes, but said he will continue to find a compromise. There was an agreement in a recent meeting with HHSC Executive Commissioner Tom Suehs, state Sen. Juan “Chuy” Hinojosa and Muñoz that a regional approach need to be taken when considering these types of policies.
“A one-size-fits-all approach is not appropriate in this case,” Muñoz said. “The health care of our children is much too critical of an issue to hastily develop state policy that effects a certain sector of the state much more than another.”
Mario Garza, a representative from Advocates for Patient Access (APA) said the change is making parents choose between their jobs or getting their child the therapy services they need.
The new policy is detrimental to children’s therapeutic process because many of the children receiving this care need a consistent plan of care, he said.
“We have been working a certain way for 11 years,” said Garza. “Then all of the sudden everything changed and it became illegal for kids to be transported.”
Garza said Demetria Hope, director of MTP, told him over 1,000 children in the Valley aren’t receiving their therapy every day because of the change in policy.
APA has filed suits against the policy changes searching for a compromise and answers.
“I’m seeing my kid suffer in pain,” said a single mother whose child hasn’t received treatment in two weeks because of her inability to get time off from her employer. “We have to work.”
Muñoz said he wants to get clarification on the new policies and looks forward to more meetings with HHSC and others to find a solution that will help the families in the Valley.blog comments powered by Disqus