Texas providers beat back rate cuts

Wednesday, March 7, 2018

AUSTIN, Texas – Providers in Texas have staved off reimbursement cuts proposed by Superior HealthPlan, a managed care company that oversees part of the state’s Medicaid program.

Providers were notified in February that Superior was reducing rates for certain product categories from 85% of Texas Medicaid rates to 60%, with a few providers receiving a reduction of 65% to 70%, effective May 1. Providers were given 30 days to accept or reject the plan.

In response, VGM Group organized a conference call with providers, encouraging them to voice their concerns with Superior, the Texas Health and Human Services Commission and state lawmakers.

“Providers stepped up and answered the call for action by engaging with public officials to display their opposition to these egregious cuts,” said Collin Brecher of VGM Government Relations. “While states are looking to trim their budgets, these proposed cuts are going to continue to appear, and providers in all states must remain proactive by building relationships at the state level to prevent these types of harmful cuts from being implemented.”

In an online notification on Feb. 26, Superior stated it was suspending the reimbursement changes at this time.

“We will be working with the Texas Health and Human Services Commission (HHSC) to address DME costs as directed by the 85th Legislature in potentially a different type of provider based initiative at a later date,” it stated.

Superior has come under fire in recent months for its plan to contract with Medline to serve as the “preferred provider” of DME and supplies to Medicaid beneficiaries.