Judge Halts $350 Million in Cuts to Children's Therapy Services

After therapy providers and families with disabled children filed a second lawsuit against the state for the deep cuts it has ordered to Medicaid therapy services, a judge has halted the cuts from going through on October 1, as the Texas Tribune reported Tuesday evening.

The lawsuit claims the Texas Health and Human Services Commission did not consider how $350 million in cuts to occupational, physical and speech therapy services over two years would affect the actual people at stake — including children with autism, cerebral palsy, severe brain damage, spina bifida and feeding disorders, among others — and all of the therapists who serve them. The therapists faced cuts to their reimbursement rates of roughly 20 percent. It was estimated the cuts would put 60,000 kids at risk of losing access to care. And State District Judge Tim Sulak said he chose to temporarily block those cuts from going through out of concern for those young patients. 

The Tribune reports that according to witnesses in this second lawsuit, not only did the state never consider how the Legislature-ordered cuts would affect access to care, but the state also appears to be blaming Texas A&M. 

The providers fighting the proposed cuts have claimed the Texas A&M study used to justify those cuts was flawed because it compared Texas’s Medicaid reimbursement rates to 11 anonymous states’ commercial rates — it's like comparing apples to oranges, they say. The commission ultimately stalled the cuts and said it was going back to the drawing board. On its second try, the state still arrived at cuts of roughly 20 percent for therapists, still using the A&M study, just without the commercial rates. “They didn’t even tap the brakes,” Bill Noble, spokesperson for the Texas Association for Home Care and Hospice, told the Houston Press following those cuts.

The commission claimed in court Monday that it paid Texas A&M researchers to analyze the impact on access to care, “but they didn’t get to it,” witness Pam McDonald, the commission’s director of rate analysis reportedly wrote down as a note during a September 3 meeting. Texas A&M, on the other hand, has denied that HHSC ever paid them to study access to care, the Tribune reports.

Paige Kincade, who runs five Medcare Pediatric Group outpatient centers with 350 employees, said that, even before these cuts were proposed at all, both adequate pay rates for therapists and access to care were already problems. After last year’s Medicaid cuts, she had already laid off 15 therapists, she told the Press after the second round of proposed cuts. And the more therapists who are let go, the more patients there are who will have to find new providers.

“There are kids on every agency’s wait list right now,” Kincade said. “There aren’t enough providers to service the kids we already have. If you cut the rates, then the agencies that already did provide the service may essentially leave the market and do other things.”

The state, which is expected to appeal Judge Sulak's decision, heard public testimony from dozens of therapy providers and families with children at stake on September 18. One eight-year-old with cerebral palsy stood before the commission and told them, “It is not fair for kids that have special needs to not get therapy. I want to keep my therapy so I can get stronger every day. I don’t want to be in a wheelchair.”

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