Medical Offices are Struggling During the Pandemic. Texas Health Officials Are Proposing a $334 Million Lifeline.

Jeph Duarte San Antonio News

click to enlarge UPSPLASH / JONATHAN BORBA

  • Upsplash / Jonathan Borba

To help keep doctors’ offices, nursing homes and hospitals open during the coronavirus outbreak, Texas officials are recommending the state increase payments to health providers to the tune of $334 million.

State health officials want approval from Gov. Greg Abbott and a panel of state lawmakers on the Legislative Budget Board to pay more to health providers from Medicaid, the state-federal insurance program that covers about 3.8 million low-income children, pregnant women and people with disabilities. Texas Medicaid has traditionally paid health workers at a stingier rate than private insurance or Medicare, the federal health insurer for the elderly.

Medicaid costs are shouldered jointly by the federal government and states. Because of the coronavirus crisis, Congress last month increased the federal share of funding for the program. The Texas Health and Human Services Commission estimated that the state would pay about $110 million for its first proposed round of bonus Medicaid payments while the federal government would pay the remaining $224 million.

The Texas Health and Human Services Commission “has an obligation to ensure that Texans in the Medicaid program continue to receive access to medically necessary services and are not negatively impacted by COVID-19,” Acting Executive Commissioner Phil Wilson wrote to state budget analysts this week in a letter obtained by The Texas Tribune.

For now, Wilson has asked to increase five types of health care payments. The first would boost reimbursements for supplies, imaging and testing to the same rate that Medicare pays for those services. The health commission said the change would help physicians, laboratories, hospitals and some emergency medical services providers.

The state would also increase payments to ambulance operators who treat patients in place without transporting them to the hospital. “This should reduce unnecessary ER visits,” the health commission wrote.

The commission also seeks to pay more to nursing homes, outpatient hospitals and group homes for people with intellectual and developmental disabilities. The increases would mean larger paychecks for direct care staff in many of those facilities, according to the commission.

State health officials also left open the possibility of further payment increases in the future. The health commission “anticipates that this request is only a first request and will be followed by subsequent requests for additional services and provider types,” Wilson wrote.

As more people stay home and skip out on routine doctor visits and elective surgeries, health care providers have requested emergency funds to keep their doors open. Some Texas hospitals have laid off staff while independent doctors’ practices struggle to keep their doors open.

Even facilities that have maintained normal levels of patient volume have asked for additional funds to keep them afloat. Nursing home administrators wrote to the health commission earlier this month to ask for emergency funding to help pay higher costs for scarce equipment and to increase staff wages to help with recruitment.

“Along with that increased level of effort has come increased labor and supply cost, especially in the area of Personal Protective Equipment,” they wrote.

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