House Committee Told of Continuing Problems with Medicaid Managed Care

Texas long term care providers need greater accountability and consistency from managed care organizations (MCOs), according to testimony provided last week to the House Human Services Committee by THCA Managed Care Committee Chair Patsy Tschudy.

Three years after the implementation of managed care in Texas, Tschudy told the committee that just three of the five MCOs have implemented quality improvement programs. Despite that, she said that Texas facilities continue to improve their quality measures through other initiatives.

She also told the committee that the average unpaid accounts receivable balance has more than tripled since the implementation of Medicaid Managed Care and that claims payment accuracy is inconsistent.

Tschudy called for better care coordination, including the ability for service coordinators to authorize physician ordered and needed services for their members.

The committee has been charged with reviewing Medicaid Managed Care in Texas and making recommendations for any needed improvement. Their report will be presented before the next Legislature convenes in January, 2019.