Lawmakers consider managed care changes in the Valley
Fri, 16 Mar 2012 03:47:13 GMT —
Behind closed doors Thursday, Texas Health and Human Services Commissioner Thomas Suehs met with Valley lawmakers.
He then talked to local doctors, dentists, pharmacists and physical therapists, also behind closed doors.
We've had a lot of deception and a lot of lies from the managed care organization, said John Calvillo, Pharmacist and President of the Rio Grande Valley Independent Pharmacy Association.
Implemented this month, managed care of Medicaid money is blamed in closing the doors of at least 10 Valley pharmacies.
Mom's Pharmacy in Weslaco was one of them.
"I worked really hard to build this business, said Mom TMs Pharmacy Owner Lydia Aguilera. I achieved the American dream, and it's over.
Pharmacists said reimbursement is the biggest problem.
Reimbursements are way below my costs, said Calvillo. It TMs just horrible.
Medicaid patients make up about 80-percent of Valley health providers' business.
In other Texas cities, the number of Medicaid patients is much lower.
We may have to have different reimbursement policies for different geographic areas, said Thomas Suehs, Texas Health and Human Services Commissioner.
The Texas Health and Human Services Commission is now reconsidering the plan that rolled out just a little over two weeks ago.
The question is whether local pharmacies and clinics should get bigger reimbursements.
State Senator Juan "Chuy" Hinojosa is debating whether to file a bill that would repeal parts of managed care.
"Next session I'm going to look at carving out pharmacies and dentists out of the system, said State Senator Hinojosa.
A decision on whether changes will come any sooner is expected within 45 days.
Commissioner Suehs said he has six workers from Austin staying in the Valley in order to get a firsthand look at how managed care is affecting patients and health care providers.