Current:Home > StocksCook Children’s sues Texas over potential Medicaid contract loss -Capitatum
Cook Children’s sues Texas over potential Medicaid contract loss
Indexbit View
Date:2025-04-06 07:45:59
Cook Children’s Health Plan has filed two lawsuits against the state to stop the Texas Health and Human Services Commission from removing them as a longstanding Medicaid contractor.
In a news conference on Wednesday, the Fort Worth-based health care system announced the lawsuits as an attempt to halt the $116 billion Medicaid procurement process that removes Cook Children’s and two other hospital-affiliated children’s health plans from Medicaid STAR and Children’s Health Insurance Program, also known as CHIP.
The proposed shake-up would remove Cook Children’s Health Plan in the state’s Tarrant service area, Texas Children’s Health Plan in the Harris region, and Driscoll Health Plan in South Texas in favor of private companies. Together, the three plans operate as managed care organizations that provide Medicaid coverage to Texans in their respective regions.
The three plans, formed two decades ago, serve more than 700,000 families, pregnant women, and children.
If the state’s health agency’s decision stands, it would mean reducing the number of managed care organizations that administer STAR and CHIP, shifting toward national for-profit health companies in most areas of the state.
It will also require the nearly 1.8 million Texans who receive Medicaid coverage from six managed care organizations across the state to shift to new insurers by next year.
The lawsuits were in Travis County. One petition asks for declaratory judgment and injunctive relief against HHSC Commissioner Cecile Erwin Young in hopes of overturning the contract decision. The second lawsuit filed is a temporary restraining order against the state’s health agency to stop finalizing procurement results.
“These actions we take are strong but necessary,” said Rick W. Merrill, president and CEO of Cook Children’s Health Care System, in a news release.
Jennifer Ruffcorn, an HHSC spokesperson said the agency doesn’t speak on pending litigation but mentioned the contract situation is still pending.
“Although the (Request for Proposals) has been posted, responded to, and evaluated, it remains an open procurement until all protests and appeals submitted by respondents have been resolved and contracts have been executed,” Ruffcorn said in an email.
Currently, the procurement process’s future lies squarely at Young’s discretion. She has no deadline for deciding whether to uphold the agency’s decision, cancel it and start over, or officially delay it until lawmakers can respond when they meet next year.
In a news release Wednesday, Karen Love, President of Cook Children’s Health Plan, said that removing the Medicaid contracts from the three hospital affiliates is based on a flawed process that will put Texas families at the mercy of national for-profit insurance companies.
“The State got it wrong, and we are asking the courts to make it right,” she said.
Texas Medicaid STAR and CHIP programs cover the cost of routine, acute, and emergency medical visits. STAR is primarily for pregnant women, low-income children, and their caretakers. CHIP provides health care to low-income children whose family’s income is too high for Medicaid, which has some of the lowest income limits in the country. Their members compose the vast majority of Texans on state Medicaid programs.
Medicaid managed care contracts are routinely the most expensive contracts taxpayers fund.
Texas officials earlier this month rejected attempts by several managed care organizations to cancel the proposal that would drop them from the state Medicaid program.
Representatives for Driscoll Health Plan said Thursday that their organization has appealed this decision to the state, as more than 500 jobs could be eliminated if it is finalized.
Craig Smith, Driscoll Health Plan CEO told The Texas Tribune on Thursday that his organization filed a second appeal last week and is now awaiting a ruling. He said he is also prepared to pursue legal action against the state if the appeal is denied.
Representatives for Superior HealthPlan, a managed care organization that operates similarly to the Driscoll and Cook health plans, expressed on Thursday their disappointment in the decision to deny the protests made by the three hospital plans. The organization is also exercising its right to appeal the current decision made by the state’s health agency, as they predict it will result in the largest disruption in member care in Texas Medicaid history.
If the procurement is negated, it would be Texas HHS’s third failed attempt in six years to award contracts for the Medicaid programs that encompass the vast majority of state health insurance’s low-income Texas recipients.
___
This story was originally published by The Texas Tribune and distributed through a partnership with The Associated Press.
veryGood! (5)
Related
- 'Kraven the Hunter' spoilers! Let's dig into that twisty ending, supervillain reveal
- CES 2024 updates: The most interesting news and gadgets from tech’s big show
- Is your new year's resolution finding a job? Here's why now is the best time to look.
- Robert Downey Jr. announces on Golden Globes stage: 'I took a beta-blocker.' What do they do?
- 3 years after the NFL added a 17th game, the push for an 18th gets stronger
- Katy Perry Details Vault of Clothes She Plans to Pass Down to Daughter Daisy Dove
- Eclectic Grandpa Is the New Aesthetic & We Are Here for the Cozy Quirkiness
- Planets align: Venus, Mercury and Mars meet up with moon early Tuesday
- Taylor Swift Eras Archive site launches on singer's 35th birthday. What is it?
- Hayley Erbert Praises Husband Derek Hough's Major Milestone After Unfathomable Health Battle
Ranking
- Clay Aiken's son Parker, 15, makes his TV debut, looks like his father's twin
- Details on Prince Andrew allegations emerge from new Jeffrey Epstein documents — but no U.K. police investigation
- Amy Robach and T.J. Holmes Share Update on Merging Their Families Amid Romance
- Why there's a storm brewing about global food aid from the U.S.
- Residents worried after ceiling cracks appear following reroofing works at Jalan Tenaga HDB blocks
- 'AGT: Fantasy League': Howie Mandel steals 'unbelievable' Ramadhani Brothers from Heidi Klum
- Margot Robbie wears pink Golden Globes dress inspired by Barbie Signature 1977 Superstar doll
- U.S. Navy sailor sentenced to over 2 years in prison for accepting bribes from Chinese officer
Recommendation
'Malcolm in the Middle’ to return with new episodes featuring Frankie Muniz
Sinéad O'Connor died of natural causes, coroner says
3 people dead, including suspected gunman, in shooting at Cloquet, Minnesota hotel: Police
Millions could lose affordable access to internet service with FCC program set to run out of funds
The 401(k) millionaires club keeps growing. We'll tell you how to join.
Kimmel says he’d accept an apology from Aaron Rodgers but doesn’t expect one
Rob Lowe gets an 'embarrassing amount' of sleep: Here are his tips to stay youthful
CES 2024 updates: The most interesting news and gadgets from tech’s big show