House Representative

Raymond, Richard Peņa


Efforts to Oversee Medicaid Managed Care Expansion Continue

- Chairman Raymond's Committee Monitors Policy to Protect Texas Families -

AUSTIN--House Health and Human Services Committee Chairman Richard Peña Raymond (Laredo) has been asked by Speaker Joe Straus to oversee the managed care rollout as part of his committee's interim charge responsibilities.

For the first time, beginning March 1, 2012, Medicaid clients living within the 10-county Hidalgo Service Area will begin receiving managed health care services. Counties included in the managed care expansion area include: Cameron, Duval, Hidalgo, Jim Hogg, Maverick, McMullen, Starr, Webb, Willacy, and Zapata.

"It is vital that we review the impact of the Medicaid managed care to South Texas on all levels," said Chairman Raymond. "The rollout of the new system will affect the lives of people and families, we cannot afford to rush anything. It must be a well thought out process with public awareness."

Although the actual rollout will not begin until March 1, the 400,000-plus Medicaid clients who will be affected are being asked now to select one of five participating managed care plans in which to enroll. Clients may sign on to a plan as late as Feb. 14 without being defaulted into a plan by HHSC. If Medicaid clients are defaulted into a health plan they can still sign on to a plan of their choice, however the change will not be effective for 30 days.

Medicaid enrollment packets have been mailed to existing clients and community outreach efforts are currently underway in an attempt to minimize the number of default placements and reach out to providers. Participating health plans include: STAR (United, Superior, Molina, Driscoll Children's Hospital); STAR+PLUS (Molina, Superior, HealthSpring). The STAR program provides services to children and mothers, while the STAR+PLUS Program serves the elderly and disabled.

Last month, Chairman Raymond organized a briefing at the state capitol that brought together local providers, client advocates and representatives from HHSC, all five participating health plans and HHSC's Medicaid enrollment broker, Maximus, Inc., to identify obstacles and promote a sense of cooperation and understanding. Earlier in the month, Chairman Raymond met privately with HHSC officials charged with spearheading the rollout to assess participation rates for both Medicaid clients and their providers.

Last November, Chairman Raymond's full committee held a formal hearing to gauge the progress being made by HHSC and its contractors.

"This is a historic policy shift impacting the largest Medicaid service region in the state. My committee has been and will continue to monitor not only the efficiencies of the implementation process, but also how individual clients, families and their providers are being impacted by the change." said Chairman Raymond.

Chairman Raymond said his committee will continue to monitor the managed care rollout with additional hearings being planned. His committee's findings along with possible legislative recommendations will be included in a formal report and submitted to the full House prior to the 83rd Legislative Session.

Jim Terrell
(512) 698-3424