Amid Lawsuit, Patrick Defends Medicaid Cuts to Therapy

Amid an ongoing lawsuit over deep cuts that lawmakers made this year to a therapy program for children with disabilities, Lt. Gov. Dan Patrick on Wednesday offered a sternly worded defense of the Legislature’s move.

"Anyone claiming the Legislature arbitrarily instructed [the Texas Health and Human Services Commission] to save taxpayers $100 million by eliminating waste, fraud and abuse without consideration of the potential impact on Texas' most vulnerable citizens — is just flat wrong,” Patrick said in a statement.

The comments came after state lawmakers in recent weeks wrote to Health and Human Services Executive Commissioner Chris Traylor, urging him to use caution when making the cuts included in the lawmakers’ biennial budget. The tone of those letters ranged from politely outraged to cautious, with lawmakers from both parties either urging state officials not to move forward with the cuts, or to at least be sure not to jeopardize children’s access to care when making them.

Patrick reiterated that the cuts passed with bipartisan support and would not endanger access to care and were meant to “make sure no provider or anyone else takes advantage of the families they serve or the taxpayers."

At issue are reductions to payments from Medicaid, the federal-state insurance program, that go to speech, physical and occupational therapists for seeing children with disabilities. Lawmakers directed the state to nix roughly $350 million in state and federal funding from the program over two years, but in doing so, they asked the health commission to strike a careful balance: trimming fat without threatening medically necessary services.

Patrick said Wednesday that he had a “long record of fighting for children with disabilities,” but that therapy services were a ripe target for fraud — and not just in Texas.

“In our nation's Capitol, the Health and Human Services Inspector General is also calling for a crackdown on excessive Medicare therapy services,” he said.

Patrick, joined by lead Senate budget writer Jane Nelson, R-Flower Mound, wrote in a letter to the health commission that the cost of Texas’ therapy services had grown quickly in recent years.

“Costs have increased from roughly $436 million a year to an estimated $722 million from 2009 to 2014,” they wrote. “Speech therapists also represent a disproportionately high number of therapy investigations within your Medicaid Provider Integrity Unit.”

But the therapy providers who have sued Texas health officials over the budget cuts say the state has failed to investigate why those costs have grown. They say the health commission also hasn’t studied how access to care will be affected by the cuts, should they be implemented.

Last week, a state district judge in Austin sided with therapists and families of children with disabilities by delaying the cuts from immediately taking effect. They were scheduled to be implemented Thursday.