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Tuesday, November 8, 2011

PHYSICIANS MUST BE PART OF PLANNING HUGE NEW MEDICAID WAIVER PROGRAM

Texas’ plan to ask CMS to allow a significant restructuring of Medicaid payments through hospital districts and counties will fail without extensive physician participation, Dr. Malone wrote in a letter to the Texas Health and Human Services Commission (HHSC). “Any sense among physicians that they have been systematically excluded from the process may further fuel the exodus of community-based physicians from Medicaid at a time the state will need more physicians practicing in the program, not less,” Dr. Malone and John Holcomb, MD, chair of TMA’s Select Committee on Medicaid, CHIP, and the Uninsured, wrote. HHSC is asking CMS for a “Medicaid 1115 waiver” to restructure Texas’ Upper Payment Limit Program. The letter suggests dozens of improvements to the waiver, including integration with the Project Access initiatives managed by several county medical societies across the state.

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