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Monday, February 20, 2012

ONCOLOGISTS, PSYCHIATRISTS WIN RELIEF FROM DUAL-ELIGIBLE CUT

Our January meeting with the Texas Health and Human Services Commission (HHSC) on the impact of the dual-eligible payment cut has yielded some relief. TMA arranged for specialty society leaders to meet with Billy Millwee, deputy executive commissioner for health services, to discuss the agency’s new policy of not paying coinsurance and deductible payments for Medicare Part B services for patients eligible for both Medicare and Medicaid. Now HHSC officials have advised us they will provide relief for oncologists by increasing payment for chemotherapy-related drugs to Medicare parity no later than June 1. HHSC also will exempt psychiatrists and psychologists from the cut entirely, effective no later than July 1. The agency will monitor the impact of the remainder of the cuts on dual-eligible patients’ access to care. HHSC officials say any additional relief will require legislative action. TMA will continue to push for a long-term solution to the high cost of caring for the dual eligibles. There is no financial incentive for states to improve continuity of care for these patients since the majority of any savings would accrue to the federal government, which pays for their acute-care services. A couple of states have shown significant savings through a federal waiver that promotes stronger case management for these patients.

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