County Attorney
José R. Rodríguez


Monday - Friday
8:00 am to 5:00 pm

500 E. San Antonio
5th Floor, Suite 503
El Paso, Texas 79901
Phone (915) 546-2050
Fax (915) 546-2133
comments
@ca.epcounty.com

 

  • El Paso County Attorney Medicaid Reimbursement, March 26, 2001
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  • SENATE HEALTH AND HUMAN SERVICES COMMITTEE TESTIMONY OF JOSE RODRIGUEZ EL PASO COUNTY ATTORNEY MARCH 26, 2001

    MR. CHAIRMAN AND MEMBERS OF THE COMMITTEE:

    THANK YOU FOR THE OPPORTUNITY TO TESTIFY ON WHAT MANY OF US BELIEVE IS ONE OF THE MOST CRITICAL ISSUES NEEDING TO BE ADDRESSED BY THIS SESSION OF THE LEGISLATURE: FUNDING DISPARITY IN THE MEDICAID AND CHIP REIMBURSEMENT RATES.

    AS COUNTY ATTORNEY, I REPRESENT BOTH THE EL PASO COUNTY AND THE EL PASO COUNTY HOSPITAL DISTRICT. IN MY ROLE AS LEGAL ADVISOR, I HAVE WORKED WITH MEMBERS OF OUR DELEGATION, PARTICULARLY SENATOR SHAPLEIGH AND REPRESENTATIVE NORMA CHAVEZ, TO FIND SOLUTIONS TO WHAT, I BELIEVE, ARE NOT ONLY INEQUITABLE BUT ALSO UNLAWFUL MEDICAID AND CHIP REIMBURSEMENT RATES IN TEXAS.

    OUR COMMISSIONERS COURT HAS IDENTIFIED MEDICAID RATES AS A TOP PRIORITY IN OUR COUNTY'S LEGISLATIVE AGENDA AND RECENTLY ADOPTED A RESOLUTION IN SUPPORT OF THE MEASURES PENDING BEFORE YOU. OUR HOSPITAL DISTRICT, HEAVILY IMPACTED BY THE STATE'S CURRENT DISPROPORTIONATELY LOW REIMBURSEMENT RATES, ALSO CONSIDERS THIS A PRIORITY ISSUE AND IT'S BOARD OF MANAGERS HAS INSTRUCTED ME TO INVESTIGATE POSSIBLE REMEDIES IN THE EVENT THE LEGISLATURE IN THIS SESSION DOES NOT TAKE ACTION TO CORRECT THE RATE DISPARITIES. IN MY OPINION, THE MEDICAID AND CHIP REIMBURSEMENT RATES DO NOT COMPLY WITH THE EQUAL ACCESS TO HEALTH CARE PROVISION OF THE FEDERAL MEDICAID ACT, SECTION 1396 A (A)(30)(A). THE "EQUAL ACCESS PROVISION" REQUIRES EACH STATE TO ESTABLISH REIMBURSEMENT RATES THAT ARE:

    "CONSISTENT WITH EFFICIENCY, ECONOMY, AND QUALITY OF CARE" AND "SUFFICIENT TO ENLIST PROVIDERS SO THAT CARE AND SERVICES ARE AVAILABLE…AT LEAST TO THE EXTENT THAT SUCH CARE AND SERVICES ARE AVAILABLE TO THE GENERAL POPULATION IN THE GEOGRAPHIC AREA"---

    MEANING THAT MEDICAID RECIPIENTS ARE ENTITLED TO ACCESS EQUAL TO THAT OF INSURED POPULATIONS.

    THE SECRETARY OF HEALTH AND HUMAN SERVICES GENERALLY CONSIDERS TWO FACTORS TO MEASURE COMPLIANCE WITH THE EQUAL ACCESS REQUIREMENT:

    1). PHYSICIAN PARTICIPATION IN THE MEDICAID PROGRAM AND

    2). THE LEVEL OF REIMBURSEMENT, AS WE HAVE HEARD TODAY, THE EL PASO EXPERIENCE SUGGESTS THAT, GIVEN THESE FACTORS MANY IN OUR COMMUNITY ARE BEING DENIED EQUAL ACCESS TO HEALTH CARE.

    NOW, I BELIEVE THAT WE HAVE GONE THE EXTRA STEP TO RESOLVE THIS INEQUITY:

    1. SENATOR SHAPLEIGH AND OTHERS SINCE LAST SPRING BEGAN TO POINT OUT THE RATE DISPARITIES TO KEY LEGISLATIVE LEADERS, AS YOU KNOW, HE AND OTHER BORDER SENATORS WERE ALSO INSTRUMENTAL IN GETTING THE DEPARTMENT OF HEALTH TO CONDUCT THE BORDER RATE WORKGROUP STUDY; AND SENATOR SHAPLEIGH RAISED THIS ISSUE WHILE SERVING ON THE BLUE RIBBON COMMITTEE FOR THE UNINSURED.

    2. DURING THIS SESSION, WE HAVE MET WITH THE GOVERNOR, THE LT. GOVERNOR, SPEAKER LANEY, COMMISSIONER GILBERT, AND OTHER LEGISLATIVE LEADERS TO WORK OUT A SOLUTION.

    3. YOU HAVE NOW BEFORE YOU FIVE MEASURES (SB 1052; 1053; 1054; 1055; 1056) OFFERING OPTIONS THAT EITHER RESOLVE THE INEQUITY OR, AT LEAST, TAKE THE INITIAL STEPS TO FIX IT.

    IF YOU DO NOT ACT, OUR LEGISLATIVE OPTIONS WILL BE CLOSED, AND WE WILL HAVE TO CONSIDER OTHER REMEDIES AVAILABLE TO US.

    IN CLOSING, CURRENT REIMBURSEMENT RATES REPRESENT YET ANOTHER EXAMPLE OF INEQUITABLE STATE FUNDING FOR IMPOVERISHED AND NEGLECTED COMMUNITIES IN THIS STATE, PARTICULARLY ALONG THE BORDER. FOR HOSPITAL DISTRICTS LIKE OURS, DISPARATE STATE FUNDING FORCES TAX INCREASES UPON AN ALREADY BURDENED TAX BASE AND FOR THE MEDICAID AND CHIP POPULATIONS, IT PERPETUATES LACK OF ACCESS TO HEALTH CARE AND NEEDED MEDICAL FACILITIES.

    I HOPE THAT YOU ADOPT A BILL THAT WILL REASSURE EL PASO AND OTHER COMMUNITIES THAT THE MEDICAID AND CHIP PROGRAMS IN TEXAS ARE EQUALLY AVAILABLE TO EVERYONE, NOT JUST TO THOSE DEPENDING ON WHERE THEY LIVE IN THE STATE.

    THANK YOU.