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Border Health Caucus
Texas Physicians Working for Border Patients
The status of health care along the U.S.-Mexico border is the canary in a coalmine for the rest of the United States. The 32-county region tops the nation’s charts for its high rates of residents who live in poverty or are uninsured, obese, or diabetic. The demand for health care is great. Yet the region has one of the lowest rates of physicians per capita to care for its poor and sick and to promote healthy behaviors and disease prevention. Physicians leaders from cities and county medical societies along the border and south Texas, including El Paso, Brownsville, Corpus Christi, Eagle Pass, Edinburg, Harlingen, Laredo, McAllen, Pharr, Rio Grande, and San Antonio united in 2001 to form the Border Health Caucus (BHC). Their mission is to ensure lawmakers in Austin and Washington, D.C., understand the unique health challenges facing the border region and improve access to care. Since 2001, BHC continues to be a strong voice for patients and their communities regarding health care policy and regulation.
Stop Medical Emergency for Medicare/Medicaid Patients
Dozens of physicians from across Texas took time away from their medical practices to ask state leaders to reinstate cuts that harm access to care for thousands of Texas’ dual-eligible patients. Dual-eligible patients are old enough to qualify for Medicare and able to qualify for Medicaid assistance because of their income.
State Now Paying Dual-Eligibles' Medicare Deductible
The Texas Health and Human Services Commission (HHSC) restored the Medicare Part B deductible payment on Jan. 25 for patients eligible for both Medicare and Medicaid, also known as "dual eligibles." - See more The Texas Health and Human Services Commission (HHSC) restored the Medicare Part B deductible payment on Jan. 25 for patients eligible for both Medicare and Medicaid, also known as "dual eligibles."
State Delays Medicaid Fee Increase
The Texas Health and Human Services Commission postponed the Medicaid primary care physician payment increase authorized under the Patient Protection and Affordable Care Act. The law requires states to increase Medicaid payments to Medicare parity for primary care services provided by pediatricians, family physicians, and general internists from Jan. 1, 2013, to Dec. 31, 2014. The federal government will pay the higher costs.
HHSC Adopts Disputed Medicaid Fraud Rules
Despite the Texas Medical Association's objections, the Texas Health and Human Services Commission (HHSC) adopted new "program integrity rules" that TMA believes give the agency's Office of Inspector General (OIG) too much power and presume that physicians are crooks. The rules took effect Oct. 14.
Medicaid HMO Expansion: South Texas Frequently Asked Question - Updated: January 2012
Q: Why is the Texas Medicaid program replacing the Primary Care Case Management Model (PCCM) with HMOs?
La Joya family physician Javier Saenz, MD, is going broke. As of early April, Medicaid had not paid the four-physician practice he manages in the Rio Grande Valley for treating patients who are both poor and elderly.
TMA Comments: Medicaid 1115 Waiver Restructuring Texas' Upper Payment Limit (UPL)
The waiver will, among other things, create a new Delivery System Reform Incentive Payment (DSRIP) funding pool from which hospital districts and counties providing Texas' state share of Medicaid waiver matching dollars will be eligible to obtain funding to implement projects to improve health care outcomes of the Medicaid and uninsured populations within their communities. HHSC will develop a list of DSRIP projects designed to improve access and quality for eligible populations.
Advocacy and Communications
Dual Eligibles: Medical Emergency Action Center
Until January of this year, the federal government (Medicare) paid 80 percent of a "dual-eligible" patients visit to a doctor —The other 20 percent of the cost was paid by Medicaid. Texas Medicaid also paid the Medicare deductible for these patients. This year the Medicare deductible is $140. Under the new guidelines, which went into effect Jan. 1, 2012, the state no longer pays the physician the patient's 20-percent coinsurance. Nor does Medicaid pay the full $140 annual deductible if Medicare's payment for a service exceeds Medicaid's allowable.
NEWS CONFERENCE: Border Health Caucus
BHC Ask State Leaders to Reverse Dual Eligible Cut (Feb. 5, 2013)
Dozens of physicians from across Texas took time away from their medical practices to ask state leaders to reinstate cuts that harm access to care for thousands of Texas’
. Dual-eligible patients are old enough to qualify for Medicare and able to qualify for Medicaid assistance because of their income.
Drop in Physician Acceptance of Medicaid, Medicare Patients
Texas Medical Association (TMA) physician leaders have long predicted government regulatory burdens, red tape, payment hassles, and low pay would erode the physician foundation of both Medicaid and Medicare.
Physicians Testify at State Capitol
Read what BHC physicians are telling state lawmakers at the state Capitol.
BHC Ask Senate Finance Committee to Restore Dual Eligible Cuts
Just a few days ago, the state did restore payment of the deductible payment, a tremendous relief to those practices financially struggling since enactment of the cut. Many of you on the committee fought hard to restore the deductible and I sincerely thank you for your help. However, the continued coinsurance reduction means every time I see a dual eligible patient there is a 20-percent payment cut, an unsustainable and devastating financial blow.
Border Health News
Annual Border Health Conference
Attend BHC’s Annual Border Health Conference Where Texas Physicians Stand Up for Border Patients in D.C.
Healthy Border 2010 Midterm Review - U.S. Boarder Area
The mission of the United States-Mexico Border Health Commission (BHC) is to provide international leadership to optimize health and quality of life along the U.S.-Mexico border.
Early Prevention of Diabetes & Improved Access to Health Care: The Feasibility of Addressing Healthy Border 2010 Objectives with Community Coalitions in Colonias in South Texas
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