Medicaid HMO Payments Must Go to Patient Care, Not Elsewhere

 Statement by Michael E. Speer, MD, president of the Texas Medical Association (TMA). Dr. Speer’s statement is regarding the proposal to increase premiums paid  by the state to Medicaid health maintenance organizations (HMOs).  

“For years, the HMOs have promised the Texas Legislature and the citizens of Texas that Medicaid managed care would save the state money, provide ‘budget certainty,’ and better coordinate health care for Medicaid recipients. A number of the HMOs have failed to keep these promises.

“At a time when physicians are forced to leave the Medicaid program in droves, it is critical that any new money be dedicated to improving patient care and the availability of that care. Any new money needs to be used to ensure Medicaid recipients have a medical home and that they can obtain needed care from specialists.

“The physicians of the Texas Medical Association have worked hard to make sure our state leaders understand where and how our Medicaid system is broken. Our action plan calls for:

  • Equalizing Medicaid payments for patient care to those of Medicare;
  • Significantly reducing the reams of paperwork and exasperating, irreconcilable red tape that plague physicians who want to care for patients enrolled in the Medicaid program; and
  • Requiring Medicaid auditors to focus on actual financial fraud instead of second guessing real-life medical treatment decisions.

 “The 2013 Texas Legislature is making significant progress on the paperwork and fraud-investigation issues. Requiring Medicaid HMOs to spend any new money on patient care would further our prescription to mend our broken system.”

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TMA is the largest state medical society in the nation, representing more than 47,000 physician and medical student members. It is located in Austin and has 112 component county medical societies around the state. TMA’s key objective since 1853 is to improve the health of all Texans.                                                  

Contact: Pam Udall
phone: (512) 370-1382
cell: (512) 413-6807

Brent Annear
phone: (512) 370-1381
cell: (512) 656-7320


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Last Updated On

May 06, 2016

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