Allow Pregnant Moms to Take Their Kids to Medical Appointments

TMA Testimony by Moss Hampton, MD

Senate Health and Human Services Committee
House Bill 25 by Rep. Mary Gonzalez

April 30, 2019

Good morning Chairwoman Kolkhorst and committee members. Thank you for the opportunity to testify in favor of House Bill 25. I am Moss Hampton, a recently retired obstetrician-gynecologist (OB-Gyn) from Odessa speaking on behalf of the American College of Obstetricians and Gynecologists-District XI (Texas) and the Texas Medical Association.

As we know, the maternal morbidity and mortality rates in Texas are concerning. Much time and effort has been spent on this issue during this legislative session. Prenatal and postpartum care are vital to the health and well-being of mothers and babies, yet transportation is a barrier for many of our most “at-risk” patients and their babies. This barrier leads to missed appointments, which is associated with increased medical costs for patients, disruption of patient care and patient-physician relationships, delayed care, and increased emergency room visits.

HB 25 is an attempt to address this problem by creating a pilot program that would streamline nonemergent medical transportation services in Medicaid. This will help more pregnant women and new mothers get to their prenatal and postpartum appointments.

This bill attempts to address four main barriers.

  1. It ensures that mothers and their children could be able to travel together to prenatal and postpartum appointments. Currently the medical transportation program doesn’t allow for that. The bill makes clear that the Medical Transportation Organization (MTO) will accept the entire family at the current “capitated rate” paid for clients (no extra cost to Medicaid or the state).
  2. Rides could be set up more quickly and efficiently. The current system requires clients to request rides 48-72 hours in advance of their doctor’s appointment. As you know, many pregnant women need to go to the OB-Gyn the next day!
  3. Mothers would be able to travel directly to and from their health appointments. Currently, transportation providers often use vans that pick up and drop off passengers throughout the day. Some clients wait four hours after their doctor’s appointment waiting for the ride to come back. In this pilot, moms can go directly to and from an appointment, not on a shared trip.
  4. MTOs and managed care organizations (MCOs) would have to coordinate more effectively. As you know, MCOs are on the hook for health outcomes and quality measures, like prenatal and postpartum visits. Yet MCOs have a hard time coordinating with the MTOs to get rides scheduled. This pilot requires the MTO and MCO to coordinate to ensure clients get to their required appointments.

The pilot program would start in one or more Health and Human Services Commission (HHSC) managed care service areas, as determined by HHSC and the Texas Maternal Mortality Task Force, and would be optional for MTOs. 

This pilot does not require ridesharing. BUT, if ridesharing becomes an option in Texas’ medical transportation program, then the pilot would leverage innovations and partnerships that MTOs have with ridesharing services where available. 

The state would evaluate this innovative approach, including whether the pilot increases quality and cost effectiveness of transportation, improves access to medical care, decreases missed appointments, and reduces pregnancy-related complications. Hopefully, by removing transportation barriers for our Medicaid patients, more moms can get the needed prenatal and postpartum care appointments.

Thank you for the opportunity to testify in favor of HB 25, and thank you, Senator Zaffirini, for your leadership in getting this bill across the line. 

Respectfully submitted by Dr. Moss Hampton, MD, FACOG, on behalf of the American College of Obstetricians and Gynecologists – District XI (Texas) and the Texas Medical Association.

86th Texas Legislature Letters and Testimonies

TMA Legislative main page

Last Updated On

April 30, 2019