Wednesday, March 29, 2017

5 months into Texas Managed Care Organizations from Medicaid

Testimony over Senate Bill 1922 "step therapy" for prescriptions

Testifying has been exhausting and emotionally personal.  The kids will hopefully learn from this experience how to advocate for themselves and people of all abilities.  Hanna and Hayden will get to be House pages next week for Representative Workman.  We are also very grateful to Senator Watson for the opportunity to be Senate pages this last March 8th.

They have the professional pictures coming soon for the Senate Media.
Testimony to Senator Nelson Finance

Testimony to Senate Committee about MCO Roll out problems

Testimony to HHSC prior to MCO roll out from Medicaid

New legislation is required this session if we have any hope of fixing the many issues that have been placed upon fragile families due to the transition of Medicaid run by the state department to being managed by for profit managed care organizations.. My work is not done and I am glad I do not have to stand alone. I am fortunate to live in Austin to have the convenience of making the day trip to speak to the politicians. Many families travel from all over the state at their own personal expense of time and sacrifice to attend these meetings. We are families of vulnerable children of all races, socioeconomic backgrounds, and religions. We are a grassroots group of mothers and fathers of fragile children who have to rise up and speak out.  #txlege Protect TX Fragile Kids

Things to know:

  • Managed Care Organizations/Insurance Companies receive tens of billions of state dollars in their contracts
  • Managed Care Organizations/Insurance Companies are for profit and get to keep their identified "cost savings" that happens to be tax payer money
  • Texas wants the federal medicaid block grants so they can "manage" the Medicaid $ giving it to the MCOs.
  • MCOs have their own prescription formularies and they want to control what medicines are approved and save cost by making patients fail generic drugs prior to allowing name brands
  • MCOs do not want to pay for many of the standard of care images and tests that doctors require for high needs patients
  • MCOs do not reimburse pay for therapies, equipment and supplies at the disclosed Medicaid rate and force many companies out of business

There are an awful lot of ways to defraud a multi-billion dollar program and that is why so many companies are turning up to offer to put their hand in the pot.

The next few weeks are vital to our family as we try and have influence over responsible careful legislation before the end in May.  The laws that are passed will be in effect for the next couple of years and directly effect our family on a daily basis.  Since most legislators at the capital hear from representatives of insurance companies, doctors, hospitals and pharmaceutical professionals, it is important for them to hear how policy effects families and individuals.  It has been a crash course to learn how to navigate politics and the capital.  If you would like to see the link to the Bills that I am following, click below: Medicaid Bills

Please know I always welcome company at the capital for any type of support.

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