Email, Bill Noble, consultant to Texas Association of Home Care and Hospice, president and CEO, Noble Strategic Partners Inc., Dec. 16, 2016
4:31 p.m.
The Snopes entry does get the issue correct in that the decision was not tied to the election results. Rather, lawmakers made these cuts in the 2015 Legislative Session and Texas Department of Health and Human Services has been trying to implement them since the middle of July 2015.
Your second question about the A&M study raises the much larger issue that is extremely interesting and has not been fact checked by anyone in the media:
Throughout the budget debate on the cuts to acute care therapy, lawmakers cited an “independent" “study" by A&M as the justification.
Among other items, the “study" asserted that Texas paid higher reimbursement rates to therapy providers than other comparison states and that Texas paid “better” reimbursement rates than private insurance.
The problem is the "study" was deeply flawed and never should have been used as justification for the cuts. (I put quotes around the words independent and study because ample evidence has now come to light from A&M and during the trial that demonstrated it was neither a study – i.e. it never achieved an IRB rating - nor was it independent.) In fact, an A&M representative (Jenny Jones) stated in an email “We were not involved in the production of the report, have no idea the process they used or how they are going about their policy decisions, and have not had contact with HHSC following submission of our information.” This is later re-affirmed by her in as noted in the AAS article below.
Also, as you can note below, that A&M researchers merely collected data and the analysis was actually performed by self-interested HHSC staff members.)
The flaws in the study were laid bare during a trial on the cuts brought by parents and providers. (I can share relevant news articles, lawsuit transcripts and other sources if you want more on this.) Here’s an example:
The A&M disavowed the findings of the study in an email (attached) and in an AAS article by a Mary Ann Roser from August 6, 2015:
Did the researchers think the therapists were overpaid in Texas?
“I don’t know that you can make that conclusion,” Jones said. “There were hundreds of tables of data provided. That’s HHSC’s interpretation.”
Jones said she doesn’t understand the processes the Health and Human Services Commission used to reach that conclusion and believes there are questions that still need to be answered.
“If someone would answer why the spike and why some of the regional variations (in clients and rates) we’d be closer to a solution,” she said.
Even in the face of mountains of evidence that Texas lawmakers relied on an “independent study by A&M” to make the cuts and that “study" turned out to be flawed and inaccurate lawmakers still argue they made the right decision to cut the budget and and still cite the study as justification for the cuts.
See here:
But last year lawmakers made an 11th hour cut to the state’s budget. Included was a reduction in the fee paid to in-home therapists including the ones who treat disabled children like Briana.
State Sen. Charles Schwertner is a Republican from Georgetown who pushed for the cuts which will affect an estimated 60-thousand special needs children. Schwertner says a Texas A&M study showed therapists were overcharging the state.
“I think everyone agrees the state has a responsibility to provide these life-changing therapies to the children of families that depend on them, but at the same time taxpayers shouldn’t be asked to pay for these services at rates that are at twice the costs of commercial market or of comparable states," Schwertner says.
A&M later said it’s study was flawed. But the cuts have gone into effect anyway.
and here:
Texas lawmakers ordered the $350 million cuts to Medicaid reimbursement rates in 2015 to help balance a $1 billion in property tax relief. “It’s a very small population. The cuts that were made were based on very sound methodology. Now, that doesn’t help the parents that has one of those issues,” said Perry. (Underline emphasis added)
A member of the Health and Human Services Senate Committee, Perry pointed to a state-commissioned study that found in comparison to other public insurance programs, in-home therapy providers were overpaid by Medicaid.
It seems the more rational conclusion should be:
1) We relied on an “independent study by A&M” to make the cuts
2) That “study" turned out to be far from independent, flawed and inaccurate,
3) Therefore, we may have made a mistake and should restore funding until we have accurate data to support a decision.
Bill Noble
On Behalf of Texas Association of Home Care and Hospice
President and CEO
Noble Strategic Partners Inc.