Tribpedia: Medicaid

Finding a Texas Way to Cover the Uninsured

Texas hospitals want state lawmakers to find a way for the state to draw down billions in federal Affordable Care Act dollars to cover the uninsured and alleviate the burden on local taxpayers. Health officials hope the Legislature looks at a program in San Antonio that they say has the makings of a Texas solution. This is the third video in our eight-part State of Mind series.

Department of Public Safety troopers guard the governor's office on April 1, 2013, as a group protests Republicans' stance on Medicaid expansion.
Department of Public Safety troopers guard the governor's office on April 1, 2013, as a group protests Republicans' stance on Medicaid expansion.

Arkansas Medicaid Plan Offers Mixed Lessons

Early on, supporters of Medicaid expansion pointed to Arkansas as an example of how Texas might go about helping insure its poor. But lately, the neighbor's grass doesn't look quite as green.

Dr. Javier Saenz checks the ear of Viviana Escareño, 6, for infection. The young girl’s mother, Claudia Escareño, has brought “Vivi” to Saenz’s clinic since she was born.
Dr. Javier Saenz checks the ear of Viviana Escareño, 6, for infection. The young girl’s mother, Claudia Escareño, has brought “Vivi” to Saenz’s clinic since she was born.

Future of CHIP Funding Looms Over State Budget

With federal funding for the Children’s Health Insurance Program set to expire next year, children’s health advocates and Gov. Rick Perry are urging Congress to reauthorize it as soon as possible.

Republican Gubernatorial candidate, Greg Abbott, speaks one-on-one with members of the media following his his appearance at a Congress Ave. coffee house on July 10th, 2014
Republican Gubernatorial candidate, Greg Abbott, speaks one-on-one with members of the media following his his appearance at a Congress Ave. coffee house on July 10th, 2014

Abbott Unveils New Health Policy Proposal

Increased funding for preventive care and luring medical professionals to Texas are at the center of gubernatorial frontrunner Greg Abbott’s health care plan, unveiled in Houston on Wednesday.

A patient at Sagebrook Health Center, a nursing facility in Cedar Park, kneads putty to build fine-motor coordination and dexterity. Officials from Sagebrook and other facilities have raised concerns about a proposed rule that would have the state close nursing homes found to have the highest-level violations of federal quality standards on three separate days over 24 months.
A patient at Sagebrook Health Center, a nursing facility in Cedar Park, kneads putty to build fine-motor coordination and dexterity. Officials from Sagebrook and other facilities have raised concerns about a proposed rule that would have the state close nursing homes found to have the highest-level violations of federal quality standards on three separate days over 24 months.

"Three-Strikes" Proposal Spurring Debate over Nursing Home Regulation

Legislators in 2015 are poised to take up a proposal that would have the state close nursing homes that rack up high-level federal violations on three separate days over a two-year period. 

Eighth-grader Montanique DeShay waits as Ashlyn Brooks, medical assistant at MedSpring Urgent Care in Austin, comes to check on her on Wednesday.
Eighth-grader Montanique DeShay waits as Ashlyn Brooks, medical assistant at MedSpring Urgent Care in Austin, comes to check on her on Wednesday.

Texas Hospitals Say They've Lost Insured Patients to Urgent Care

The increasing number of urgent care centers in Texas is proving problematic for hospitals, which say they are competing with the clinics for the same pool of insured Texans at a time when they are also getting less money to cover the cost of treating uninsured patients.

Patients are shown checking out in 2010 at the People's Community Clinic in Austin, a safety-net clinic that serves Medicaid recipients and the underinsured.
Patients are shown checking out in 2010 at the People's Community Clinic in Austin, a safety-net clinic that serves Medicaid recipients and the underinsured.

Health Program Changes Could Increase Access to Contraceptive Products

Texas women who receive state-financed health services may be able to more easily access contraceptive products like intrauterine devices and hormonal implants beginning Friday, when rule changes to the state’s Medicaid program and the Texas Women’s Health Program go into effect.

Yesenia Alvarado holds her daughter, Medicaid patient Melanie Almaraz, 2, while waiting to see Dr. Alberto Vasquez for the treatment of a fever at the Su Clinica Familiar in Harlingen on Jul. 9, 2013.
Yesenia Alvarado holds her daughter, Medicaid patient Melanie Almaraz, 2, while waiting to see Dr. Alberto Vasquez for the treatment of a fever at the Su Clinica Familiar in Harlingen on Jul. 9, 2013.

Texas Sees Rise in Medicaid Signups

More than 80,000 additional Texans have enrolled in Medicaid or the Children’s Health Insurance Program since the rollout of the Affordable Care Act last fall, despite Republican state leaders’ decision not to expand eligibility.

Dr. Rose Okoro, a nurse practitioner, who owns Daystar Family Clinic in Katy, is shown on May 12. 2014. She says she has struggled to treat a greater number of Medicaid patients because of state regulations.
Dr. Rose Okoro, a nurse practitioner, who owns Daystar Family Clinic in Katy, is shown on May 12. 2014. She says she has struggled to treat a greater number of Medicaid patients because of state regulations.

Nurse Practitioners Say That Greater Autonomy Would Cure Challenges

Nurse practitioners say state regulations, which link them to supervising physicians, limit their ability to treat patients in a state with a looming shortage of primary care physicians. 

Dr. Behzad Nazari at his remaining dental clinic in Houston on Friday, April 25, 2014. Nazari sold two of three Antoine Dental clinics after the state began withholding Medicaid payments while they investigated the clinics for fraud.
Dr. Behzad Nazari at his remaining dental clinic in Houston on Friday, April 25, 2014. Nazari sold two of three Antoine Dental clinics after the state began withholding Medicaid payments while they investigated the clinics for fraud.

Texas Cancels Medicaid Contract, Sues Xerox Over Allegedly Misspent Money

Health officials canceled a multi-million-dollar contract with Xerox, and the state sued the contractor on Friday amid allegations it erroneously doled out hundreds of millions of dollars for medically unnecessary Medicaid claims.

Dr. Behzad Nazari at his remaining dental clinic in Houston on Friday, April 25, 2014. Nazari sold two of three Antoine Dental clinics after the state began withholding Medicaid payments while they investigated the clinics for fraud.
Dr. Behzad Nazari at his remaining dental clinic in Houston on Friday, April 25, 2014. Nazari sold two of three Antoine Dental clinics after the state began withholding Medicaid payments while they investigated the clinics for fraud.

When is a State Contract Too Big to Fail?

While health officials have repeatedly raised concerns with a state contractor for its role in opening the door to a massive Medicaid fraud scheme, they have not severed its multiyear contract worth hundreds of millions of dollars.

Dr. Behzad Nazari at his remaining dental clinic in Houston Friday, April 25, 2014. Nazari operated 3 clinics in Houston with 15 licensed dentists. After the state alleged he had committed Medicaid fraud and began withholding payments, he sold two clinics. He has challenged the state's payment hold in court.
Dr. Behzad Nazari at his remaining dental clinic in Houston Friday, April 25, 2014. Nazari operated 3 clinics in Houston with 15 licensed dentists. After the state alleged he had committed Medicaid fraud and began withholding payments, he sold two clinics. He has challenged the state's payment hold in court.

Company That Approved Unnecessary Orthodontia Kept Its State Contract

While dental providers accused of overbilling Texas' Medicaid program by hundreds of millions of dollars remain in legal limbo, the contractor that approved the procedures is still being paid more than $100 million annually by the state.

Helen Hawkins, a certified pediatric nurse practitioner, treats 13-month-old Kevin Gorostieta at Carousel Pediatrics in Austin on Nov. 8, 2012.
Helen Hawkins, a certified pediatric nurse practitioner, treats 13-month-old Kevin Gorostieta at Carousel Pediatrics in Austin on Nov. 8, 2012.

Medicaid Fraud Settlement Worries Health Providers

For providers who treat the state’s poorest patients, a settlement between the state and a Medicaid provider raises questions about how the state distinguishes fraudulent intent from human error.