Medicaid for the elderly takes a hit in Texas, TMA fights back

March 15, 2013

Medicaid for the elderly takes a hit in Texas, TMA fights back

Article provided by Wright Abshire, Attorneys, A Professional Corporation
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In June of 2011, the Texas Legislature adopted a budget plan that reduced the amount of funding provided to the state's Medicaid program. The plan required the Texas Health and Human Services Commission to limit certain types of Medicaid payments over a span of two years.

One area that took a hit under the plan: dual eligibles. Dual eligible is a term used to refer to patients that can receive aid from both Medicaid and Medicare. The elderly often fall into this group.

The budget proposed a large cut to these recipients, a cut that the Texas Medical Association (TMA) publicly disagreed with. After many rallies, lobbying efforts and meetings, the TMA convinced the Legislative Budget Board to direct the Texas Health and Human Services Commission to reverse the cuts.

Reasons for concern

Professionals with the American Medical Association (AMA) voiced concerns that the cuts would reduce the number of physicians willing to take patients who participate in Medicaid. Numbers of participating physicians were already shrinking, and the AMA was concerned additional cuts would make it even more difficult to find physicians to treat these patients. According to the organization, 78% of all physicians in Texas accepted Medicaid patients in 1998. As of 2010, that number shrunk to 42%.

One reason for the decrease is the low reimbursement rate; physicians providing care to these patients were receiving a much lower rate compared to those paid by private insurers. As a result, the TMA pushed to have the cuts removed from the budget plan.

Medicaid assistance for the elderly still available in Texas

Although a portion of the cuts were removed, funding for Medicaid has still taken a hit. Regardless, assistance remains available.

Applying for benefits can be done either online or through the use of a paper application. The application is submitted to the Texas Health and Human Services Commission. An interview may then be conducted, either in person or over the phone.

The Commission will review the applicant to determine if he or she meets the basic Medicaid eligibility requirements. This assessment can include a review of applicants' income and resources to make sure they fall within the program's limits.

If granted, Medicaid can provide a wide array of benefits. Services can include:
-Access to food pantries
-Housing
-Senior services
-Assistance paying rent or utilities
-Tax help

The extent of services available varies with each community. Generally, assistance is also available to help cover the cost of nursing home facilities. As a result, it can be wise to include Medicaid planning in an estate plan.

Navigating the Medicaid application process and attempting to work it into an estate plan can be intimidating. If you or a loved one is considering including Medicaid planning in your estate plan, contact an experienced Medicaid eligibility and joint assets lawyer to discuss your situation and better ensure your estate plan is designed to fit your needs.