TEXAS BLUES: Opt Out of Medicaid HMOs in Dallas
Blue Cross and Blue Shield of Texas said yesterday that it will not serve patients under the state's Medicaid managed care program in the Dallas area, citing "unreasonably low reimbursement rates." The Dallas Morning News reports that the state's monthly rate for "each Medicaid recipient in Dallas County is nearly $30 less than in [neighboring] Tarrant County," according to David Bick, Blue Cross' vice president of government programs. He said, "It's a black eye professionally because here we are in our back yard, and we're not going to be doing business here. ... All the company asked for was a break-even on this business, and we were projecting anywhere from a half-million to a $2 million loss." But state officials said an auditor recommended by Blue Cross "concluded that the state's figures were valid." Consumer advocates criticized the company for abandoning "its public-service mission after its recent merger with its Illinois counterpart." Lisa McGiffert, senior policy analyst for Consumers Union, said, "Economics is going to drive their decision-making, where in the past there was an element of public service. Public service was clearly in their history, and it's not going to be in their future. That's a loss to the people of Texas." The Blues' move leaves the Dallas area with Parkland Community Health Plan and Americaid Texas as its only Medicaid HMO participants (Ornstein, 2/3).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.