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Texas Ordered To Improve Medicaid

August 30, 2000

HOUSTON (AP) _ The state must improve access for children’s care and fix other problems in its $11 billion Medicaid system that provides medical coverage to more than 1.7 million low-income Texans, a judge has ruled.

U.S. District Judge William Wayne Justice ruled that the Texas Health and Human Services Commission has not lived up to a 1996 agreement to make major changes in the Medicaid system.

Justice’s 175-page order could trigger sweeping changes in the state’s program, prompting it to back off a plan to push most poor people into managed care and to raise reimbursements to dentists who treat Medicaid patients.

Justice ordered the commission to prepare a plan of corrective action by October.

``Basically, what we have is a Medicaid program in shambles,″ said Susan Zinn, a San Antonio lawyer who filed the 1993 class-action lawsuit that resulted in the agreement.

Justice contended that the state had failed to address the needs of about 13,200 abused and neglected children supervised by the Texas Department of Protective and Regulatory Services. He also said the state failed to inform the nearly 1 million children enrolled in Medicaid about available benefits.

The judge’s Aug. 14 ruling said the state had provided ``inflated and inaccurate″ data about the frequency of checkups for children under the program, and he also criticized the quality of those checkups.

The Texas Medicaid program also provides inadequate dental care to children, Justice said, partly because of low reimbursement rates to dentists.

A spokeswoman for the attorney general’s office said they were still reviewing the order and had not decided whether to appeal.

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