Texas Medicaid Beneficiaries Lack Access To Care, State Medical Association Says

Medical News Today - The Kaiser Daily Health Policy Report, Wed. Aug. 9, 2007
Only 18% of physicians in Austin, Texas, accept all new Medicaid beneficiaries, according to a survey of physicians by the Texas Medical Association, the Austin American-Statesman reports. According to the American-Statesman, "Austin has become ground zero in what some in the medical community are calling an unfolding Medicaid crisis in Texas."

The medical association's survey, which is conducted every two years, found that the number of physicians accepting all new Medicaid beneficiaries statewide declined from two-thirds in 2000 to 38% last year. The survey also found that 9% of orthopedic surgeons in the state accept all new Medicaid beneficiaries, and the percentages of some other specialists who accept all new beneficiaries also are in the single digits, the American-Statesman reports. Over the past year, the Texas Health and Human Services Commission said it has paid travel expenses for about 100 Medicaid beneficiaries in Austin to receive care in San Antonio, Texas.

William Hinchey, head of the state medical association, said, "Some of us believe [Medicaid] has collapsed because these patients do not have access to care like they should." Regina Rogoff, head of the People's Community Clinic in Austin, said Medicaid in the state has "effectively collapsed," adding, "If the state paid a fair rate for Medicaid, then those patients would be able to be seen in the private sector."

However, Stephanie Goodman, a spokesperson for the commission, said, "I could not disagree more strongly with that." Goodman said that the program has problems but is still functional, adding, "We pay for more than half of all births and two-thirds of all nursing home care. It is a huge program and takes up a quarter of the state's budget. Are there issues out there? Yes. But the good works shouldn't be lost."

Goodman said the situation should improve after Medicaid reimbursement rates to physicians are increased Sept 1. Some of the increases are required by a settlement in a 14-year-old class-action lawsuit filed by parents of children receiving Medicaid benefits who had difficulty finding physicians because of low reimbursements. Reimbursements for physicians who care for child beneficiaries will increase by an average of 25%, and reimbursements to dentists who treat children will increase by 50%. The state Legislature also increased physician reimbursements for adult care by 10% (Jaspin, Austin American-Statesman, 8/6).

Reprinted with kind permission from http://www.kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation. © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.

Surgeon's suit claims UT Southwestern patients mistreated

By BRETT SHIPP = WFAA-TV - Tuesday, July 3, 2007
The former chairman of Parkland Memorial Hospital's emergency room has made disturbing allegations about the care of patients.

In addition to claiming taxpayers are being cheated by his bosses who are breaking the law, he said patients are being mistreated. He also said the moment he voiced complaints to UT Southwestern officials, he was then demoted.

Dr. Larry Gentilello is recognized as one of the top trauma surgeons in the country.

However, he was demoted in March after he said he complained to his supervisor, Dr. Robert Rege, that UT Southwestern was cheating indigent patients and taxpayers by not properly staffing the emergency room with experienced surgeons as required.

Gentilello said he observed patients at Parkland's emergency room being treated by residents with no attending physicians. He also said he saw residents conduct surgeries without supervision.

In his lawsuit against UT Southwestern Health Systems, Gentilello claimed the situation at the hospital is not only "illegal," but has also resulted in "inadequate patient care," and at the very least, violates "proper operating room and patient treatment protocols."

UT Southwestern released a statement that said Gentilello's claims are "baseless" and that he was removed from his position for "legitimate reasons."

In fact, on the witness stand, Gentilello's supervisor said the ER director never talked with him about any problems.

But Gentilello said he did blow the whistle, not only because UT Southwestern has billed for services not rendered, but also because he said supervisory surgeons have been busy serving paying customers at Zale Lipshy Hospital next door.

Gentilello said he wants his old job back and wants UT Southwestern to treat patients and taxpayers fairly and honestly.
Watch report on WFAA