Hinojosa wins praise for his efforts to stop Medicaid procurement changes

EDINBURG, Texas – Driscoll Children's Hospital CEO Eric Hamon has praised state Sen. Juan Hinojosa for leading the fight to stop radical changes to the Medicaid procurement process in Texas.

If implemented by the Health & Human Services Commission, the proposed changes would result in Driscoll Health Plan being eliminated from the process As a result, Driscoll would, for the first time in over 20 years, not be able to provide healthcare services via its Medicaid contract in 24 counties in South Texas.

Speaking at the official opening of Driscoll Children's Hospital-Rio Grande Valley, Hamon went off script to say:

"I'm just going to do something real quick. Senator Hinojosa has been a great friend to all of us. There is an issue that came up a couple of months ago, call it eight, nine months ago. I will tell you what Senator Hinojosa did before I could even get (into gear). He grabbed the bull by the horns, and led, literally, the entire state of Texas with the issue," Hamon said.

"And now, from Lubbock to Dallas to South Texas, they're taking his lead. So, thank you, Senator for doing that."

As soon as the proposed changes to Medicaid procurement came out, Hinojosa secured the signatures of every legislator in South Texas, Democrats and Republicans alike, to send a joint letter to Gov. Greg Abbott and HHS Commissioner Cecile Young.

In an exclusive interview with the Rio Grande Guardian, Hinojosa said it is very important Driscoll be allowed to continue to be the conduit for Medicaid services in South Texas.

"It isvery important because they have roots in the community. They have an infrastructure set up. It would be very damaging to many families and many children that need quality health care if they were to be excluded from providing services and being part of the managed care organization," Hinojosa said.

"One quick point. Whatever decision they (HHS) make, it will not go into effect until September. 2025. We'll be a session January 2025. So, it gives us (lawmakers) a chance to make the changes necessary to make sure that those three children's hospitals are not excluded. At the end of the day, we (the Legislature) have the final say so."

The three children's hospital systems that would lose Medicaid contracts with the state, should the proposals be enacted are Cook Children's Health Plan in Tarrant County, Texas Children's Health Plan in the Harris County region, and Driscoll Health Plan in South Texas.

Pieri's analysis

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Sean Pieri, Driscoll's vice president for development and marketing, spoke about the Medicaid procurement process in an interview with the Guardian at the official opening of Driscoll Children's Hospital-Rio Grande Valley.

"The State of Texas issued its Medicaid procurement process back in March, and the Driscoll Health Plan, which has been in business for over 20 years, was eliminated from the process. So, 24 counties which Driscoll services… no longer would Driscoll be able to provide Medicaid insurance in those areas," Pieri said.

"That procurement process right now is in litigation. A number of health plans are suing the state, trying to get the procurement overturned at this point in time."

Like Hamon, Pieri praised Hinojosa for his efforts to block the proposed changes to the Medicaid procurement process.

"Senator Hinojosa, along with all the representatives from South Texas, are working very closely, trying to overturn it. Obviously, it's a big deal here in South Texas. And so, we have legislators throughout the state who are involved this process, and there's a lot of talk and conversation about overturning or changing the approach that has happened so far."

Asked if Driscoll and the other two health plans that would be negatively affected are looking for the Legislature to intervene, Pieri said:

"Yes, that's our hope, to wait to the next legislative session. I think the contracts were to be signed by September 1, but that's not going to happen because of the legal issues that are underway right now.

"But right now it looks like it's going to start getting pushed out into that legislative session in 2025. That would be beneficial, not only for Driscoll, but for the other health plans that did not receive bids this during this procurement process."

Asked if Driscoll is getting support from legislators across the state, Pieri said:

"We have a lot of support from the legislators around the state. Our biggest concern about this whole thing is when the state looked at the health plans, they didn't take into consideration past performance at all from health plans."

Pieri added: "We've been doing this for 20 years. The reason why they (HHS) didn't take past performance into consideration was because they thought it would give an unfair advantage to the incumbents. So, instead of looking at past performance, looking at past results, they just eliminated it altogether, and they gave the contracts to other companies."

Editor's Note: Here is a video recording of the Guardian's interview with Sean Pieri:

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