Decision on Medicaid refunds delayed; hearing scheduled for March

Riley Lucio, left, and Aubrie Lopez, both 5, read the alphabet while in their pre-k class Tuesday, May 1, 2018, at De La Viña Elementary in Edinburg. (Monitor photo)

A decision on whether to extend a temporary restraining order filed by local home health agencies against the Texas Health and Human Services Commission has been delayed until March.

Edward Friedman, the attorney for the home health agencies, was nonetheless back in court Friday in Travis County, where he and legal counsel for the commission held oral arguments over whether the case should be dismissed.

Friedman said the commission filed a motion arguing the home health agencies didn’t have jurisdiction to sue.

After hearing oral arguments, state District Judge Catherine Mauzy did not rule, needing more time to review documents before doing so.

The lawsuit was filed on behalf of four home health agencies — Unidos Healthcare LLC, Corazon Health Care Services, Cleveland Health Care and Millennium Comfort Home Health Care, which are either based in or have offices in the Rio Grande Valley.

The agencies claimed they were unable to receive Medicaid reimbursements for telemonitoring services beginning in January, when HHSC discontinued a procedure code through which those agencies filed reimbursement claims.

According to Friedman, the move led to hundreds of patients throughout the state being unable to receive telemonitoring services and hundreds of employees that provided those services to be furloughed.

On Jan. 17, Mauzy signed a temporary restraining order to allow the agencies to keep receiving reimbursements for those services.

A hearing on whether to extend that restraining order is now scheduled for March 6.

But why the commission stopped reimbursing agencies in the first place is still unclear.

Carrie Williams, spokesperson for the commission, stated the procedure code for telemonitoring services was discontinued by the Centers for Medicare and Medicaid Services, the federal agency that helps administer Medicare and Medicaid.

“It’s common for CMS to revise and update the thousands of codes used for billing purposes,” Williams stated in an email. “As a result, HHSC must replace the old CPT codes with new ones.”

“We’re exploring solutions to find other codes to work with so we can keep those services moving forward,” she stated. “We’re actively working on a code fix and on finalizing the rates.”

Williams added that companies will be reimbursed but under a new rate that’s being finalized.