MM Curator summary
A judge has ruled that TX Medicaid has the right to determine whether a provider is qualified to provide services to its members.
The article below has been highlighted and summarized by our research team. It is provided here for member convenience as part of our Curator service.
Planned Parenthood lost a last-minute bid yesterday to remain on the Medicaid program in Texas.
A Travis County district court judge ruled against the organization’s claim that Texas failed to provide proper notice before cutting it from the program, the latest loss for the company in a legal back-and-forth that began in 2015 and may leap up to a federal appeal.
Motivated by a series of undercover videos showing Planned Parenthood higher-ups discussing the sale of fetal remains, Texas decided to cut Planned Parenthood from the Medicaid program in October 2015. The Office of Inspector General sent a final notice of termination to Planned Parenthood in December 2016.
Planned Parenthood sued the Texas agency and found favor in court with a 2017 ruling that kept it on the Medicaid program. However, the company lost in late 2020 when an appeals court ruled that the state reserved the right to determine Medicaid providers.
“A state agency may determine that a Medicaid provider is unqualified and terminate its Medicaid provider agreement even if the provider is lawfully permitted to provide health services to the general public,” the ruling reads.
In response to Planned Parenthood’s request for a grace period to refer patients to new providers, the Texas Health and Human Services Commission (HHSC) gave the organization 30 days, beginning January 4 of this year. The decision that came yesterday ended a new tangent of litigation that began as that grace period came to a close, when Planned Parenthood successfully argued that the state didn’t send proper notice of termination.
The court kept the state on the Medicaid program with a temporary restraining order against the state before the fourteen-day renewal ended yesterday, when Judge Lora Livingston sided with Texas against Planned Parenthood.
The Austin American-Statesman
reports that Livingston treated the decision with gravity.
“This decision is not made lightly. In the light of the ongoing public health crisis, the risks of the individual losing health care and medical attention requires increased attention and scrutiny,” Livingston wrote.
Though Livingston sided against the company yesterday, a similar concern for harm to Planned Parenthood patients motivated the 2017 ruling at least in part.
“The Individual Plaintiffs have proven a substantial likelihood of success on their claim terminating the Provider Plaintiffs from Medicaid violates their right to their chosen provider and would cause irreparable harm,” Judge Sam Sparks wrote.
“If the termination were allowed to proceed, the Individual Plaintiffs would, at minimum, see their health care disrupted.”
The videos that prompted the state to cut Planned Parenthood from Medicaid show a range of personnel including abortion physicians discussing how best to harvest the organs from fetal remains for sale to researchers.
While federal money cannot fund abortions, Democrat lawmakers have proposed a bill that would let the state pay for them with taxpayer money in a program parallel to Medicaid, dispensed by the Texas Health and Human Services Commission.