Cook Children’s Sues Texas Over Medicaid Contract Changes

FORT WORTH, Texas – Fort Worth-based Cook Children’s Medical Center is suing the state of Texas over a plan that could exclude the hospital from critical healthcare programs. This action could impact 125,000 North Texas families.

Impact on Families

Two-year-old Zachariah Sudolcan, born with a rare and complex genetic disorder, has been receiving care from a dedicated team at Cook Children’s since birth. “From birth, we’ve seen him grow tremendously, and Cook’s has played a real big part in that,” said Zachariah’s father, Samuel Sudolcan. “His doctors, they have from the very beginning given us a lot of hope in his future.”

State’s Decision

The Texas Health and Human Services Commission (HHSC) recently decided not to extend a Medicaid contract to Cook Children’s Health Plan and other local plans. Instead, HHSC awarded the funding to United Healthcare, Aetna, and Blue Cross Blue Shield.

Hospital’s Response

Karen Love, President of Cook Children’s Health Plan, emphasized their determination to fight the decision. “The families and children covered by Cook Children’s Health Plan deserve the ability to choose us,” she said. “That’s why we’ve decided to file litigation in court to stop the state from ending our Medicaid, STAR, and CHIP-managed care.”

Legal Challenge

In addition to the lawsuit, the hospital filed an appeal against the initial decision, citing legal challenges. The state, however, maintains that “No violation of the specific statutory or regulatory provisions cited by [Cook Children’s] has occurred.”

Concerns of Affected Families

Families like the Sudolcans are worried about the potential changes. “If we lost the health plan, we have to get completely new doctors, completely new home health who don’t know him, don’t know his background, don’t know anything about him and his progress,” Samuel explained. “We’d have to learn all new therapists, doctors, and it would be extremely stressful for him.”

Request for Temporary Restraining Order

Cook Children’s has requested a temporary restraining order to prevent the state from implementing the changes. Love expressed hope that the Texas Legislature would intervene to find a middle ground before convening. “Our hope is that we get them to recognize that there’s no reason to remove solid performers from the plan,” she said.