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Opinion

We haven’t forgotten D’ashon Morris: An update on our Pain & Profit investigative series

In June, The Dallas Morning News published Pain & Profit, about the shortcomings — and too often tragic consequences for our most vulnerable citizens — of Medicaid’s corporate management in Texas.

In June, The Dallas Morning News published Pain & Profit, a five-part investigative series on the shortcomings — and too often tragic consequences for our most vulnerable citizens — of Medicaid's corporate management in Texas.

We're proud of the series, a product of more than a year of dogged reporting and data analysis, and the reforms it's already spurred. The Legislature has held three hearings to discuss the series' findings and, as we reported in August, has promised to beef up oversight of the 20 Medicaid managed care organizations, or MCOs, in the state.

As part of that oversight, the Texas Health and Human Services Commission has announced it will allocate $7 million to hire about 100 MCO regulators to monitor the quality of health care that patients receive, including nurses to check on homebound patients. Those are welcome steps toward reforming a system that does a fairly good job of providing emergency and preventive care to the majority of its recipients, but too often fails Medicaid recipients most in need of long-term care for chronic illnesses or disabilities.

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First introduced in the 1990s, MCOs promised to deliver better health care at lower costs to the state’s 4.5 million Medicaid recipients, including some 720,000 “medically fragile” children and adults who require special services like in-home health care.

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Medicaid receives some $17 billion from state taxpayers annually, in addition to about $23 billion from the federal government. Yet despite billions pouring in from state contracts, MCOs too often fail those Texans who need medical attention the most but lack effective advocates, including children in foster care, those in long-term residential care and the mentally ill.

Even more disheartening, our reporters’ analysis of more than 70,000 pages of documents, including patient medical records, determined that “state officials are protecting a booming multibillion-dollar industry while the most vulnerable Texans wait in vain for wheelchairs, psychiatric drugs and doctors’ appointments.”

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In short, our investigation found “the system has failed countless disabled adults and sick children who can’t advocate for themselves.”

One of those sick children was D’ashon Morris, a disabled toddler who suffered irreparable brain damage after his adoptive mother couldn’t convince the MCO that managed his case, Superior HealthPlan, that he needed full-time nursing care to prevent him from removing his tracheotomy.

The first story in our Pain & Profit series is titled “The preventable tragedy of D’ashon Morris” for a reason. We believe the state can — and should — do more to protect the most vulnerable Medicaid recipients, who rely on private companies to provide the medical care they need to survive.

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In August, we published a sixth installment on denial of care for foster kids. And we intend to continue the series in coming weeks with a story on the byzantine appeals process that too often prevents delivery of necessary care.

Many of the changes thus far proposed by health care experts, providers and lawmakers cannot be fully addressed or implemented until the Legislature is in session. Until then, we will continue to hold those who profit from this public-private partnership — while discounting or covering up its failures — accountable.