Cook Children’s Health Plan Files Suit to Protect Local Families
Legal action designed to stop the State from replacing Medicaid benefits provided by local community health plans with national for-profit insurance plans
For Immediate Release
June 26, 2024
Fort Worth, Texas - Cook Children’s Health Plan today announced it is taking legal action to stop the flawed process that led to the Texas Health and Human Services Commission (HHSC) taking away Cook Children’s longstanding contract administering Medicaid to local families. Cook Children’s has successfully run the Medicaid STAR and CHIP program for more than 20 years and has provided more than $200 million in charity care and other community benefits out of its own pocket to families not covered by Medicaid.
“The State got it wrong, and we are asking the courts to make it right,” said Karen Love, President of Cook Children’s Health Plan. “We have taken such good care of our Members for so many years because we live here, and they are our neighbors. We genuinely care about them. And our providers know them by name. Now, thanks to a flawed process that did not follow the guidelines set by Texas law, these families will be at the mercy of national for-profit insurance companies.”
The HHSC process was deeply flawed and failed to follow the law requiring it:
- Recognize and give preference to health plans with long and successful track records of facilitating care for the children and mothers in our community and with ties to charity care providers.
- Give weight to health plans that provide care to special populations like children.
- Consider how continuity of care would be impacted, as well as costs to the state.
Finally, HHSC did not go through the proper rulemaking process for making critical changes to the Request for Proposal (RFP). Their scoring was riddled with mistakes, and they gave one of the winning bidders an unfair advantage by prematurely disclosing copies of its’ competitors’ proposals.
Cook Children’s has filed a Petition for Declaratory Judgment and Injunctive Relief against HHSC Commissioner Cecile Erwin Young. This is the lawsuit to overturn the decision. In the meantime, Cook Children’s has also filed a Temporary Restraining Order request to stop HHSC from finalizing its procurement results. Both actions were filed in Travis County.
Cook Children’s also filed a protest of the STAR Kids RFP to stop HHSC from making the same mistakes it made in the STAR & CHIP RFP and from taking away options from the kids who need help the most.
“These actions we take are strong but necessary,” said Rick W. Merrill, President and CEO of Cook Children’s Health Care System. “For more than 20 years, Cook Children’s has set the standard for serving Medicaid families in outstanding fashion. Our reviews from our Members are always high. And we go the extra mile to cover costs they can’t. There is zero chance that a national for-profit will care about these patients the way we do.”
For more information, including key facts, videos, photos and recent media coverage, please visit SaveCookChildrensHealthPlan.com.
Breakdown on STAR/CHIP/STAR Kids in Texas:
All three are programs that provide health insurance for children in Texas.
- STAR (Children's Medicaid): This is for children from low-income families who don't have disabilities.
- STAR Kids (Medicaid Managed Care): This is for children with disabilities up to age 20 who qualify for Medicaid. It offers extra support services beyond basic Medicaid.
- CHIP (Children's Health Insurance Program): This is for children whose family income is too high for regular Medicaid, but they can't afford private insurance.
