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Cook Children's sues Texas over Medicaid contract denial

Cooks Children's Medical Center is located in Fort Worth.
Emily Nava
/
KERA
Cooks Children's Medical Center is located in Fort Worth.

Cook Children's is suing the state of Texas after it denied the hospital's health plan a new Medicaid contract.

Officials with the Fort Worth-based health care system announced the lawsuit during a news conference Wednesday.

The Texas Health and Human Services Commission’s $116 billion Medicaid procurement — which is set to start in September 2025 — would remove Cook Children's and two other hospital-affiliated children's health plans from Medicaid STAR and CHIP programs, which serve low-income children and families. The state is awarding contracts to Molina Healthcare, Blue Cross and Blue Shield, Aetna and UnitedHealthcare to serve families in Tarrant County.

This would be the first time Cook Children's has been excluded from CHIP since the plan was created in 2000, according to the health system's protest. The change could potentially result in "severe disruptions" to services provided to at-risk patients.

"Texas Health and Human Services' decision to deny us a renewal of our contract won't hurt Cook Children's nearly as much as it will hurt the families we serve, while denying them a meaningful choice of plans and the right to choose us," Karen Love, president of Cook Children's Health Plan, told reporters Wednesday.

Tarrant County lawmakers have also protested the decision. Six state representatives signed a letter addressed to HHSC Executive Commissioner Cecile Young earlier this month expressing concerns about the potential impact on the more than 125,000 Tarrant County families enrolled in the Cook Children's Health Plan, the Fort Worth Report previously reported.

"The decision to potentially exclude Cook Children's will disrupt essential healthcare services to our community's most vulnerable populations," local lawmakers wrote. "Such a change threatens to dismantle long-standing healthcare relationships and infrastructure, which have been integral to Cook Children’s significant public health achievements in Tarrant County."

The Texas Legislature's next regular session is set to start in January.

Got a tip? Email Megan Cardona at mcardona@kera.org.

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Megan Cardona