Updated: 2:33 p.m.

Central Health CEO Mike Geeslin provided insight on Central Health’s decision to no longer offer STAR Medicaid or Children's Health Insurance Plan services through its health maintenance organization, or HMO, Sendero Plans.

“It’s obviously not what we would have wanted to have happen, but I commend the Sendero Health Plans board for doing everything they could,” Geeslin said.

The premium rates for both STAR Medicaid and CHIP established by the Texas Health and Human Services Commission at the end of 2017 were not sufficient enough to cover Sendero Health Plans' services. Prior to the rate change these programs were breaking even and following the rate change Geeslin said they were projected to lose $800,000 a month.

“When the rates were changed towards the end of last year, that’s when we first started taking a very critical look at what type of premiums we need to make,” Geeslin said.

Sendero provides services for 18,000 members receiving Medicaid and CHIP plans and about 27,000 members receiving its Affordable Care Act Plan, IdealCare. Sendero will continue to offer its IdealCare plans.

For clarification, Geeslin said the $26 million in funding that Central Health allocated to Sendero in January was required by insurance regulators to establish that Sendero  had an appropriate amount of capital on its 2017 financial statements. The decision was not related to Sendero’s plans to no longer offer STAR Medicaid and CHIP plans.

Posted: 10:59 a.m.

Sendero Health Plans, the nonprofit health maintenance organization operated by Central Health, will no longer provide plans for 18,000 of its members enrolled in STAR Medicaid and Children’s Health Insurance Program, or CHIP, plans starting May 1, according to a news release

STAR Medicaid is the program through which most Texas residents get Medicaid coverage, according to Texas Health and Human Services.

Recipients have until April 13 to choose a new plan, according to the release.

Central Health is pulling out of these programs because insurance premiums do not cover care, the release stated. The premium rate established for Sendero by The Texas Health and Human Services Commission is projected to cause over $800,000 in losses per month for its STAR Medicaid and CHIP Programs, according to the release.

The three remaining insurance plans in Travis County offering STAR Medicaid and CHIP are BlueCross Blue-Shield, Dell Children’s Health Plan and Superior.

“Sendero’s STAR Medicaid and CHIP members will have the option of choosing a new health coverage plan. If they don’t choose a plan by April 13, they’ll automatically be assigned to a new plan so they will not go without health insurance,” Central Health CEO Mike Geeslin said in the release.

In January, Central Health Board of Managers approved a $26 million increase in funding for Sendero Health plans.

“The premiums paid to Sendero do not cover the projected cost of care for members,” Geeslin said. “Sendero would either have to substantially cut the rates it pays local providers or continue to lose money on its STAR Medicaid and CHIP programs. Neither option was sustainable or good for patients.”