Feds kill FL plan to switch Medicaid patients to HMOs

Dec 23, 2008

By Carol Gentry
12/23/2008 © Florida Health News 

Bowing to a decision by federal authorities, the Agency for Health Care Administration has shelved a plan to shift Medicaid patients in 25 counties into managed care -- mostly HMOs -- if they didn't specifically request not to be moved. The provision, passed in the most recent session, was seen as a gift to Medicaid HMOs because it was expected to bring them thousands of new recipients in 25 counties. (See FHN's article published May 1.)

The Centers for Medicare and Medicaid Services interpreted the Florida law, passed in the most-recent session, as violating federal rules, AHCA spokeswoman Shelisha Durden said.

The cancellation of the controversial change to MediPass was announced quietly, with little fanfare -- the same way it was created. The bill was slipped into the budget during the last session of the Legislature, without hearings.

It came to light in a conference call last Friday billed simply as an "update" on the MediPass program, which pays primary-care physicians $3 per p atient per month to manage the care of Medicaid patients. The consumer group Florida Community Health Action Information Network, or CHAIN, mentioned it in a mass e-mail on Monday.

The reason behind the cancellation apparently was not clear to CHAIN, which indicated in the e-mail that it appeared related to AHCA's change in vendors for its information systems.

--Carol Gentry can be reached at 727-410-3266 or Carol.Gentry@FloridaHealthNews.org.