Medicaid

Breaking
11:11 am
Thu May 21, 2015

FL Could Get Low Income Pool Funds

Vikki Wachino, director of the federal Centers for Medicare & Medicaid Services, said in a letter dated May 21 that Florida can likely expect $1 billion in the budget year that begins July 1 for the Low Income Pool.

The Obama administration has made an offer that it hopes will resolve Florida’s $1 billion state budget stalemate over health care funds for poor people.

Federal health officials agreed to extend Florida’s hospital funds for another two years, but only at about half the amount the state received last year. That means Florida lawmakers may have to dip into the state budget to fill the gap or state hospitals will get less money in the coming year.

In a letter Thursday to Gov. Rick Scott, federal officials stressed that they would not use Low Income Pool hospital funds to cover anyone who could be covered by Medicaid expansion, but they also acknowledged the loss of those funds may be difficult for the state. The current hospital funds are $2.1 billion dollars, put up by the state and federal government. The administration’s preliminary offer drops that to $1 billion for the 2015-2016 fiscal year and to $600 million the following year.

The proposal is still subject to a formal review but federal officials said they wanted to work with the state in good faith, recognizing that the Legislature needs to pass a budget by June 30 to avoid a state government shutdown.

“The decision about whether or not to expand Medicaid is a state option … (R)egardless of whether a state expands Medicaid, uncompensated care pool funding should not pay for costs that would be covered in Medicaid expansion,” federal health officials said in the letter.

The funds, which are part of a federal program that covers the hospital bills of uninsured and Medicaid patients, were supposed to end this year as President Barack Obama’s health care program grew. Patients covered by the low-income pool were supposed to be covered by Medicaid, but the Florida House and Scott have balked at expanding it.

The bitter standoff between the Republican governor and the Obama administration tore apart the state legislative session, with the House abruptly adjourning three days early last month. Scott sued the Obama administration, comparing federal officials to the TV mobster show “The Sopranos” and accusing them of withholding the hospital funds because the state wouldn’t expand Medicaid.

The dispute created a $1 billion hole in the governor’s budget that should now be much easier for lawmakers to address when they return for a special session June 1.

Scott pressed for the extension for months, even visiting Washington twice and blaming the Obama administration for ruining his budget and ignoring his timeline even though he’s known for more than a year that the funds were ending. He waited until mid-April to submit a proposal, although the months-long required public comment period made it impossible to get an answer before the Legislature adjourned last month.

The Obama administration and hospitals want the governor to expand Medicaid to more than 800,000 low-income Floridians and will not spend federal hospital funds on those who would be covered by Medicaid expansion. That’s because federal health officials say it’s more efficient to use the money to give people health insurance than to pay hospitals for caring for the uninsured retroactively.

But Scott and Republican House leaders refuse to accept any money tied to the Affordable Care Act - including Medicaid expansion. They even snubbed a Senate proposal that would eventually take billions of federal dollars and allow the Medicaid expansion recipients to buy private health insurance - a solution that Scott has fought for in the past.

The House and Senate recently announced they would discuss Medicaid expansion during the special session, snubbing the governor’s call to focus only on the budget.

Senate leaders had prepared to move ahead with a health care coverage plan during the upcoming special session, but the announcement from the federal government bolsters the argument of House Republicans who maintained that the state would continue to receive a decent chunk of the hospital money without having to expand Medicaid.

During a recent closed-door session, House and Senate budget chiefs discussed the House’s objections to the Senate’s current proposal. Senate budget chief Tom Lee agreed there were “reasonable” concerns raised about the Senate plan.

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HNF Stories
8:48 am
Wed May 20, 2015

Hospital Commission Set for First Meeting

Gov. Rick Scott
Credit Florida Office of the Governor

Gov. Rick Scott’s new hospital commission consists of Republican donors and business leaders who will likely help him go after some of the state’s hospitals as the standoff over Medicaid expansion intensifies.

The panel, which will meet for the first time today, is beginning its work as the governor has become increasingly antagonistic toward hospitals that receive taxpayer funds in the face of a $1 billion hole in his budget.

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Health News Florida
7:59 am
Wed May 20, 2015

HCA Seeks Higher Medicaid Payments To Replace LIP

Saying the Low Income Pool is "not a long-term solution and often yields inequitable results," the hospital company HCA has sent a letter to Gov. Rick Scott calling for an overhaul of the way Florida pays for care of low-income patients. 

HCA, which has 46 hospitals in the state, recommended increasing base Medicaid payment rates for hospitals --- and offered the possibility of increasing a hospital-provider tax to help finance the changes. Money collected through such a tax hike could be used to draw down additional federal Medicaid funding.

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Consumer
8:36 am
Thu May 14, 2015

College Students Face Coverage Choices

A key question remains for many students who've finally settled on a college destination: How will they or their parents handle health care coverage?

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HNF Stories
8:31 am
Wed May 13, 2015

PolitiFact Florida on Scott Giving LIP to the Feds; Clinton on Immigration

Originally published on Wed May 13, 2015 8:32 am

The quagmire in Tallahassee over health care spending forced an early end to the spring legislative session. At the heart of it is a federal program known as the Low Income Pool, or LIP. It reimburses Florida hospitals more than two billion dollars a year for providing care to low-income or indigent patients. The federal government is phasing the program out as it shifts to new programs provided by the Affordable Care Act, or Obamacare. 

Now, Gov. Scott is making the rounds in Washington D.C., trying to prod the feds to keep funding LIP. Now, Scott has backtracked from his previous position on supporting expansion of Medicaid in the state to serve low-income residents.

Scott recently spoke to reporters in the nation's capitol.

"The families that are covered through the Low Income Pool is a different group of individuals than are covered by Obamacare," Scott said.

Click on the video below to hear what he had to say about LIP and Medicaid:

PolitiFact Florida rated his statement "Mostly False," saying:

This makes it sound as if the people who would qualify for Medicaid under an expansion are completely different than patients who leave hospitals with unpaid bills the LIP fund helps pay to providers. Health policy experts said that while there would still be uninsured people not paying their bills under an expansion, plenty of overlap exists between the two, especially at lower incomes.

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HNF Stories
8:47 am
Tue May 12, 2015

Scott Appoints 9 To Hospital Commission

Gov. Rick Scott on Monday announced his nine appointments to a commission tasked with examining hospital finances, naming only one health care professional to the commission and a chair that has been a frequent donor to the governor and other Republican causes.

The governor has gone on the attack against hospitals over a fight to expand Medicaid and extend federal funds that help hospitals who care for Medicaid and uninsured patients. The issue is creating a potential $1 billion hole in the state budget.

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HNF Stories
3:43 am
Tue May 12, 2015

State Legislatures Quarrel Over Whether To Expand Medicaid

Alaskans attend a rally in Anchorage for Medicaid expansion.
Jonathan Casurella/Alaska Public Media

Originally published on Thu May 14, 2015 9:22 pm

Five years after the Affordable Care Act passed, the law's provision allowing the expansion of Medicaid coverage to more people is still causing huge fights in state legislatures.

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HNF Stories
2:13 pm
Wed May 6, 2015

No Agreement Between Scott, Feds On Medicaid

Credit Associated Press

Florida Republican Gov. Rick Scott says he and the Obama administration are still far apart on health care financing issues that have paralyzed the state's efforts to pass a new budget.

After meeting privately with federal Health and Human Services Secretary Sylvia M. Burwell on Wednesday, Scott said the two "had a good conversation," but added, "we don't have resolution."

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HNF Stories
8:14 am
Wed April 29, 2015

House Adjourns 3 Days Early Over Healthcare Fight; Major Policy Bills Are Dead

Originally published on Tue April 28, 2015 9:51 pm

The Florida House has adjourned for the 2015 lawmaking session. The move comes as the legislature was gridlock over whether to expand Medicaid under the Affordable Care Act.

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HNF Stories
8:55 am
Mon April 27, 2015

House Passes Programs For Intellectually Disabled Children

Credit Wikimedia Commons

Two bills headed for Gov.

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HNF Stories
7:23 am
Fri April 24, 2015

House Republicans Make Budget Offer

House Speaker Steve Crisafulli
Credit Florida Legislature

 Top Republicans in the Florida House made an offer Thursday to try to bridge a budget gap with Senate Republicans, but it could still result in the state's hospitals getting significantly less than they are receiving now.

House leaders offered to trim back spending on tax cuts and education - in order to boost spending in the state's safety net health care program. The offer, however, would be unconnected to a push by the Senate to expand Medicaid or revamp an existing program that takes federal money for hospitals.

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HNF Stories
2:50 pm
Thu April 23, 2015

Selling Hard Boiled Eggs For Medicine: Tradeoffs People In The Gap Make For Health Care

Cynthia Louis in one of Florida International University's Neighborhood HELP Program parked in parking lot of the Pentecostal Tabernacle Church in Miami Gardens.
Credit Wilson Sayre / WLRN

 This is the third part in our series, Falling Into The Gap, in collaboration with the Miami Herald. Read more about the coverage gap and find affordable care on WLRN.org/healthgap.

Every Tuesday, a giant blue bus parks in front of the Pentecostal Tabernacle Church in Miami Gardens. Inside looks like a doctor’s office with a reclining exam chair and anatomical charts. You only know that it’s not a traditional office when it shakes as people get on and off.

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Opinion
9:33 am
Thu April 23, 2015

Letter to the Editor: LIP Fight Jeopardizes Sickest Children

Florida families may have read about a fight over Medicaid expansion in Tallahassee and how it may impact adults. Fewer have heard how the fight is jeopardizing money our state desperately needs to care for some of our sickest children.

18 month old Ana and four year old Connor McCorkle are two of the thousands of children who ended up in the middle of the battle through no fault of their own.  The children of a firefighter and a law student were born with a rare disease that affects their nerves and muscles and are treated by our neurologist, one of very few in the country.

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HNF Stories
8:35 am
Tue April 21, 2015

Senate LIP Plan Added to Federal Proposal

Credit Agency for Health Care Administration

The state agency responsible for Medicaid submitted a new proposal Monday to the federal government for up to $2.2 billion in health-care funding, but the move might be too late to break a budget impasse.

The new model for the Low Income Pool, or LIP, program closely follows legislation approved by the state Senate earlier this month. LIP, which is largely used to cover the expenses of uninsured, low-income Floridians who show up at hospitals needing treatment, is set to expire June 30.

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Health News Florida
1:52 pm
Thu April 16, 2015

Scott Suing Feds for Holding Hospital Funds

Credit Associated Press

  

Gov. Rick Scott said Thursday he is suing the Obama administration for withholding hospital funds because the state won't expand Medicaid.

The announcement is another twist in what has been a gritty yearlong battle with the feds over roughly $1 billion in funds for Florida hospitals that serve low-income people. The fight has come to a head as the state Legislature is desperate for an answer from the feds so it can finalize a state budget before May 1.

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HNF Stories
9:56 pm
Fri April 10, 2015

Health Care Mogul Criticizes Scott's Medicaid Stance

Mike Fernandez paid a visit to the university of South Florida St. Petersburg campus to promote his new book, "Humbled By The Journey."
Credit Daylina Miller/WUSF

Mike Fernandez's made billions building health care companies and he is not happy with the governor's stance on Medicaid expansion.

He said  Gov. Rick Scott is wrong to not want federal money that would expand health insurance to poor Floridians.

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Consumer
8:36 am
Tue March 24, 2015

GOP Hits Medicaid to Offset Doc Fee Hikes

House Republicans quietly deepened recommended budget savings from the government's chief health care program for the poor by about $140 billion in recent weeks to offset part of the cost of higher payments to doctors who treat Medicare patients, according to officials familiar with the tradeoff.

The maneuver comes as Republicans in both houses struggle with competing priorities, in this case a desire to stabilize what is widely viewed as a dysfunctional system of provider payments under Medicare, while pursuing a 10-year goal of balancing the budget.

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HNF Stories
3:03 pm
Thu March 19, 2015

Health Expansion, LIP Program Divide Budget Proposals

In a move that creates a $5 billion divide with the House, the Senate released a budget proposal Thursday that banks on expanding health-care coverage for low-income Floridians and extending a critical funding program for hospitals.

The Senate proposal, approved by a key budget panel and touted by President Andy Gardiner, reinforces that health-care funding could be the most-vexing issue facing lawmakers during the rest of this year's legislative session.

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Health News Florida
9:19 am
Mon March 16, 2015

Bill Seeks Medicaid Money for Mental Health

The Florida Senate is working on bills that would increase the amount of federal Medicaid money used to fund mental health and substance abuse problems, Florida Politics reports. The Senate Appropriations Subcommittee on Health and Human Services will discuss the bill drafts Monday at its meeting.

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Health News Florida
8:33 am
Wed March 11, 2015

House Panel Blocks Medicaid Dental Changes

Credit Dave Buchwald

A House panel Tuesday rejected a proposal to revamp the Medicaid program's system of providing dental services to children.

The House Health Innovation Subcommittee deadlocked 6-6 on the proposal (HB 601), filed by Rep. MaryLynn Magar, R-Tequesta. A tie kills a bill. 

Under the state's new Medicaid managed-care system, HMOs and other types of managed-care plans are responsible for providing dental services to children.

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Health News Florida
9:09 am
Mon March 9, 2015

Broward Health Racks Up $10.2M Legal Tab

Federal authorities haven’t publicly accused taxpayer supported Broward Health of submitting bogus claims to Medicare and Medicaid, but the health system still has racked up a $10.2 million tab for legal advice, the Florida Bulldog reports.

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HNF Stories
8:52 am
Tue March 3, 2015

Study: Foster Kids Not Getting Health Care

Credit Wikimedia Commons

Some foster children are not getting their required medical screenings even though the visits are paid for by Medicaid, federal health investigators warn in a study released Monday.

The Health and Human Services' inspector general study looked at a random sample of roughly 400 foster children from California, Texas, New York and Illinois and found nearly 30 percent did not receive one or more of their required health screenings between 2011 and 2012.

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HNF Stories
9:21 am
Tue February 24, 2015

Survey: Uninsured Rate Hit New Low in 2014

Credit HealthCare.gov

The share of Americans without health insurance dropped to its lowest level in seven years in 2014 as President Barack Obama's overhaul took full effect, according to an extensive survey released Tuesday.

The Gallup-Healthways Well-Being Index found that the trend appears likely to continue this year, since 55 percent of those who remained uninsured told the pollster they plan to get coverage rather than face escalating tax penalties.

In Florida, the rate dropped 3.4 points.

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HNF Stories
8:39 am
Wed February 4, 2015

Senate Health Panel Tries Again on Telemedicine

Senate Health Policy Chairman Aaron Bean
Credit Florida Senate

Pointing to a need to increase access to health care in areas such as rural communities, a bipartisan group of House and Senate leaders Tuesday expressed confidence they will reach agreement this year on a plan to boost the use of telemedicine in Florida.

Sometimes called "telehealth," telemedicine involves using the Internet and other technology to provide care to patients remotely.

As a basic example, a physician could use a video link to consult with a patient who is at home.

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HNF Stories
7:45 pm
Tue February 3, 2015

Disputes About Old Hospital Rates Stir Controversy

  A Senate committee Tuesday postponed taking action on a controversial bill that stems from disputes about old Medicaid payment rates for hospitals.

The bill (SB 322), filed by state Sen. Kelli Stargel, R-Lakeland, would create a five-year time limit on challenges by hospitals to reimbursement rates. Supporters of the bill said it is needed because some hospitals have filed administrative challenges to reimbursements that date back to the 1990s or earlier.

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HNF Stories
3:00 pm
Tue February 3, 2015

FL Negotiates For LIP Money Amid Questions

Credit Agency for Health Care Administration

 Florida's Medicaid director met Tuesday with federal officials as the state tries to continue receiving $1 billion a year to help hospitals and other providers care for low-income and uninsured people. Justin Senior, a deputy secretary at the state Agency for Health Care Administration, traveled to Baltimore to meet with federal officials about what is known as the Low Income Pool, or "LIP," program.

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Health News Florida
9:25 am
Tue January 27, 2015

Alzheimer’s Care Costs Growing

Credit Centers for Disease Control and Prevention

Caring for Alzheimer’s and dementia patients is emotionally demanding but also is increasingly expensive, according to a Fort Myers News-Press analysis of 10 years of records from state agencies, nursing homes and hospitals.

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Health News Florida
8:31 am
Wed January 14, 2015

FL Chamber Supporting Health Care Expansion

A new health-care policy plan from the Florida Chamber of Commerce backs an expansion of health coverage under an alternative to Medicaid expansion, the Florida Times-Union reports. The chamber president says they “largely agree" with the "A Healthy Florida Works” plan backed by several Florida business groups.

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Health News Florida
9:28 am
Thu December 18, 2014

AHCA Boss Plans for Scott's Second Term

AHCA Secretary Liz Dudek

Agency for Health Care Administration Secretary Elizabeth "Liz" Dudek has an ambitious "to-do" list for Governor Rick Scott's upcoming second term, according to Christine Jordan Sexton of SaintPetersblog

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HNF Stories
8:56 am
Tue December 16, 2014

WellCare Appoints New CEO

Ken Burdick
Credit WellCare Health Plans

WellCare Health Plans, Inc., Florida’s largest Medicaid HMO provider, announced Monday that Kenneth Burdick will be appointed as CEO, according to a statement released by the Tampa-based company. 

Burdick, who previously served as the company’s president and chief operating officer, will be replacing interim CEO David J. Gallitano Jan. 1.

According to the statement, Burdick has previously held executive positions with companies such as Blue Cross Blue Shield, Coventry Health Care, and UnitedHealth Group.

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