Medicaid

Health News Florida
9:02 am
Tue August 19, 2014

Pediatric Pay Lawsuit Nears End

Pediatricians challenging how the state pays for Medicaid services to children could see the nine-year-old case end in October, the Miami Herald reports.

The lawsuit, filed in 2005, claims that the Agency for Health Care Administration, Department of Health and Department of Children and Families violated federal law, and also hampered patient access by making low Medicaid payments to providers, the Herald reports.

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HNF Stories
9:22 am
Mon August 18, 2014

Report: FL Losing Most ACA Medicaid Money

Florida looks to lose more federal money set aside for Medicaid than any state that has opted out of expanding the health care program for the poor, says a new report from the Robert Wood Johnson Foundation and the Urban Institute.

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Health News Florida
9:39 am
Mon August 11, 2014

Hospitals: State Underpaid by $73.3M

 Several Florida safety net hospitals have filed a complaint claiming the Florida Agency for Health Care Administration underpaid them $73.3 million for Medicare patient care over the past 13 years, the Gainesville Sun reports.

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Health News Florida
9:41 am
Wed July 23, 2014

85 Jobs Cut at Polk Health Dept.

The expansion of Medicaid managed care is the reason for the elimination of 85 state jobs at the Florida Department of Health in Polk County, the Lakeland Ledger reports. Among the positions that will be eliminated are registered nurses, advanced registered nurse practitioners, licensed practical nurses and health support workers. According to the Ledger, 28 of the positions are vacant.   

Health News Florida
9:31 am
Fri July 11, 2014

Medicaid Fraud Veto Bothers GOP Lawmaker

While many didn’t notice Gov. Rick Scott’s line item veto of funding to investigate Medicaid fraud, the chairman of the Criminal & Civil Justice Appropriations Subcommittee certainly did.

Associated Press
8:24 am
Wed July 9, 2014

Judge Won't Dismiss Medicaid Lawsuit

Federal appeals judge Adalberto Jordan
Credit law.fiu.edu

A federal judge refused Tuesday to dismiss a lawsuit that alleges Florida provides inadequate care to children in its Medicaid program, despite state claims that privatizing the program will resolve many of the problems.

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10:48 am
Tue July 8, 2014

Managed Care Answer in Medicaid Battle?

Lead in text: 
Florida’s Agency for Health Care Administration will argue in a hearing today that its new Medicaid managed-care system, which takes full effect next month, should end a legal battle over the quality of care for children in Florida’s Medicaid program. As the News Service of Florida reports, the lawsuit brought by the Florida Pediatric Society says low payment rates mean doctors can’t afford to treat children, thus denying the young Medicaid patients access to physicians. A federal judge will hear the case Tuesday in Miami.
  • Source: Usf
  • | Via: News Service of Florida
Pointing to a new managed-care system, the state is seeking to scuttle a long-running lawsuit that challenges the adequacy of care provided to children in
Health News Florida
10:49 am
Mon July 7, 2014

FL Hospitals Owe $267M, Feds Say

Florida hospitals have just one year to repay $267 million for Medicaid charges the federal government says it shouldn’t have covered during the past eight years, the Times/Herald Tallahassee Bureau reports.

State and hospital officials are asking for three years to pay back the overpayments to hospitals through the so-called Low-Income Pool fund, saying one year would leave them in dire straits.

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Health News Florida
11:01 am
Wed June 25, 2014

Feds Join Suit Against Hospitalist Co.

The federal government has joined a whistleblower lawsuit against a company that provides doctors and other health professionals to work in hospitals in Florida and many other states. IPC The Hospitalist Group operates practice groups in Jacksonville, Ocala, Southwest Florida, Tampa, Broward County, Palm Beach County, Miami-Dade County and Orlando.

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HNF Stories
8:20 am
Thu June 19, 2014

FL Flubs Long-Term Care: Report

Florida can do a better job of caring for its elderly and disabled residents and the loved ones who care for them, a new report says.

The state ranked 43rd nationwide in a new AARP scorecard on long-term care released today, which measured criteria from affordability and access to choice of setting and providers. In particular, Florida placed dead last or near the bottom regarding quality of life and quality of care regarding adults with disabilities.

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Health News Florida
9:15 am
Fri June 13, 2014

Shands Settles Case, To Pay $3.25M

Shands Health Care System will pay $3.25 million to settle part of a whistle-blower lawsuit claiming six Shands hospitals billed and received overpayments from the government’s Medicare, Medicaid and Tricare programs, the Orlando Sentinel reports.

ProPublica
10:16 am
Mon June 2, 2014

Medicare Won't Pursue Overpayments

Medicare spent $6.7 billion too much for office visits and other patient evaluations in 2010, according to a new report from the inspector general of the U.S. Department of Health and Human Services.

But in its reply to the findings, the Centers for Medicare and Medicaid Services (CMS), which runs Medicare, said it doesn't plan to review the billings of doctors who almost always charge for the most expensive visits because it isn't cost effective to do so.

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Health News Florida
10:05 am
Tue May 27, 2014

Nothing Interim to WellCare CEO's Work

Dave Gallitano, interim CEO of Tampa-based WellCare Health Plans
Credit WellCare Health Plans

The interim CEO of WellCare Health Plans says he’s trying to move past the company’s troubles and focus on expanding its Medicare, Medicaid and prescription drug business, the Tampa Bay Times reports.

Dave Gallitano, the WellCare board chairman who led the ouster of the Tampa-based firm's most recent CEO last November, has made significant changes the past six months.

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Health News Florida
9:46 am
Thu May 1, 2014

Children’s Medical Change Confusing

Pediatricians are worried the privatization of the state’s Children’s Medical Services program will leave some children without services, the News Service of Florida reports.

Medicaid coverage for these children changes to pre-paid health plans on Aug. 1. Some pediatricians think the transition has been poorly planned and could leave as many as 70,000 children without medical coverage.

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Opinion
11:05 am
Mon April 28, 2014

‘Sneaky Lie’ on Medicaid Expansion

John Romano

In a column in the Tampa Bay Times, John Romano writes that more than a year ago, lawmakers claimed they were going to look for a solution to help low-income Floridians get health coverage after the House  turned down  a Senate bill to accept $51 billion in federal funds -- money made available through an alternative to  Medicaid expansion under the Affordable Care Act.

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Health News Florida
10:44 am
Mon April 28, 2014

Focus on Floridians Caught in Gap

With 800,000 uninsured Floridians stuck in the “coverage gap” - too much money to qualify for Medicaid, but not enough for subsidies under the Affordable Care Act - the focus is turning on what can be done to help. 

The Florida Legislature turned down the option of accepting $51 billion in federal funds that would have provided them health coverage last year. With only one week left in this year's session, those in the gap - 20 percent of Florida’s uninsured - will most likely be left hanging.

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Health News Florida
10:16 am
Fri April 25, 2014

Medicaid Fraud Suspect: 'I got greedy’

A Marion County woman accused of defrauding Medicaid said in an affidavit she was caught up in living well and "got greedy," the Ocala Star-Banner reports.

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HNF Stories
3:51 pm
Wed April 23, 2014

Delay Helps Safety-Net Hospitals

Jackson Health System, Miami
Credit CBS Miami

A plan to redistribute federal money among all of Florida’s hospitals will be delayed at least a year, legislators announced at a joint Health and Human Service budget conference committee meeting on Monday.

The so-called “tiering” plan would be a significant blow to the state’s 14 safety-net hospital systems, such as Miami’s Jackson Health System, which had been bracing for a $140 million cut to its budget, and the state’s two free-standing children’s hospitals, which were prepared to lose a combined $17.6 million.

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HNF Stories
10:22 am
Mon April 21, 2014

Gaetz Letter Seeks Medicaid 'Flexibility'

  All session long, Florida's legislative leaders have frustrated advocates for the poor, as well as much of the business community, by declining to talk about the billions of federal dollars for Medicaid expansion that the state is forgoing.

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Health News Florida
10:18 am
Mon April 14, 2014

Mother of 3 in Medicaid 'Gap' Dies

While 7 million Americans enrolled for health insurance before the March 31 Affordable Care Act deadline,  Charlene Dill wasn’t one of them.

The young mother of three collapsed and died from a treatable heart condition on March 21. She fell into  Florida’s health care gap; her income from part-time commission-based jobs was just $9,000, too poor for Affordable Care Act subsidies, the Orlando Weekly magazine reports.

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HNF Stories
6:55 pm
Fri April 11, 2014

Feds OK $2.2B for Hospitals, Med Schools

Cindy Mann, director of Medicaid.
Credit Medicaid.gov

Florida Medicaid received word Friday evening that federal officials have authorized a $2 billion hospital fund for indigent care starting July 1 and an extra $200 million for the state’s medical schools.

Justin Senior, Florida’s Medicaid director, said the Centers for Medicaid and Medicare Services okayed $2.2 billion for the “Low Income Pool (LIP),” which is used to support “safety-net” hospitals and clinics that treat a lot of Medicaid patients. The LIP is a combination of local and state funds that draw down federal match.

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Opinion
11:19 am
Fri April 11, 2014

Make KidCare Available Sooner

Getting rid of the five-year waiting period for children of legal immigrants to get health coverage through KidCare will improve health outcomes and save money, writes Cindy Arenberg Seltzer, president/CEO of the Children's Services Council of Broward County, in a column in the South Florida Sun Sentinel. Seltzer is urging lawmakers to pass measures that would eliminate the waiting period and give KidCare to more than 25,000 children.  

HNF Stories
10:21 am
Fri April 11, 2014

FL Medicaid Enrollment Expands

Florida’s Republican lawmakers remain staunchly opposed to expanding Medicaid — a system they’ve repeatedly said is too expensive and doesn’t improve health outcomes. Yet Florida’s Medicaid rolls are expanding under the Affordable Care Act whether Florida likes it or not.

That’s because people trying to sign up for health insurance under President Obama’s new health law are finding out — to their surprise — that they qualify for Medicaid, the federal health insurance program for the poor.

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Health News Florida
9:34 am
Mon April 7, 2014

Broward Ponders $1.29M Insurance Incentive

Broward County Commissioners are considering a $1.29 million incentive package for an unnamed health insurance company wanting to hire 265 employees in Sunrise.

HNF Stories
11:09 am
Thu April 3, 2014

House Health Panel OKs Dental Carveout

The House Health & Human Services Committee on Thursday approved HB 27, which would take away $200 million in children’s dental services from the Medicaid HMOs and other plans that have already contracted with the state to provide complete medical and dental care for patients of all ages.

The bill, sponsored by state Rep. Jose Diaz, R-Miami, passed 11 to 6.

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Health News Florida
10:31 am
Fri March 28, 2014

Fact-Checking Recovery of Medicaid Costs Under ACA

Does the Affordable Care Act permit the government to seize assets after Medicaid patients age 55 or older die? According to the Florida Times-Union, states have had the option to do that since the Medicaid program started in 1965.

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Health News Florida
10:13 am
Mon March 24, 2014

New Drugs: 1 Pricey, 1 Risky

A new drug hailed as a breakthrough against hepatitis C comes at a price that  puts treatment out of reach for most who need the medication -- $84,000 for a standard 12-week course of Sovaldi, manufactured by Gilead Sciences.

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HNF Stories
11:04 am
Thu March 20, 2014

Nelson Says CMS in Talks on Medicaid

Raising hopes that Medicaid expansion isn't as dead as it seems, U.S. Sen. Bill Nelson told Florida House Democrats on Wednesday that he is working on a solution with federal health officials -- but he wouldn't say what it was.

As The Florida Current reports, Nelson also said the state budget for 2014-15, which is being written right now, could lose $600 million in federal funds if the state doesn't compromise. He said it will be "a real shocker," but didn't elaborate.

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Health News Florida
10:23 am
Thu March 13, 2014

Medicare Contractor Questions Drug Tests

Florida’s Medicare contractor, First Coast Service Options in Jacksonville, recently announced plans to limit coverage for follow-up drug tests, and is accepting public comment.

Health News Florida
10:14 am
Mon March 10, 2014

Insurers Quietly Settle Medicaid Disputes

Behind-the-scenes negotiations between insurers are powering Florida Medicaid’s transition to statewide managed care plans, the Naples Daily News reports (paywall alert).

The Agency for Health Care Administration last year awarded contracts to 17 companies in 11 regions across Florida. That prompted 64 different legal challenges from insurers that stood to lose out on a share of an estimated $80-billion pie.  

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