Medicaid

President-elect Donald Trump unveiled two big health care decisions Tuesday.

Nursing homes are gearing up to fight a plan that could result in what they say are widely varied Medicaid reimbursement rates. Its part of a legislative push for efficiency, but the move is worrying providers in the $4.8 billion program.

p1 lawyer / Flickr

A fall 2017 trial date is set for a South Florida businessman accused of orchestrating a $1 billion Medicare and Medicaid fraud scheme.

Health Policy Institute/Georgetown University

According to a new report, more children than ever before have health insurance.

Florida joins 40 other states that insured more children between 2013 and 2015.

State Eyes Medicaid-Managed Care Extension

Oct 18, 2016

The Florida Agency for Health Care Administration will start holding public meetings Tuesday as it moves forward with seeking federal approval of a three-year extension of the state's Medicaid managed-care program.

Voting and healthcare advocacy groups want Floridians to consider healthcare as they cast ballots on November 8th.

WellCare

WellCare Health Plans, Inc., one of the largest public companies and one of the largest employers in Tampa Bay, has signed an agreement that expands its footprint in Arizona’s Medicaid and Medicare markets, according to the Tampa Bay Business Journal.

Appeals Court Upholds Convictions Of Ex-WellCare Executives

Aug 12, 2016
WellCare Health Plans

In a 124-page ruling, a federal appeals court Thursday upheld the convictions of four former WellCare Health Plans executives in a case that stemmed from allegations of defrauding Florida's Medicaid program.

Donna Nickerson spent her last working years as the activity and social services director at a Turlock, Calif., nursing home.

But when she developed Alzheimer's disease and needed that kind of care herself, she and her husband couldn't afford it: A bed at a nearby home cost several thousand dollars a month.

"I'm not a wealthy man," said Nickerson's husband Mel, a retired California State University-Stanislaus professor. "There's no way I could pay for that."

The Commonwealth Fund

Florida cities are losing ground on key health care indicators, according to a report released today.

The researchers say one reason for the decline is the state's decision to not expand Medicaid.

Many babies born to mothers who are covered by Medicaid are automatically eligible for that health insurance coverage during their first year of life. In a handful of states, the same is true for babies born to women covered by the Children's Health Insurance Program.

Appeals Court Rules Against St. Pete Nursing Home In Medicare Fight

Jul 12, 2016
Google Maps

A federal appeals court Monday said a bankruptcy judge did not have the authority to block health officials from cutting off Medicare and Medicaid payments to a Florida nursing home that was alleged to have violated patient-care regulations.

A decade-long lawsuit over Florida’s Medicaid program has cost taxpayers millions, according to the Sarasota Herald-Tribune.

Georgetown University

Since 2014, Florida’s Medicaid program has been run not by the state but through private insurance companies. The Sarasota Herald-Tribune has written about problems with the managed care system and a recent report from Georgetown University surveyed pediatricians to determine how they feel about the system.

A Miami federal judge gave final approval Tuesday to a settlement agreement in a decade-long legal battle between the Florida Academy of Pediatrics and the state.

Federal Judge Approves Medicaid Settlement

Jun 29, 2016

A federal judge has given final approval to a settlement in a decade-long legal fight over care provided to children in Florida's Medicaid program. 

Forty-nine children and their families, including one from Clay County, are hoping face-to-face meetings with members of Congress helps lawmakers understand the plight of kids with medically complex conditions.

The group is lobbying leaders to pass a law expanding coordination between medical specialists across state lines.


More Than 100 Charged In Florida In Health Care Fraud

Jun 22, 2016
U.S. Department of Justice

In what the U.S. Department of Justice described as an "unprecedented nationwide sweep," more than 100 people in Florida have been charged with crimes related to Medicare and Medicaid fraud, the federal agency announced Wednesday. 

Private insurance companies that say they were underpaid by Florida’s Medicaid system over the past two years delivered a $433 million bill to the state this month, according to the Miami Herald.

Judge To Hear Arguments In Abortion Law Challenge

Jun 15, 2016

A Tallahassee federal judge will hear arguments June 29 on a request from Planned Parenthood to block parts of a major abortion law approved this year by Gov. Rick Scott and Florida lawmakers.

According to a report by the Georgetown University Health Policy Institute, Florida's system for delivering Medicaid to children is among the worst in the nation. 

Hospitals Must Wait For Day In Court Over Undocumented Patient Care

Jun 8, 2016

A state appeals court has rescheduled arguments for June 21 in a dispute about Medicaid payments to hospitals that provide emergency care to undocumented immigrants.

WMFE

Florida health officials are changing the state's policy for administering costly hepatitis C drugs to Medicaid patients and will now require insurance companies to provide the drug at an earlier stage in the disease.

Demand for long-term care is expected to increase as the nation ages, but the majority of Americans 40 and older lack confidence in their ability to pay for it.

Opioid Epidemic Fueling Hospitalizations, Hospital Costs

May 3, 2016
Associated Press

Every day, headlines detail the casualties of the nation’s surge in heroin and prescription painkiller abuse: the funerals, the broken families and the patients cycling in and out of treatment. Now, a new study sheds light on another repercussion — how this public health problem is adding to the nation’s ballooning health care costs and who’s shouldering that burden.

Administration Says New Rules For Medicaid Plans Will Improve Service For Enrollees

Apr 26, 2016

The Obama administration tightened rules Monday for private insurance plans that administer most Medicaid benefits for the poor, limiting profits, easing enrollment and requiring minimum levels of participating doctors.

Study: Medicaid Expansion Encourages More Poor Adults To Get Health Care

Apr 19, 2016
Source: The Kaiser Family Foundation

In states that expanded Medicaid under the Affordable Care Act, low-income adults were more likely to see a doctor, stay overnight in a hospital and receive their first diagnoses of diabetes and high cholesterol, according to a study published Monday.

Florida Gov. Rick Scott Responds To Coffee Shop Showdown

Apr 11, 2016
YouTube/Stephen Bender

Florida Gov. Rick Scott, responding to a viral video showing him being cursed at by an activist at a coffee shop, has brewed the frothy fracas into a full-force Floridian feud.

Settlement Reached In Battle Over Children’s Health Care

Apr 6, 2016
AP

After a court fight that lasted more than a decade, the state and groups representing pediatricians and dentists have settled a class-action lawsuit about care provided to children in Florida's Medicaid program.

The settlement, released Tuesday, came about 15 months after a federal judge found that Florida's history of low reimbursement payments to doctors led to a lack of access to care for many poor children. But the agreement also came after the state argued that an overhaul of the Medicaid system had effectively made the case moot.

Court Backs DCF In Nursing Home Expenses Case

Apr 6, 2016

An appeals court Monday sided with the Florida Department of Children and Families in a dispute about expenses for a woman who went into a Tallahassee nursing home after suffering a spinal-cord injury in an accident.

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