Medicaid

Florida employers could get hit with up to $219 million in federal penalties if the state doesn’t expand Medicaid or do the functional equivalent, Bloomberg News reports. That’s because they’ll  have to pay a penalty under the Affordable Care Act if their low-wage employees are forced to seek subsidized care through the federal health exchange because they can’t get Medicaid.  

Ocala Star-Banner

Alicia Ford, who suffered brain damage at birth 28 years ago, learned how to get around with a walker when she was getting physical therapy. But she lost Medicaid eligibility at 18. Now her muscles have shriveled and she can’t get out of her wheelchair, the Ocala Star-Banner reports. 

Medicaid expansion for 1 million low-income adults in Florida may technically be dead, after committees in both the House and Senate voted to kill it. And yet, chances for an alternative plan that would accomplish the same goals are looking up.

On Wednesday, federal health officials  signaled interest in seeing Florida’s alternative plan, which is still just a  gleam in the eye of a powerful state senator, as soon as the state has something in writing.

It wasn't much of a surprise to newspapers around the state that both the House and Senate committees on the Affordable Care Act said no to Medicaid expansion.

But as the Tampa Tribune's editorial board said, it's not enough to just say no, not with 4 million uninsured -- the poorest 1 million of whom would have been helped by the expansion.

Weatherford's Political ‘Instincts’ Failed Him on Medicaid Remarks

Mar 13, 2013

At his site Our Health Policy Matters, consultant Paul Gionfriddo writes that Florida House Speaker Will Weatherford has a duty to embrace Medicaid expansion, especially since he openly shared how the program helped his younger brother.

Palm Beach Post

A measure working its way through the Florida Legislature would make it more difficult to sue corporate executives, directors and other “decision-makers” when something goes wrong at their nursing homes, the Palm Beach Post reports. 

Thousands of non-English-speaking Floridians face a difficult barrier when they go to the state’s web page to sign up for Medicaid and and other programs, the Associated Press reports. Health advocates worry they’ll lose out on new opportunities under the federal health law. 

Lawmakers are in Tallahassee today to start the 2013 Legislative session, which will take up a slew of health issues, the Miami Herald reports.

In addition to Medicaid expansion, lawmakers will also consider:

Palm Beach Post

After the Palm Beach Post reported last spring that juveniles in youth prisons were getting large doses of antipsychotics, and doctors were getting large kickbacks from the makers of those drugs, the state promised action. 

The day that WellCare Health Plans dreaded for years arrived on Tuesday: The criminal trial of four company ex-executives began in earnest in Tampa's federal court, with lots of accusations about health fraud and conspiracy.

As the Tampa Tribune reported, interest in the case is so high that the courtroom was packed, with spillover space on another floor.

The Department of Children and Families says the Legislature needs to close loopholes in the law that allow financially stable nursing home patients to hide their assets and get Medicaid to foot the bill for their care, the Associated Press reports.  The state found more than 500 cases totaling $29 million in a six-year review.

Tampa Bay Times

A woman who deliberately works fewer hours so her children can get coverage...a 61-year-old adjunct professor ...A family doctor who had to call in a personal favor to get a biopsy for a patient...

The Tampa Bay Times and Miami Herald show what an expansion of the program would mean for these people.

Several Florida newspapers published editorials today on Gov. Rick Scott’s announcement to expand Medicaid, and the general theme was “Hallelujah!”:

As legislative hearings continue on the cost vs. benefit of Medicaid expansion – a decision Florida must make in the coming session -- only a few things are clear:

--No one knows for sure whether the expansion to approximately 1 million uninsured Floridians whose incomes are below 138 percent of the federal poverty level will end up being a net plus to the state – since the federal government is putting up over $26 billion over 10 years – or a net minus. A study is available to fit every opinion.

Last week, the Senate Select Committee on the Affordable Care Act heard presentations critical of Medicaid expansion -- one of the most important issues facing this year's Legislature.

The presentations concerned the experience of Maine and Arizona, both of which expanded their Medicaid programs several years ago, only to regret it. See "Medicaid Expansion Can Backfire, Witnesses Say."

AP

Illegal immigrants aren't supposed to be covered under Medicaid except in emergencies. It turns out that emergency care adds up to a lot of money, as Phil Galewitz of Kaiser Health News reports.

Federal health officials have given Florida permission to enroll elderly, sick Medicaid patients into private managed-care plans, Gov. Rick Scott’s office announced on Monday.

The three-year waiver of federal Medicaid rules can begin July 1, according to the letter from two officials at the Centers for Medicare and Medicaid Services, part of the federal Department of Health and Human Services.

The Palm Beach Post rebukes Gov. Rick Scott and the Legislature in general -- in particular Sen. Joe Negron, who chairs a key committee on implementation of the federal health law -- for failing to do their jobs in time for insurers to file their 2014 plans and for Florida to run its own exchange.

House members and the governor, like thousands of other high-ranking state employees, continue to get ultra-cheap health insurance even as they’re deciding whether to expand Medicaid so that 1 million uninsured Florida citizens can get coverage, the Associated Press reports.

Just how big is the gap in government spending? See the graphics that break down how money is spent on the elderly and children.

American Cancer Society Cancer Action Network

Florida voters by a wide margin support expanding Medicaid to cover more of the state's uninsured, according to a poll sponsored by the American Cancer Society.

Support topped opposition 63 percent to 25 percent and  crossed all age and demographic groups, ACS reported. The proposal drew its strongest support from Latinos.

Florida Hospital Association president Bruce Reuben writes that all Floridians should care about how the state handles the decision on Medicaid expansion, since it ultimately affects everyone.

Hospitals Ask for Delay on New Medicaid Payment System

Jan 24, 2013

Florida hospitals asked the Legislature for a delay on the new Medicaid payment system scheduled to begin July 1, 2013.

Gionfriddo: Reform Costs, Not Entitlements

Jan 23, 2013

Health consultant Paul Gionfriddo writes that the myth of entitlement reform may go by the wayside. The problem, he writes, isn’t the cost to the government, but the increasing cost to the individuals who rely on the programs.
 

Sen. David Simmons was a math major in college. So the Orlando Republican was well-equipped to search for flaws in cost estimates for expanding Medicaid that are floating around Tallahassee.

But he's a lawyer, not an economist. So like other senators on the Select Committee on the Patient Protection and Affordable Care Act, he had to do a lot of homework before this week's hearings with two health economists.

While many hospitals will see an increase in payment for treating Medicaid patients in the switch to the "Diagnosis Related Group” model, teaching hospitals will get less. Tampa General, which has 301 resident doctors, estimates it will lose $10 million.

Residents of a nursing home in St. Petersburg are livid over a change in policy that limits them to nine 20-minute smoke breaks a day. The facility says it changed the rules after federal health officials sent a letter about a nursing-home patient who died after her cigarette lit her clothes on fire.

Three companies stand out as major winners in Florida’s competition for contracts in the Statewide Medicaid Managed Care Program for Long-Term Care, a market worth an estimated $3 billion.

They are American Eldercare, Sunshine State Health Plan and UnitedHealthcare of Florida.

American Eldercare -- a little-known Delray Beach firm that specializes in caring for seniors in independent living, assisted living and rehab centers, as well as in their homes --  is the only company that won contracts to enroll customers in every region of the state.

Florida Legislature

Many speakers at a Health Care Affordability Summit on Friday said the medical culture is mired in the past and called for smarter use of technology to contain costs, reduce errors and improve access.

Rep. Matt Hudson, who chairs the House Health Care Appropriations Subcommittee, served as convener and cheerleader for a panel of experts who pressed that case. Hudson said one of his main quests since he came into office is to "create some better efficiencies."

The region that includes Orlando and Melbourne will be the first in the state to enroll its frail elderly patients who are on Medicaid into managed-care plans, the Agency for Health Care Administration announced Monday.

A map on AHCA's website offers a guide as to which counties are included in the rollout, which hinges on approval by the U.S. Department of Health and Human Services for Florida's requests for a waiver of federal law for its Statewide Medicaid Managed Care program. 

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