Medicaid

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. 

Gov. Rick Scott said after the election that he was open to considering cooperation with "ObamaCare." But his penchant for phony cost estimates indicates maybe he isn't sincere.

Politico

Health News Florida’s story on Gov. Rick Scott’s Medicaid cost estimates generated a huge buzz this week online and in publications around the country.

On Thursday, WUSF aired a conversation between News Director Scott Finn and Health News Florida’s editor Carol Gentry, who broke the story. The WUSF story-behind-the-story tells how it came to light.

Estimates from AHCA show the hospitals that serve Florida’s neediest patients would lose millions of dollars if Medicaid starts paying by the diagnosis, as Medicare does.

After two days of heavy criticism, Gov. Rick Scott’s administration released  a new, much smaller estimate of the cost of expanding Florida Medicaid late Wednesday night. The new report pegs the price tag at about $3 billion.

At the most, if all those eligible signed up, it would cost the state $5 billion over a decade, the new report says. That is less than one-fifth the cost that Scott has been citing.

Although Medicare has been using the payment system for decades, Florida is only now making the switch to paying hospitals by the diagnosis for Medicaid patients.

Gov. Rick Scott, a health-industry millionaire who became governor after promising to kill 'ObamaCare,' made national news Monday simply by going to Washington.

Associated Press

The state’s chief economist has warned the staff of Gov. Rick Scott that his Medicaid cost estimates are wrong, but Scott keeps using them anyway, according to e-mails obtained by Health News Florida  (Update: Scott to Look at Other Estimates).

Scott says he opposes expanding Florida Medicaid because it would cost too much: $63 billion over 10 years, he says, with the state paying $26 billion of that.

healthcare.gov

Florida is one of five states that pay primary-care doctors so little for treating Medicaid patients that those doctors will get a raise of more than 100 percent when a federal subsidy kicks in on Jan. 1, according to a new study.

The raise, which brings Medicaid pay up to the level of Medicare for two years, is part of the  Patient Protection and Affordable Care Act. The idea is to lure more doctors into primary care and make it worth their while to care for those insured by Medicaid, the joint state and federal program for the very poor.

Many people who are uninsured, the ones whom the Affordable Care Act is designed to help, are terrified of it because they have little understanding of it. A non-profit group says that 83 percent of those who would qualify for free coverage don't know that.

Florida Gov. Rick Scott and 10 other Republican governors have asked the President for discussion on relaxing the health-law rules about Medicaid expansion and health exchanges.

A 25-year-old social worker and recent USF grad was stabbed and killed by her 53-year-old client, a man with a criminal history who had been Baker-Acted once before.

According to PolitiFact, there’s truth to Congressman Alan Grayson’s claims about Wal-Mart employees’ high dependence on Medicaid; data on food stamp usage is not as clear cut.

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