Medicaid

A new study released Wednesday by the Georgetown University Health Policy Institute's Center for Children and Families found that Hispanic children in Florida are more likely to lack health insurance than Hispanic children in other states, the Miami Herald reports.

43% of FL Medicaid Kids Miss Checkups

Nov 13, 2014
U.S. Navy

Millions of low-income children - including almost half of those in Florida - are failing to get the free preventive exams and screenings guaranteed by Medicaid and the Obama administration is not doing enough to fix the problem, according to a federal watchdog report.

Medicaid Expansion Still a No-Go in FL, TX

Nov 12, 2014

Texas and Florida, with their large uninsured populations, are not expected to offer coverage to many low-income patients. KHN’s Phil Galewitz and Mary Agnes Carey discuss:

MARY AGNES CAREY:  Welcome to Enrollment Encore: What you need to know before open enrollment in the health law’s marketplaces begins again on November 15th. I’m Mary Agnes Carey.

KHN Senior Correspondent Phil Galewitz joins me now to talk about Medicaid and the health law.

An appeals court says Florida Hospital Orlando should repay more than $22,000 in Medicaid payments it claimed in the care of a 3-year-old child with leukemia, the News Service of Florida reports. The judges said Florida’s Agency for Health Care Administration was justified in requesting repayment in the case that centers around the state’s determination of whether care is a “medical necessity,” according to the News Service.

Hospitals Taking Cues From Hospitality

Nov 5, 2014

Two years ago, Inova Health System recruited a top executive who was not a physician, had never worked in hospital administration and barely knew the difference between Medicare and Medicaid.

What Paul Westbrook specialized in was customer service. His background is in the hotel business – Marriott and The Ritz-Carlton, to be precise.

  Democratic candidate Judithanne McLauchlan, who was inspired to run for Florida Senate District 22 against incumbent Republican Jeff Brandes because he was the only vote in the Senate against an alternative to Medicaid expansion, lost 57 percent to 43 percent.

During the 2013 Legislative session, Brandes was the lone vote against state Sen. Joe Negron’s alternative to Medicaid expansion. The plan, which would have drawn down $51 billion in federal funding over 10 years under the Affordable Care Act, was ultimately defeated by the Republican-controlled House.   

Florida's candidates for Attorney General met for their first and only debate earlier this month in the studios of Bay News 9.

Florida pediatricians who care for severely disabled children  say the state's overhaul of Medicaid has left  kids, parents and caregivers in turmoil.

Extremely fragile children, including some with tracheostomies and feeding tubes, face barriers in access to specialty care, physical therapy, home medical supplies and other urgent needs, the pediatricians say.

If former Florida Gov. Charlie Crist gets his old job back, he promises to expand Medicaid to roughly 1 million low-income residents by calling a special session of the Legislature or through an executive order. If Gov. Rick Scott is re-elected, the decision will be once again left to the Legislature with little meddling from him.

Medicaid expansion is an issue in the race for Florida’s Senate District 22, a swing district that covers most of Pinellas County and extends to South Tampa.

"This is an issue that propelled me into the race because I am running against the only senator that voted against the Medicaid expansion,” Democrat Judithanne McLauchlan said.

Lottie Watts / WUSF

Democratic candidates were the only ones to show at a legislative forum organized by the Tampa Bay Healthcare Collaborative. And each one said Florida needs to take federal funding to expand Medicaid under the Affordable Care Act.

The participants included Lorena Grizzle (D) – House District 66 candidate; Steve Sarnoff (D) – House District 67 candidate; Scott Orsini (D) - House District 69 candidate; and Judithanne McLauchlan (D) – Senate District 22 candidate.

The number of uninsured patients admitted to hospitals has dropped markedly this year, reducing charity care and bad debt cases, particularly in states that have expanded Medicaid coverage under the new federal health care law, a government report released Wednesday concluded.

The report from the Department of Health and Human Services said hospitals in states that have taken advantage of new Medicaid eligibility levels have seen uninsured admissions fall by about 30 percent. Florida is not one of those states.

For Autistic Adults, Options Scarce

Sep 23, 2014

It’s getting easier for parents of young children with autism to get insurers to cover a pricey treatment called applied behavioral analysis. Once kids turn 21, however, it’s a different ballgame entirely.

Many states have mandates that require insurers to cover this therapy, but they typically have age caps ranging from 17 to 21, says Katie Keith, research director at the Trimpa Group, a consulting firm that works with autism advocacy groups.

CHIP Future Unclear Under Health Law

Sep 18, 2014

The Children’s Health Insurance Program, a joint federal-state program known as CHIP, has helped cut in half the number of uninsured children since being enacted less than two decades ago, but its future is in doubt due to limited funding in the federal health law of 2010.  A year from now, CHIP will run out of money.  Some advocates for the program want the federal government to finance CHIP for another four years, while other experts have suggested two would suffice.  The Senate Finance Committee’s Subcommittee on Health Care will hold a hearing on the issue Tuesday.

Income inequality is taking a toll on state governments.

The widening gap between the wealthiest Americans and everyone else has been matched by a slowdown in state tax revenue, according to a report released Monday by Standard & Poor’s.

Even as income for the affluent has accelerated, it’s barely kept pace with inflation for most other people. That trend can mean a double-whammy for states: The wealthy often manage to shield much of their income from taxes. And they tend to spend less of it than others do, thereby limiting sales tax revenue.

Many people newly insured by Medicaid under the federal health care law are seeking treatment in hospital emergency rooms, one of the most expensive medical settings, a study released Monday concludes.

The analysis by the Colorado Hospital Association provides a real-time glimpse at how the nation’s newest social program is working.

It also found indications that newly insured Medicaid patients admitted to hospitals may be sicker than patients previously covered under the same program, which serves more than 60 million low-income and disabled people.

The nation's respite from troublesome health care inflation is ending, the government said Wednesday in a report that renews a crucial budget challenge for lawmakers, taxpayers, businesses and patients.

Economic recovery, an aging society, and more people insured under the new health care law are driving the long-term trend, according to the report published online by the journal Health Affairs.

States Help Pay ACA Tax On Insurers

Sep 2, 2014
Kaiser Health News

When Congress passed the Affordable Care Act, it required health insurers, hospitals, device makers and pharmaceutical companies to share in the cost because they would get a windfall of new, paying customers.

But with an $8 billion tax on insurers due Sept. 30 -- the first time the new tax is being collected -- the industry is getting help from an unlikely source: taxpayers.

Amerigroup

Two major health care groups have named new Chief Operating Officers for their Florida operations.

 Liz Miller has been promoted to the position at WellCare of Florida, the Tampa Bay Business Journal reports. She has been the vice president of product operations at the Tampa-based company since 2012. WellCare is Florida’s large Medicaid HMO contractor.

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.

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.

 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.

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.   

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.

Judge Won't Dismiss Medicaid Lawsuit

Jul 9, 2014
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.

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.

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.

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.

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.

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.

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