Medicaid

The Florida Senate is working on bills that would increase the amount of federal Medicaid money used to fund mental health and substance abuse problems, Florida Politics reports. The Senate Appropriations Subcommittee on Health and Human Services will discuss the bill drafts Monday at its meeting.

House Panel Blocks Medicaid Dental Changes

Mar 11, 2015
Dave Buchwald

A House panel Tuesday rejected a proposal to revamp the Medicaid program's system of providing dental services to children.

The House Health Innovation Subcommittee deadlocked 6-6 on the proposal (HB 601), filed by Rep. MaryLynn Magar, R-Tequesta. A tie kills a bill. 

Under the state's new Medicaid managed-care system, HMOs and other types of managed-care plans are responsible for providing dental services to children.

Federal authorities haven’t publicly accused taxpayer supported Broward Health of submitting bogus claims to Medicare and Medicaid, but the health system still has racked up a $10.2 million tab for legal advice, the Florida Bulldog reports.

Wikimedia Commons

Some foster children are not getting their required medical screenings even though the visits are paid for by Medicaid, federal health investigators warn in a study released Monday.

The Health and Human Services' inspector general study looked at a random sample of roughly 400 foster children from California, Texas, New York and Illinois and found nearly 30 percent did not receive one or more of their required health screenings between 2011 and 2012.

HealthCare.gov

The share of Americans without health insurance dropped to its lowest level in seven years in 2014 as President Barack Obama's overhaul took full effect, according to an extensive survey released Tuesday.

The Gallup-Healthways Well-Being Index found that the trend appears likely to continue this year, since 55 percent of those who remained uninsured told the pollster they plan to get coverage rather than face escalating tax penalties.

In Florida, the rate dropped 3.4 points.

Senate Health Panel Tries Again on Telemedicine

Feb 4, 2015
Florida Senate

Pointing to a need to increase access to health care in areas such as rural communities, a bipartisan group of House and Senate leaders Tuesday expressed confidence they will reach agreement this year on a plan to boost the use of telemedicine in Florida.

Sometimes called "telehealth," telemedicine involves using the Internet and other technology to provide care to patients remotely.

As a basic example, a physician could use a video link to consult with a patient who is at home.

Disputes About Old Hospital Rates Stir Controversy

Feb 3, 2015

  A Senate committee Tuesday postponed taking action on a controversial bill that stems from disputes about old Medicaid payment rates for hospitals.

The bill (SB 322), filed by state Sen. Kelli Stargel, R-Lakeland, would create a five-year time limit on challenges by hospitals to reimbursement rates. Supporters of the bill said it is needed because some hospitals have filed administrative challenges to reimbursements that date back to the 1990s or earlier.

FL Negotiates For LIP Money Amid Questions

Feb 3, 2015
Agency for Health Care Administration

 Florida's Medicaid director met Tuesday with federal officials as the state tries to continue receiving $1 billion a year to help hospitals and other providers care for low-income and uninsured people. Justin Senior, a deputy secretary at the state Agency for Health Care Administration, traveled to Baltimore to meet with federal officials about what is known as the Low Income Pool, or "LIP," program.

Centers for Disease Control and Prevention

Caring for Alzheimer’s and dementia patients is emotionally demanding but also is increasingly expensive, according to a Fort Myers News-Press analysis of 10 years of records from state agencies, nursing homes and hospitals.

A new health-care policy plan from the Florida Chamber of Commerce backs an expansion of health coverage under an alternative to Medicaid expansion, the Florida Times-Union reports. The chamber president says they “largely agree" with the "A Healthy Florida Works” plan backed by several Florida business groups.

Agency for Health Care Administration Secretary Elizabeth "Liz" Dudek has an ambitious "to-do" list for Governor Rick Scott's upcoming second term, according to Christine Jordan Sexton of SaintPetersblog

WellCare Health Plans

WellCare Health Plans, Inc., Florida’s largest Medicaid HMO provider, announced Monday that Kenneth Burdick will be appointed as CEO, according to a statement released by the Tampa-based company. 

Burdick, who previously served as the company’s president and chief operating officer, will be replacing interim CEO David J. Gallitano Jan. 1.

According to the statement, Burdick has previously held executive positions with companies such as Blue Cross Blue Shield, Coventry Health Care, and UnitedHealth Group.

St. John's County

Former employees of a medical clinic accuse the St. Johns County Commissioner and his mother of improperly billing for nearly 40 Medicaid patients, illegally storing controlled substances and forging prescriptions, the Florida Times-Union reports. 

Governor Rick Scott is reappointing Elizabeth Dudek to oversee the Florida Agency for Health Care Administration.

Dudek has been the head of the agency since 2011. Together, they helped privatize the Medicaid program, paying private insurance companies a set fee for roughly 3 million Medicaid recipients instead of the state paying for each service patients incur.

Scott also praised Dudek for overseeing that Florida hospitals were prepared for Ebola.

The veteran business executive hired by Florida Healthcare Plus is trying to repair the image of the firm after six former employees were indicted for their role in an international, $25 million Medicare and Medicaid scam, the Miami Herald reports.

In an interview, Susan Rawlings Molina says no one else at the company knew about the fraud, except for the ex-employees who are now facing charges. Only the former workers, not the company, are accused of wrongdoing.

U.S. Health Spending Growth Lowest Since 1960

Dec 4, 2014

National health spending grew 3.6 percent in 2013, the lowest annual increase since the Centers for Medicare and Medicaid Services (CMS) began tracking the statistic in 1960, officials said Wednesday.

Spending slowed for private health insurance, Medicare, hospitals, physicians and clinical services and out-of-pocket spending by consumers.  However, it accelerated for Medicaid and for prescription drugs, according to the report, published online by the journal Health Affairs.

A whistleblower’s lawsuit by an ex-Plaza Health Network executive alleges that false claims were submitted to Medicare and Medicaid to the tune of $130 million, the Broward Bulldog reports.

Sarasota Memorial Hospital will no longer be an in-network hospital for patients signed up with the region’s largest Medicaid provider, according to the Sarasota Herald-Tribune.

After Dec. 31, Staywell Wellcare patients will not be covered at Sarasota Memorial, which currently treats 90 percent of the area’s Medicaid patients who need hospital care.

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.

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