Medicaid

In the Miami Herald, Fabiola Santiago writes that it's negligent for lawmakers to reject more than $51 billion in federal money to provide health insurance to poor Floridians. She calls House Speaker Will Weatherford, R-Wesley Chapel, a “fool” and a “hypocrite” in his fight against Medicaid expansion and resistance to alternatives drawn up by Republicans.

No one questions that assisted living facilities need to be regulated - or if they do question it, they’re being quiet about it. But there’s disagreement on how the regulation should be carried out, especially how much the fines should be.

A South Florida health plan ramped up its legal challenge to the state’s decision to award a Medicaid managed-care contract to a competitor, the News Service of Florida reports.

Care Access PSN (for "provider service network") wants the 4th District Court of Appeal to block the state's contract with Prestige Health Choice for patients in Miami-Dade and Monroe counties.

'Moral Monday' Ushers in 2014 Session

Mar 4, 2014
AP

With the 2014 legislative session opening Tuesday, about 400 Floridians rallied in the Capitol Courtyard for what was billed as "Moral Monday." 

Speakers at the rally called for lawmakers to expand Medicaid, stop the state's voter purge and roll back the “stand your ground” self-defense law.

None is likely to occur during the impending legislative session, but the protestors vowed to carry their concerns to the polls in the midterm elections this fall.

Florida’s 2014 Legislative session will start with the typical benign tone that comes during an election year. But it’s unclear if the Republican-led legislature can keep things status quo, the Hearld/Times Tallahassee Bureau reports.

The funding formula in Florida’s Medicaid reform law means hospitals across the state will see millions of dollars in cuts, the Tampa Bay Times reports, while a handful will see funding increase (paywall alert).

 

The federal government intends to fine Florida for what it describes as a violation of the Social Security Act -- limiting Medicaid patients' emergency room visits to six a year -- the Tampa Bay Times reports.  

In December 2012, the Centers for Medicare and Medicaid Services  rejected the plan from the Florida Agency for Health Care Administration to cap the visits.

Because of the U.S. Supreme Court decision and Florida’s anti-Obamacare politics, legal immigrants will qualify for subsidies on health plans in this state even as citizens under the poverty level get turned away. 

As The Associated Press reports from Miami, many low-income uninsured are baffled that they don’t qualify for a tax credit.

 Though controversy over health care reform continues, America’s governors appear to agree on one thing: the Affordable Care Act is here to stay, according to the Associated Press

This weekend in Washington D.C., Republican and Democratic governors said a complete repeal of the law would be impractical, especially since states already are implementing the ACA with varying degrees of success, the AP reports.

A new study shows that critically injured patients with health insurance are more likely to stay put at non-trauma hospitals than be transferred to more skilled facilities, according to Kaiser Health News and NPR.

Efforts to clamp down on health care fraud continue across Florida, different media report.

Gubernatorial candidate Charlie Crist’s national media tour includes a fiery salvo: Gov. Rick Scott and the Republican Legislature are tied to the deaths of uninsured Floridians. 

The former governor and Democratic candidate told MSNBC’s “Daily Rundown” that “six people in Florida die every day as a result” of the state’s failure to expand Medicaid for the poor and uninsured.

Baby boomers have seen it coming for quite some time -- retirement, senior living and senior survival. 

Experts say most of us begin planning too late for the help we might need as we get older.

Mary Shedden / WUSF

Milagros Medina rents a room in a quiet subdivision on the outskirts of Lakeland. At 68, her arthritis, high blood pressure and chronic back pain are not going away. 

And she doesn’t want to end up in a nursing home.

This retiree who likes being called Miss Millie tries to keep going by getting help with the chores most people take for granted. She says without financial help from Florida’s Medicaid program, she couldn’t afford it. And her health would suffer.

Amid the ongoing Medicaid expansion debate, health consultant Paul Gionfriddo points to several studies that say thousands nationwide could die prematurely if Medicaid is not expanded. At his blog Our Health Policy Matters, Gionfriddo writes that lawmakers should not ignore the compelling data indicating the life and death impacts of health coverage through Medicaid.

Federal officials are lengthening a temporary moratorium on new home health care agencies in Miami-Dade and Monroe counties, and have also included Broward County in the ban. As the Miami Herald reports, the six-month ban that starts today is an attempt to deter Medicare and Medicaid fraud. Federal health officials say Miami-Dade has the highest ratio of home health agencies to Medicare beneficiaries and has the biggest payments.

A bill that would provide health insurance coverage to Floridians under the poverty level by accepting federal funds available for that purpose has been filed in the Florida House of Representatives.

Following the example of private companies, Medicare is moving to limit the number of drug brands it will cover. The Centers for Medicare and Medicaid Services have proposed to allow private prescription-drug plans under Medicare Part D to cover only some of the antidepressants on the market, not all, according to the South Florida Sun Sentinel.

A Florida man found mentally incapable of caring for himself spent most of the $400,000 he won on a lottery scratch-off ticket and now may lose the government benefits he needs. 

A study about the impact of the 2008 Oregon Medicaid expansion on hospital emergency department visits doesn’t actually tell us much about the Affordable Care Act, consultant Paul Gionfriddo writes at his website, Our Health Policy Matters. Gionfriddo details why he thinks the study is more history than news.

Miami-Dade County, the juiciest plum in Florida Medicaid’s switch to mandatory managed care, could still be in play following a ruling against the Agency for Health Care Administration in its contracting decisions. Hundreds of millions of dollars could ride on the outcome. 

The decision by Administrative Law Judge John Van Laningham, issued Jan. 2 tells AHCA that it should rescind its decision to award a contract to Prestige Health Choice for the region that encompasses Dade and Monroe counties.

healthcare.gov

About 35,000 Floridians who found they were eligible for health coverage through Medicaid are still waiting for confirmation that they’re covered, Kaiser Health News reports.

The Associated Press

Florida’s Medicaid program says it is providing free flu shots to as many as 75,000 additional pregnant women this season.

The state did away with fees late last week for 65,000 to 75,000 adult women enrolled in the Medicaid program, Michelle Dahnke, spokeswoman for the Agency for Health Care Administration, told Health News Florida.

Miami Herald

A state agency’s proposal to eliminate the state’s prepaid dental health plan for low-income children has garnered opposition from two Miami-Dade lawmakers and a coalition of dentists.  The Agency for Health Care Administration has proposed switching children’s dental services from the prepaid dental plan to a Medicaid managed care model, the Miami Herald reports. 

AP

Gov. Rick Scott, who is running for re-election, chose not to answer questions Wednesday about whether he still supports Medicaid expansion -- for which the federal government has offered Florida $51 billion over the next decade as part of the Affordable Care Act.

Getting people to sign up for health insurance under the Affordable Care Act remains an uphill battle in much of Florida.

Politicians in the state erected roadblocks to the law from the beginning — from joining in the 2010 lawsuit to thwart the law to placing restrictions on what insurance helpers called navigators can tell people seeking advice.

People filling out insurance applications on the federal marketplace may learn they're eligible for Medicaid and their information is being sent to state officials to sign them up. However, states are getting unusable information because of technical problems that continue to plague the website.

Yoselis Ramos / WUSF

If you weren't looking for it, you might miss it, sitting between a nail salon and a discount grocery store in a shopping plaza that seems to have an endless parking lot. Tucked in the plaza is a multi-million dollar medical clinic. 

"The model is all inclusive, where you can come and get everything taken care of in one place," said Mark Kent, CEO of CAC-Florida Medical Centers, a subsidiary of health insurance giant Humana.

Even though Florida’s Legislature turned down federal funds to expand Medicaid under the Affordable Care Act, leaving billions of federal dollars on the table, the state's health insurance program for the poor continues to grow.

State Sen. Joe Negron, R-Negron, said he doesn’t expect there to be any movement on the issue of Medicaid expansion during the upcoming session, the Florida Current reports. Negron, who chairs the Senate Appropriations committee, tried last session to pass a private-sector version of Medicaid expansion that accepted federal money to cover the low-income uninsured.

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