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Feds Back Change To Trim Medicaid Costs

Despite fears that the move could cut access to health care for poor residents, Florida has won approval from the federal government for a change that will let the state reduce how much it spends on Medicaid.

The change in how the state administers the safety-net program was approved by federal officials Friday and takes effect Feb. 1. It allows the state to trim money it spends on people when they initially become eligible for Medicaid.

Seema Verma, administrator for the federal Centers for Medicare & Medicaid Services, said in a letter giving approval that the change will remain in effect until June 30 unless state lawmakers agree to extend it.

The federal agency, commonly known as CMS, said it expects Florida to use the change to see whether it can stop people from jumping off and on Medicaid and instead receive continuous care.

“As part of this demonstration, Florida will test whether this policy encourages Medicaid beneficiaries to obtain and maintain health coverage, even when healthy, or to obtain health coverage as soon as possible after becoming eligible,” the letter said.

Federal law directs state Medicaid programs to provide 90-day retroactive coverage to give people time to apply for coverage following traumatic incidents or diagnoses of illnesses. That way, people have time to gather information needed to apply, including such things as proof of age, citizenship, sources of income and assets.

The new policy allows the state to only pick up 30 days of existing health care bills for people who become eligible for Medicaid. The shortened retroactivity period, however, would not apply to children or pregnant women. Medicaid officials earlier this year estimated it would impact about 39,000 people

The Medicaid change was estimated to save Florida nearly $100 million when it was first proposed to federal officials. Some Democratic legislators and others criticized the move. CMS acknowledged that most of the feedback it received about the policy was negative and that critics warned it would hurt poor, disabled and elderly people.

But federal officials said that’s why they were ordering the state to educate the public and health-care providers about the change and to put the outreach strategy on the state’s Medicaid website.

“This will help ensure that eligible individuals apply for and receive Medicaid coverage in a timely manner, as well as ensure that providers understand how to assist individuals in gaining coverage,’’ the letter said.

Federal officials also said the state would be required to provide coverage as of the first day of the month someone applies for Medicaid. CMS said that should mitigate some of the concerns.

Florida is also being ordered to do an independent evaluation of the change to see whether it will prompt Medicaid beneficiaries to enroll for coverage sooner.

The CMS letter Friday also included approval of other changes, including allowing community mental-health providers to participate in a supplemental Medicaid funding program known as the Low Income Pool. The change could result in a funding increase for community facilities that treat patients for mental-health and substance-abuse disorders, including opioid addictions.

Melanie Brown-Woofter, president and chief executive officer of the Florida Council for Community Mental Health, said the funding will help "ensure that individuals experiencing behavioral health crisis have access to critical resources in their communities. "

Florida also won permission to offer a news statewide Medicaid managed dental plan and to make other adjustments to the Low Income Pool.

Medicaid officials this summer inked contracts with three managed dental-care providers. The new contracts roll out in Southeast Florida this month.

Low Income Pool dollars are supplemental Medicaid funds made available by the federal government but funded by hospital taxing districts and other county entities.

The Low Income Pool changes including making additional funds available to regional perinatal care centers, which provide obstetrical services to women who have a high-risk pregnancies.