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Benson resigns as AHCA chief

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By Christine Jordan Sexton

10/15/2009 © Health News Florida

One of the chief architects of Florida’s Medicaid Reform project has resigned. 

Holly Benson, secretary of the Agency for Health Care Administration, submitted a resignation letter to Gov. Charlie Crist on Wednesday saying her future plans require it, although she did not say what they are. She is widely expected to run for Attorney General. 

“Health care is at a critical crossroads, and its course is being determined not in Tallahassee, but in Washington, D.C.” she wrote. “Likewise, I find myself at a critical juncture wherein I must consider how to best use my talents to serve the people in our state.” 

Her departure comes as Florida enters the final year of its controversial “Medicaid Reform” experiment, which was intended to hold down rising costs, prevent fraud and coordinate patients’ care. It remains unclear how much money it saved and what the tradeoffs were.
 
AHCA press secretary Tiffany Vause said there’s been no announcement on who will head the agency after Benson’s Oct. 28 departure. Already, though, there is interest in the job. 

“I would love to take a whack at it,” said Rep. Ed Homan, an orthopedic surgeon and Republican from Tampa. “It’s a great time for anybody to get in there and make some changes.” 

State Sen. Durell Peaden said  he was surprised at the resignation, although he had heard rumors that Benson was interested in the Attorney General position. Peaden said he'd like to see Tom Arnold, AHCA Deputy Secretary, be named to the top post.
 
Arnold has had a long career in state health policy, working for AHCA and the Department of Health. He's worked successfully with several governors and understands the multibillion-dollar Medicaid budget and the Reform pilot, Peaden said.

"We don't need to get anybody in there who needs on-the-job training," the senator said. When asked if he had an interest in the position, Peaden replied:  "Not at all. I have zero interest."

Benson is best known as being the architect of Gov. Jeb Bush’s experiment to alter Medicaid from a limitless entitlement program for certain low-income groups – children, pregnant women, and the elderly and disabled -- to something that more closely resembles private insurance. Benson served in the Legislature for six years.
 
She made a brief bid for the state Senate, but after drawing tough opposition in the Republican primary from Don Gaetz, withdrew. Gaetz went on to win the general election. 

In 2006 Benson was named Secretary of the Department of Business and Professional Regulation by Gov. Charlie Crist. Then Crist named her AHCA Secretary in February 2008.
 
Because she was the main architect of the Bush reform plan, her appointment was controversial from the start. Her AHCA predecessor, physician Andrew Agwunobi, opposed expansion of Medicaid Reform beyond its current five counties, citing a critical report from his inspector general, Linda Keen.
 
Within months of Benson’s arrival at AHCA, Keen resigned from the agency. Thereafter, AHCA reversed its position on Medicaid Reform and lobbied for it to be expanded into heavily populated Miami-Dade and Hillsborough counties, among others. But the Legislature refused. 

The pilot project requires most Medicaid beneficiaries in Ft. Lauderdale, Duval, Baker, Clay and Nassau counties to enroll in HMOs or other managed care plans. It is made possible by a five-year waiver of federal Medicaid rules that will expire in 2010. 

Benson has placed emphasis on getting more information on health costs and quality to consumers through the state's Web site, www.FloridaHealthFinder.gov. Coincidentally, AHCA received word today that it received an award for that effort from the National Association of Health Data Organizations.

--Christine Jordan Sexton is co-founder of TallahasseeReporters.com.