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Medicaid overhaul could lead to ‘Granny-dumping’, lawyers say

Around the state, lawyers for the elderly are coming out in force to denounce Florida’s Medicaid overhaul as “Granny-dumping.”

Armed with data, horror stories and courtroom-caliber eloquence, members of the Elder Law bar warned this morning at a public hearing in Largo that frail seniors who qualify for Medicaid because they are poor will suffer if they are forced into managed-care plans.

It’s simple math, they said. HMOs make nothing off enrollees in nursing homes, but can profit if they are returned to the community or prevented from entering institutions in the first place.

Florida’s most vulnerable Medicaid enrollees will not be protected from “Granny-dumping for profit, and it will go undetected,” warned Charles F. Robinson, an elder law attorney in Clearwater.

“This managed-care fiasco is a big step backwards,” he said. “Florida can’t afford to drive in reverse.”

HMO executives said that keeping elderly people in their own homes and out of institutions is a blessing – good for taxpayers and patients as well.

William L. McHugh, president and CEO of AmeriGroup Community Care in Tampa, said he was “appalled” at the unfair headlines warning of “Granny-dumping.” He talked about how frequent visits from an AmeriGroup social worker enabled an 88-year-old member to remain in her home safely for a year after her daughter had planned to move her to assisted-living.

“She just wanted one more year and she got it,” he said.

While more than 150 people -- mostly health-care executives and advocates for the elderly -- were squeezed into the conference room at a state building, the real audience for the speakers was the federal Department of Health and Human Services. HHS' permission is required for Florida to enact its Medicaid overhaul, even though the law is set to go into effect July 1.

The Agency for Health Care Administration is holding hearings around the state as required before submitting to HHS a formal request for a waiver of federal Medicaid law and rules. AHCA officials say they plan to turn in the waiver request Aug. 1.

The Medicaid overhaul bills, which Gov. Rick Scott signed, requires nearly all 3 million Floridians who are enrolled in the program for the poor to be in some type of managed care. Florida now contracts with 25 Medicaid plans -- 19 HMOs and six "provider service networks," which are organized and led by either hospital or doctor groups.

At AHCA's Largo hearing, the elder-law attorneys hammered the point that frail elders -- called "dual eligibles" because their poverty qualifies them for both Medicare and Medicaid -- were not part of the state's five-county pilot program that tested the managed-care requirement starting in 2005.

The "Granny-dumping" warning surfaced prominently Tuesday at a similar AHCA hearing in West Palm Beach, which suggests a coordinated campaign by the elder-law bar is under way.


Carol Gentry, founder and special correspondent of Health News Florida, has four decades of experience covering health finance and policy, with an emphasis on consumer education and protection.