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FMA to feds: Reject Medicaid waiver

The Florida Medical Association voted to publicly oppose the state's Medicaid overhaul and write a letter of concern to the federal government, according to three members of the organization.

In a meeting that was closed to the press, FMA leaders passed a resolution Sunday to discourage the federal Centers for Medicare & Medicaid Services from approving a waiver that would allow the state to move hundreds of thousands of poor and elderly beneficiaries into HMOs and other managed care plans.

“The letter will explain that we understand the budget constraints of the Legislature, but we cannot approve of expanding managed care,” said Dr. Miguel Machado, FMA president.

FMA leaders will meet within the next few weeks to confer on the language and tone of the letter, he said.

Broward County Medical Association President Dr. Aaron Elkin, who introduced the resolution, said it went through some debate but passed by an “overwhelming majority."

Dr. Arthur Palamara of Hollywood said the FMA has long opposed the overhaul, but this is the organization's most tangible and public move to date.

For many physicians, he said, opposition stems from the lack of available data on whether the pilot program has achieved its stated objectives: To improve access to care and save the state money.

Broward, Duval and three rural counties implemented managed care Medicaid five years ago, but study results have been unclear.

Still, the state plans to begin enrolling the elderly--who will go first because they are most expensive--- by October 2013.

Michael Garner, president of the Florida Association of Health Plans, said he's glad there are multiple voices in the debate but he believes that privatized Medicaid can deliver good care efficiently.

“We have a model, it's been debated, refined, adopted and now it's being implemented,” he said. “I respect (the FMA's) right to disagree, but I fundamentally ask...what is their alternative?”

The patient advocacy group Florida CHAIN recently sent a petition to CMS with signatures from 107 medical organizations that oppose the overhaul.

CMS spokesman Brian Cook said the agency has received the waiver application and will consider the comments and concerns from all organizations and interested parties before deciding whether to grant the state's request.

-Reporter Brittany Davis can be reached at 954-239-8968 or by e-mail.