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Nursing Home Exemption Sought In Medicare Managed Care

Nurse escorts elderly man using walker
Wikimedia Commons
The Florida Channel
Leon County Judge John Cooper on June 30, 2022, in a screen grab from The Florida Channel.

With the nursing-home industry lobbying for changes, a Senate Republican has proposed exempting some nursing-home residents from the statewide Medicaid managed-care system.

The bill (SB 682), filed Friday by Sen. Kelli Stargel, R-Lakeland, would apply to residents who have been in nursing homes for at least 60 consecutive days and residents who receive hospice care. Part of the Medicaid managed-care system is aimed at providing services to seniors in their communities rather than in nursing homes. But the nursing-home industry argues that an exemption should apply to residents who live long periods of time in nursing homes.

The industry contends, in part, that enrolling those residents in managed-care plans adds unnecessary costs. But the Florida Association of Health Plans and other parts of the managed-care industry say nursing-home residents should not be carved out of the system. They say health plans provide services that can help transition many long-term nursing home residents back to community-based care.