Overhaul Moves Patients to Managed Care

By: Kathleen Haughney, The News Service of Florida
By: Kathleen Haughney, The News Service of Florida

THE CAPITAL, TALLAHASSEE, February 17, 2011 --

In a proposal that would make sweeping changes to the state’s Medicaid program, lawmakers Thursday released a bill to move millions of low-income Floridians to HMO-style health plans and put limits on how much the state will spend on the health care program.

Sen. Joe Negron, R-Stuart, the chair of the Senate Health and Human Services Appropriations Subcommittee, had hinted at parts of a comprehensive overall plan two days ago, but did not release the more than 200-page bill until Thursday morning. The crux of the proposal is a plan to carve the state into 19 regions and push the majority of Medicaid recipients into HMOs or other managed care plans beginning in December 2011.

Negron believes the plan will save the state $4.3 billion over three years, but it will only work if the federal government first gives the state the OK. If federal officials do not, then Negron has proposed that the state run its Medicaid program without Washington’s rules – and without its help - meaning the state would lose billions of dollars to pay the health care costs of the poor.

Negron said he believes the federal government will accept the state’s plan and would give the government from August 2011 to December 2011 to approve Florida’s reforms.

“They would have to make a decision of going from being a partner to being a bully and I don’t think they’re going to do that,” he said.

But the idea alone of retreating from the federal money has rankled some lawmakers, including House Speaker Dean Cannon who told the Florida Tribune that the Senate’s proposal could be a “hazardous threat” that could jeopardize negotiations with the Obama administration.

Democratic leaders too appeared wary of saying farewell to what Senate Democratic Leader Nan Rich estimated could be up to $12 billion per year in federal funds.

“Unlike you,” Rich said to Negron during a hearing on the bill, “I feel there would be a crisis in this state if we were not part of the federal Medicaid program.”

The overall proposal contains many smaller additions that may or may not make the final product when the House and Senate work out the differences between their proposals. The House has not yet released a bill on Medicaid reform.

Among the other changes is reducing the amount of money that covers services to senior citizens with high medical expenses, but don’t qualify for Medicaid; creating restrictions on the use of psychotropic drugs for children; and extending lawsuit limits to better protect doctors from legal action.

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