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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  • by Danno Location: Tally on Feb 18, 2011 at 12:02 PM
    If the governor's cap on medical insurance becomes law in 2013 my family coverage with CHP will cost an additional $650 per month. Thank you very much Mr. Scott. GRRR!
  • by Hobo on Feb 18, 2011 at 09:18 AM
    mm - I didn't realize the CEO of Captial Health Plan was on here promoting his business. Don't you have work to do? After all, CHP does make "a lot" of money!
  • by cmac Location: tallahassee on Feb 18, 2011 at 09:14 AM
    mm: I like CHP, too, but CHP is NOT a Medicaid HMO. The Medicaid HMO's are not about patient care; they are in business to make money and the less care they provide, the more money they make. The so far, Medicaid Reform has been a dismal failure yet the Legislature is determined to expand it at all cost.
  • by anonymous Location: tally on Feb 18, 2011 at 08:35 AM
    So it's wrong when Obama says take his healthcare option but this Rep. thinks it's ok to tell floridians that they have to accept his version of healthcare.
  • by mm Location: Tallahassee on Feb 18, 2011 at 08:24 AM
    I think moving the Medicaid patients to a HMO is absolutely necessary to have better care and save money. I've been with CHP for many years now and my HMO plan is excellent. If you can afford to go to any doctor anytime, then you don't need Medicaid, pay cash instead...out of your pocket, not mine. Actually you receive better care with CHP HMO because your primary care doctor can refer you to specialists when ever necessary. Quite a few specialties do not require a referral. Why should Medicaid patients feel they need better health plans than the people that have to pay their own way? Check out Capital Health Plan, they ARE the best...
  • by Jonathan Swift Location: Florida on Feb 18, 2011 at 08:22 AM
    What irony! President Obama and the Democrat leadership are falsely accused---by Tea Party and GOP leadership---of creating "Death Panels." Yet, our class-warfare, Tea Party/GOP hero governor, Rick Scott, has actually created the infamous "Death Panel." Governor Scott has proposed to deny Medicaid patients, who suffer from life-threatening conditions, the transplants that will save their lives. What a guy! What a monster! To all of the "useful idiots" who voted this miscreant into office: Better write, phone or email your hero, Governor Scott, and let him know that you do not support his Death Panel. Lest you be as responsible as he will be when people start to die. Let's get to work!
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