The Florida Current Provides an Update on Statewide Medicaid Reform Hearings: Medicaid reform gets a rough reception at public hearing
The Florida Current provided this update on Florida's statewide Medicaid reform hearings:
(Photo Credit: Ana Goni-Lessan)
Medicaid reform gets a rough reception at public hearing
Christine Jordan Sexton, 6/10/2011
http://www.thefloridacurrent.com/
Dozens of citizens showed up at a state health care agency in Tallahassee for the first public meeting on Florida's new Medicaid overhaul passed during the 2011 session.
Most of those who testified at the Friday meeting -- from caregivers to providers to lobbyists -- expressed concerns with what they considered to be the pitfalls of the legislation: requiring most Medicaid patients to enroll in managed care, mostly Medicaid HMOs.
Seniors at risk of nursing home care are the first group impacted by the mandate, followed by Medicaid patients who receive traditional medical care.
Martha Moor's son was 21 when he was shot and paralyzed while breaking up a fight. He now is 30. She said she worries that managed care plans will try to make money off her son. He is enrolled in the brain and spinal injury Medicaid waiver program, which pays her to stay at home in Gadsden County and provide care for him.
"HMOs are in business to make money. I do not see how anybody can make money on my son's condition. I am not making any money on my son’s condition," she said adding, "I hope you all pray for us."
Representatives from AARP Florida, the Elder Affairs section of the Florida Bar, the Florida Hospital Association, and Florida Legal Services expressed concerns with the plan, including the Legislature's refusal to require medical loss ratios. Federal authorities expressly said it wanted the inclusion of MLRs -- which are part of the federal health care overhaul -- in a letter it sent to the state on April 23. Medical loss ratios require that a certain amount of money be spent on direct patient care.
State officials also heard from a number of independent pharmacists who want assurances that they will be included in managed care networks. Bill Mincey encouraged every attendee in the room to contact their legislator and demand that they change the law to include any willing pharmacist.
Florida Association of Health Plans President and Chief Executive Officer Michael Garner said many of the negative remarks at the meeting came from "providers who fought throughout the session to keep the status quo. Other providers," Garner said, "were unfamiliar with managed care or the actual components of the new law."
Garner said the pharmacists are concerned that the law would allow HMOs to exclusively use mail order for pharmacies. Garner said the law doesn't allow that.
The public meetings are required under both federal and state law. A handful of other meetings will occur all next week. The Agency for Health Care Administration -- which is conducting the public hearings -- has doubled up the meetings by holding events in Ft. Lauderdale, Tampa, Miami and Orlando all on June 16.
The agency must submit a Medicaid waiver to the federal government by Aug. 1 to begin implementing an overhaul of the Medicaid program where the state competitively bids medical care and long-term care among managed care plans across 11 different regions. Medicaid currently accepts all providers who meet the qualifications, but the overhaul would limit the number of providers.
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