The Florida Current: House Democrats ask feds to just say no to all Medicaid managed care; concerns over AHCA not being able to assess overhaul impact
Rep. Mark Pafford speaks on the House floor. Photo Credit: Ana Goni-Lessan
From The Florida Current
House Democrats on Friday sent a letter to the federal government asking it to reject Florida's efforts to implement a new statewide Medicaid managed care program covering health care from the cradle to the grave.
In their letter to Centers for Medicare and Medicaid Services Deputy Administrator Cynthia Mann, Democratic legislators expressed concerns that the state Agency for Health Care Administration, which administers the Medicaid program in Florida, won't be able to analyze the effects to the changes and to assess the impact the proposed overhaul would have on access, quality and cost effectiveness of the Medicaid program.
The ranking Democratic members of the four substantive health care committees -- Reps. Mia Jones, Mark Pafford, Steve Perman and Elaine Schwartz -- sent the letter. They also requested the federal government let expire the exiting 1115 waiver that creates a Medicaid managed care program in five Florida counties: Broward, Duval, Baker, Clay and Nassau.
Both the new and existing programs rely heavily on managed care, including commercial HMOs, to bring down Medicaid costs. "The track record of Medicaid managed care and Medicaid HMOs in Florida is cause for every serious concern," the letter reads. "The current Medicaid Reform experiment has been plagued with problems over its five-year history."
The letter was met with criticism from House Majority Leader Carlos Lopez Cantera, R-Miami, who accused Democrat leaders of being "reckless and irresponsible" for sending it.
"That these leaders would recommend to the federal government that Florida should continue with an outrageously expensive, fraud-laden Medicaid system, almost certain to throw our state into a financial abyss, is indefensible and a political tactic that will only jeopardize Florida's financial stability and future,'' he said.
Florida launched a Medicaid Reform program under the leadership of former Gov. Jeb Bush that required most Medicaid patients in five counties to enroll in managed care plans, either run by HMOs or hospital networks. That program operates under an 1115 waiver that expired last month. The federal government gave Florida a 30-day temporary extension so the state can continue negotiations to extend the program for another three years.
AHCA still has not gotten final approval of the waiver and the 30-day extension expires Sunday, July 31.
"The Agency is currently working with federal CMS to gain approval of a three-year extension of this waiver," AHCA spokesperson Michelle Dahnke said in an email. "If agreement is not reached by July 31, we anticipate a short-term extension would be appropriate as we continue discussion about final terms of a waiver extension. "
AHCA also is working on the required federal waivers to implement the new Medicaid overhaul and is on track to submit those requests by August 1. If approved by the federal government the Medicaid overhaul would take effect in 2014, when the existing Medicaid Reform program would come to an end.
Under the new Medicaid overhaul the state will limit the number of managed care plans in each region that can care for patients. Medicaid patients would be required to enroll with one of the plans the state contracts with. The Medicaid overhaul -- unlike the existing reform plan -- also impacts long-term care.
Mary Pat Moore, with the Florida Association of Health Plans, said the lawmakers are "entitled to their point of view" and the letters are "consistent with the opinions" the members shared during the recent legislative session. But Moore, who is the vice president of government programs for the association, said that her group is "confident" that the Medicaid overhaul will improve access to quality care, reduce fraud and abuse and achieve "significant costs savings, while at the same time creat[e] a predictable fiscal environment."
Health Care Medicaid, Medicaid Reform
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