The Florida Current Reports Florida Medical Association Opposes State's Medicaid Managed Care Overhaul

Florida Senator Nan Rich initiated the objection to Florida's misguided managed care overhaul.  The Florida Current reports on the latest development:







Powerful doctors group opposes Medicaid managed care overhaul


Christine Jordan Sexton, 8/4/2011
www.thefloridacurrent.com 


A powerful new foe has come out against Florida's push to overhaul the state's $22 billion Medicaid program.


The Florida Medical Association is now the latest group to join a long list of those opposed to the sweeping reform of the safety-net program for the poor, elderly and disabled passed by the GOP-controlled Legislature and signed into law by Gov. Rick Scott.


The move is significant because Republicans have worked in tandem with the FMA on several initiatives in recent years, including a medical malpractice bill during the 2011 session.


Under a resolution approved by the FMA House of Delegates last weekend, the state’s largest doctor’s organization will be required to send a letter to the federal government within one month specifically asking the Centers for Medicare and Medicaid Services not to extend an existing waiver that allows a Medicaid Reform pilot in five counties to expand statewide and, furthermore, not to approve any new waiver needed to remodel Medicaid "because Florida has failed and is still failing to properly address concerns by patients, physicians, hospitals" and the federal government.


The resolution was championed by the Broward County Medical Association and its president, Aaron Elkin, an OB/GYN and a Medicaid participating provider who has first hand experience with the Medicaid Reform pilot project since its inception in 2005. Elkin said under Medicaid Reform he rarely sees pregnant patients in their first trimester and often does not see them until midway of their second semester.


"It's a huge thing for the FMA to send a letter to CMS and to say 'stop,'" Elkin said in an interview. "We're going to put our foot down."


The FMA resolution also maintains that there is "no clear and convincing evidence" that the five-year old Medicaid reform pilot program in place in Broward and four Northeast Florida counties has saved money or ensured access to quality care.


Florida Medical Association President Miguel Machado was traveling and unavailable for comment.


Elkin said the FMA always opposed reform initiatives that would place more patients into managed care, but that the organization had different priorities during the recent legislative session.


The FMA’s priority bill for the 2011 session was a medical malpractice related measure HB 479 -- which requires out of state physicians to obtain an expert witness certificate before they can testify in medical malpractice cases.


“It’s not enough to oppose an issue,”said Elkin. “This is the first time an organization that is so close to the Legislature is standing publicly against (Medicaid reform).”


There already have been a series of letters sent to CMS asking the federal government to reject Florida’s waiver for the existing Medicaid Reform pilot project and the new overhaul of the Medicaid program that would require everyone to be enrolled in managed care, including those requiring nursing home care.


Senate Democratic Leader Nan Rich, D-Weston sent a two page letter to the federal government in June. That was followed by a letter sent July 14 from four House Democrats -- Reps. Mia Jones, Steve Perman, Elaine Schwartz and Mark Pafford -- who also called on the feds to reject the plan.


Those letters were followed up by a letter from the health care advocacy group Florida CHAIN, whose letter was signed by more than 100 organizations -- including the Broward, Miami-Dade and Hillsborough county medical associations.


"It's America, everyone is entitled to their opinion," said Sen. Don Gaetz, R-Niceville and incoming Senate president. Gaetz was one of a number of Republicans in the Senate who negotiated the Medicaid Reform overhaul with the House of Representatives.


Gaetz said that the FMA never made any promise to him to support the plan to overhaul Medicaid. But he said he asked the FMA -- as well as Senate Democrats -- for input to help improve the proposal so the Senate "could make the legislation as good as it could be."


"I guess if Leader Rich can do it so can the FMA," said Gaetz.


Elkin has had experience with the Medicaid Reform pilot since 2005 when it launched in Broward County and he said the program has been a mess since its inception. "Managed care companies don’t coordinate care," he said, "they manage claims."




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