Florida primary care programs could get cut if feds cut off Low Income Pool health care money because of Republican Medicaid overhaul
Above: A Naples primary care clinic (Photo: colemama)
Primary care programs could get cut if feds cut off health care money
Christine Jordan Sexton, 8/4/2011
www.TheFloridaCurrent.com
Hospitals aren’t the only health care providers impacted by the recent questions surrounding the continuation of Florida’s billion pot of money from the federal government to cover health care costs.
If the federal government puts the brakes on the $1 billion Low Income Pool program federally qualified health centers and other providers who receive LIP dollars to treat uninsured and poor residents might find themselves losing money.
Agency for Health Care Administration spokeswoman Shelisha Coleman said in an email that if the federal government terminates the LIP program Florida would “evaluate its options" with federal authorities to continue to provide funding for uninsured care.” Potential options, Coleman said, include replacing LIP with a program called “upper payment limit,”or UPL.
There are significant differences between the payment schemes but at least two significant ones are the amount of money Florida can earn and which providers are eligible for reimbursement. In short, Florida would lose $500 million in FY 2013-14 under UPL, if the federal government ends the program in December 2013. Additionally, only hospitals would be eligible to receive the dollars, Coleman said.
“It should be noted that UPL funding is available for hospitals only, while LIP funding is available to provider access systems, which include entities such as hospital, clinics or other provider types and entities designated by Florida statutes to improve health services access in rural communities, which incur uncompensated medical care costs in providing medical services to the uninsured and underinsured,” Coleman said.
Sen. Joe Negron, and chairman of the Senate health care budget committee, said Florida and Washington are having a continuing dialogue and that LIP will be part of an agreement on “how to best provide health care to people who are in need of our help.” Negron did say the $1 billion in LIP and the flexibility the state has in appropriating the money makes maintaining it “very important.”
Andrew Behrman, president and chief executive officer of the Florida Association of Community Health Centers, said elimination of the LIP program would have a huge impact on the 45 federally qualified health centers across the state. The centers this year will tap into $18.3 million in funding for primary care because of the LIP program.
“The money is well spent on us,” said Behrman, who said the clinics saw more than 1 million patients last year, 52 percent of whom were uninsured.”The return to the state is incredible.”
Other non-hospital programs LIP funds this year are the state’s poison control efforts, an emergency room diversion program in Manatee County, some county health departments and two programs that provide assistance to those who want to buy health insurance. One program is in Miami-Dade County and the other in Palm Beach County.
The Centers for Medicare and Medicaid Services granted Florida a two-week extension of its sweeping Medicaid 1115 waiver which allows the program in five Florida counties to operate as is until Aug. 14. According to correspondence between the state a sticking point is final approval of the $1 billion LIP program. In a letter to the federal government Deputy Secretary for Medicaid Roberta Bradford said she was "surprised" by the news that the federal government is "evaluating the termination of all supplemental funding pools" effective December 2013, including Florida's LIP program.
Florida wants the LIP funding pool to stay intact through June 2014. That's the year when the state expects to have fully implemented its Medicaid overhaul.
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