Monday, May 28, 2018
News Roundup

Florida wins federal approval of Medicaid privatization plan

FORT LAUDERDALE — Federal health officials gave Florida the green light to enroll long-term care patients into a statewide Medicaid privatization program. But Gov. Rick Scott noted Monday that he is awaiting a final sign-off from the feds to privatize the program statewide for most of the state's nearly 3 million Medicaid recipients.

Florida lawmakers have been waiting for nearly two years to learn whether the feds would allow them to expand a program that allows for-profit providers to determine the health care of millions of the state's poor. The goal of the sweeping privatization bills passed in 2011 was to save the state money while improving services, though solid data on whether the approach works are scarce. Lawmakers warned that Medicaid's roughly $21 billion annual costs were consuming the state budget.

But critics worry that for-profit providers are scrimping on patient care and denying medical services to increase profits.

U.S. Health and Human Services Secretary Kathleen Sebelius approved the long-term care portion of the request late Friday. During a meeting in Washington last month, Scott asked her to act quickly on the statewide request so that Florida lawmakers could figure out how it will affect their plans to implement the Affordable Care Act.

The waiver approved Friday will allow Florida to enroll patients who require long-term care into managed care programs that will offer services in their home or other community programs to keep them out of nursing homes. Long-term care patients typically have extensive medical needs.

Federal health officials have been cautious all along about Florida's statewide privatization request to continue with an overhaul that expands on a five-county pilot program.

Some doctors have dropped out of the pilot program, complaining of red tape and that the insurers deny the tests and medicine they prescribe. Patients have complained that they struggled to get doctor appointments. Supporters of the overhaul say new accountability measures will address those concerns.

Lawmakers say they have fixed the pilot program's shortcomings, with provisions including increased oversight and more stringent penalties, including fining providers up to $500,000 if they drop out. The measures also increase reimbursement rates for doctors and limit malpractice lawsuits for Medicaid patients in hopes of increasing doctor participation in the program.

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