TAMPA — Dozens of advocates for the elderly, people with long-term illnesses and small businesses weighed in Thursday on plans to put most of the state's Medicaid recipients into managed-care programs.
"I see it as an issue with jobs," said Dan Fucarino, owner of the Carrollwood Pharmacy, at a public hearing at the Florida Department of Transportation office in Tampa.
Now, he said, most prescriptions for Medicaid patients in Florida are filled by independent pharmacies like his. He cautioned against a managed-care program that would require mail-order prescriptions or purchases at major chain pharmacies, which would hurt small businesses.
"It's wrong for the state of Florida," Fucarino said.
Yellow Cab owner Louis Minardi, who operates a Medicaid transport program in the Tampa Bay area, said he is concerned the program will cut transportation payments so much that no one will offer the services.
"One of the most important things people have to realize, if people can't get to the doctor, it doesn't matter what they're providing," he said.
The hearing, hosted by the state's Agency for Health Care Administration, was one of nearly a dozen conducted throughout the state over the past week. A final meeting is set for today in Fort Myers.
This year's state Legislature approved the overhaul of the $22 billion Medicaid program, which provides state-funded and federally funded medical care to low-income people. The law divides the state into 11 regions that health care companies will compete to serve. Federal officials required the public hearings as part of a waiver application for the program that has to be turned in by Aug. 1. If approved, the program would be fully operational by October 2014.
Republican lawmakers who pushed to move Medicaid patients to managed-care programs say it's a cost-saving measure. Democrats generally opposed the plan.
"I'm not completely afraid of managed care. Most of us are in some kind of managed care," said state Rep. Janet Cruz, D-Tampa, who voted against the proposal. "But the plan is still not complete. There is a lot of work that needs to be done before we implement this."
As state health officials hammer out details of the plan, the refrain has generally been the same at meetings from the Panhandle to Fort Lauderdale: Managed-care programs, which pay companies per patient rather than fees for specific services, mean health care will be limited in the interest of turning a profit. Speakers have expressed particular concern about cutting care for elderly patients and people with chronic diseases.
But Diane Smeltzer, a registered nurse with the HMO Amerigroup, defended the concept Thursday in Tampa.
She told the story of a patient in her late 30s with diabetes and kidney failure who was ready to give up on life. But a case manager with Amerigroup helped her get to doctors appointments and even find better housing.