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Coronavirus aid to boost Florida as feds relax Medicaid restrictions

Florida’s Medicaid program will be allowed to waive certain rules, such as prior authorization requirements for care, certain hospital admission requirements and rules for residents who are transferred between nursing homes.

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TALLAHASSEE — Florida’s ability to respond to the coronavirus crisis received a significant boost from federal healthcare regulators this week when the Trump administration approved a waiver that will allow the state to sign up and pay doctors and hospitals through Medicaid, the public health insurance program for low-income people.

Under the approval, the state’s Medicaid program, which currently has about 4 million Floridians enrolled, can waive application fees, certain criminal background checks and other requirements for doctors who sign up, according to the approval letter.

Florida’s Medicaid program also will be allowed to waive certain rules, such as prior authorization requirements for care, certain hospital admission requirements and rules for residents who are transferred between nursing homes.

The waiver also allows hospitals, nursing homes and clinics that are forced to evacuate to an unlicensed facility to receive payment for the care they give at the unlicensed facility.

“President Trump recognizes this need and Administrator Seema Verma is providing Florida the critical flexibility for our state’s Medicaid program by waiving prior authorization requirements for essential health care services and expedited provider enrollment,” Gov. Ron DeSantis said in a statement Tuesday.

Sara Rosenbaum, a Medicaid expert and professor of health law and policy at George Washington University, said the waiver will allow Florida to work with more doctors and hospitals in response to the crisis.

“Basically, the key to 1135,” Rosenbaum said, “is bringing more providers on, getting providers paid faster, changing payment methods — doing the things that have to be done to make sure providers are getting the payment they need to do this job.”

Anne Swerlick, a health policy attorney and analyst for the Florida Policy Institute, said the waiver is a “very good step in the right direction,” though it doesn’t go far enough to help under-served Floridians.

There is more flexibility that the state can be asking for, Swerlick said, like suspending the termination of Medicaid eligibility for people who don’t have computer access to re-certify or extend Medicaid eligibility temporarily to people who are uninsured.

There are nearly 400,000 uninsured Floridians living below the poverty line who don’t qualify for Medicaid.

“Florida has not expanded its Medicaid program,” she said. “These particular waivers don’t do anything to ensure that this group of Floridians will have access to testing and treatment that they need. These are two major areas where we can go further in trying to really address this unprecedented crisis.”

Samantha J. Gross reported from Tallahassee, and Daniel Chang reported from Miami.

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