Advertisement
  1. Health

Castor and Nelson pressure Florida to reinstate sick children to top-tier Medicaid plan

U.S. Sen. Bill Nelson and U.S. Rep. Kathy Castor speak Thursday to news reporters at Tampa International Airport. They are calling for the federal government to intervene in the state’s handling of 13,000 sick and disabled children who, in 2015, were removed from Children’s Medical Services, a Medicaid program that provides specialized medical care.
Published Sep. 1, 2017

TAMPA — Two Democratic congressional lawmakers are asking the federal government to intervene and pressure Florida to reinstate specialized health coverage for thousands of sick and disabled children.

U.S. Sen. Bill Nelson and U.S. Rep. Kathy Castor called Thursday for action to help children previously enrolled in Children's Medical Services, a Medicaid plan that covers treatment for conditions such as birth defects, heart disease, diabetes and blindness.

About 13,000 children were switched to less comprehensive Medicaid plans in 2015 after the state changed eligibility rules.

An administrative judge ordered the state to scrap the rules that same year. But as of July, only about 6,000 affected families had been told they could rejoin the program, according to a letter Nelson and Castor sent this week to Tom Price, secretary of the U.S. Department of Health and Human Services.

"I'm asking for answers why poor children, very sick with huge medical needs, were kicked off that program and not notified for two years they could be back on the program," Nelson said.

Florida Department of Health officials said Nelson and Castor were misled by an "inaccurate" CNN report. The department sent letters to families in July, they said. Only about 6,000 letters were needed because many families are already back in the Children's Medical Services program or are no longer eligible for Medicaid, said spokeswoman Mara Gambineri.

The two-year lag in notifying families stemmed from legal concerns that the Department of Health could be accused of promoting one insurance plan over another, she said. When that was cleared up, a draft letter had to be vetted by the Agency for Health Care Administration.

"It was difficult determining if we could do it," Gambineri said. "We didn't want to cause more confusion, but at this point everyone has been notified."

This is not Castor's first run-in with the state over the issue. She previously asked the Centers for Medicare and Medicaid Services to intervene. She said the two-year delay is unacceptable and accused the state of "obliterating" a program that families rely upon.

"They had the direction then to fix this," Castor said. "Nonetheless, the state, the governor, the Department of Health has dragged their feet."

Florida's CMS plan was developed decades ago to help poor families caring for children with chronic health issues navigate the complex medical system. Unlike most other Medicaid plans, it pays for a health case manager who helps parents find pediatric specialists.

Also, the Medicaid plans that children were switched to were not accepted by some specialists, said Dr. Toni Richards-Rowley, a Lithia pediatrician.

The new eligibility rules were introduced in May 2015. At the time, the program covered about 70,000 children. Its enrollment is now about 61,000.

Health Department leaders said in 2015 that the changes were necessary to "ensure that only children with chronic and serious health conditions were part of the (program)" in light of its $826 million budget.

The families of four children dropped from the program challenged the changes in court, saying the new tool had not gone through the state's formal rulemaking procedure. An administrative judge ruled in their favor and threw the changes out. Another revised screening process was adopted in January 2016.

Dr. Louis St. Petery, a pediatric cardiologist who practices in Tallahassee, was among a group of physicians who said the 2015 rules had hurt some of the state's most vulnerable kids. He is still skeptical that the state has made amends.

"There's some lack of information here coupled with the fact they didn't want to do it in the first place," he said. "That makes me suspicious that all the parents have been notified."

Contact Christopher O'Donnell at codonnell@tampabay.com or (813) 226-3446. Follow @codonnell_Times.

ALSO IN THIS SECTION

  1. FILE  - In this Aug. 28, 2019, file photo, a man exhales while smoking an e-cigarette in Portland, Maine. Walmart says it will stop selling electronic cigarettes at its namesake stores and Sam's Clubs following a string of illnesses and deaths related to vaping.  The nation's largest retailer said Friday, Sept. 20 that it will complete its exit from e-cigarettes after selling through current inventory. It cited growing federal, state and local regulatory complexity regarding vaping products. ROBERT F. BUKATY  |  AP
    The nation’s largest retailer said Friday that it will complete its exit from e-cigarettes after selling through current inventory.
  2. Erik Maltais took an unconventional path to becoming CEO of Immertec, a virtual reality company aimed at training physicians remotely. He dropped out of school as a teenager, served in Iraq in the Marine Corps and eventually found his way to Tampa. OCTAVIO JONES   |   TIMES  |  Times
    Software from Immertec can bring physicians into an operating room thousands of miles away.
  3. Homeowner Cheryl Murdoch, 59, explains the workings of the Philips Smart Mirror in her bathroom. Murdoch and her husband live in the Epperson neighborhood in Wesley Chapel, home of the Crystal Lagoon, where some residents are piloting new health technologies inside their homes. SCOTT KEELER  |   Times
    In Pasco’s Crystal Lagoon community, AdventHealth and Metro Development Group are testing in-home technology aimed at keeping people away from the hospital.
  4. Dr. Paul McRae was the first black chief of staff at Bayfront Medical Center in St. Petersburg. Dr. McRae died on September 13, 2019. He was photographed here in the Tampa Bay Times photo studio for the 2008 Dr. Carter G Woodson Museum's "Legends Honorees" gala. BOYZELL HOSEY  |  BOYZELL HOSEY  |  Times
    ‘His extraordinary example paved the way for so many others.’
  5. Michael Jenkins spent seven days at North Tampa Behavioral Health last July. Since then, he says his three children have been afraid he’ll leave and not come home. JOHN PENDYGRAFT   |   Times
    The patients have no choice, and the hospital is making millions.
  6. Samantha Perez takes a call for someone in need of counseling at the Crisis Center of Tampa Bay earlier this year. The center handles calls dealing with suicide, sexual assault, homelessness and other traumatic situations. They also do outreach and counseling, and operate Transcare, an ambulance service. JONES, OCTAVIO  |  Tampa Bay Times
    Florida’s mental health care system saves lives.
  7. The Florida Department of Health in Hillsborough County identified a positive case of hepatitis A in a food service worker at Hamburger Mary's in Ybor City on Oct. 22, 2018. [JOSH FIALLO | Times] JOSH FIALLO | TIMES  |  JOSH FIALLO | Times
    Slightly more than 200,000 people have been vaccinated this year — a huge jump from the 49,324 people vaccinated in all of 2018.
  8. FILE - In this Feb. 20, 2014, file photo, a patron exhales vapor from an e-cigarette at a store in New York. Under the Trump administration, former FDA commissioner Scott Gottlieb kicked off his tenure in 2017 with the goal of making cigarettes less addictive by drastically cutting nicotine levels. He also rebooted the agency’s effort to ban menthol flavoring in cigarettes. But those efforts have been largely eclipsed by the need to respond to an unexpected explosion in e-cigarette use by teens. AP
    Hundreds of people nationwide have come down with lung illness related to vaping.
  9. This May 2018, photo provided by Joseph Jenkins shows his son, Jay, in the emergency room of the Lexington Medical Center in Lexington, S.C. Jay Jenkins suffered acute respiratory failure and drifted into a coma, according to his medical records, after he says he vaped a product labeled as a smokable form of the cannabis extract CBD. Lab testing commissioned as part of an Associated Press investigation into CBD vapes showed the cartridge that Jenkins says he puffed contained a synthetic marijuana compound blamed for at least 11 deaths in Europe. JOSEPH JENKINS  |  AP
    The vapor that Jenkins inhaled didn’t relax him. After two puffs, he ended up in a coma.
  10. H. Lee Moffitt Cancer Center & Research Institute is the centerpiece of Project Arthur, an 800-acre corporate park that could include up 24 million square feet of office and industrial space on nearly 7,000 acres of what is now ranch land, but targeted for development in central Pasco. Times
    The H. Lee Moffitt facility is the centerpiece of an economic development effort in a proposed 800-acre corporate park.
Advertisement
Advertisement
Advertisement