Centers for Medicare and Medicaid Services

An intriguing new theory is gaining traction among conservative foes of the Obama-era health law: Its Medicaid expansion to low-income adults may be fueling the opioid epidemic.

President Donald Trump's administration has ended Affordable Care Act contracts that brought assistance into libraries, businesses and urban neighborhoods in 18 cities, including three in Florida, meaning shoppers on the insurance exchanges will have fewer places to turn for help signing up for coverage.

Federal health officials say more than a half million Floridians have picked a health care plan through Obamacare since open enrollment began at the start of November.


FL Shines in Home Health Star Ratings

Jul 21, 2015

The federal government released a new five-star rating system for home health agencies, hoping to bring clarity to a fast-growing but fragmented corner of the medical industry where it’s often difficult to distinguish good from bad.

FL Could Get Low Income Pool Funds

May 21, 2015

The Obama administration has made an offer that it hopes will resolve Florida’s $1 billion state budget stalemate over health care funds for poor people.

Federal health officials agreed to extend Florida’s hospital funds for another two years, but only at about half the amount the state received last year. That means Florida lawmakers may have to dip into the state budget to fill the gap or state hospitals will get less money in the coming year.

In a letter Thursday to Gov. Rick Scott, federal officials stressed that they would not use Low Income Pool hospital funds to cover anyone who could be covered by Medicaid expansion, but they also acknowledged the loss of those funds may be difficult for the state. The current hospital funds are $2.1 billion dollars, put up by the state and federal government. The administration’s preliminary offer drops that to $1 billion for the 2015-2016 fiscal year and to $600 million the following year.

The proposal is still subject to a formal review but federal officials said they wanted to work with the state in good faith, recognizing that the Legislature needs to pass a budget by June 30 to avoid a state government shutdown.

“The decision about whether or not to expand Medicaid is a state option … (R)egardless of whether a state expands Medicaid, uncompensated care pool funding should not pay for costs that would be covered in Medicaid expansion,” federal health officials said in the letter.

The funds, which are part of a federal program that covers the hospital bills of uninsured and Medicaid patients, were supposed to end this year as President Barack Obama’s health care program grew. Patients covered by the low-income pool were supposed to be covered by Medicaid, but the Florida House and Scott have balked at expanding it.

The bitter standoff between the Republican governor and the Obama administration tore apart the state legislative session, with the House abruptly adjourning three days early last month. Scott sued the Obama administration, comparing federal officials to the TV mobster show “The Sopranos” and accusing them of withholding the hospital funds because the state wouldn’t expand Medicaid.

The dispute created a $1 billion hole in the governor’s budget that should now be much easier for lawmakers to address when they return for a special session June 1.

Scott pressed for the extension for months, even visiting Washington twice and blaming the Obama administration for ruining his budget and ignoring his timeline even though he’s known for more than a year that the funds were ending. He waited until mid-April to submit a proposal, although the months-long required public comment period made it impossible to get an answer before the Legislature adjourned last month.

The Obama administration and hospitals want the governor to expand Medicaid to more than 800,000 low-income Floridians and will not spend federal hospital funds on those who would be covered by Medicaid expansion. That’s because federal health officials say it’s more efficient to use the money to give people health insurance than to pay hospitals for caring for the uninsured retroactively.

But Scott and Republican House leaders refuse to accept any money tied to the Affordable Care Act - including Medicaid expansion. They even snubbed a Senate proposal that would eventually take billions of federal dollars and allow the Medicaid expansion recipients to buy private health insurance - a solution that Scott has fought for in the past.

The House and Senate recently announced they would discuss Medicaid expansion during the special session, snubbing the governor’s call to focus only on the budget.

Senate leaders had prepared to move ahead with a health care coverage plan during the upcoming special session, but the announcement from the federal government bolsters the argument of House Republicans who maintained that the state would continue to receive a decent chunk of the hospital money without having to expand Medicaid.

During a recent closed-door session, House and Senate budget chiefs discussed the House’s objections to the Senate’s current proposal. Senate budget chief Tom Lee agreed there were “reasonable” concerns raised about the Senate plan.

Continued uncertainty over federal health funding is causing budget pains in the Florida legislature. The House and Senate have a $4 billion  gap in their proposed spending plans for the upcoming fiscal year—and that’s largely due to disagreements over the biggest part of state spending: Medicaid.

The first floor of the Capital is swarming with people dashing back and forth—some pushing frantically at the slow-running elevators, others giving up—and dashing up the stairwells instead. Off to the side, is 23-year-old Broward resident Matt Ross.

Former Orlando Health patients may have to help repay the Centers for Medicare and Medicaid Services after a federal audit discovered the hospital overbilled Medicare by $1.45 million, the Orlando Sentinel reports.

State Nixes Changes for Medically Needy

Jun 5, 2014

After running into objections from the federal government, Florida has scrapped a proposal that would have required tens of thousands of people with debilitating illnesses to enroll in managed-care plans.

Gov. Rick Scott this week signed a bill that repealed part of state law calling for people in the "Medically Needy" program to participate in managed care and to pay monthly premiums. The Medically Needy program serves people, such as transplant recipients, who have costly medical conditions but do not qualify for regular Medicaid coverage because of their incomes or assets.

Medicare Won't Pursue Overpayments

Jun 2, 2014

Medicare spent $6.7 billion too much for office visits and other patient evaluations in 2010, according to a new report from the inspector general of the U.S. Department of Health and Human Services.

But in its reply to the findings, the Centers for Medicare and Medicaid Services (CMS), which runs Medicare, said it doesn't plan to review the billings of doctors who almost always charge for the most expensive visits because it isn't cost effective to do so.

While only a small fraction of doctors receive more than $3 million a year from Medicare, Florida accounts for way more than its share -- one in four. And guess which state is home to the doctor who made nearly $21 million?

Those are among the findings of an Associated Press analysis of physician data released Wednesday by the Obama administration, part of a move to open the books on health care financing.

Even though Florida’s Legislature turned down federal funds to expand Medicaid under the Affordable Care Act, leaving billions of federal dollars on the table, the state's health insurance program for the poor continues to grow.

U.S. Navy

In a long-awaited move, federal health officials on Friday granted Florida's request to expand its five-county pilot Medicaid managed-care project statewide.  Mindful of how some Florida Medicaid HMOs have behaved in the past, the deal includes what an independent analyst called "unprecedented consumer protections."

Nearly half of Universal Health Care customers -- those enrolled in one of Universal's Medicare plans --  need to act immediately if they want to protect themselves from the possibility of unexpected expenses next month.

If they switch plans by Sunday, March 31, they will be fully covered under their new plan as of Monday, April 1. If they don't, the federal government will automatically enroll them in traditional Medicare. If they had prescription-drug coverage under Universal, they will be automatically enrolled in a drug plan.

In a week or two, seniors enrolled in certain Medicare health plans and drug plans will get a letter from the federal government. It is not good news.

The Centers for Medicare and Medicaid Services (CMS) letter will say their plan is substandard, "rated 'poor' or 'below average' for at least the last three years."