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Medicaid managed care

Senate Moves Again On Health Insurance Changes

Nov 8, 2017

Physicians would have greater leeway in prescribing medications to patients, and insurance companies would have less time to approve prior-authorization requests under a bill unanimously approved by a Senate panel Tuesday.

Doctors Can Have Say On Managed Care Plans

Oct 27, 2017

State Medicaid officials are soliciting physicians to share their experiences with Medicaid managed-care plans by Nov. 20.

In 2011, the Florida legislature passed a measure to convert Medicaid insurance into a managed care system. But Republican lawmakers now want to take the program away from “big businesses” and change it into a block grant system. But Medicaid providers said if that happens low income families will lose access to health care.

Since 2014, Florida’s Medicaid program has been run not by the state but through private insurance companies. The Sarasota Herald-Tribune has written about problems with the managed care system and a recent report from Georgetown University surveyed pediatricians to determine how they feel about the system.

Judge Gives Preliminary Approval To Medicaid Kids Settlement

May 4, 2016

A federal judge has preliminarily approved the settlement of a decade-long lawsuit focused on allegations that Florida's Medicaid program did not provide adequate care to children.

Bill Could Carve Out Medicaid Dental Benefits

Feb 10, 2016

Despite opposition from the committee chairman, a House panel Tuesday approved a bill that could lead to revamping children's dental care in the Medicaid program.

The House Health & Human Services Committee voted 11-2 to approve the bill (HB 819), sponsored by state Rep. Jose Felix Diaz, R-Miami. Chairman Jason Brodeur, R-Sanford, and state Rep. Katie Edwards, D-Plantation, cast the dissenting votes.

As a mother, Anya Staton says her primary instinct is to feed her children.

So when her oldest son developed an eating disorder she knew he needed help -- help she didn't know how to give. 

And care the family's insurance company, through Florida's Medicaid program, denied the boy needed.

Florida is one of only three states where county public health departments employ obstetricians for pregnant women.

It’s a legacy of the 1990s, when Florida’s infant mortality rate was one of the worst in the nation. But this safety net is eroding.

Insurers participating in Florida's new Medicaid managed care program say they've lost $542 million through 2014 and want the state to raise their rates. But after losing major federal funding for hospitals, Gov. Rick Scott doesn't want to use any more state money for the Medicaid program.

Scott and the insurers are locked in intense negotiations that could undermine the fledgling program that gives federal funds to private health insurance companies to oversee medical care for poor and disabled people instead of reimbursing doctors and hospitals for each service.

A state health care official has criticized a proposed rate increase by private health plans that cover Florida's poorest residents.

The Tampa Bay Times reports that the plans, which work with Medicaid, say they need to raise rates by 12 percent to offset the rising cost of prescription drugs and an uptick in doctor's visits.

Medicaid health plans, which lost $543 million in the first half-year of Florida’s Statewide Medicaid Managed Care program, have been hoping for major rate relief Sept. 1, when the second year of the program begins.

The Agency for Health Care Administration has proposed a rate increase averaging 6.4 percent for the coming year, ranging from less than 1 percent in the Pasco-Pinellas Counties region to 14 percent in two north Florida regions that cover rural counties.

AHCA Plans to Close Three Field Offices

Jan 24, 2015
Agency for Health Care Administration

With Florida now enrolling most Medicaid beneficiaries in managed-care plans, the Agency for Health Care Administration plans to close three field offices this summer, Secretary Liz Dudek told lawmakers Thursday.

The agency last year closed field offices in Tallahassee and Ocala and plans additional closures of offices in West Palm Beach, Panama City and Alachua.

Feds OK Medicaid Managed Care Program For Three Years

Aug 4, 2014

Federal officials have approved a three-year extension of a program that requires almost all Florida Medicaid beneficiaries to enroll in managed-care plans.

The federal Centers for Medicare & Medicaid Services, in a letter Thursday, formally approved the extension of what is known as a Medicaid "waiver." The move was expected, as federal officials indicated in April they would approve the extension, which will last through June 30, 2017.

The race for Florida governor is heating up.

Gov. Rick Scott's likely Democratic challenger Charlie Crist released his first TV ad this week. It's called "Sunshine" -- and its focus is definitely positive.

But mud is being slung in the campaign.

Though, sometimes, it's hard to figure out who is slinging it.

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."