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Florida Medicaid

Gov. DeSantis' Budget Vetoes A 'Big Hit' To Florida's Health Care System

Jun 30, 2020
Gov. Ron DeSantis speaking during a news conference
WFSU

Gov. Ron DeSantis vetoed more than $140.5 million in health care spending from the state’s new budget Monday as he brought the spending plan in line with reduced revenues stemming from the COVID-19 pandemic.

Insurance Regulators Back Tampa-Based Wellcare-Centene Merger

Sep 20, 2019

Insurance regulators in Florida and 16 other states have approved a proposed merger between Tampa-based WellCare Health Plans and Centene Corp., the managed-care companies said Thursday. 

Florida Economists Grapple With Medicaid Expansions

Jul 31, 2019

State economists are struggling to come up with estimates of how much it would cost the state and how it would affect Florida’s economy if voters approve a far-reaching constitutional amendment that calls for expanding Medicaid. 

Nelson, Democrats Blast Proposed Medicaid Cut

May 11, 2018

U.S. Sen. Bill Nelson and Democratic U.S. House members Thursday called for the federal Centers for Medicare & Medicaid Services to reject a move by Gov. Rick Scott’s administration to cut $98 million by trimming the length of time people have to apply for the Medicaid program.

“I rise here today because the state of Florida has again proposed to harm thousands of seniors and folks with disabilities who rely on Medicaid for their health care,” Nelson, a Democrat who faces an election challenge this year from Scott, said on the Senate floor.

Deadline Looms For Medicaid Managed-Care Protests

Apr 26, 2018

Managed care organizations that want to challenge the award of upward of $90 billion in Medicaid contracts to nine health plans across the state have until late Friday afternoon to launch protests. 

Proposed changes to Florida’s Medicaid eligibility requirements would make it harder for people to get coverage after they become sick.

In the spring and summer of 2015, the state switched more than 13,000 children out of Children's Medical Services, a part of Florida Medicaid, according to a report by CNN.

Managed Care Contracting Begins To Move Forward

Feb 6, 2017

Health plans that want to compete for contracts in Florida's Medicaid managed-care system face a Feb. 13 deadline for signaling their interest to the state Agency for Health Care Administration.

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.

Federal Judge Approves Medicaid Settlement

Jun 29, 2016

A federal judge has given final approval to a settlement in a decade-long legal fight over care provided to children in Florida's Medicaid program. 

Settlement Reached In Battle Over Children’s Health Care

Apr 6, 2016

After a court fight that lasted more than a decade, the state and groups representing pediatricians and dentists have settled a class-action lawsuit about care provided to children in Florida's Medicaid program.

The settlement, released Tuesday, came about 15 months after a federal judge found that Florida's history of low reimbursement payments to doctors led to a lack of access to care for many poor children. But the agreement also came after the state argued that an overhaul of the Medicaid system had effectively made the case moot.

Scott Signs Bills On Body Cameras, Dental Care

Mar 28, 2016

Gov. Rick Scott on Thursday signed 34 bills into law, including a measure that will require standards for the use of police body cameras and a plan that could lead to revamping dental care in the Medicaid program.

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.

Children who get health insurance through Medicaid go to the dentist about half as often as children in Florida who have private insurance, according to a new study out from the American Dental Association and the Health Policy Institute.

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.

The state last month removed about 2,000 children from a specialized program that provides services to medically fragile kids, finding that they were no longer "clinically eligible" under a new screening process.

 

But the move by the Department of Health to re-evaluate children in the Children's Medical Services Network is drawing criticism from pediatricians and some children's advocates.

State Impasse Over Health Care Expansion Deepens

Apr 15, 2015

The stalemate between the House and Senate over billions of dollars in health-care funding deepened Tuesday, as the federal government suggested that the fate of a pool of money for hospitals and other medical providers was tied to the state's decision on Medicaid expansion.

Ruling Targets Non-Lawyers Providing Medicaid Advice

Jan 16, 2015

The Florida Supreme Court issued a ruling Thursday that took aim at non-lawyers who are paid to help people get Medicaid benefits -- including seniors who need Medicaid coverage for nursing-home care.

The Supreme Court approved a proposal that said some of the services provided by so-called Medicaid planners constitute the improper "unlicensed practice of law." The proposal came from a Florida Bar committee, which worked on the issue for months and concluded a need to "protect the public from harm."

The pro-business Florida Chamber of Commerce has unveiled its health priorities for the upcoming legislative session.

The list includes big battles of years past—like letting some nurses and physician assistants expand their scope-of-practice, revamping the rules regarding medical lawsuits and possibly expanding the state’s Medicaid program for low-income Floridians. But that last part comes with a caveat--like capping how much Medicaid can take up in overall state spending.

Health care advocates gathered across Florida today — in Orlando, Tampa, Tallahassee, and Miami — calling on the state to accept federal funds and expand its Medicaid program.

A handful of people gathered in outside the Stephen P. Clark Government Center in Miami, several with big black circles painted under their eyes, making them appear sickly. Others wore face masks with slogans like “no coverage equals death” written on them.

State: Old Medicaid System For Kids 'No Longer Exists'

Jan 7, 2015
Florida Senate

Arguing that Medicaid has undergone a transformation, state officials pushed back Wednesday against a federal judge's finding that Florida has not properly provided health care to low-income children.

"Everything around the program has changed,'' state Medicaid director Justin Senior told the Senate Health and Human Services Appropriations Subcommittee. "He (the judge) is critiquing a situation on the ground that no longer exists, and that's unfortunate."

A federal judge has ruled that Florida’s health care system for impoverished and disabled children violates several U.S. laws.

In a ruling Wednesday, U.S. Circuit Judge Adalberto Jordan of Miami said lawmakers had for years set the state’s Medicaid budget at an artificially low level, causing pediatricians and other specialists for children to opt out of the insurance program for the needy.

Anthem to Buy Florida Medicaid Plan

Dec 22, 2014

Simply Healthcare Holdings, a managed-care firm that is a major player in Florida's Medicaid program, will be purchased by Indianapolis-based Anthem, Inc., the companies announced on Dec. 21.

Simply Healthcare, which is based in Coral Gables, operates through subsidiaries Simply Healthcare Plans, Inc. and Better Health, Inc. It manages care for about 170,000 people in Medicaid and 22,000 people in Medicare, according to a news release about the sale.

Florida Medicaid has spent at least $30.6 million in the past year on costly drug treatments for Hepatitis C, according to records from the Agency for Health Care Administration. 

Most of the spending was for Sovaldi, an antiviral approved by the Food and Drug Administration in December 2013. It was fast-tracked after clinical trials showed it had a high cure rate for patients in advanced stages of liver disease who were infected with the most common strain of the Hepatitis C virus.

State Attempt to Reopen Medicaid Case Draws Fire

Oct 30, 2014
iStock

With a federal judge possibly close to ruling in the case, plaintiffs' attorneys are objecting to a state attempt to offer new evidence in a lawsuit about whether Florida has adequately provided care to children in the Medicaid program.

The lawsuit, which has been spearheaded by the Florida Pediatric Society, was filed in 2005. A trial ended in 2012, and federal judge Adalberto Jordan is expected to issue a ruling soon, according to court documents.

In an ordinary house on an ordinary street near Orlando live some extraordinary children. To stay alive, they depend on machines and tubes and the caregivers sent out by an agency called Children First.

Registered nurse Maria Schiavi, co-owner of Children First, says some of the kids they care for were injured in an accident, such as a near-drowning. Others were born with life-threatening problems that modern medicine can’t fix.

It’s much too soon to say whether this summer’s flood of Florida Medicaid patients into private managed-care plans will accomplish the state’s goals of improving access to care and saving money.

But one result is already clear: The overhaul is concentrating power in the hands of specialty companies over which the state has no direct control.  Some say one such company has essentially taken over home care services and equipment.

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.

Special-Needs Kids in Insurance Quandary

Apr 30, 2014
Wikimedia Commons

Florida pediatricians say an expected legislative move heightens worries about what will happen to young special-needs patients as the state privatizes the Children's Medical Services program over the next three months.

The changes are part of a larger transition for Medicaid patients from a fee-for-service delivery system to one in which they would be enrolled in prepaid health plans. Thanks to a 2011 law revamping Medicaid, Children’s Medical Services must make the transition to managed care by Aug. 1.

Republicans have had control of the Florida Legislature and governor's office since 1999 and have used their power to restrict abortions, loosen gun laws, strip state workers of benefits, allow private school vouchers and enact a slew of other policy changes that Democrats opposed but could do nothing to stop.

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