Medicaid Managed Care

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The Florida House has unveiled plans to overhaul the state’s Medicaid program. The proposal includes new premiums and work requirements. But longtime observers say the program is stingy as-is, and they’re questioning whether the House plan is even feasible.

Florida’s long-term care industry group says the state’s Medicaid Managed Care system isn’t quite working for it. And it wants long term care to be carved out of the system. The state long-term care association brought its complaints to a state healthcare committee Tuesday.

Daniel Oines / flickr.com

Changes could soon be on the way when it comes to how the state administers dental services in its Medicaid Managed Care program.  Dental care could be re-established as an independent service in the state’s Medicaid program.

LHatter / WFSU News

A decade ago, a group of providers sued the state, charging Florida’s Medicaid program shortchanged medical and dental care for kids. Proponents said Medicaid Managed Care was supposed to make it better, but five years into the new system, the legislature is poised to remove dental coverage for kids and roll it into a separate program.

taxcredits.net

Florida’s Medicaid costs will soon take up about half of the state’s new revenue. And enrollment in the program continues to grow. The increasing costs of the program has the state’s chief economist putting part of the blame on prescription drugs.

Florida’s Medicaid costs will go up next year. Enrollment in the program that insurers low-income Floridians continues to grow even without a legislative move to expanding it to people who qualify under the Affordable Care Act. Now  lawmakers are feeling the pressure to put cost controls in place.

A map representing the 13 regions for Medicaid Managed Care
Agency For Healthcare Administration

Florida’s Medicaid Managed Care program is expected to get more expensive. State economists expect the cost to grow by more than a half-billion dollars next year.

A map representing the 13 regions for Medicaid Managed Care
Agency For Healthcare Administration

Florida’s plan to privatize the state’s Medicaid program for low-income residents, was billed as a cost saver. And last year, Florida healthcare officials started steering people out of the old fee-for-service model, and into private health plans.  Now the insurance companies say they’re running more than $500 million in the red.

Leon County's "Molar Express" dental clinic is one of several in eight counties that will once again serve foster care children.
Leon County Health Department

The Florida Department of Health has closed a loophole in the state’s healthcare programs for low income families. The Department has made a deal to provide dental services to foster care children in eight counties.

A map representing the 13 regions for Medicaid Managed Care
Agency For Healthcare Administration

Florida recently finished rolling out a new way of providing care to more than 3.5 million low-income Floridians. Nearly all of them are now enrolled in managed care plans. The state agency that runs Medicaid recently released a series of comments from various players in the industry praising the rollout. But some groups say the new system is still plagued with problems.

Now that Florida’s health care agency has finished implementing a managed care system statewide for Medicaid recipients, it’s time to do some refining.          

“We are going to streamline our credentialing process of the coming year," says AHCA Medicaid Director Justin Senior. "We are going to try to speed up health plan enrollment during the course of the coming year.”

A map representing the 13 regions for Medicaid Managed Care
Agency For Healthcare Administration

Florida health officials kicked off the state’s transition to a Medicaid managed care system Thursday.  Seniors in nursing homes are the first to enter the newly privatized system.

More than 9,000 Central Florida long-term care patients have signed up for insurance plans to cover the cost of their care. The move comes two years after state lawmakers approved the privatization of Medicaid for low-income Floridians.

The federal Centers for Medicaid and Medicare Services has given full approval for Florida to essentially privatize its Medicaid program.  Under the agreement, healthcare companies will have to spend a set amount of money directly on patient care.

Low-income seniors living in and around Orlando will be the first entrants into the state’s Medicaid managed care program.

The state will begin an outreach program in the next few months to get eligible seniors enrolled. It’s the latest move in the state’s effort to save money by effectively privatizing the Medicaid program.

NPR.org

Governor Rick Scott says the state will expand access to Medicaid under the Affordable Care Act to more low-income Floridians. The announcement marks a dramatic shift in a Governor who was once one of the leading opponents to the federal healthcare law.

The federal Centers for Medicaid and Medicare Services has moved closer to granting Florida permission to transition the state's Medicaid program into a managed care system.

The move means the state will no longer pay individual providers on a fee-for-service model, but will hand over billions of dollars to insurance companies, which will contract with local providers, hospitals, and nursing homes.

Agency For Health Care Administration

This week the federal government signed off on the first part of a plan steering three million low-income Floridians on Medicaid into a managed care or HMO system. The decision comes two years after state lawmakers approved the conversion in an attempt to control costs in the $22 billion program. When the measure was first approved, many people were skeptical about how it would work.

It’s About Florida: Medicaid Managed Care

Feb 8, 2013

The Federal Centers for Medicaid and Medicare Services signed off on the first part of a plan that will steer Florida on a path toward Medicaid managed care. This will impact thousands of Florida’s seniors in long term care. Under managed care, the state will be split into several different regions, and health insurance companies will compete in those regions for customers. As the state awaits approval of a full statewide transition we discuss all the changes you can expect in this first phase with our panel of experts.

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Trimmel Gomes

A year and a half ago, Florida lawmakers had an idea: the state may be able to save money and get a handle on the rising costs of Medicaid, if it stopped writing checks every time a bill came in. That’s called a fee-for-service model, and for years, Florida’s Medicaid program has operated on that system. But at a cost of around $22 billion, Medicaid has also grown to be the state’s single largest spending item.

The Federal Centers for Medicaid and Medicare Services Monday signed off on the first part of a plan that will steer Florida on a path toward Medicaid managed care.

Florida is pushing forward with its plan to shift more than three million Floridians on Medicaid into managed care. The move is part of a state overhaul of the program that provides state and federally subsidized healthcare to low-income people. Lynn Hatter reports the first group to go into the managed care system will be seniors.

Independent and community pharmacists are fighting to be included in Florida's new Medicaid managed care program. They want the Agency for Healthcare Administration to adopt a rule allowing Medicaid patients to get prescriptions filled at the drugstore of their choice.

Tallahassee, FL – The entire Medicaid issue is still a "moving target" in Florida. Tom Flanigan reports the state's plan to move Medicaid patients into managed care could have a big impact, not only on the patients, but also the very industries that will have to work together closely under the proposal.