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Florida applies for extension to Medicaid pilot

By Lynn Hatter


Tallahassee, FL – Florida has requested another extension for its Medicaid pilot project. A federal waiver granted to the state back in 2006 allows managed care companies to operate the Medicaid program in five Central and South Florida Counties. Lynn Hatter reports, that waiver was set to expire earlier in the year, but the two-sides are hung up on the issue of money and where and how it's spent.

Negotiations over a more permanent extension to the program are being tied up over the state's lack of a cap on how much managed care companies can spend on administration versus actual treatment. Florida's Acting Medicaid Director Justin Senior says it's called a medical-loss ratio.

"The federal government is thinking about requiring a medical-loss ratio for the HMO's. And they way our statute is set up, we would have something different from the medical-loss ratio. That program is not set up and it would be very hard to impose a medical-loss ratio on such short notice."

Florida's Medicaid pilot project was supposed to expire at the end of June, but a series of temporary waivers have kept it going. The state has also applied for other waivers to implement Medicaid Managed Care statewide. The state-wide proposal does not include a medical-loss ratio.