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House and Senate moving closer to medicaid compromise

By James Call


Tallahassee, FL – A Florida Senate Committee has made changes to a Medicaid reform package to more closely resemble a House proposal. James Call reports, Wednesday , Senators approved a profit sharing plan with managed care companies and eliminated a law suit protection provision for non profit groups that provide child protection services.

Medicaid reform is a top priority for both the House and Senate this session. The annual budget for the health care program for the poor and catastrophically sick has increased from about 900 million dollars to almost 20 billion dollars in about two decades. Lawmakers fear Medicaid could, in their word, hijack the state budget. Nearly three million people receive health care through Medicaid now and another 800 thousand people will become eligible for services in 2013. Lawmakers want to save money by moving most patients into managed care plans. Senator Joe Negron, leading the Senate's reform effort, believes an hmo model would simplify the system for patients and save money for the state.

"Lost in a fee for service world with 100K providers... Once you enroll in Medicaid you're going to know who your primary care physician is, you are going to know this is where you know who your doctor is, and you have an appointment in 30 days in order to connect so you are not seeing him or her for the first time in a crisis situation."

Florida has been working to control costs. Since 1996 the Legislature has reduced 5.3-billion in spending through rate reductions, program limits and other cost control initiatives. Karen Woodall, a lobbyist for social services, told Senators the idea that Medicaid is out of control is a mis-characterization.

"I would like to point out, in addition, Medicaid is one of the largest economic development programs that we have in the state, that money goes into jobs and communities and into our economy. So whenever we are looking at cutting a Medicaid program we are eliminating our economic development opportunities."

The Senate is planning on spending 22 billion dollars on Medicaid next fiscal year. Moving most patients into a managed care plan will require federal approval. Negron's proposal includes a plan to withdraw from the federal system if a waiver is not granted. That raises questions about the services Florida would provide if it dropped out of the federal program. The discussion is between Negron and Senator Nan Rich.

Negron: "All the things we currently pay for Medicaid we continue to pay for to people who qualify for services."

Rich: "Uh, Senator Negron let me just add on to that if with a hard cap one of the options is to limit options to benefits so if we got to that point then wouldn't dentures, eyeglasses hearing aids, they are optional benefits and they could be ones that could be eliminated?"

Negron: "If we got to that point and then government walked away from its partnership with us on Medicaid which I think is highly unlikely then you, uh, we give them a thousand reasons in the bill to work with us."

Negron said his proposal is patient centric and is designed to bring Medicaid costs in line with what the state has to spend. Senators, Wednesday approved a profit sharing plan supported by the managed care industry.

"Under the plan, managed-care organizations would keep the first five percent of any profits, split with the state profits between five and 10-percent. The state would get all profits above 10 percent. Senators also eliminated lawsuit protection for non profits that provide child protection services. Negron said a stand alone proposal providing the protection is moving through the Senate.
Next stop for Negron's proposal is the Budget committee and then a debate will scheduled for the Senate Floor.