100 groups ask feds not to approve Florida Medicaid waiver

The following article was published in the Health News of Florida on July 17, 2011:

100 groups ask feds not to approve Florida Medicaid waiver

By Brittany Davis

A letter asking the Obama administration to reject Florida’s Medicaid overhaul has been signed by more than 100 state organizations, including some medical societies and a wing of the Florida Bar.

The letter, released by the patient-advocacy group Florida CHAIN, asks the federal Centers for Medicare and Medicaid Services to reject the state’s expected application for a waiver of federal rules in the joint federal-state program for low-income families, elderly and disabled.

That application, now being prepared by the Agency for Health Care Administration, is due to CMS by Aug. 1. It seeks a waiver that would allow virtually all Medicaid recipients to be moved into HMOs and provider-owned networks. The 2011 Legislature passed the plan, with proponents saying it would save money and improve access to care.

The medically frail elderly — including those in nursing homes — would be among the first to go into managed care plans, since they cost the most.

Among the groups signing the letter are the medical associations of Hillsborough, Lee, Dade, Broward, and Charlotte counties. The Elder Law Section of the Florida Bar also signed.

The letter states that the track record of the managed care pilot, which took place over the past five years in Broward, Duval and three rural counties, should be enough evidence to show that the switch to privatized Medicaid will compromise the health of the state’s most vulnerable.

It also states that the switch would result in “too many far-reaching changes” that would put patients at an “unacceptable risk.”

“We’ve had hundreds of people turn out at meetings around the state. We’ve seen 3,000 emails sent to CMS from individuals. The only support you hear for this plan are from the legislators who voted for it based on ideology…and from the HMO industry,” said Laura Goodhue, of Florida CHAIN.

Mary Pat Moore, vice president of the Florida Association of Health Plans, said that while organization leaders are entitled to their opinions, managed care organizations are doing right by citizens.

“Millions of Floridians are currently being served by managed care through the private sector and in other state programs (including Medicaid) with high rates of satisfaction, better outcomes, and lower cost to the state,” she wrote in an e-mail.

The Agency for Healthcare Administration, the state agency that is applying for the waiver, continues to work toward meeting its August 1 deadline, AHCA spokeswoman Shelisha Coleman wrote in an e-mail.

“(The state) looks forward to creating the best possible program for Floridians,” she said.

CMS spokesperson Brian Cook said the agency has not yet received the letter but will have a public comment process and take into account the views of advocacy organizations.

“We will be sitting down with consumer groups, provider organizations and other interested parties as the process unfolds,” he said.

Dr. Aaron Elkin, president of the Broward County Medical Association, has been a vocal opponent of the bill and said now is “the critical time” for all organizations to reach out to CMS and try to stop managed care Medicaid from expanding.

“This is the time for all groups to stand together and sign and send the message that the experiments have failed and approving the waiver and expanding it statewide is going to cost Florida lives and dollars,” he said.

Leonard Elliot Mondschein, chair of the Elder Law Section of the Florida Bar, said his organization opposes the expansion of managed care because it has not been shown to save money or protect citizens. His group is concerned that the financial incentives for HMOs to keep frail elders out of nursing homes will backfire, given that there is a waiting list for home and community services.

Controversial studies from Georgetown University and from the University of Florida have been unclear on whether managed care Medicaid saves money and whether HMOs provide all services needed.

Find this article here:  http://www.healthnewsflorida.org/hnf_stories/read/100_groups_ask_feds_not_to_approve_fl_medicaid_waiver