No Bull, No Fluff, No Smudges
Your news source for
Flagler, Florida and Beyond

Florida House: Medicaid “Reform” for All?

| April 6, 2010

By Jim Saunders

Seeking dramatic changes in Florida’s Medicaid program, House leaders late Monday released a proposal that would require almost all beneficiaries statewide to enroll in managed-care plans — including seniors who need long-term care.

The proposal would take years to carry out, but Medicaid managed care would become mandatory next year in Miami-Dade County. The state’s most populous county would join five other counties in a controversial managed-care pilot program.

The House proposal would carve up the state into six regions, where health-maintenance organizations, provider-service networks and other types of managed-care plans would seek state approval to sign up Medicaid beneficiaries.

Ultimately, it would do away with the fee-for-service system, in which doctors are paid by the visit or treatment. Fee-for-service has been the traditional payment method since Medicaid, the joint state-federal program for certain groups of low-income people, began in the 1960s.

Its drawback is that since Medicaid pays a lot less per service than other payers, there is a temptation for treatment providers to do more of them to make up the difference. Medicare’s traditional fee-for-service payment system shares the same drawbacks.

Critics of managed care, which pays a flat fee per month no matter how many services are provided, has incentives that trend in the opposite direction. That is why vulnerable populations — especially low-income elderly people in long-term care — have been exempt from managed-care experiments in Florida and most other states.

“The Florida Medicaid program is established as a statewide, integrated managed-care program for all covered services, including long-term care services,” said one of two draft bills released Monday night by the House Select Policy Council on Strategic & Economic Planning.

Members of the House council are scheduled to discuss the proposal during a workshop tonight. The proposal is substantially different from a Senate bill that calls for expanding the pilot program to 19 additional counties.

Print Friendly, PDF & Email

Leave a Reply

Read FlaglerLive's Comment Policy | Subscribe to the Comment Feed rss flaglerlive comment feed rss

More stories on FlaglerLive

Get FlaglerLive Alerts by Email

Sign Up for email alerts to new stories.


support flaglerlive palm coast flagler county news pierre tristam
news service of florida
Log in | FlaglerLive, P.O. Box 354263, Palm Coast, FL 32135-4263 | 386/586-0257