Several health plans also dropped out of the pilot program, saying they couldnt make enough money. Patients complained they were bounced from plan to plan with lapses in care. Nearly half of the 200,000 patients enrolled in the pilot have been dropped from at least one plan, federal health officials noted at one point during negotiations.
Lawmakers say they have fixed the pilot programs shortcomings, with provisions including increased oversight and more stringent penalties, including fining providers up to $500,000 if they drop out. The measures also increase doctors reimbursement rates and limits malpractice lawsuits for Medicaid patients in hopes of increasing doctor participation in the program.
Advocates noted that the pending agreement with federal health officials is very different from the states original proposal.
The version of the experiment currently awaiting approval significantly limits the ability of managed care plans to vary benefits, evade accountability and consumer protections, and implement other dangerous elements of the original experiment ... additionally, stronger accountability, oversight, and transparency requirements that will come with this waiver approval alleviate many of our worst fears, said Greg Mellowe, policy director of the health care advocacy group Florida CHAIN.
Earlier this month, the feds gave Florida the green light to move tens of thousands of older Medicaid recipients to get long-term care through managed care organizations, including home and community-based services to keep them out of nursing homes. But the feds are requiring an ombudsmen monitor that portion of the program.
As part of the federal health care law, the state must decide whether to participate in a planned expansion of the Medicaid program. The expansion could add at least 1 million people to Floridas Medicaid rolls, with the federal government covering most, but not all, of the cost.
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