Feds Approve Statewide Medicaid Managed Care

By James Call, The Florida Current

The federal government has approved a long-term care waiver for the Statewide Medicaid Managed Care Program. Patients, mainly nursing home residents but some who still live in their homes, will be enrolled in private health-maintenance organizations or other types of managed-care programs. Gov. Rick Scott lobbied U.S. Health and Human Services Secretary Kathleen Sebelius for the waiver last month on a trip to Washington. Scott says Florida’s plan to overhaul how Medicaid services are delivered will lower costs.

“The additional flexibility provided through this waiver helps improve our system,” said Scott in a news release Monday. “And HHS approval allows us to begin implementing changes to our current Medicaid program.”

Lawmakers approved a plan in 2011 to require almost all Medicaid patients to sign on to a managed care plan. Florida wants to implement the change in two phases with long-term care patients moving to managed care by this October and most of the other Medicaid recipients switching to a health-maintenance-organization like system next year.

“Florida elected officials have said they are pushing this reform effort forward because they want to assure the highest quality of care for frail and vulnerable Floridians under Medicaid. AARP Florida will hold them to their word,” said AARP Florida State Director Jeff Johnson.

The Agency for Health Care Administration has chosen five managed-care companies for patients needing long-term care. The plan divides the state into 11 regions, with a limited number of companies receiving permission to operate in a region.

Medicaid is a federal-state partnership and spends about $22 billion a year to provide health care to the poor and catastrophically sick. Florida is also requesting a waiver to move to a manage-care system for children and others on Medicaid. The state has experimented with a managed-care program in five counties since 2006. Florida is waiting for federal approval to take the pilot program statewide. There is no deadline for HHS to respond to the state’s request for a waiver to implement the policy change.

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