As state officials scramble to get out a federal waiver application for Floridas Medicaid reform plans, one state representative is worried the feds will drag their feet in responding.
I have no great degree of confidence that they (federal officials) will get this approved in any reasonable time frame, Rep. Matt Hudson, R-Naples, said Wednesday.
Hudson, who chairs the House Health Care Appropriations Committee, reviewed the states Medicaid reform package for a commission created by Gov. Rick Scott to review taxpayer-funded hospitals.
Scott signed a sweeping change in the Medicaid program passed by lawmakers this year, which transitions recipients from the current fee-for-service delivery model, where doctors and hospitals are reimbursed for services rendered, into a managed-care system, where HMOs and provider service networks contract with the state to deliver health-care services and are expected to meet cost control goals.
The transition is expected to begin in 2012 for long-term care patients and be completed for all Medicaid recipients by late 2014.
The changes require a federal waiver, and state Agency for Health Care Administration officials have until Aug. 1 to submit it to the Center for Medicare and Medicaid Services (CMS).
For Hudson, who said the federal government moves at the speed of sand, any decision made by CMS may not come in time for lawmakers to include the expected cost savings generated by the Medicaid reform into their calculations for the 2012-2013 fiscal year budget.
Florida lawmakers will head into session in January next year, instead of the usual March start date, because of the added task of redistricting.
That leaves five months for CMS to come back with an answer before legislators begin budget deliberations in earnest. Last month, the federal agency issued a waiver extension through July for a five-county pilot program, similar to the proposed statewide reforms.
But Hudson is less than confident of a positive response from CMS. A delegation of Florida House Democrats and Florida CHAIN, a health-care advocacy group, sent separate letters to CMS officials this week asking them to deny the waiver request, which has not yet been submitted by AHCA.
It certainly got complicated in the last few weeks because a number of advocacy groups wrote in, asking them to not approve this waiver, Hudson said.
Lawmakers pushed the Medicaid reform package this year as a way to control a program known as the Pac-man of the state budget, which takes up nearly 30 percent of the budget and costs $21 billion, serving 2.9 million beneficiaries.
Hudson defended the move to managed care, saying it will cut down on fraud and waste while including protections for recipients to ensure quality care, as well as produce savings that can be put toward education or other areas of the budget. But he resisted other cost-cutting measure suggestions from commission members, like further reducing Medicaid reimbursement rates -- which were cut 12 percent this year -- because they could drive up costs for all patients.
When we cut Medicaid rates, the hospital is not going to go out of business, they're just going to find a way to divert that to another paying patient, Hudson said.
Reach Gray Rohrer at grohrer@sunshinestatenews.com or at (850) 727-0859.
